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The original survey complied with the Declaration of Helsinki and was officially approved by the Institutional Review Board (IRB) of Nanchong Psychosomatic Hospital (Approval No. NCPP 2022002). Before the original survey, legal guardians of all participants provided signed informed consent. This study was granted an exemption after evaluation by the ethics review committee of the first author\u2019s institution. Throughout the research process, strict adherence to data anonymization and privacy protection principles was maintained to ensure compliance with ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"774"}}