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Article History

Received: 17 April 2025

Accepted: 11 October 2025

First Online: 11 November 2025

Declarations

:

: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Nagasaki City Medical Association Ethics Review Committee (approval no. 2023–5).

: Not applicable.

: The authors declare that they have no competing interests.