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The study used aggregated, fully anonymized numerical data and did not involve any direct contact with individuals, patients, or healthcare personnel. As no personal or identifiable data were accessed and no human participants were involved, ethics approval and informed consent were not required. According to the regulations of the Bioethics Committee of the Nicolaus Copernicus University in Toru\u0144, Collegium Medicum in Bydgoszcz (Order No. ZR.215.2023), studies based solely on fully anonymized aggregated data do not require ethics committee approval. Therefore, formal approval from an institutional ethics committee was not required. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was not required, as no individual-level data were collected and no participants were directly involved in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"161"}}