Ethical approval and informed consent

In this study, we adhered to ethical principles and obtained ethical approval from the Institutional Review Board (IRB) of Jinan University (Approval No. JNUKY-2021-008). Prior to obtaining ethical approval, we submitted a detailed research plan and an ethics application, including information on the research objectives, methods, risk assessment, and protective measures. The research protocol was reviewed by the ethics committee, which confirmed its compliance with ethical guidelines and regulatory requirements.

Before the commencement of the study, we provided detailed research information to all participants and addressed any questions they may have had. Informed consent was collected using a consent form, which included information on the purpose of the study, procedures involved, potential risks and benefits, and the participants' voluntary right to withdraw from the study. We emphasized the participants' freedom to choose whether or not to participate and ensured the confidentiality of their personal information.