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Article History

Received: 18 November 2024

Accepted: 28 February 2026

First Online: 18 March 2026

Competing interests

: The authors declare no competing interests.

: This study was deemed exempt from ethical review by the Medical Board of Kyoto University because it involved analysis of social media records and did not use human data beyond measuring internet activity. The findings, including those related to medical conditions, were reported in a way that individual identities could not be identified. Tweet content was also translated and adapted to avoid detection of individual identities. We complied with relevant data protection laws and platform terms of service; anonymised personal identifiers; and we used secure, controlled-access repositories for sharing. This study follows the recommendations of the Association of Internet Researchers and the Ethical Guidelines for Life Science and Medical Research Involving Human Subjects by the Japanese Ministry of Health, Labor and Welfare.

: For the reasons stated above, this study did not require informed consent, as per The Ethical Guidelines for Life Science and Medical Research Involving Human Subjects by the Japanese Ministry of Health, Labor and Welfare, in the case of research involving big data.