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Article History

Received: 27 July 2025

Accepted: 10 November 2025

First Online: 7 December 2025

Declarations

:

: This study was conducted in strict accordance with the ethical principles outlined in the Declaration of Helsinki, Given the nature of the study and the practical constraints, oral informed consent was obtained from all adolescent participants and their legal guardians prior to the distribution and collection of the questionnaires. The oral consent process was witnessed and documented by school leaders and teachers, who also provided their consent and support for the study. The study protocol was reviewed and approved by the Institutional Review Board (IRB) of Xinjiang Medical University (Approval No: XJYKDXR20240724003).

: All participants and their guardians were thoroughly informed about the purpose, procedures, potential risks, and benefits of the study before their enrollment. They were clearly informed that their participation was voluntary, and they had the right to withdraw from the study at any time without penalty. The oral consent was obtained through a detailed verbal explanation, during which any questions or concerns were addressed. By verbally agreeing to participate, they consented to their involvement in the study and the use of their anonymized data for research purposes. The oral consent process was carefully recorded and supervised to ensure its validity and compliance with ethical standards.

: The authors declare no competing interests.