highly significantp < 0.005
Statistical significance was determined by a two-tailed p -value < 0.05, with hierarchical notation based on the degree of difference: * p < 0.05 (statistically significant), ** p < 0.01 (highly significant), *** p < 0.005 (extremely highly significant), **** p < 0.0001 (profoundly significant), and ns (no significant difference between groups). 3.