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Akihiro Yoshimura, Juichiro Yoshida, and Chieko Takumi declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.","order":1,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Approval for this study was obtained from the Ethics Committee of the Japanese Red Cross Society, Kyoto Daiichi Hospital (approval no. 1775). Permission for the secondary use of the C-CAT data was obtained through the C-CAT review and information governance process (approval no. CDU2025-026N). All procedures were conducted in accordance with the Declaration of Helsinki (2013 revision).","order":2,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The requirement for informed consent was waived in accordance with local regulations because the study used anonymized secondary-use data generated in routine clinical practice.","order":3,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The dataset was obtained from C-CAT on 18 October 2025, under regulated secondary-use approval and is not publicly available. Access to the C-CAT data is subject to relevant reviews and governance processes.","order":5,"name":"Ethics","label":"Data Availability","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":6,"name":"Ethics","label":"Code Availability","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Akihiro Yoshimura conceived and designed the study. Akihiro Yoshimura, Juichiro Yoshida, and Chieko Takumi developed the methodology. Akihiro Yoshimura acquired the data, performed the analysis, and interpreted the results. Akihiro Yoshimura wrote the original draft. Akihiro Yoshimura, Juichiro Yoshida, Chieko Takumi, and Koichi Takayama reviewed and revised the manuscript. Akihiro Yoshimura provided administrative, technical, and material support. Koichi Takayama supervised the study. All authors have read and approved the final manuscript.","order":7,"name":"Ethics","label":"Author Contributions","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No AI tools were used.","order":8,"name":"Ethics","label":"Use of Artificial Intelligence (AI)","group":{"name":"EthicsHeading","label":"Declarations"}}]}}