Abstract
Mindfulness is a type of awareness achieved through purposeful attention, in the present moment and without judgment, to current events at any moment. This study investigates the association between mindfulness and academic performance among final-year medical students. This cross-sectional study was conducted among 285 final-year medical students. Data were collected using a checklist of demographic characteristics, student grade point average, and the Five Facet Mindfulness Questionnaire (FFMQ) and analyzed in SPSS-24 software. The average grade point average was 16.01 ± 1.07. The mean total mindfulness scores were 125.96 ± 13.00 with a range of scores (92–172). Therefore, mindfulness was at a relatively high level. Among the mindfulness components, the highest score was in the observation dimension (3.49 ± 0.68), and the lowest was in the non-judgment dimension (3.01 ± 0.62). There was a weak and positive correlation between mindfulness and the interns’ grade point average, which was statistically significant (P-value = 0.019, d = 0.12). Given the existence of this relationship, university educational officials can consider programs to strengthen the mindfulness of clinical students as one of the factors for improving academic performance.
Keywords: Mindfulness, Internship, Education, Medical students
Subject terms: Psychology, Human behaviour
Introduction
The definition and conceptualization of mindfulness
Mindfulness is paying attention to the present moment and observing present experiences with full awareness1. In the first definition, Kabat-Zinn, a pioneer in the use of mindfulness in psychology, defined mindfulness as a type of awareness achieved through purposeful attention, in the present moment and without judgment, to current events at any given moment2. Mindful individuals process events more realistically, rather than reacting impulsively or habitually. Given that they perceive internal and external realities without distortion, they perceive and process events as less distressing and have a more remarkable ability to deal with a wide range of thoughts, emotions, and experiences3.
In general, there are two perspectives on the conceptualization and measurement of mindfulness. The first perspective, which mainly considers mindfulness as a general ability, and the second perspective, which conceptualizes and measures this construct as a multifaceted ability. In the multifaceted approach, mindfulness is measured in five components: observation, description, action with awareness, non-judgment, and non-reaction4.
The special importance of mindfulness throughout the life of a medical student
Since the ability to direct and regulate attention to a specific task is a central component of mindfulness, this ability is essential for particular, including student life. Student life is a challenging time, especially for medical students who face more stressors. One of the criteria for measuring success in this period is academic performance5. Academic performance is the result of students’ learning in an educational curriculum and represents performance results that show to what extent an individual has achieved specific goals that are the focus of activities in educational environments, especially universities6. With a comprehensive approach, the factors that influence and contribute to academic performance can be presented in three categories: individual factors, intra-organizational factors, and extra-organizational factors. Among individual factors, items such as motivation, anxiety, intelligence, physical factors, behavioral maladjustment, and emotional and psychological conditions have been mentioned7.
Previous evidence on the association of mindfulness with academic factors
Gunsilius et al. concluded that with increasing stress among physicians, medical schools should provide programs to address such stress early in their education. Mindfulness training is one intervention that can reduce stress during medical school8. Studies have shown an association between mindfulness and individual factors of students’ academic success. Rostami et al. in a survey on psychology master’s students showed that mindfulness training was effective in improving motivation to progress and academic achievement in students with academic burnout9. Armani et al.‘s study on all medical students in Zanjan showed that mindfulness can explain overall academic procrastination, procrastination in preparing for exams, and procrastination in completing homework10. Sajjadi et al. in a study on medical students showed that there is a significant association between emotion regulation strategies and mindfulness with depression, anxiety, and stress11.
Despite evidence linking mindfulness to individual factors associated with academic success, no studies have specifically examined the distinct components of mindfulness and their association with academic performance in final-year medical students in Iran. Moreover, the lack of baseline data for this clinically sensitive period indicates that further research is needed to understand better how mindfulness components may influence academic outcomes in this population. This study aimed to investigate the status of mindfulness components and their association with academic performance and some related individual factors in final-year medical students.
Methods
Research design
This study was a cross-sectional study conducted using a descriptive-analytical method. The study population was all medical students interning at Golestan University of Medical Sciences in 2023–2024 (approximately 300 people).
Population sampling
To determine the sample size, according to similar studies12,13 and considering a standard deviation of 11.34 and the probability of a type I error of 0.05 and a maximum error of 1.4; also by adding 5% for greater certainty according to the standard formula (sample size determination formula for estimating the mean), the required sample size was determined to be 285 people. Therefore, considering the size of the population, in this study, census sampling was used and, all students participated in the study according to the inclusion and exclusion criteria. The response rate in this study was 95%.
Instrumentation
The data collection tool consisted of three sections. Demographic characteristics, student academic performance, which is the average grade of the entire internship phase recorded in the student’s last academic semester, were recorded in a self-reported questionnaire by the students. These scores were divided into 5 groups based on the five-point system (ECTS): very poor: 10–12, poor: 12–14, average: 14–16, good: 16–18, and excellent: 18–20. The following section was the Five Facet Mindfulness Questionnaire (FFMQ). The 39-item FFMQ (Baer et al., 2006) measures the trait-like tendency to be mindful in daily life14. The validity and reliability of this questionnaire have also been examined in the Iranian student population and have been approved15. In the present study, the overall reliability of the questionnaire was calculated and confirmed using Cronbach’s alpha coefficient of 0.82.
As shown in Table 1, this self-report instrument consists of 39 items that measure five mindfulness factors.
Table 1.
Mindfulness components and their related conceptual definitions.
| Factors | Conceptual definition |
|---|---|
| Observation | Paying attention to internal stimuli such as feelings, cognitions, emotions, sounds, and smells. |
| Description | Naming external experiences with words. |
| Awareness | Acting with complete mindfulness in each moment, instead of mechanical action in which the mind is elsewhere at the time of occurrence. |
| Non-judgment | Having a non-judgmental attitude toward thoughts and feelings. |
| Non-reaction | Allowing internal thoughts and feelings to come and go without involving oneself. |
The questions were scored on a 5-point Likert scale (never = 1; rarely = 2; sometimes = 3; often = 4; always = 5). The questions for each dimension were as follows: Observation dimension (questions 1, 6, 11, 15, 20, 26, 31, 36), Description dimension (questions 2, 7, 12, 22, 27, 32, 37), Action with awareness dimension (5, 8, 13, 18, 23, 28, 34, 38), Non-judgment dimension (3, 10, 14, 17, 25, 30, 35, 39), Non-reaction dimension (4, 9, 19, 21, 24, 29, 33). The scoring of questions with negative connotations is reversed (never = 5; rarely = 4; sometimes = 3; often = 2; always = 1).
Data analysis
The data were analyzed using SPSS version 24 statistical software (version 24, SPSS Inc., Chicago, IL) and descriptive statistics methods (tables, numbers, frequency percentages for qualitative data and, means, standard deviation for quantitative data). Also, according to the results of the Shapiro-Wilk test and the values of skewness and kurtosis obtained for the questionnaire dimensions and the P-P and Q-Q diagrams, the assumption of normality of all dimensions was confirmed. Therefore, parametric tests (Pearson’s correlation coefficient tests, independent t-test and one-way analysis of variance and post hoc tests) and the Somers’d coefficient were used to examine the association between the ordinal variables of academic performance (Dependent variable) and mindfulness (Independent variable). The significance level of statistical tests was determined to be less than 5%.
Ethical consideration
The study was conducted in compliance with all applicable ethical standards (the Declaration of Helsinki). The present study was approved by the Iran National Committee for Ethics in Biomedical Research (IR.GOUMS.REC.1402.465). The study carried no harmful risks as it was observational, and the anonymity of all participants was warranted as personal identifiers weren’t traced during data collection and analysis. All participants agreed to participate and provided informed consent.
Results
The distribution of demographic characteristics of the interns participating in the study is presented in Table 2. 53.7% of the interns participating in the study were female and 80% were single. The mean and standard deviation of the age were 25.88 ± 1.96 years. The mean and standard deviation of the academic grade point average of the interns were 16.01 ± 1.07. As shown in Table 2, the academic performance (total grade point average of the internship period) was between 14 and 16 in 47.7% of the interns and between 16 and 18 in 44.6% of the interns.
Table 2.
Distribution of demographic characteristics.
| Characteristics (N = 285) | |
|---|---|
| Age (Mean ± SD) | 25.88 ± 1.96 (23–41) |
| The past tense of the internship (M ± SD) | 10.15 ± 5.58 (1–24) |
| Academic grade point average (M ± SD) | 16.01 ± 1.07 (13–19) |
| Gender | N (%) |
| Female | 153 (53.7) |
| Male | 132 (46.3) |
| Marital status | N (%) |
| Single | 228 (80.0) |
| Married | 53 (18.6) |
| Other | 4 (1.4) |
| Native | N (%) |
| Yes | 146 (51.2) |
| No | 139 (48.8) |
| Place of residence | N (%) |
| Government Dormitory | 55 (19.3) |
| Family Living | 128 (44.9) |
| Student House | 102 (35.8) |
| Mother’s education | N (%) |
| Diploma and below | 88 (30.9) |
| Bachelor’s degree | 118 (41.4) |
| Master’s degree and above | 79 (27.7) |
| Father’s education | N (%) |
| Diploma and below | 53 (18.6) |
| Bachelor’s degree | 113 (39.6) |
| Master’s degree and above | 119 (41.8) |
| Academic performance | N (%) |
| 10–12 | 0 (0) |
| 12–14 | 16 (5.6) |
| 14–16 | 136 (47.7) |
| 16–18 | 127 (44.6) |
| 18–20 | 6 (2.1) |
SD: Standard Deviation; N: Number.
The highest score among the dimensions was related to the observation dimension (3.49 ± 0.68). The range of scores on the mindfulness scale is 195 − 39, with the higher the score, the greater the mindfulness. As shown in Table 3, the average total mindfulness scores are 125.96 ± 13.00 with a range of scores (92–172). Considering that it is higher than the average value of 117, mindfulness is at a relatively high level. As shown in Table 4, the mindfulness score of most students (70.9%) was in the range of 118–156 and was at a reasonable level.
Table 3.
Summary statistics for mindfulness dimensions among medical Students.
| Dimensions | Mean ± SD | Domain |
|---|---|---|
| Observation | 3.49 ± 0.68 | 1–5 |
| Description | 3.38 ± 0.58 | 1.75–5.75 |
| Awareness | 3.17 ± 0.62 | 1.63–5.63 |
| Non-judgment | 3.01 ± 0.62 | 1.13–5.13 |
| Non-reaction | 3.08 ± 0.44 | 1–4.57.57 |
SD: Standard Deviation.
Table 4.
Frequency distribution by mindfulness score.
| Dimensions | Total Mindfulness Score Range | N (%) |
|---|---|---|
| Poor | 39–78 | 0 (0) |
| Average | 79–117 | 78 (27.4) |
| Good | 118–156 | 202 (70.9) |
| Excellent | 157–195 | 5 (1.8) |
N: Number.
As shown in Table 5, interns’ gender was significantly related to the dimensions of observation (P-value = 0.010), description (P-value = 0.032), and mindfulness (P-value = 0.030). Scores for the observation, Description and, Mindfulness dimensions were significantly higher among women (mean = 3.59, 3.45, 3.27, respectively). The variable of being a native of the province was significantly related to the dimension of description (P-value = 0.029). Scores for the Description dimension were substantially lower among in people who were native to the province than in other people (mean = 3.31). The mother’s education was significantly related to the dimensions of action with awareness (P-value = 0.008) and mindfulness (P-value = 0.019), so the average scores in action with awareness dimension were higher in those with a diploma and lower education than in those with a bachelor’s degree (P-value = 0.002) in the mindfulness dimension, those with a bachelor’s degree and higher education were higher than those with a master’s degree and higher education (P-value = 0.006). Father’s education was significantly associated with the non-judgment dimension (P-value = 0.015) and non-reaction (P-value = 0.033), such that the mean scores in the non-judgment dimension were higher with diploma and lower education, higher than bachelor’s degree (P-value = 0.004) and master’s degree (P-value = 0.039), and in the non-reaction dimension were higher with diploma and lower education than bachelor’s degree (P-value = 0.011) and master’s degree (P-value = 0.032). No significant association was observed between marital status and place of residence with mindfulness and its dimensions (P-value < 0.05).
Table 5.
Examining the association between mindfulness and its dimensions with qualitative demographic characteristics of the study.
| Characteristics | Levels | Observation | Description | Awareness | Non-judgment | Non-reaction | Mindfulness |
|---|---|---|---|---|---|---|---|
| Gender | Female | 3.59 ± 0.72 | 3.45 ± 0.58 | 3.14 ± 0.62 | 3.05 ± 0.63 | 3.10 ± 0.45 | 3.27 ± 0.35 |
| Male | 3.38 ± 0.61 | 3.30 ± 0.58 | 3.20 ± 0.62 | 2.96 ± 0.60 | 3.06 ± 0.43 | 3.18 ± 0.30 | |
| P-Value* | 0.010 | 0.032 | 0.457 | 0.229 | 0.491 | 0.030 | |
| Marital status | Single | 3.47 ± 0.68 | 3.38 ± 0.47 | 3.16 ± 0.65 | 3.00 ± 0.65 | 3.08 ± 0.45 | 3.22 ± 0.34 |
| Married and Other | 3.57 ± 0.66 | 3.38 ± 0.65 | 3.01 ± 0.51 | 3.01 ± 0.48 | 3.11 ± 0.43 | 3.26 ± 0.33 | |
| P-Value* | 0.314 | 0.935 | 0.431 | 0.766 | 0.647 | 0.388 | |
| Native | Yes | 3.53 ± 0.67 | 3.31 ± 0.59 | 3.12 ± 0.61 | 3.96 ± 0.62 | 3.09 ± 0.48 | 3.20 ± 0.35 |
| No | 3.45 ± 0.68 | 3.46 ± 0.56 | 3.22 ± 0.63 | 3.06 ± 0.62 | 3.07 ± 0.41 | 3.26 ± 0.31 | |
| P-Value* | 0.335 | 0.029 | 0.176 | 0.158 | 0.647 | 0.187 | |
| Place of residence | Government Dormitory | 3.46 ± 0.68 | 3.37 ± 0.67 | 3.25 ± 0.68 | 3.04 ± 0.57 | 3.10 ± 0.39 | 3.25 ± 0.35 |
| Family Living | 3.51 ± 0.69 | 3.32 ± 0.67 | 3.16 ± 0.57 | 3.02 ± 0.61 | 3.05 ± 0.46 | 3.21 ± 0.36 | |
| Student House | 3.49 ± 0.67 | 3.47 ± 0.67 | 3.13 ± 0.65 | 2.98 ± 0.67 | 3.11 ± 0.45 | 3.24 ± 0.29 | |
| P-Value** | 0.913 | 0.134 | 0.537 | 0.820 | 0.496 | 0.753 | |
| Mother’s education | Diploma and below | 3.38 ± 0.65 | 3.40 ± 0.54 | 3.31 ± 0.70 | 3.01 ± 0.63 | 3.11 ± 0.42 | 3.25 ± 0.32 |
| Bachelor’s degree | 3.51 ± 0.72 | 3.49 ± 0.56 | 3.20 ± 0.56 | 3.96 ± 0.59 | 3.03 ± 0.41 | 3.17 ± 0.31 | |
| Master’s degree and above | 3.59 ± 0.72 | 3.49 ± 0.56 | 3.20 ± 0.58 | 3.08 ± 0.66 | 3.13 ± 0.51 | 3.30 ± 0.36 | |
| P-Value** | 0.127 | 0.064 | 0.008 | 0.413 | 0.193 | 0.019 | |
| Father’s education | Diploma and below | 3.47 ± 0.68 | 3.36 ± 0.61 | 3.11 ± 0.66 | 3.80 ± 0.55 | 3.22 ± 0.44 | 3.19 ± 0.29 |
| Bachelor’s degree | 3.42 ± 0.65 | 3.36 ± 0.55 | 3.22 ± 0.62 | 3.10 ± 0.62 | 3.03 ± 0.40 | 3.23 ± 0.33 | |
| Master’s degree and above | 3.57 ± 0.70 | 3.41 ± 0.60 | 3.15 ± 0.60 | 3.01 ± 0.64 | 3.06 ± 0.47 | 3.24 ± 0.36 | |
| P-Value** | 0.255 | 0.777 | 0.461 | 0.015 | 0.033 | 0.611 |
* T-Test, **ANOVA.
The results of the Pearson correlation test showed, there was a weak positive and significant association between age and non- reaction (r = 0.16; P-value = 0.006). With the increase in age, the non-reaction dimension score rises. There was a weak positive and significant association between the number of months of internship and mindfulness (r = 0.12; P-value = 0.044). With the increase in the number of months of internship, the mindfulness score increases. There was a weak positive and significant association between academic performance (grade point average) and the dimensions of action with awareness (P-value < 0.001) and mindfulness (P-value = 0.023). With increasing grade point average, the scores of this dimension rises.
As shown in Table 6, a somers ’d test was conducted to determine the association between mindfulness and interns’ grade point average among 285 participants. There was a weak and positive correlation between mindfulness and interns’ grade point average that was statistically significant (P-value = 0.019 and d = 0.12).
Table 6.
Examining the association between interns’ grade point average and mindfulness scores.
| Mindfulness | Interns’ grade point average | Somers’ d Test | P-Value | CI for Mont Carlo Significant | ||||
|---|---|---|---|---|---|---|---|---|
| 12–14 | 14–16 | 16–18 | 18–20 | L | U | |||
| 39–78 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.12 | 0.019 | 0.016 | 0.022 |
| 79–117 | 7 (9.0) | 41 (52.6) | 30 (38.5) | 0 (0.0) | ||||
| 118–156 | 9 (4.5) | 94 (46.5) | 93 (46.0) | 6 (3.0) | ||||
| 157–195 | 0 (0.0) | 1 (20.0) | 4 (80.0) | 0 (0.0) | ||||
*CI: 95% Confidence Interval; L: Lower; U:Upper.
Discussion
This study examined the state of mindfulness components and their association with academic performance in final-year medical students. The average mindfulness scores of interns in this study were assessed as higher than average. In the studies of Motiei et al.16, Yaghoubi et al.17, and Armani et al.10, the average mindfulness score was higher than average, which was consistent with the present study. In contrast, in Ajilchi et al.18 and Sajjadi et al.11, the average mindfulness score was lower than average, which was inconsistent with the present study. The reasons for the inconsistency of the results of these studies can be attributed to the differences in the field, university, and educational levels. Of course, whether the field, level, and higher-level university, especially medical universities, can play a role in the higher mindfulness scores of students requires further study and investigation.
According to the results of this study, the average scores of all five mindfulness components were evaluated as higher than average, and the highest score was related to the observation dimension, which is consistent with the results of the study by Armani et al.10 on medical students. One of the reasons for the higher observation dimension in this test is the sensitivity of the clinical environment of the students, which can create attention to detail in the patient history for clinical students.
The academic performance of students in this study was assessed as suitable. These results are consistent with the studies of Pourbarat et al.19, Dehnualian et al.20, Issa-Nazar et al.21, Abdi et al.22, and Naderi et al.23. In all the aforementioned studies conducted on the medical student population between 2010 and 2013, the average grade point average of students was assessed as 16–17. The academic performance of 92.3% of students in this study was evaluated as 14–16 and 16–18, and no student was in the range of 10–12.
According to the results, there was a weakly significant association between mindfulness and academic performance. The results of this study were in line with the study of Lu et al. in China24 and Chiang et al. in the United States25, which showed a significant association between mindfulness and grade point average. In addition, the results of this study were not consistent with the research of Pahlavani et al26. and Ahmadi et al.27. Also, among the components of mindfulness, only the element of action with awareness had a significant association with academic performance. The results of Zhao et al.‘s study showed that four mindfulness facets were positively correlated with academic engagement, except for non-judging of inner experiences, showing a negative association. Among the five mindfulness facets, acting with awareness was the strongest predictor of educational engagement28. In the study of Ahmadi et al.27 conducted among undergraduate students of Hamedan University of Medical Sciences, only the component of action with awareness had a significant association with academic procrastination. Action with awareness is the same as action with awareness and presence of mind. In explaining this significance, most of the courses in the internship phase of medical students are learning combined with the experience of clinical treatment of patients, and in the training process, the student must carefully diagnose and treat the history, clinical symptoms, and medical documents, and inaccuracy can cause errors in diagnosis.
In explaining the lack of significance of the dimensions of observation and description with academic performance as components that include the ability to understand feelings, emotions, and internal cognitions and name them, it can be noted that clinical students’ attention to patients’ physical problems can gradually distance them from their internal experiences and, due to constant involvement with the issues of others, their ability to identify and describe internal experiences gradually weakens. Of course, given that no study was found to accept or reject this explanation, it is necessary to examine this issue through subsequent studies.
In explaining the lack of significance of the two components of non-judgment and non-reactivity to internal experiences with academic performance, it is because the process of treating a disease requires a relatively rapid judgment (diagnosis) and reaction (therapeutic action) to the patient’s problems, the frequency of this action can increase the internal judgment and reaction patterns of clinical students. In the study of Ahmadi et al.27, it was determined that in the area of emotional intelligence impulse management, which is considered a type of reaction, basic science students have a better situation than clinical students, which can be consistent with this explanation.
According to the results of this study, mindfulness had a significant association with gender. Among the components of mindfulness, there was a substantial association with observation and description with female gender and older age with absence and reaction. The results of Alispahic’s study showed that there are age and gender differences for some aspects of mindfulness in a sample of the general Bosnian population. Women had higher scores on the observation subscale than men, and the average mindfulness scores in the age group of 33–49 were higher than in the age group of 20–3229. In explaining this issue, women have more access to their inner emotional and feeling experiences and can express them.
There was also a significant inverse association between the components of description and action and the mother’s awareness and education. Since it is usually expected that we will see more adaptive behavioral patterns with higher education, it is difficult to explain this inverse relationship. It can be demonstrated that higher education raises the individual’s expectations of a desirable life. Consequently, these expectations are transferred to the children. In other words, the children of mothers with higher education are looking for happiness and peace in the future. They cannot engage in internal experiences and conscious action in the present moment.
There was also a significant inverse association between the non-judgmental and non-reactive component and the father’s education. Similarly, the initial expectation is that with higher education, we will see more adaptive behavioral patterns, and it is difficult to explain this inverse relationship. However, as a possibility, since the father has a decisive role in the family decision-making and action, the father’s higher education can raise expectations and expectations from family members and increase the frequency of reactive and judgmental behavioral patterns based on who should be and how to behave.
Given the unexpected results of this study regarding the association between mindfulness and higher parental education, it seems that conducting a study that examines this issue more closely would be beneficial. It would also be helpful to explore the association between gender and mindfulness, both in the student population and in the general population. It is also recommended to conduct a systematic review of on the association between mindfulness and educational performance. If it is inevitable that mindfulness affects the academic performance of medical students, it is recommended to provide mindfulness training as an optional course in the general medical course.
To incorporate mindfulness training into medical curricula, the following are suggested for implementation in Iran:
Start with a pilot in one entry or one academic year and collect quantitative and qualitative data.
Collaborate with psychiatric and clinical psychology groups and clinical professors to adapt the content.
Prepare a Persian educational package including short videos and guided-practice audio files.
Limitations and future directions
This is a cross-sectional study, so cause-and-effect relationships were not examined; therefore, its results should be interpreted with caution. Data were collected via self-report questionnaires, and grade point average was self-reported; participants may have withheld truthful answers due to fear of consequences. To mitigate this, respondents were informed about the anonymity and confidentiality of their responses. Completing the questionnaire in a clinical hospital setting may have reduced response accuracy; to address this, participants were asked to complete it when not busy and to take sufficient time. Because the sample consisted of medical students from a single university, generalizing these findings to other communities or students in different fields should be done cautiously. Potential confounding factors—for example, stress levels, socioeconomic background, or clinical workload—that may affect both mindfulness and academic performance should be controlled for in future studies.
Conclusion
In general, the results of this study showed that the level of mindfulness among final-year medical students was reasonable. Additionally, there was a weak but positive correlation between mindfulness and the academic performance of interns. Given this association and recognizing that mindfulness may be one of several factors associated with academic performance, university educational officials could consider programs to strengthen clinical students’ mindfulness as a means to improve academic outcomes.
Author contributions
N.J conceptualized and designed the study. Z.K wrote the first draft of the manuscript; F.E acquired the data and Z.K designed the methodology; Z.K carried out the analysis; RB.OD and M.A interpreted the results, N.J were responsible for project administration and supervision. All authors read and approved the final version of the manuscript.
Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Declarations
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.