{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:03:05Z","timestamp":1790618585314,"version":"4.1.0"},"reference-count":60,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100016239","name":"University of Occupational and Environmental Health","doi-asserted-by":"publisher","award":["19K17919"],"award-info":[{"award-number":["19K17919"]}],"id":[{"id":"10.13039\/100016239","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"\n Objective<\/jats:title>\n Osteoporosis causes fractures that further increase the disease burden of rheumatoid arthritis (RA); however, osteoporosis treatment rates remain low. Although several studies have reported that biologic or targeted synthetic disease\u2010modifying antirheumatic drugs (b\/tsDMARDs) can prevent or improve osteoporosis in RA, our large\u2010scale, real\u2010world study showed that one\u2010year b\/tsDMARDs use did not arrest osteoporosis progression. This study aimed to examine longer\u2010term changes in bone mineral density (BMD).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n BMD was observed for up to five years in patients receiving b\/tsDMARDs for active RA. The primary endpoint was change in BMD (T score), and the secondary endpoint was change in T score\u2013related factors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 797 patients (antiosteoporosis\u2013, n = 645; antiosteoporosis+, n = 152) were included, with a median 3.1\u2010year follow\u2010up (2,489 patient\u2010years). Clinical Disease Activity Index (CDAI) improved in both groups (antiosteoporosis\u2013 26.0 to 6.6; antiosteoporosis+ 24.4 to 6.8). T scores decreased significantly in the femoral neck and radius in the antiosteoporosis\u2212 group but not in the antiosteoporosis+ group (antiosteoporosis\u2013: mean change \u20130.11 to \u20130.33, both\n P<\/jats:italic>\n < 0.001; antiosteoporosis+ \u20130.01 to \u20130.10,\n P<\/jats:italic>\n = 0.830 and 0.071, respectively). Overall, 460 patients (58%) experienced a decrease in T score. A high baseline T score correlated with a subsequent decrease, whereas longer osteoporosis treatment duration correlated with an increase. Unexpectedly, the duration of b\/tsDMARD use and mean CDAI during observation were not associated with BMD maintenance.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Even when RA activity was controlled with b\/tsDMARDs, BMD still decreased. This study emphasizes the importance of considering osteoporosis as an independent aspect of RA, beyond inflammation control.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/art.70125","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:51:10Z","timestamp":1773035470000},"page":"2036-2049","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Biologic and Targeted Synthetic Disease\u2010Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long\u2010Term Multicenter Observational Study"],"prefix":"10.1002","volume":"78","author":[{"given":"Takafumi","family":"Aritomi","sequence":"first","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Laboratory and Transfusion Medicine Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4003-8842","authenticated-orcid":false,"given":"Koshiro","family":"Sonomoto","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Clinical Nursing School of Health Sciences, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Shunan Memorial Hospital Kudamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Nakayamada","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Saiseikai Yahata General Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Medical Informatics and Management Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Nagayasu","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Infectious Disease Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9693-9263","authenticated-orcid":false,"given":"Satoshi","family":"Kubo","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Kyusyu Rosai Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ippei","family":"Miyagawa","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Molecular Targeted Therapeutics University of Occupational and Environmental Health Japan, Kitakyushu Japan"},{"name":"Department of Rheumatology Kokura Memorial Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Laboratory and Transfusion Medicine Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Fukuoka Shin Mizumaki Hospital Kitakyushu Japan"},{"name":"Department of Rheumatology Shin\u2010Kokura Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoaki","family":"Ohkubo","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Environmental Epidemiology University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Obase Hospital Kanda Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4646-592X","authenticated-orcid":false,"given":"Yasuyuki","family":"Todoroki","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Molecular Targeted Therapeutics University of Occupational and Environmental Health Japan, Kitakyushu Japan"},{"name":"Department of Rheumatology Steel Memorial Yawata Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yurie","family":"Satoh\u2010Kanda","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Tochiku Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0212-172X","authenticated-orcid":false,"given":"Masanobu","family":"Ueno","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8247-6595","authenticated-orcid":false,"given":"Ryuichiro","family":"Kanda","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4163-9356","authenticated-orcid":false,"given":"Yuya","family":"Fujita","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Ashiya Central Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Funada","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Sakai","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Yamaguchi\u2010ken Saiseikai Shimonoseki General Hospital Shimonoseki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satsuki","family":"Matsunaga","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Yamaguchi Rosai Hospital Sanyo\u2010Onoda Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Hagiwara Central Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Shinojima","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Kenai Memorial Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Kawamura","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Ohira Medical Care Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Hosoe Clinic Shimonoseki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyabi","family":"Ando","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Sasaki Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Haru","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Yoshino Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5692-3881","authenticated-orcid":false,"given":"Yusuke","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology and Diabetology Wakamatsu Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Hanami","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Diabetology Kitakyushu General Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Nawata","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Kokura Rheumatology Clinic Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Fukuyo","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology and Diabetology Wakamatsu Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Nakatsuka","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Japan Community Health care Organization Fukuoka Yutaka Central Hospital Nogata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikiko","family":"Tokunaga","sequence":"additional","affiliation":[{"name":"Hakataeki Minami Tokunaga Clinic Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology Tobata General Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0807-7139","authenticated-orcid":false,"given":"Yoshiya","family":"Tanaka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Molecular Targeted Therapeutics University of Occupational and Environmental Health Japan, Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10061241"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-017-4170-5"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200003)43:3<522:AID-ANR7>3.0.CO;2-Y"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2014.125"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2022.101773"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22988"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-020-04593-6"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.17519"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2022-eular.329"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.2025-0314.135"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207524"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41752"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.017780"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kei082"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1351.040"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.044198"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2219"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.076604"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.091611"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-12-54"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-012-2128-8"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes320"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket468"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2014.10.015"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0188454"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-017-3922-z"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.783030"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-021-05871-0"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-025-01598-8"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-021-05824-7"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead579"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40744-025-00762-w"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.70232"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2019.09.001"},{"key":"e_1_2_7_37_1","first-page":"1","article-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group","volume":"843","year":"1994","journal-title":"World Health Organ Tech Rep Ser"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2007.11.001"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2016.06.036"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.24.2077"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.14.1344"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-009-1077-9"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-020-05488-9"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2022.01.017"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2023-003919"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-009-1102-z"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.277817"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3777"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.2986"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107142"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-016-3703-7"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-021-05900-y"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0969-8043(98)00026-8"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez655"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2024-004564"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-017-4230-x"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-019-04844-8"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-020-00871-9"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.15.1889"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-022-01061-5"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bonr.2020.100"}],"container-title":["Arthritis & Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.70125","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/art.70125","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.70125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:50:42Z","timestamp":1790617842000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/art.70125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":60,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/art.70125"],"URL":"https:\/\/doi.org\/10.1002\/art.70125","archive":["Portico"],"relation":{},"ISSN":["2326-5191","2326-5205"],"issn-type":[{"value":"2326-5191","type":"print"},{"value":"2326-5205","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]},"assertion":[{"value":"2025-10-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}