Abstract
Background
The cultivation of innovation skills is being recognized as a crucial component in medical education. While the effectiveness of the teaching assistant model in the classroom is well-documented, there has been limited exploration of their role in the medical innovation course, particularly those involving undergraduate teaching assistants (UTAs). This study aimed to investigate the role of UTAs in the medical innovation course and to assess their impact on students, the UTAs themselves, and the course as a whole.
Methods
In this study, based on the stimuli-organism-response model and social cognitive career theory, a questionnaire was designed and distributed to students participating in the course to explore their innovation skills, self-efficacy, and satisfaction in the context of UTAs’ involvement. Additionally, semistructured interviews and an in-depth interview were conducted to assess the impact of the UTA model on the UTAs themselves and the course, with the interview content being recorded and analyzed.
Results
Firstly, the survey results indicated that UTAs had a positive impact on students’ self-efficacy (β=0.102, P = 0.005). Students’ self-efficacy was strongly correlated with both innovation and entrepreneurship (β=1.275, P < .001) and learning satisfaction (β=0.595, P < .001). Secondly, based on interview content, this study identified the reasons why undergraduate UTAs became TAs, skill enhancement, and intentions for continuous teaching. Lastly, through the in-depth interview, professors expressed that UTAs represented an innovative attempt in medical education, offering numerous advantages such as improving teaching effectiveness, relieving teaching pressure, and identifying outstanding students.
Conclusions
UTAs enhanced students’ self-efficacy, thereby promoting the development of innovation and entrepreneurship skills, as well as course satisfaction. Moreover, this teaching model had unexpectedly positive effects on the UTAs’ own skill development and course advancement. Therefore, the involvement of UTAs in the medical innovation course provided a reference for cultivating innovation capabilities in medical education.
Introduction
In the current, rapidly evolving medical environment, 1 essential goal of medical education is to cultivate students’ innovation. Innovative capabilities improve students’ ability to address complex medical issues in their future clinical practice, improve the quality and efficiency of healthcare, and drive progress in the medical field.1,2 However, in the past few decades, medical education has primarily emphasized knowledge memorization, which is lacking in cultivating innovation ability. 3 Undergraduate education is characterized by severe homogenization, a lack of individualization, and particularly a scarcity of innovative talent. 4 The traditional teaching model cannot meet scientific research and innovation requirements, and strategies to improve students’ innovation and entrepreneurship abilities are still being explored. In addition, outstanding clinicians in China are required to possess not only excellent clinical diagnosis and treatment skills but also the ability to conduct independent scientific research enabling clinical translation. Therefore, Chongqing Medical University has launched an emerging course titled “Special Lecture on Medical Innovation.” This initiative aims to enhance the professional competence of Chinese medical students, align with the global movement in medical education curriculum reform, advance their innovation and entrepreneurship abilities, and broaden their scientific research and innovative thinking.
Peer education involves individuals from similar social groups who contribute to each other's learning and knowledge acquisition without autonomous teaching without the involvement of a professional tutor. 5 Several medical schools have already implemented peer education in their classrooms and have found widespread benefits to students, teachers, and departments.6,7 However, most peer educators are graduate teaching assistants.8,9,10 As medical knowledge is highly specialized and complex, with the heavy academic pressure and limited free time of graduate students, graduate assistants have less participation in medical teaching. In recent years, various studies have found that undergraduate teaching assistants (UTAs) are as effective as or even better than graduate teaching assistants. Still, most are limited to teaching objective knowledge and have little application in medical innovation education.11,12,13,14
Therefore, we propose to apply the UTA model to the medical innovation course. This article aims to evaluate the role of the UTA model for undergraduate medical students, teaching assistants, and curriculum development and to provide adequate practical experience for cultivating innovative and entrepreneurial talents for medical undergraduates in the future.
Course and Theoretical Background
Course: Lectures on medical innovation
To help undergraduate students better understand the importance of medical innovation and grasp the fundamental theories of medical innovation entrepreneurship, our university has introduced a course titled “Special Lecture on Medical Innovation.” This course is a public elective open to students from various majors, such as clinical medicine and anesthesiology, which not only helps to enhance students’ professional competence but also provides a platform for interdisciplinary communication and an opportunity for students to learn about the frontiers of medical development. Various teaching methods are employed in the course, including theoretical lectures, multimedia teaching, problem-based learning (PBL), case-based learning (CBL), and group discussions. These are designed to stimulate students’ proactive learning and strengthen their ability to analyze and solve problems. Integrating exemplar medical innovation cases—such as Professor Huang (Orthopedics), a lead lecturer who pioneered the global conceptualization and clinical translation of “dual-lubricating drug-loaded hydrogel microspheres” for osteoarthritis treatment—the course is structured around 9 topics including “Innovative Thinking in Medicine,” “Theory and Practice of Medical Innovation and Entrepreneurship,” and “The Application of Big Data and Artificial Intelligence in Medicine.” The research team selected the chapter “Theory and Practice of Medical Innovation and Entrepreneurship” as the experimental classroom.
Stimuli-organism-response model and social cognitive career theory
The stimuli-organism-response (SOR) model posits that environmental and informational cues serve as stimuli that influence an individual's cognitive and emotional responses, which in turn impact behavior.15,16 Stimuli can take various forms. In this context, a UTA serves as a stimulus that can influence or alter students’ internal and organic state. An organism is encoded as an intermediary cognitive or affective state that bridges the gap between a stimulus and an individual's corresponding response. This response incorporates psychological reactions expressed through identifiable attitudinal or behavioral pattern shifts.
The social cognitive career theory (SCCT) model is based on the social cognitive theory (SCT), emphasizing 3 areas that are crucial for career development: self-efficacy beliefs, outcome expectations, and personal goals.17,18,19 Self-efficacy beliefs refer to an individual's belief that they can perform specific activities or tasks. Outcomes expectations describe an individual's judgment of the possible outcomes they may achieve by taking particular actions. Personal goals represent individuals’ desired outcomes or goals for their efforts and aspirations. In medical education research, the SCCT has demonstrated a positive correlation between self-efficacy in terms of career choice and outcome expectations.20,21 Self-efficacy beliefs and positive outcome expectations can be strengthened by exposure to successful role models and supportive learning environments.
22
Previous research has shown that self-efficacy may affect learning motivation.
23
Therefore, incorporating the concept of the SOR model into the SCCT model will assist this study in articulating the impact of UTAs on students’ innovativeness and their learning satisfaction, as well as assist in helping to identify the effect of the program (Figure 1). Liu et al
24
assessed scientific creativity and innovation ability among medical students using metrics such as creative thinking, cognition and skills in medical science, and academic performance. Hindin et al,
25
similarly, evaluated creativity and innovation ability in medical students across 4 parts: medical humanities, design thinking, entrepreneurship, and technology transfer. However, given that our study focuses on investigating the impact of the UTAs model on students following its integration into an innovative teaching curriculum, and considering the constraints of class time and the feasibility of student acceptance, we ultimately included creative thinking, cognition in innovation, and entrepreneurship as the criteria for assessing students’ innovation and entrepreneurship skills. Based on this evidence, we propose the following hypothesis:
H1: UTAs are positively correlated to the self-efficacy of students. H2: UTAs are positively correlated to the innovative entrepreneurship ability of students. H3: The self-efficacy of students is positively correlated to the innovative entrepreneurship ability. H4: The self-efficacy of students is positively correlated to learning satisfaction. H5: The innovative entrepreneurship ability of students is positively correlated to learning satisfaction.
Research model and hypotheses.
Methods and Materials
Recruitment of undergraduate teaching assistants
UTAs are peer educators, traditionally focused on textbook knowledge. Due to the abstract nature of innovative knowledge, traditional UTAs are unsuitable. As a result, the course team has established the following criteria for the selection: (i) published papers; (ii) awards in innovation and entrepreneurship competitions; (iii) fifth-year undergraduates; (iv) willingness to teach. Three UTAs were recommended and joined in, all fifth-year undergraduate students with academic papers or innovation and entrepreneurship competition awards.
Class design
This study was a cohort study conducted in the classroom “Theory and Practice of Medical Innovation and Entrepreneurship” at Chongqing Medical University in March 2024. The reporting of this study conformed to the STROBE statement 26 (Appendix 1). One month before the class, the professor, the teaching assistant for the course, and 3 UTAs collectively prepared for the class in an online format. The professor assigned specific teaching topics to the UTAs based on themselves experience, and each UTA prepared PowerPoint presentations. One week prior to the class, the UTAs conducted a trial lecture to adjust the content and pace of the class. The professor reviewed the teaching content provided by the UTAs, offered specific suggestions for modifications, and finalized the teaching version. All students were informed of this study at the beginning of the course with an introduction to UTAs by the primary instructor. The class consisted of 2 sessions—1 led by the primary instructor, providing an overview of the theoretical concepts, and the other conducted by 3 UTAs. The UTAs’ instruction focused on discovering innovative points, resource acquisition, and the process of innovation practice. These were presented as PowerPoint slides, with each UTA allotted 7 min. The remaining class time was dedicated to free discussion, during which students could ask questions about topics that interest them, and the teaching assistant would provide one-on-one answers.
Questionnaire design and collection
The questionnaire was designed based on relevant references and distributed to students.27–29 The questionnaire was primarily divided into 2 parts (Appendix 2). The first part included personal information such as gender and major. The second part consisted of adapted scales, designed based on specific classroom contexts and relevant research, to measure self-efficacy, innovation and entrepreneurship, and learning satisfaction. After the class, each student received the online questionnaire. We conducted an anonymous closed-ended survey using the “Questionnaire Star” website. After distributing the questionnaire, we sent 1 reminder email on the third day to increase the response rate. Student participation in the voluntary, anonymous questionnaire was fully informed and uncompensated. 167 invitations were sent, assuming a response rate of 98.8%.
Semi-structured and in-depth interviews
We conducted qualitative research on UTAs and professors using semistructured and in-depth interviews, respectively, with informed consent from all participants (Appendix 3). The average duration of the interviews was 60 min. During the interviews, real-time member checking was conducted to ensure comprehension of the intended meaning. The interviews were audio-recorded and transcribed verbatim, with transcripts deidentified before analysis.
Data analysis
This study used SPSS 21.0 statistical software (IBM, Armonk, New York, USA) for descriptive analysis and model reliability testing. The participants’ responses were measured on a 5-point Likert scale ranging from 1= Strongly disagree to 5 = Strongly agree. Nominal variables are numbers and percentages. Nonparametric variables were compared using the Wilcoxon rank-sum test. The adequacy of the research model was assessed using AMOS 26.0 software, and the model's path coefficients and significance levels were validated and analyzed. After each interview, the recorded data were transcribed and imported into MAXQDA 2022. Two researchers who are experienced in qualitative methods independently conducted a constructivist/interpretive thematic analysis of the transcribed interview data. The data were analyzed line by line to identify recurring concepts and assign codes, subsequently refined into themes using the constant comparative method. Any discrepancies were resolved through comprehensive discussion and negotiated consensus. The contents and themes of the interviews were translated into English and checked for accuracy by Dr Taylor.
Ethical approval and informed consent
The study was approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (ethics number, 2024-154-01). Participants in the study were voluntary and informed of the study's purpose, their rights, and the confidentiality of their responses through an informed consent statement presented at the beginning of the survey and interview. Participants could choose to withdraw from the study at any time without consequence.
Results
Students: Characteristics
Overall, 167 questionnaires were distributed, and after excluding 2 invalid questionnaires with contradictory responses, 165 questionnaires were included for analysis with an effective rate of 98.8% (Figure 2). According to the course schedule, the classroom teaching was divided into 2 groups, 1 with UTAs (Prof. Gao, n = 103) and the other without (Prof. Zuo and Prof. Huang, n = 62). The participants were all from the senior year of undergraduate, and their major was clinical medicine. Students with UTAs had significantly higher overall satisfaction compared to those with no UTAs (4.592 vs 3.887; P < .001). Students with UTAs preferred a course model with the participation of senior UTAs, compared to traditional classroom learning (4.621 vs 3.210; P < .001). Additionally, the UTAs group demonstrated better self-efficacy, innovation, and entrepreneurship performance (Table 1).
Flowchart illustrating enrollment.
Mean and percentage on the factors affecting students’ innovation and entrepreneurship capacity and satisfaction toward undergraduate teaching assistants in students with and without undergraduate teaching assistants. 1: Strongly disagree; 2: Disagree; 3: Neutral; 4: Agree; 5: Strongly agree. Percentages are the sum of the proportions of “Agree” and “Strongly agree”.
Students: Hypothesis testing
To investigate the factors affecting students’ innovation entrepreneurship ability and learning satisfaction with the class, the results are presented in Table 1 for different measurement instruments. We used SPSS 27.0 and Amos 26.0 to test the reliability and validity of the scales, as presented in Table S1. First, Cronbach's alpha (α) was employed to evaluate the internal consistency of each measurement instrument, with values exceeding the recommended threshold of 0.7. 30 Second, confirmatory factor analysis (CFA) was conducted, revealing that the composite reliability (CR) and average variance extracted (AVE) for all measurement instruments surpassed the thresholds of 0.7 and 0.5, respectively. The results indicated the reliability of each measurement tool within the hypothesized model.
The association paths between each hypothesis in the research model were tested, and each path's explained variance (R2 value) was also examined. The correlation between UTAs and innovative entrepreneurship ability (β=−0.051, P = .133) and the link between innovative entrepreneurship ability and learning satisfaction (β=−0.103, P = .437) were not significant. Therefore, the H2 and H5 hypotheses were invalid (Table 2). Furthermore, the revised model was validated by removing the H2 and H5 hypotheses, as shown in Table 2 and Figure 3. UTAs positively impacted self-efficacy (β=0.102, P = .005). Self-efficacy was strongly associated with both innovation entrepreneurship ability (β=1.275, P < .001) and learning satisfaction (β=0.595, P < .001), respectively. Based on the above results, hypotheses H1, H2, H4, and H5 were all supported. Finally, hypothesis testing was conducted using AMOS with maximum likelihood estimation techniques. The results showed that CFI (0.921), TLI (0.901), and IFI (0.922) all exceeded the threshold of 0.9. The model fit indices were presented in Table S2. Therefore, the research model fits well and the results are acceptable.
Hypothesis testing results.
Summary of hypothesis tests.
Undergraduate teaching assistants: Semi-structured interviews
Three UTAs who participated in the course had no experience as teaching assistants, and all agreed to be interviewed (Appendix 3). A total of 26 initial codes were extracted from the preliminary analysis. After categorizing the codes, subthemes were identified within 4 significant themes (Figure 4). We will describe each central theme below.
Undergraduate teaching assistants and their subthemes used 4 significant themes.
Reasons to become an undergraduate teaching assistant
The reasons why participants become teaching assistants involve 3 themes: the desire for a teaching experience, the willingness to help undergraduate students, and invitations from subject matter professors. All UTAs mentioned wanting to help younger students.
“…I hope to use my experience as an example so that students can find their direction, give themselves some inspiration, and have a rich and fulfilling university life.”
Self-efficacy
Participants reported having confidence and satisfaction with their classroom performance.
“…We are confident about what we are teaching.”
Generic skills
Participants expressed that they gained a lot from this experience, such as teaching experience, inspiration for teaching interest, skill improvement, and a sense of accomplishment.
“…One of them impressed me very much. A student recently sent me a picture of a thank-you letter from a freshman when she was working as a similar teaching assistant. She said to me, ‘Hahaha, senior, I thought of you when I saw this.’ At that time, I felt that something had been passed on to me, and my heart was warmed, and I seemed to have realized a hint of what it is like to ‘teach and educate.’”
Continued intention
Participants all showed a wish to continue to be a UTA.
“…I am delighted with the results of this program. If the opportunity arises, I will continue to sign up for teaching assistantships.”
Professor: An in-depth interview
During an interview with the professor teaching the course in which UTAs were involved, she indicated that including UTAs was an innovative attempt at medical education with many advantages.
Improve teaching effectiveness
“The participation of UTAs has enriched the classroom format, increased student classroom participation, stimulated student interest, and improved teaching effectiveness, leading to higher student satisfaction with the teaching experience.”
Relieve teaching burdens
“With a large number of Chinese students and a shortage of teacher resources, the addition of UTAs can alleviate the teaching pressure on teachers, compensate for the shortcomings of a ‘one-teacher-serving-all-students’ model in traditional higher education classes, and work together to continuously optimize teaching methodology and content, thereby improving teaching quality.”
Find outstanding students
“…by selecting UTAs, professors can identify outstanding students, develop their teaching abilities, explore their creative potential, and cultivate their general skills, ultimately preparing more comprehensive talents for the future of the healthcare industry.”
Discussion
Enhancing innovation capability has become an essential strategic requirement for innovation-oriented countries, and the medical industry urgently needs more high-quality innovative talents. Cultivating scientific research and innovation ability among medical undergraduates is 1 of the goals of higher medical education, so promoting high-quality innovation and entrepreneurship among undergraduates is a crucial focus for medical schools. Given that the traditional teaching model has not effectively cultivated the innovative abilities of undergraduates, we propose and attempt for the first time to incorporate UTAs into classroom instruction. Based on the SCCT and SOR models, students, UTAs, and professors were satisfied with the model.
First, unlike traditional classrooms, UTAs with experience in innovation and entrepreneurship created a friendlier learning space. Because they were students themselves, their similar age and status made classmates feel more comfortable and supported. In the classroom, we found that students were more enthusiastic about asking questions than those in the traditional classroom, and students in the group with UTAs were more satisfied with the classroom, similar to the results of previous studies.31,32 Role modeling is considered an essential teaching strategy in medical education.33,34 We chose UTAs who are peers who have published academic papers or have excelled in innovation and entrepreneurship competitions to fulfill the role modeling effect, thus promoting self-efficacy, innovation, and entrepreneurship among students. According to the model, this study found that UTAs can further improve students’ innovative and entrepreneurial abilities and satisfaction by enhancing their self-efficacy. This finding underscored the importance of students’ self-efficacy in the cultivation of innovation and entrepreneurship ability. Future teaching should have focused on enhancing students’ self-efficacy and fostering their initiative to promote innovation and entrepreneurship development and increased satisfaction. In contrast, there was no direct significant relationship between UTA and innovation and entrepreneurship ability (H2). The inclusion of UTA did not improve students’ innovation and entrepreneurship ability, possibly due to limited class time. UTA had not been integrated into the systematic cultivation of students’ innovation and entrepreneurship ability and thus could not effectively enhance the skills. Additionally, it was observed that innovation and entrepreneurship ability did not correlate with learning satisfaction (H5) align with our integrated SOR-SCCT theoretical model. Whereas learning satisfaction (SOR construct) captured immediate affective responses to UTAs stimuli, innovation competence (SCCT outcome) manifested as a long-term developmental trajectory. Crucially, self-efficacy served as the pivotal mediator—as evidenced by H3-H4 significance—transforming UTAs stimuli into both competence development and satisfaction. This suggested that innovation competence required consolidation through clinical practice and project incubation before exerting retrospective influence on course evaluation, a process exceeding our assessment window.
Second, unlike the previous peer education, which involved students helping each other and learning independently without a professional tutor, 5 our proposed UTA program involves selecting senior students with significant experience in their field to serve as mentors, demonstrating superior performance compared to their peers. For UTAs, the invaluable practical experience of being involved in the entire process of pre-class preparation, reforming, and innovating teaching content and methods, as well as classroom instruction, is unparalleled. This study revealed that altruism motivated all UTAs to assist junior students, as consistently cited in their self-reported motivations. These qualities are considered the most important features of a good doctor. 35 Unsurprisingly, participants emphasized the significance of the general skills, communication, and experiential teaching opportunities provided by the experience in shaping their career development, as these attributes are frequently cited as indispensable.36,37 The results further supported including UTA selection in medical student development programs to influence career development. In addition, our study identified several themes, such as reasons for becoming a UTA, skill enhancement, intentions for continued, and described the attitudes and perceptions of UTAs toward the program. They were aligned with the core principles of the SCCT and the SOR model and can provide information for the future development and implementation of other medical innovation and entrepreneurship education projects.
To enhance the quality of medical education in the 21st century, the Chinese government has carried out large-scale reforms in medical education. 38 China has been holding national college student innovation and entrepreneurship competitions, such as “Internet+” and “Challenge Cup,” to encourage students to learn and innovate through competitions, thus nurturing college students as the new force of innovation and entrepreneurship. Cultivating innovation and entrepreneurship abilities has become an important aspect of medical education. Since founding the People's Republic of China in 1949, China has invested in modern medical education. By September 2020, there were over 200 medical schools, with approximately 800,000 students enrolled annually.39,40 In China, the primary source of teachers in medical schools is hospital clinicians, who have heavy clinical workloads and need to balance teaching loads. Confronted with such a large number of students, improving the innovation and entrepreneurship abilities of undergraduates in a high-quality manner is a challenge that warrants exploration. Therefore, the introduction of UTAs can effectively alleviate the teaching pressure on teachers. The UTA model is a way to utilize educational resources in colleges and universities fully. Colleges and universities cultivate excellent undergraduate talents and have them become teaching assistants, forming a virtuous cycle, self-sustaining, and maximizing the benefits of educational resources. These benefits reflect highly trained UTAs in longitudinal educationally purposeful roles, distinct from traditional peer assistance, with future implementations requiring comparable depth of involvement and preparation to achieve similar outcomes. Additionally, the results indicated that students in groups with UTAs had higher satisfaction. Surprisingly, after class, many students took the initiative to add the teaching assistants’ contact information, seeking further experience exchange and practical guidance, improving the overall teaching quality.
Limitations and further research
Our study only focused on students’ satisfaction and innovative and entrepreneurial awareness, and there was no long-term follow-up on improving students’ innovation ability after the class. The long-term effect evaluation of UTAs’ innovative courses still needs further evaluation. Meanwhile, with the development of artificial intelligence and online education, the model of UTAs is expected to be further optimized, providing more possibilities for medical talent cultivation. Lastly, the considerable time commitment demanded of UTAs presents scalability challenges, necessitating more institutional support.
Conclusions
As the future main force in the medical industry, the cultivation of innovation and entrepreneurship ability of medical undergraduates is worthy of in-depth discussion. This study innovatively integrated the model of UTAs into the innovative courses for medical students. UTAs can markedly improve students’ innovation and entrepreneurship ability, as well as their satisfaction, by enhancing their self-efficacy. Meanwhile, the UTAs model can elevate UTAs’ self-efficacy and skills, while also enhancing teaching effectiveness and relieving teaching burdens. The UTAs model embodies a novel, tripartite win-win teaching strategy for cultivating innovation and entrepreneurship competencies in medical students. Although the UTAs model has received positive feedback in innovation courses, its application in additional courses remains to be further explored.
Supplemental Material
sj-docx-1-mde-10.1177_23821205251374817 - Supplemental material for Effectiveness of Undergraduate Teaching Assistants Model in Medical Innovation Education in China
Supplemental material, sj-docx-1-mde-10.1177_23821205251374817 for Effectiveness of Undergraduate Teaching Assistants Model in Medical Innovation Education in China by Yujuan Wu, Lucy Taylor, Tao Ran, Yinsong Sun, Zhong Zuo, Dan Zhu and Diansa Gao in Journal of Medical Education and Curricular Development
Supplemental Material
sj-docx-2-mde-10.1177_23821205251374817 - Supplemental material for Effectiveness of Undergraduate Teaching Assistants Model in Medical Innovation Education in China
Supplemental material, sj-docx-2-mde-10.1177_23821205251374817 for Effectiveness of Undergraduate Teaching Assistants Model in Medical Innovation Education in China by Yujuan Wu, Lucy Taylor, Tao Ran, Yinsong Sun, Zhong Zuo, Dan Zhu and Diansa Gao in Journal of Medical Education and Curricular Development
Footnotes
Acknowledgments
Many thanks to all the authors of this article.
Consent for Publication
Not applicable.
Ethics Approval and Consent to Participate
The study was approved by the Ethics Committee of The First Affiliated Hospital of Chongqing Medical University (ethics number, 2024-154-01). We obtained informed consent from all the participants.
Author Contributions
Wu, Zhu, and Gao designed the study. Sun and Ran extracted and analyzed the data. Taylor translated and interpreted the content and themes of the study. Wu wrote the first draft of the manuscript. Gao, Taylor, Zuo, and Zhu reviewed the subsequent versions and the final draft. All authors have read and agreed to the published version of the manuscript.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Exploration on Curriculum Localization of Integration for Clinical Application in Clinical Medicine/Clinical Science Joint Educational Programme, CQMU Program for Youth Innovation in Future Medicine, Higher Education Research General Project from Chongqing Association of Higher Education in 2023-2024, Chongqing Higher Education Teaching Reform Research Project, Youth Foundation of Chongqing Municipal Education Commission (grant number JY210332, W0010, cqgj23030C, 233171, KJQN202100462).
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
Data collected for this study are available from the corresponding author upon reasonable request.
Clinical Trial Number
Not applicable.
Supplemental Material
Supplemental material for this article is available online.
References
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