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The study was conducted in accordance with the Declaration of Helsinki and its later amendments.","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"AI-assisted language tools (Grammarly) were used solely for grammar and clarity editing. No AI tool was used for data analysis, interpretation, conclusion generation, or figure creation. All intellectual content is the sole responsibility of the authors.","order":2,"name":"Ethics","label":"AI Assistance Statement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}