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Article History

Received: 26 September 2025

Accepted: 29 December 2025

First Online: 10 January 2026

Declarations

:

: This study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Tokai University Hospital (approval date: October 27, 2023; approval number: 23R073). The study’s purpose and procedures, voluntary nature of participation, right to withdraw at any time, and protection of personal information were explained to all participants both in writing and verbally. Written informed consent was obtained from each participant.

: While the data does not contain personally identifiable information, we have obtained consent after explaining that data such as lyrics content will be published.

: NN reports receiving grants from the 2024 Tokai University School of Medicine Research Aid and the 2023 Foundation for Promotion of Cancer Research in Japan. AY reports receiving grants from the 2021 and 2024 Grants-in-Aid for Scientific Research, outside the submitted work. MT reports receiving grants from the 2017 international cooperation research grant, and personal fees from Otsuka Pharmaceutical Factory, Inc.; Eisai Co., Ltd., and Specialist Doctors Inc., outside the submitted work. BT reports receiving personal compensation from Daiichi Sankyo Co., Ltd., MSD K.K., Shionogi & Co., Ltd., and Ono Pharmaceutical Co., Ltd., outside the submitted work. OM reports receiving personal fees from Daiichi Sankyo Co., Ltd., outside the submitted work. KY reports receiving grants and personal fees from Otsuka Pharmaceutical Co., Ltd.; Shionogi & Co., Ltd., and Eisai Co., Ltd., as well as personal fees from Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., Meiji Seika Pharma Co., Ltd., Pfizer Japan Inc., Eli Lilly and Company, EA Pharma Co., Ltd., Merck Sharp & Dohme, Viatris Inc., and Astellas Pharma Co., Ltd. He also reports receiving grants from the Grants-in-Aid for Scientific Research (C), and from Medical corporation, Tanzawa hospital, Seishinkai, Kishikai, Kensuikai, Seikikai, Kyogetsukai, Aokisuejiroukinenkai; and from the Social welfare corporation, Social Business department of Houanji, all outside the submitted work. MK, SO, TI, and KH declare no conflicts of interest.