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Article History

Received: 25 February 2025

Accepted: 7 July 2025

First Online: 21 July 2025

Declarations

:

: Written informed consent was obtained from each participant, and the study was carried out in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of NEC Life Science (protocol code LS2018-004). Trial registration: UMIN, UMIN000050353. Registered 15 February 2023—Retrospectively registered, umin.ac.jp/ctr.

: Participants were provided with information about the background and purpose of the study, voluntary participation, the type of research intervention, the duration, risks, benefits, confidentiality, sharing of the findings, the right to refuse or withdraw from the study, alternative ways to participate, and who to contact regarding informed consent. They were asked to sign an agreement form if they agreed with all the content.

: I.O. reports receiving grants and consultation fees from NEC Solution Innovators Ltd. for projects related to the submitted work; grants from Infocom Co.; lecture fees from Otsuka Pharmaceutical Co. Ltd., MSD LLC, Shionogi & Co., Ltd., and Eisai Co. Ltd.; and consultation fees from Suntory Wellness Ltd. for projects unrelated to the submitted work. M.S., N.T., I.K., R.I., and J.A. report receiving salaries from NEC Solution Innovators Ltd. The funders had no role in the study design; collection, analyses, or interpretation of data; writing of the manuscript; or decision to publish the results.