{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T14:28:30Z","timestamp":1784903310091,"version":"3.55.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"1204","license":[{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Numerous observational studies suggest that modifiable risk factors contribute to the onset of atrial fibrillation (AF). This study aims to assess the causal relationship between 46 modifiable risk factors and AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Univariable, multivariate, and mediation Mendelian randomization (MR) analyses were employed to examine the causal relationship between 46 modifiable risk factors and AF. Summary-level data from genome-wide association studies (GWAS) meta-analysis and FinnGen consortium were utilized for both discovery and replication. The combined results were analyzed using a fixed-effect model to confirm the robustness of the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 46 modifiable risk factors, both the discovery dataset and the combined results confirmed that alcohol consumption, smoke consumption, job involves heavy manual or physical work, sleep apnea syndrome, trunk fat mass, body fat percentage, whole body fat mass, waist circumference, body mass index, basal metabolic rate, poor health status, diastolic blood pressure, systolic blood pressure, glycosylated hemoglobin type A1C (HbA1C), lipoprotein A, serum uric acid, coronary artery disease, myocardial infarction, heart failure, hypertension, hyperthyroidism, and negative emotions increased the risk of AF (P\u2009&amp;lt;\u2009.05 and false discovery rate\u2013adjusted P\u2009&amp;lt;\u2009.05). Conversely, college or university degree, impedance of whole body, and heart rate were associated with a decreased risk of AF (P\u2009&amp;lt;\u2009.05 and false discovery rate\u2013adjusted P\u2009&amp;lt;\u2009.05). Multivariate MR identified sleep apnea syndrome, basal metabolic rate, diastolic blood pressure, systolic blood pressure, HbA1C, lipoprotein A, serum uric acid, coronary artery disease, myocardial infarction, heart failure, and hypertension as risk factors for AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings offer new and comprehensive evidence demonstrating the confirmed causal effects of various risk factors on AF among Europeans. Larger-scale GWAS will be necessary to further validate these causal associations in the future.<\/jats:p>\n                    <jats:p>Highlights<\/jats:p>\n                    <jats:p>Our study investigated the causal association between 46 modifiable risk factors and AF under a two-sample MR framework. This comprehensive MR study confirmed that alcohol consumption, smoke consumption, job involves heavy manual or physical work, sleep apnea syndrome, trunk fat mass, body fat percentage, whole body fat mass, waist circumference, body mass index, basal metabolic rate, poor health status, diastolic blood pressure, systolic blood pressure, HbA1C, lipoprotein A, serum uric acid, coronary artery disease, myocardial infarction, heart failure, hypertension, hyperthyroidism, negative emotions, college or university degree, impedance of whole body, and heart rate contribute causally to the onset and development of AF. No significant association was found between lipid levels and AF.<\/jats:p>\n                    <jats:p>Key messages What is already known on this topic: Previous studies have identified several risk factors associated with AF, yet the precise causal relationships between these factors and the development of AF remain unclear, highlighting the need for further research. What this study adds: This study systematically evaluates the causal association of 46 modifiable risk factors with AF by combining data from two independent GWAS datasets. How this study might affect research, practice, or policy: The discovery of AF-related risk factors provides valuable knowledge for early identification and intervention strategies for AF patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/postmj\/qgaf141","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T11:52:48Z","timestamp":1754567568000},"page":"147-157","source":"Crossref","is-referenced-by-count":1,"title":["Insights into modifiable risk factors of atrial fibrillation: a comprehensive Mendelian randomization study"],"prefix":"10.1093","volume":"102","author":[{"given":"Xuexue","family":"Zhang","sequence":"first","affiliation":[{"name":"Shenzhen Traditional Chinese Medicine Hospital , No.1, Fuhua Road, Futian District, 518000 Shenzhen ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xujie","family":"Wang","sequence":"additional","affiliation":[{"name":"Xiyuan Hospital, China Academy of Chinese Medical Sciences , No. 1, Xiyuan Playground, Zhong Zhi Road, Hai Dian District, 100091 Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wantong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Xiyuan Hospital, China Academy of Chinese Medical Sciences , No. 1, Xiyuan Playground, Zhong Zhi Road, Hai Dian District, 100091 Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences , No. 1, Xiyuan Playground, Zhong Zhi Road, Hai Dian District, 100091 Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxuan","family":"Li","sequence":"additional","affiliation":[{"name":"Xiyuan Hospital, China Academy of Chinese Medical Sciences , No. 1, Xiyuan Playground, Zhong Zhi Road, Hai Dian District, 100091 Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8183-9945","authenticated-orcid":false,"given":"Qiuyan","family":"Li","sequence":"additional","affiliation":[{"name":"Xiyuan Hospital, China Academy of Chinese Medical Sciences , No. 1, Xiyuan Playground, Zhong Zhi Road, Hai Dian District, 100091 Beijing ,","place":["China"]},{"name":"Department of General Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences , No. 1, Xiyuan Playground, Zhong Zhi Road, Hai Dian District, 100091 Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,31]]},"reference":[{"key":"2026012308320272600_ref1","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1016\/j.jacc.2023.06.029","article-title":"Ablation to reduce atrial fibrillation burden and improve outcomes: JACC review topic of the week","volume":"82","author":"Schwennesen","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"2026012308320272600_ref2","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1038\/s41569-022-00820-8","article-title":"Epidemiology and modifiable risk factors for atrial fibrillation","volume":"20","author":"Elliott","year":"2023","journal-title":"Nat Rev Cardiol"},{"key":"2026012308320272600_ref3","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1001\/jama.2019.20144","article-title":"Improving outcomes in patients with atrial fibrillation and hypertension","volume":"323","author":"Estes","year":"2020","journal-title":"JAMA"},{"key":"2026012308320272600_ref4","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1161\/CIRCRESAHA.120.316340","article-title":"Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights","volume":"127","author":"Kornej","year":"2020","journal-title":"Circ Res"},{"key":"2026012308320272600_ref5","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur Heart J"},{"key":"2026012308320272600_ref6","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1177\/2047487318780435","article-title":"Tobacco smoking and the risk of atrial fibrillation: a systematic review and meta-analysis of prospective studies","volume":"25","author":"Aune","year":"2018","journal-title":"Eur J Prev Cardiol"},{"key":"2026012308320272600_ref7","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1016\/j.clnu.2023.07.002","article-title":"Omega-3 fatty acid supplements and risk of atrial fibrillation and \u2018micro-atrial fibrillation\u2019: a secondary analysis from the OMEMI trial","volume":"42","author":"Myhre","year":"2023","journal-title":"Clin Nutr"},{"key":"2026012308320272600_ref8","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12020479","article-title":"Alcohol consumption and the risk of incident atrial fibrillation: a meta-analysis","volume":"12","author":"Giannopoulos","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"2026012308320272600_ref9","doi-asserted-by":"publisher","first-page":"4180","DOI":"10.1093\/eurheartj\/ehab505","article-title":"Long-term night shift work is associated with the risk of atrial fibrillation and coronary heart disease","volume":"42","author":"Wang","year":"2021","journal-title":"Eur Heart J"},{"key":"2026012308320272600_ref10","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1177\/2047487320909065","article-title":"Caffeinated coffee consumption and risk of atrial fibrillation in two Spanish cohorts","volume":"28","author":"Bazal","year":"2021","journal-title":"Eur J Prev Cardiol"},{"key":"2026012308320272600_ref11","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.1016\/j.jacep.2020.08.008","article-title":"Body mass index, sex, and incident atrial fibrillation in diabetes: the ACCORD trial","volume":"6","author":"Singleton","year":"2020","journal-title":"JACC Clin Electrophysiol"},{"key":"2026012308320272600_ref12","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s10654-022-00914-0","article-title":"Blood pressure, hypertension and the risk of atrial fibrillation: a systematic review and meta-analysis of cohort studies","volume":"38","author":"Aune","year":"2023","journal-title":"Eur J Epidemiol"},{"key":"2026012308320272600_ref13","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1016\/j.jacc.2022.02.026","article-title":"Lipoprotein(a) and incident atrial fibrillation: leveraging nature\u2019s randomization to identify novel causal associations","volume":"79","author":"Kim","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026012308320272600_ref14","first-page":"e934007","article-title":"Serum uric acid levels in relation to atrial fibrillation: a case-control study","volume":"28","author":"Zhong","year":"2022","journal-title":"Med Sci Monit"},{"key":"2026012308320272600_ref15","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.ijcard.2010.10.039","article-title":"HbA1c and atrial fibrillation: a cross-sectional study in Japan","volume":"156","author":"Iguchi","year":"2012","journal-title":"Int J Cardiol"},{"key":"2026012308320272600_ref16","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.jchf.2019.03.005","article-title":"Heart failure and atrial fibrillation, like fire and fury","volume":"7","author":"Carlisle","year":"2019","journal-title":"JACC Heart Fail"},{"key":"2026012308320272600_ref17","doi-asserted-by":"publisher","first-page":"H1","DOI":"10.1152\/ajpheart.00702.2020","article-title":"Coronary heart disease and atrial fibrillation: a vicious cycle","volume":"320","author":"Liang","year":"2021","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2026012308320272600_ref18","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1177\/2047487317715769","article-title":"Atrial fibrillation and the risk for myocardial infarction, all-cause mortality and heart failure: a systematic review and meta-analysis","volume":"24","author":"Ruddox","year":"2017","journal-title":"Eur J Prev Cardiol"},{"key":"2026012308320272600_ref19","doi-asserted-by":"publisher","first-page":"179","DOI":"10.5498\/wjp.v14.i1.179","article-title":"Global epidemiology of mental disorder in atrial fibrillation between 1998-2021: a systematic review and meta-analysis","volume":"14","author":"Zhang","year":"2024","journal-title":"World J Psychiatry"},{"key":"2026012308320272600_ref20","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1001\/jama.2017.17219","article-title":"Mendelian randomization","volume":"318","author":"Emdin","year":"2017","journal-title":"JAMA"},{"key":"2026012308320272600_ref21","doi-asserted-by":"publisher","first-page":"1234","DOI":"10.1038\/s41588-018-0171-3","article-title":"Biobank-driven genomic discovery yields new insight into atrial fibrillation biology","volume":"50","author":"Nielsen","year":"2018","journal-title":"Nat Genet"},{"key":"2026012308320272600_ref22","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1002\/hep.32728","article-title":"The associations between modifiable risk factors and nonalcoholic fatty liver disease: a comprehensive mendelian randomization study","volume":"77","author":"Xie","year":"2023","journal-title":"Hepatology"},{"key":"2026012308320272600_ref23","doi-asserted-by":"publisher","first-page":"e2331558","DOI":"10.1001\/jamanetworkopen.2023.31558","article-title":"Genetic variants, serum 25-hydroxyvitamin D levels, and sarcopenia: a mendelian randomization analysis","volume":"6","author":"Sha","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026012308320272600_ref24","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1093\/ije\/dyy101","article-title":"Improving the visualization, interpretation and analysis of two-sample summary data mendelian randomization via the radial plot and radial regression","volume":"47","author":"Bowden","year":"2018","journal-title":"Int J Epidemiol"},{"key":"2026012308320272600_ref25","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.jare.2023.05.008","article-title":"Insights into modifiable risk factors of erectile dysfunction, a wide-angled mendelian randomization study","volume":"58","author":"Xiong","year":"2024","journal-title":"J Adv Res"},{"key":"2026012308320272600_ref26","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a038984","article-title":"Multivariable mendelian randomization and mediation","volume":"11","author":"Sanderson","year":"2021","journal-title":"Cold Spring Harb Perspect Med"},{"key":"2026012308320272600_ref27","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1186\/s12933-023-01974-6","article-title":"Causal associations between type 1 diabetes mellitus and cardiovascular diseases: a mendelian randomization study","volume":"22","author":"Liu","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"2026012308320272600_ref28","doi-asserted-by":"publisher","DOI":"10.1111\/eci.14194","article-title":"Associations of 50 modifiable risk factors with atrial fibrillation using mendelian randomization analysis","volume":"54","author":"Zhang","year":"2024","journal-title":"Eur J Clin Investig"},{"key":"2026012308320272600_ref29","doi-asserted-by":"publisher","first-page":"52","DOI":"10.11909\/j.issn.1671-5411.2022.01.005","article-title":"Alcohol consumption in relation to the incidence of atrial fibrillation in an elderly Chinese population","volume":"19","author":"Ye","year":"2022","journal-title":"J Geriatr Cardiol"},{"key":"2026012308320272600_ref30","doi-asserted-by":"publisher","first-page":"e2229799","DOI":"10.1001\/jamanetworkopen.2022.29799","article-title":"Habitual alcohol intake and risk of atrial fibrillation in young adults in Korea","volume":"5","author":"Han","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2026012308320272600_ref31","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1093\/eurjpc\/zwad270","article-title":"Changes in alcohol consumption habits and risk of atrial fibrillation: a nationwide population-based study","volume":"31","author":"Lee","year":"2024","journal-title":"Eur J Prev Cardiol"},{"key":"2026012308320272600_ref32","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1177\/2047487316655464","article-title":"Occupational physical activity, but not leisure-time physical activity increases the risk of atrial fibrillation: the Copenhagen City heart study","volume":"23","author":"Skielboe","year":"2016","journal-title":"Eur J Prev Cardiol"},{"key":"2026012308320272600_ref33","doi-asserted-by":"publisher","first-page":"e29443","DOI":"10.1097\/MD.0000000000029443","article-title":"Association between obstructive sleep apnea (OSA) and atrial fibrillation (AF): a dose-response meta-analysis","volume":"101","author":"Zhang","year":"2022","journal-title":"Medicine (Baltimore)"},{"key":"2026012308320272600_ref34","doi-asserted-by":"publisher","first-page":"1516","DOI":"10.1016\/j.cjca.2014.10.014","article-title":"Obstructive sleep apnea as a predictor of atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis","volume":"30","author":"Qaddoura","year":"2014","journal-title":"Can J Cardiol"},{"key":"2026012308320272600_ref35","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1136\/jech-2019-212720","article-title":"Socioeconomic position and risk of atrial fibrillation: a nationwide Danish cohort study","volume":"74","author":"Lunde","year":"2020","journal-title":"J Epidemiol Community Health"},{"key":"2026012308320272600_ref36","doi-asserted-by":"publisher","first-page":"2022","DOI":"10.1016\/j.jacc.2017.09.002","article-title":"Obesity and atrial fibrillation prevalence, pathogenesis, and prognosis: effects of weight loss and exercise","volume":"70","author":"Lavie","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2026012308320272600_ref37","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jacep.2015.04.004","article-title":"Obesity and the risk of incident, post-operative, and post-ablation atrial fibrillation: a meta-analysis of 626,603 individuals in 51 studies","volume":"1","author":"Wong","year":"2015","journal-title":"JACC Clin Electrophysiol"},{"key":"2026012308320272600_ref38","doi-asserted-by":"publisher","first-page":"e750","DOI":"10.1161\/CIR.0000000000000748","article-title":"Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American Heart Association","volume":"141","author":"Chung","year":"2020","journal-title":"Circulation."},{"key":"2026012308320272600_ref39","doi-asserted-by":"publisher","first-page":"20190874","DOI":"10.1259\/bjr.20190874","article-title":"Measurement of total and visceral fat mass in young adult women: a comparison of MRI with anthropometric measurements with and without bioelectrical impedance analysis","volume":"93","author":"Froelich","year":"2020","journal-title":"Br J Radiol"},{"key":"2026012308320272600_ref40","doi-asserted-by":"publisher","first-page":"e14153","DOI":"10.1111\/eci.14153","article-title":"The association between the basal metabolic rate and cardiovascular disease: a two-sample mendelian randomization study","volume":"54","author":"Chen","year":"2024","journal-title":"Eur J Clin Investig"},{"key":"2026012308320272600_ref41","doi-asserted-by":"publisher","first-page":"e031447","DOI":"10.1161\/JAHA.123.031447","article-title":"Causal effects of basal metabolic rate on cardiovascular disease: a bidirectional mendelian randomization study","volume":"13","author":"Zhao","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"2026012308320272600_ref42","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1016\/j.jacc.2022.02.018","article-title":"Elevated lipoprotein(a) and risk of atrial fibrillation: an observational and mendelian randomization study","volume":"79","author":"Mohammadi-Shemirani","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026012308320272600_ref43","doi-asserted-by":"publisher","first-page":"e956","DOI":"10.1210\/clinem\/dgad250","article-title":"Iodine-induced hyperthyroidism and long-term risks of incident atrial fibrillation and flutter","volume":"108","author":"Inoue","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"2026012308320272600_ref44","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1016\/j.jacc.2022.06.017","article-title":"Severe mental illness and cardiovascular disease: JACC state-of-the-art review","volume":"80","author":"Goldfarb","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026012308320272600_ref45","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1080\/13651501.2023.2248214","article-title":"Depression and atrial fibrillation in a reciprocal liaison: a neuro-cardiac link","volume":"27","author":"Manolis","year":"2023","journal-title":"Int J Psychiatry Clin Pract"},{"key":"2026012308320272600_ref46","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.ijcard.2022.05.048","article-title":"Psychological factors and risk of atrial fibrillation: a meta-analysis and systematic review","volume":"362","author":"Wu","year":"2022","journal-title":"Int J Cardiol"},{"key":"2026012308320272600_ref47","doi-asserted-by":"publisher","first-page":"e240219","DOI":"10.1001\/jamanetworkopen.2024.0219","article-title":"Physical activity and weight loss among adults with type 2 diabetes and overweight or obesity: a post hoc analysis of the look AHEAD trial","volume":"7","author":"Huang","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026012308320272600_ref48","doi-asserted-by":"publisher","first-page":"e002489","DOI":"10.1136\/bmjdrc-2021-002489","article-title":"Adiposity and risks of vascular and non-vascular mortality among Chinese adults with type 2 diabetes: a 10-year prospective study","volume":"10","author":"Iona","year":"2022","journal-title":"BMJ Open Diabetes Res Care"},{"key":"2026012308320272600_ref49","doi-asserted-by":"publisher","first-page":"195","DOI":"10.4111\/icu.20200438","article-title":"A high basal metabolic rate is an independent predictor of stone recurrence in obese patients","volume":"62","author":"Kang","year":"2021","journal-title":"Investig Clin Urol"},{"key":"2026012308320272600_ref50","doi-asserted-by":"crossref","first-page":"28","DOI":"10.15420\/aer.2018.76.2","article-title":"Obesity and atrial fibrillation: epidemiology, pathophysiology and novel therapeutic opportunities","volume":"8","author":"Vyas","year":"2019","journal-title":"Arrhythm Electrophysiol Rev"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/102\/1204\/147\/64169139\/qgaf141.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/102\/1204\/147\/64169139\/qgaf141.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T13:32:11Z","timestamp":1769175131000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/102\/1204\/147\/8244884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,31]]},"references-count":50,"journal-issue":{"issue":"1204","published-online":{"date-parts":[[2025,8,31]]},"published-print":{"date-parts":[[2026,1,23]]}},"URL":"https:\/\/doi.org\/10.1093\/postmj\/qgaf141","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2025,8,31]]}}}