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Students provided informed assent through their homeroom teachers. An information sheet explaining the purpose and procedures of the study was distributed to parents by each school. The document informed parents that, if they wished to decline their child\u2019s participation, they could notify the school administration (e.g., the principal) or the homeroom teacher by the specified deadline, and that failure to submit a refusal by the deadline would be regarded as consent. Parents were also informed that they could decline participation at any time without disadvantage. This procedure is an accepted method for minimal-risk, anonymous school surveys in Japan. In addition, before allowing participation in the survey, homeroom teachers confirmed\u2014through school-wide parent meetings and related communication channels\u2014that no refusal had been submitted by each child\u2019s parent or guardian.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"123"}}