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For participants who were unable to provide consent independently due to physical or cognitive limitations, written informed consent was obtained from their legally authorized representatives. All consent procedures were conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No AI-assisted tools were utilized by the authors for research, writing, or editing during the preparation of this manuscript.","order":4,"name":"Ethics","label":"Artificial intelligence and AI-assisted technology","group":{"name":"EthicsHeading","label":"Declarations"}}]}}