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Article History

Received: 20 October 2025

Accepted: 17 November 2025

First Online: 28 November 2025

Declarations

:

: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. The study protocol was reviewed and approved by the Institutional Review Board of the Shanghai Civil Aviation College (Ethics Committee Reference Number: SCAC-2022-078) on March 15, 2022. Written informed consent was obtained from all adult participants. For participants under 18 years of age, written informed consent was obtained from parents or legal guardians, and assent was obtained from the participants themselves. All participants were informed of their right to withdraw from the study at any time without penalty.

: Not applicable. No identifying images or other personal or clinical details of participants that compromise anonymity are presented in this manuscript. All data presented in this study are reported in aggregate form with no individual participant identification possible.

: The authors declare no competing interests.