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The study was conducted in accordance with the principles of the Helsinki Declaration.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Compliance with ethical standard"}},{"value":"Written informed consent for publication was obtained from all participants. Copies are available from the corresponding author on request.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Compliance with ethical standard"}},{"value":"None.","order":3,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Compliance with ethical standard"}},{"value":"Artificial intelligence tools were used solely to support language editing, improve clarity and flow, and assist with the organization of reviewer-response-related revisions. DeepL Translator (DeepL SE; accessed on July 2026) was used for language translation\/editing support. OpenAI ChatGPT (August 2026) was used to support language. AI tools were not used to generate or analyze data, perform statistical analyses, create results, select references independently, or draw scientific conclusions. All AI-assisted text was critically reviewed, edited, and approved by the authors, who take full responsibility for the integrity, accuracy, originality, and scientific content of the manuscript. All references and citations were verified against the original sources by the authors.","order":4,"name":"Ethics","label":"Use of artificial intelligence","group":{"name":"EthicsHeading","label":"Compliance with ethical standard"}},{"value":"The authors confirm that no part of this manuscript has been copied from previously published or unpublished work. No part of the scientific content, data, analyses, results, interpretation, or conclusions was generated by artificial intelligence. AI tools were used only for language editing, clarity, flow, and organization of reviewer-response-related revisions, as disclosed above. All AI-assisted text was critically reviewed, edited, and approved by the authors, who take full responsibility for the originality, accuracy, integrity, and scientific content of the manuscript.","order":5,"name":"Ethics","label":"Originality and AI generation statement","group":{"name":"EthicsHeading","label":"Compliance with ethical standard"}},{"value":"This manuscript adheres to the STROBE guideline; the completed checklist is available as Supplementary Material\n                      \n                      .","order":6,"name":"Ethics","label":"Reporting guideline","group":{"name":"EthicsHeading","label":"Compliance with ethical standard"}}]}}