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Article History

Received: 23 October 2025

Accepted: 27 January 2026

First Online: 4 February 2026

Declarations

:

: This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Lanzhou University (Ethics Committee Reference: LZU-2022-IRB-0847, approved on March 15, 2022). Additional ethical clearances were obtained from partner institutions in Kazakhstan (Nazarbayev University Ethics Committee, Reference: NU-IRB-2022-089), Uzbekistan (National University of Uzbekistan Ethics Board, Reference: NUU-EB-2022-034), Kyrgyzstan (American University of Central Asia Research Ethics Committee, Reference: AUCA-REC-2022-021), and Tajikistan (Tajik National University Ethics Review Board, Reference: TNU-ERB-2022-056). All participants provided informed consent prior to participation in the study.

: Not applicable.

: The authors declare no competing interests.