Abstract
Background
Paramedic students often face high levels of occupational anxiety due to heavy theoretical and clinical workloads. This anxiety can adversely affect academic performance, clinical competence and the quality of patient care. Emotional intelligence (EI), defined as the ability to recognize and manage emotions while maintaining healthy social relationships, may help reduce such anxiety. This study aimed to determine the relationship between EI and occupational anxiety in paramedic students and to evaluate the effect of a short-term EI training program on reducing occupational anxiety.
Methods
This study employed a single-group quasi-experimental design. The population consisted of students enrolled in the paramedic program, and the sample included 110 paramedic students who participated in both the pre-test and post-test assessments. The intervention involved delivering a structured EI training program to the students. Data were collected using a Demographic Information Form, the Emotional Intelligence Scale, and the Occupational Anxiety Scale. All instruments were administered twice, before and after the training.
Results
The mean EI score of the students increased significantly from 75.12 ± 11.15 before the training to 79.42 ± 12.59 after the training (p = 0.002). The mean occupational anxiety score decreased significantly from 59.48 ± 13.57 before the training to 54.60 ± 17.16 after the training (p = 0.003). Moreover, a significant negative correlation was found between EI and occupational anxiety (r=–0.474, p < 0.001). Regression analysis indicated that EI was a significant predictor of occupational anxiety (β=–0.560, p < 0.001), explaining 22.4% of the total variance in occupational anxiety scores.
Conclusion
EI training significantly improved paramedic students’ levels of emotional recognition/understanding, facilitation, and regulation, while significantly reducing their occupational anxiety levels. These findings highlight the importance of interventions aimed at enhancing emotional resilience in health education. Structuring training programs to support the development of EI is crucial for effective anxiety management and the prevention of burnout.
Clinical trial number
Not applicable.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12909-025-08448-1.
Keywords: Emotional intelligence, Occupational anxiety, Paramedic, Student, Training
Introduction
Students in the First and Emergency Aid (Paramedic) program face numerous challenges in a dynamic and intensive educational process. These challenges can increase their levels of occupational anxiety. Students in health sciences programs experience higher levels of anxiety compared to the general university student population [1]. Literature indicates that anxiety is present in 54.55% of students in health-related fields [2]. Clinical experiences, the intensity of theoretical coursework, internship requirements, and frequent contact with patients are among the primary factors influencing students’ anxiety levels [3]. Increased occupational anxiety can negatively affect students’ academic achievement and performance [4–6]. Furthermore, factors such as clinical practice processes and professional competence can have a direct impact on the quality of patient care [7–9]. In addition to anxiety, students in health sciences programs may experience increased symptoms of depression, higher rates of course withdrawal, and even a greater risk of suicide [10]. Therefore, identifying effective interventions for anxiety is crucial for protecting student well-being and enhancing academic success [11].
The provision of psychological support systems by educational institutions to promote students’ mental health is an important initiative in coping with anxiety [2]. In the context of reducing anxiety, non-pharmacological strategies such as mindfulness and music therapy have been reported to be highly effective [12, 13]. In this regard, emotional intelligence (EI) emerges as a factor that can play a significant role in managing anxiety. EI is defined as the ability to understand one’s own emotions and to recognize the emotions of others [14]. It enhances resilience, promotes psychological well-being, and protects against burnout. EI encompasses key competencies such as self-awareness, self-regulation, motivation, and social skills [15]. Its positive impact on healthcare professionals has been demonstrated in various studies, showing that it increases resilience and psychological well-being while reducing the risk of burnout [16]. It has been suggested that healthcare professionals can develop their EI through self-awareness techniques such as exercise, journaling, and reading personal development literature [17]. In particular, structured training programs have been observed to enhance healthcare professionals’ empathy and communication skills, thereby reducing occupational stress [18, 19]. High EI contributes to healthcare professionals’ ability to build positive relationships with patients and colleagues, manage stress effectively, and adapt to changing circumstances [20].
In the literature, various studies have examined the relationship between healthcare professionals’ levels of EI and occupational anxiety; however, research focusing specifically on paramedic students remains limited. Therefore, the present study investigated the relationship between EI and occupational anxiety levels among paramedic students. Subsequently, the effect of an educational program aimed at enhancing EI on students’ occupational anxiety levels was evaluated using a quasi-experimental design.
Methods
Study design and participants
In this study, the relationship between paramedic students’ EI levels and occupational anxiety was examined cross-sectionally, and in addition, a quasi-experimental design (pre-test–post-test) was employed to determine the effect of EI training on occupational anxiety levels. The study population consisted of 128 paramedic students enrolled in the Vocational School of Health Services at a foundation university, and a simple random sampling method was used for sample selection. Based on the known population sampling formula, with a 5% margin of error, 95% confidence level, and 50% response distribution, the minimum required sample size was calculated as 97 [21]. To account for potential non-responses, an additional 10% was added, setting the target at 107 participants. Ultimately, a total of 110 students were included in the study. To protect confidentiality, participants were tracked using ID numbers instead of personal information, and students’ EI and occupational anxiety levels were assessed through scale applications administered before and after the training.
Data collection and instruments
Data were collected through face-to-face interviews using questionnaires. Participants were informed about the purpose and procedures of the study and were invited to voluntarily participate. Approximately 20 min were allocated for each participant during the data collection process. The data collection instruments consisted of three parts: the “Personal Information Form,” the “Emotional Intelligence Scale” and the “Occupational Anxiety Scale”. The Personal Information Form was developed by the researchers for this study based on a literature review [22–24], consisted of 10 items covering participants’ age, gender, class level, academic performance, reason for choosing the profession, family income level, personal income status, daily sleep duration, and smoking and alcohol consumption (Appendix-1).
The Emotional Intelligence Scale was originally developed by Lee and Kwak [25] and adapted into Turkish by Kayıhan and Arslan [26]. The scale included 20 items and three subdimensions: items 1–6 measured “Emotional Recognition/Understanding”, items 7–12 measured “Emotional Facilitation”, and items 13–20 measured “Emotional Regulation”. It was designed as a five-point Likert-type scale ranging from “Strongly Disagree” to “Strongly Agree.” The possible total scores ranged from 20 to 100, with higher scores indicating higher levels of EI. The internal consistency values reported in the Turkish adaptation study were 0.83 for the overall scale, 0.72 for emotional recognition/understanding, 0.71 for emotional facilitation, and 0.76 for emotional regulation. In the present study, the Cronbach’s alpha coefficient for the overall scale was 0.85, and the subdimension values were 0.78 for emotional recognition/understanding, 0.80 for emotional facilitation, and 0.81 for emotional regulation.
The Occupational Anxiety Scale for Healthcare Services Students was developed by Çelebi et al. [27]. The scale has two different structures for undergraduate and associate degree students, and in this study, the version for associate degree students was used. The scale consisted of four factors (professional knowledge, work life, occupational health, and communication) and 30 items. Each item was scored as “1 = Not anxious,” “2 = Undecided,” and “3 = Anxious.” No reverse items were included in the scale. The possible score range is 30–90, and higher scores indicate higher levels of occupational anxiety. In the original adaptation study, the Cronbach’s alpha coefficient for the associate-degree version was reported as 0.81, while subscale reliability values were not individually reported. In the present study, Cronbach’s alpha values were 0.88 for professional knowledge, 0.88 for work life, 0.79 for occupational health, 0.87 for communication, and 0.92 for the total scale.
Intervention
A structured emotional intelligence training titled “First Response to Anxiety: Emotional Intelligence Training for Paramedics” was implemented to enhance students’ emotional awareness, emotion-regulation skills, and coping abilities in high-stress emergency settings. Grounded in emotional intelligence theory, the program aimed to improve recognition and management of emotions and anxiety-related responses commonly encountered in paramedic practice. The training was delivered face-to-face in a group seminar format on 29 May 2025 in a university conference hall and comprised two instructional sessions totalling three hours. The intervention was facilitated by a clinical psychologist with professional experience in emotional skills development and psychoeducation. Educational content included presentation slides, case examples, and a SWOT-based self-reflection worksheet, and combined psychoeducation (fear vs. anxiety, EI components, and EI development strategies) with interactive exercises such as guided emotional expression, group discussion, personal reflection, and applied emotion-regulation practice (Fig. 1). In the first session, students engaged in a SWOT self-reflection exercise to enhance awareness of their emotional strengths and anxiety-related vulnerabilities. Key concepts including fear vs. anxiety, the definition and core components of emotional intelligence, and the relationship between EI and other intelligence types were discussed. The session also covered practical strategies to foster emotional intelligence in professional practice, with examples relevant to prehospital emergency care. The second session emphasised interactive and experiential learning. Students shared personal reflections related to stress and emotional challenges in emergency settings, participated in guided emotional expression exercises, and received structured feedback. Throughout the programme, the psychologist actively engaged with participants, creating a supportive environment that encouraged open discussion and emotional processing.
Fig. 1.
Emotional intelligence training for paramedic students
Statistical analysis
Data were analyzed using the SPSS 27.0 statistical software package. Prior to the analyses, the dataset was examined for missing values and outliers, and the assumption of normality was assessed. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were employed. To compare pre- and post-training scores, paired samples t-tests were conducted. The reliability of the overall scores and subdimension scores of the scales used in the study was assessed with Cronbach’s alpha coefficient. The relationships between dependent and independent variables were examined using correlation and regression analyses. A significance level of p < 0.05 was considered statistically significant.
Results
The study included 110 paramedic students with a mean age of 20.2 ± 2.92 years (range: 17–45). The majority were female (84.5%, n = 93), while males comprised 15.5% (n = 17). In terms of year of study, 52.7% (n = 58) were first-year and 47.3% (n = 52) were second-year students. Regarding self-reported academic performance, 67.3% (n = 74) rated their achievement level as “moderate,” 18.2% (n = 20) as “low,” and 14.5% (n = 16) as “high.” Most students (84.5%, n = 93) chose the program voluntarily, 10.0% (n = 11) due to job opportunities, and 5.5% (n = 6) due to family preference. The majority reported a middle income level (83.6%, n = 92), with 5.5% (n = 6) reporting low and 10.9% (n = 12) high income. In terms of financial support, 59.1% (n = 65) received assistance from their families, 22.7% (n = 25) were employed with regular income, and 18.2% (n = 20) were unemployed without regular income. Daily sleep duration was reported as 6–8 h by 60.0% (n = 66), less than 6 h by 25.5% (n = 28), and more than 8 h by 14.5% (n = 16). Smoking prevalence was 34.5% (n = 38), while 65.5% (n = 72) did not smoke. Alcohol use was relatively low, with 16.4% (n = 18) reporting consumption (Table 1).
Table 1.
Characteristics of the students
| Variables | X ± SD | Min-Max |
|---|---|---|
| Age | 20.2 ± 2.92 | 17–45 |
| n | % | |
| Gender | ||
| Female | 93 | 84.5 |
| Male | 17 | 15.5 |
| Year of study | ||
| 1st year | 58 | 52.7 |
| 2nd year | 52 | 47.3 |
| Academic achievement status | ||
| Low | 20 | 18.2 |
| Moderate | 74 | 67.3 |
| High | 16 | 14.5 |
| Reason for choosing the program | ||
| Own choice | 93 | 84.5 |
| Job opportunities | 11 | 10.0 |
| Family’s choice | 6 | 5.5 |
| Family income level | ||
| Low | 6 | 5.5 |
| Middle | 92 | 83.6 |
| High | 12 | 10.9 |
| Personal income status | ||
| I receive financial support from my family. | 65 | 59.1 |
| I am employed and have a regular income | 25 | 22.7 |
| I am unemployed and do not have a regular income. | 20 | 18.2 |
| Daily sleep duration | ||
| Less than 6 h | 28 | 25.5 |
| 6–8 h | 66 | 60.0 |
| More than 8 h | 16 | 14.5 |
| Smoking | ||
| Yes | 38 | 34.5 |
| No | 72 | 65.5 |
| Alcohol consumption | ||
| Yes | 18 | 16.4 |
| No | 92 | 83.6 |
SD Standart Deviation
Students’ EI levels were measured before and after the training to evaluate the impact of the intervention (Table 2). The mean total Emotional Intelligence Scale score increased from 75.12 ± 11.15 at baseline to 79.42 ± 12.59 post-training (p = 0.002, Cohen’s d = 0.362). Improvements were also observed across subdomains: emotional recognition/understanding increased from 23.58 ± 4.08 to 24.83 ± 3.79 (p = 0.008, Cohen’s d = 0.317); emotional facilitation increased from 21.92 ± 4.05 to 22.93 ± 4.23 (p = 0.025, Cohen’s d = 0.244); and emotional regulation increased from 29.62 ± 5.77 to 31.66 ± 6.36 (p = 0.003, Cohen’s d = 0.336).
Table 2.
Comparison of emotional intelligence scores before and after training
| Variables | Training | X̄ | SD | SE | t | p | Cohen’s d |
|---|---|---|---|---|---|---|---|
| Emotional Recognition/Understanding | Pre-training | 23.58 | 4.08 | 0.39 | -2.680 | 0.008 ** | 0.317 |
| Post-training | 24.83 | 3.79 | 0.36 | ||||
| Emotional Facilitation | Pre-training | 21.92 | 4.05 | 0.39 | -2.280 | 0.025 * | 0.244 |
| Post-training | 22.93 | 4.23 | 0.40 | ||||
| Emotional Regulation | Pre-training | 29.62 | 5.77 | 0.55 | -3.020 | 0.003 ** | 0.336 |
| Post-training | 31.66 | 6.36 | 0.60 | ||||
| Total EIS | Pre-training | 75.12 | 11.15 | 1.06 | -3.220 | 0.002 ** | 0.362 |
| Post-training | 79.42 | 12.59 | 1.20 |
EIS Emotional Intelligence Scale, SD Standard Deviation, SE Standard Error
*p < 0.05, **p < 0.01, ***p < 0.001
Analysis of the Occupational Anxiety Scale scores demonstrated a reduction in overall occupational anxiety following the training (Table 3). The mean total score decreased from 59.48 ± 13.57 pre-training to 54.60 ± 17.16 post-training (p = 0.003, Cohen’s d = 0.316). At the subscale level, professional knowledge scores changed from 23.21 ± 6.50 to 22.37 ± 8.18, but this difference was not statistically significant (p = 0.254, Cohen’s d = 0.113). Significant decreases were observed in work life (18.07 ± 4.84 to 15.83 ± 6.08; p < 0.001, Cohen’s d = 0.406), occupational health (8.61 ± 2.60 to 7.75 ± 2.98; p = 0.005, Cohen’s d = 0.307), and communication (9.59 ± 3.67 to 8.65 ± 3.71; p = 0.016, Cohen’s d = 0.255) subscales.
Table 3.
Comparison of occupational anxiety scores before and after training
| Variables | Training | X̄ | SD | SE | t | p | Cohen’s d |
|---|---|---|---|---|---|---|---|
| Professional Knowledge | Pre-training | 23.21 | 6.50 | 0.62 | 1.150 | 0.254 | 0.113 |
| Post-training | 22.37 | 8.18 | 0.78 | ||||
| Work Life | Pre-training | 18.07 | 4.84 | 0.46 | 4.140 | < 0.001 *** | 0.406 |
| Post-training | 15.83 | 6.08 | 0.58 | ||||
| Occupational Health | Pre-training | 8.61 | 2.60 | 0.24 | 2.870 | 0.005 ** | 0.307 |
| Post-training | 7.75 | 2.98 | 0.28 | ||||
| Communication | Pre-training | 9.59 | 3.67 | 0.35 | 2.450 | 0.016 * | 0.255 |
| Post-training | 8.65 | 3.71 | 0.35 | ||||
| Total OAS | Pre-training | 59.48 | 13.57 | 1.29 | 3.090 | 0.003 ** | 0.316 |
| Post-training | 54.60 | 17.16 | 1.63 |
OAS Occupational Anxiety Scale, SD Standard Deviation, SE Standard Error
*p < 0.05, **p < 0.01, ***p < 0.001
Post-training findings indicated a significant negative correlation between EI and occupational anxiety (r=–0.474, p < 0.001) (Table 4). A simple linear regression analysis conducted to assess the effect of EI on occupational anxiety revealed that the model was significant (p < 0.001). The results showed that EI accounted for 22.4% of the total variance in occupational anxiety scores.
Table 4.
Correlation analysis between emotional intelligence and occupational anxiety
| ER/U | EF | ER | EIS | PK | WL | OH | C | OAS | |
|---|---|---|---|---|---|---|---|---|---|
| ER/U | — | ||||||||
| EF | 0.597*** | — | |||||||
| ER | 0.728*** | 0.799*** | — | ||||||
| EIS | 0.845*** | 0.883*** | 0.959*** | — | |||||
| PK | -0.335*** | -0.396*** | -0.437*** | -0.438*** | — | ||||
| WL | -0.304** | -0.397*** | -0.384*** | -0.404*** | 0.690*** | — | |||
| OH | -0.221* | -0.319*** | -0.251** | -0.289** | 0.545*** | 0.476*** | — | ||
| C | -0.276** | -0.205* | -0.372*** | -0.330*** | 0.440*** | 0.420*** | 0.443*** | — | |
| OAS | -0.365*** | -0.429*** | -0.468*** | -0.474 *** | 0.911*** | 0.857*** | 0.698*** | 0.652*** | — |
ER Emotional Recognition/Understanding, EF Emotional Facilitation, ER Emotional Regulation, EIS Emotional Intelligence Scale, PK Professional Knowledge, WL Work Life, OH Occupational Health, C Communication, OAS Occupational Anxiety Scale
*p < 0.05, **p < 0.01, ***p < 0.001
Discussion
This study examined the relationship between EI and occupational anxiety among paramedic students and evaluated the impact of an EI training program. The findings demonstrated that EI levels significantly increased after the training, while occupational anxiety levels decreased. These results indicate that EI can be effectively improved through targeted training, and that such improvement has a positive influence on reducing occupational anxiety. Our findings are consistent with previous studies highlighting the benefits of EI training in healthcare and organizational contexts. For instance, an Randomized Controlled Trial (RCT) conducted in China demonstrated that EI training enhanced nurses’ EI, resilience, and stress management while also improving inpatient experiences [28]. Likewise, a study among UK managers found that EI training led to significant improvements in EI, stress reduction, health, and performance outcomes [29].
Although the positive effects of EI and EI-based training have been well documented among nurses and other healthcare professionals, research specifically focusing on paramedics remains limited. Existing studies in this field have primarily examined employed paramedics and emergency medical technicians (EMTs) rather than students. For example, Markert-Green [30] reported that private sector EMTs experience higher rates of PTSD, with coping avoidance and insecure attachment styles emerging as significant predictors. Kaplan and Markenson [31] found that higher trait EI was associated with lower turnover intention among EMS providers, although factors such as physical health and perceived stress were stronger predictors. Similarly, Roh et al. [32] identified that higher EI and self-efficacy reduced job stress among ambulance workers, with gender, age, and educational level influencing outcomes. Other studies have emphasized the importance of empathy as a component of dispatcher competence [33], the negative impact of poor sleep quality on empathic responses among experienced paramedics [34], and the mediating role of coping skills in the relationship between EI and organizational citizenship behaviors in the paramedical sector [35]. Collectively, these findings highlight the relevance of EI for EMS professionals’ psychological well-being and professional functioning. However, very limited evidence is available regarding paramedic students. Therefore, the present study contributes to filling this gap by demonstrating the effectiveness of EI training in reducing occupational anxiety within a student population.
The increase in total EI scores, as well as in all subdimensions (emotional recognition/understanding, facilitation, and regulation), is consistent with previous research suggesting that emotional intelligence is a trainable skill and can be enhanced through structured interventions [36–38]. Similar improvements in emotional recognition/understanding and regulation have been documented among nursing and medical students who participated in EI-focused educational programs, supporting the notion that targeted training fosters both intrapersonal and interpersonal competencies essential for healthcare practice. Furthermore, the observed enhancement in emotional facilitation suggests that the training not only supported students’ ability to recognize emotions but also strengthened their capacity to use emotions more effectively in decision-making and stress management—skills that are particularly critical in the demanding context of prehospital emergency care.
Regarding occuopational anxiety, the significant reduction in overall scores, particularly in the subscales of work life, occupational health, and communication, suggests that the training not only supported paramedic students in recognizing and regulating their emotions but also alleviated stressors directly associated with the realities of prehospital clinical practice. Given that paramedics frequently encounter unpredictable, high-pressure environments, improvements in these domains may contribute to better coping with the demands of fieldwork and patient interactions. Similar outcomes have been reported in studies showing that higher EI is linked to lower stress and anxiety among nursing and medical students [39–41]. However, in the professional knowledge subscale, no significant change was observed, which may indicate that knowledge-based concerns—such as procedural competence and technical skills—require complementary educational strategies, including curriculum integration, scenario-based simulation, or clinical mentorship, rather than EI training alone.
The negative correlation identified between EI and occupational anxiety after training (r = − 0.474) supports the notion that students with higher EI are better equipped to manage stress, adapt to challenges, and maintain psychological well-being [42, 43]. Furthermore, the regression analysis revealed that EI explained 22.4% of the variance in occupational anxiety, underlining its predictive role and practical significance in reducing anxiety levels. These findings emphasize that fostering EI is not only beneficial for personal growth but also serves as a protective factor against professional stress in healthcare education [44]. For paramedic students, who are preparing to enter a field characterized by urgency, unpredictability, and high emotional demands, such training may be especially valuable. In this sense, the present study provides important evidence that EI development can function as a cornerstone in reducing occupational anxiety, strengthening resilience, and ultimately enhancing the readiness of future paramedics for both routine clinical care and crisis situations.
Although statistically significant improvements were observed in both emotional intelligence and occupational anxiety, the effect sizes were generally small (Cohen’s d = 0.113–0.406). This pattern is common in short-term behavioral and psychosocial training interventions [45]. Given that emotional intelligence–based skills typically require sustained practice, repeated exposure, and long-term reinforcement to produce more pronounced and lasting behavioral change, the modest effect sizes in this study are consistent with expectations for a single three-hour training session. Nonetheless, even small improvements can hold meaningful practical value for paramedic students, who are expected to work in emotionally demanding and high-stress environments. These findings support the potential benefit of incorporating structured emotional intelligence components into paramedic education curricula. Future research involving longer-term, multi-session interventions and follow-up assessments may produce stronger and more enduring effects.
Limitations
This study has certain limitations. The quasi-experimental design without a control group restricts the ability to draw definitive causal inferences. Moreover, the absence of a follow-up assessment prevented evaluation of the long-term sustainability of the training effects. Data were also collected from a single institution, which may limit the generalizability of the results. Future studies should employ randomized controlled designs with larger, multicenter samples and include follow-up assessments to validate and extend these findings.
Conclusions
This study revealed a significant negative correlation between EI and occupational anxiety, with regression analysis confirming EI as a significant predictor of anxiety levels. Following the intervention, students’ EI scores increased significantly, while occupational anxiety scores decreased, indicating that EI training can positively influence psychological well-being. Improvements across subdimensions such as emotional recognition/understanding, facilitation, and regulation suggest an enhanced ability to manage occupational stress. Integrating EI training into health sciences curricula may serve as an effective strategy to prepare future healthcare providers for the emotional demands of their profession. Beyond reducing anxiety, such interventions may also contribute to broader outcomes, including greater job satisfaction, reduced burnout, and enhanced occupational readiness—particularly valuable for healthcare professionals expected to serve in high-stress environments such as disasters and crises.
Supplementary Information
Acknowledgements
The authors would like to express their sincere gratitude to Emirhan Temel, Hayal Nisa Koskos, and Ayşe Göktaş for their valuable contributions and support during the implementation of this project. The authors also extend their special thanks to Clinical Psychologist Tülay Kaçan for delivering the emotional intelligence training and for her professional support throughout the study.
Authors’ contributions
ADK and NT were responsible for the conceptualization and methodology of the study. Project administration and supervision were carried out by ADK. Resources and investigation were contributed by ADK and NT, with ADK also leading the formal analysis. All authors participated in writing the original draft, reviewing and editing the manuscript, and approved the final version.
Funding
This study was supported by the Scientific and Technological Research Council of Türkiye (TÜBİTAK) under the 2209-A University Students Research Projects Support Program.
Data availability
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Declarations
Ethics approval and consent to participate
All procedures were performed in accordance with the ethical standards of the institutional research committee and with the Declaration of Helsinki in 1964 and its subsequent amendments or comparable ethical standards. This study was approved and supported by the Scientific Research Ethics Committee of Bezmialem Vakıf University on April 11, 2025 (reference number 189155). Informed consent from all participants was obtained prior to participation in the study. Participants also provided consent for photography during the training session and for the use of these images for academic dissemination purposes.
Consent for publication
Not applicable.
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.
Supplementary Materials
Data Availability Statement
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.