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Article History

Received: 25 June 2025

Accepted: 20 August 2025

First Online: 2 September 2025

Declarations

:

: This study was approved by the Ethics Committee of Nagasaki Medical Center (Approval No. 2024016). This study does not involve a clinical trial; therefore, a clinical trial number is not applicable. All methods were performed in accordance with relevant guidelines and regulations. This study was conducted in accordance with the ethical standards of the Declaration of Helsinki (1964) and its amendments. All observational protocols were approved by the institutional and licensing committees of Nagasaki Medical Center. Informed consent was obtained from all participants prior to their inclusion in the study. Participants were provided with detailed explanations of the study’s purpose, methods, risks, and benefits to ensure their voluntary participation. Privacy and confidentiality of the participants were strictly protected, and the recorded data and interview content were anonymized and handled with the utmost care to ensure data security.

: Not applicable.

: The authors declare no competing interests.