{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:08:49Z","timestamp":1787756929577,"version":"build-2784847793"},"reference-count":50,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T00:00:00Z","timestamp":1742083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["22K17386"],"award-info":[{"award-number":["22K17386"]}]},{"name":"JSPS KAKENHI","award":["JPMJCE1302"],"award-info":[{"award-number":["JPMJCE1302"]}]},{"name":"JSPS KAKENHI","award":["JPMJCA2201"],"award-info":[{"award-number":["JPMJCA2201"]}]},{"name":"JSPS KAKENHI","award":["JPMJPF2210"],"award-info":[{"award-number":["JPMJPF2210"]}]},{"name":"JST","award":["22K17386"],"award-info":[{"award-number":["22K17386"]}]},{"name":"JST","award":["JPMJCE1302"],"award-info":[{"award-number":["JPMJCE1302"]}]},{"name":"JST","award":["JPMJCA2201"],"award-info":[{"award-number":["JPMJCA2201"]}]},{"name":"JST","award":["JPMJPF2210"],"award-info":[{"award-number":["JPMJPF2210"]}]},{"name":"COI","award":["22K17386"],"award-info":[{"award-number":["22K17386"]}]},{"name":"COI","award":["JPMJCE1302"],"award-info":[{"award-number":["JPMJCE1302"]}]},{"name":"COI","award":["JPMJCA2201"],"award-info":[{"award-number":["JPMJCA2201"]}]},{"name":"COI","award":["JPMJPF2210"],"award-info":[{"award-number":["JPMJPF2210"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objective: This study investigated the relationship between the composition of oral microbiota and metabolic dysfunction-associated steatotic liver disease (MASLD) in the general population. Methods: In total, 712 participants in a health check-up project were divided into four oral microbiota patterns by principal component analysis and cluster analysis; they were included in Neisseria, Streptococcus, Fusobacterium, and Veillonella groups. The Neisseria group had the largest number of patients and was used as a reference group to compare the incidence of MASLD and cardiometabolic criteria with the other groups. Results: In a multivariate analysis, the Veillonella group was a risk factor for MASLD independent of cardiometabolic criteria compared with the Neisseria group. The correlation between oral bacterial species and MASLD-related items showed that Neisseria was negatively correlated with controlled attenuation parameters, body mass index, waist circumference, hemoglobin A1c, alanine aminotransferase, and fatty liver index. Veillonella showed a positive correlation with controlled attenuation parameters, waist circumference, body mass index, blood pressure, triglycerides, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and fatty liver index, and a negative correlation with high-density lipoprotein cholesterol. In contrast, the Streptococcus and Fusobacterium groups were not clearly associated with MASLD. Conclusions: Maintaining oral hygiene and preventing periodontitis may contribute to preventing MASLD and extending a healthy lifespan.<\/jats:p>","DOI":"10.3390\/jcm14062013","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T04:29:28Z","timestamp":1742185768000},"page":"2013","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Effect of Oral Microbiota Composition on Metabolic Dysfunction-Associated Steatotic Liver Disease in the General Population"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5569-7093","authenticated-orcid":false,"given":"Satoshi","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikara","family":"Iino","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Furusawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3897-5546","authenticated-orcid":false,"given":"Kenta","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1690-5923","authenticated-orcid":false,"given":"Daisuke","family":"Chinda","sequence":"additional","affiliation":[{"name":"Division of Endoscopy, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaori","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Preemptive Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6657-6446","authenticated-orcid":false,"given":"Tatsuya","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Preemptive Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4190-5151","authenticated-orcid":false,"given":"Shigeyuki","family":"Nakaji","sequence":"additional","affiliation":[{"name":"Department of Preemptive Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinsaku","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotake","family":"Sakuraba","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s11892-024-01542-6","article-title":"Metabolic dysfunction-associated steatotic liver disease and atherosclerosis","volume":"24","year":"2024","journal-title":"Curr. Diab Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"8377","DOI":"10.3748\/wjg.v20.i26.8377","article-title":"Non-alcoholic fatty liver disease and diabetes: From physiopathological interplay to diagnosis and treatment","volume":"20","author":"Leite","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/S1542-3565(04)00014-X","article-title":"Nonalcoholic fatty liver disease in patients with type 2 diabetes","volume":"2","author":"Younossi","year":"2004","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"78","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/S2468-1253(22)00165-0","article-title":"The prevalence and incidence of NAFLD worldwide: A systematic review and meta-analysis","volume":"7","author":"Riazi","year":"2022","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_6","first-page":"72","article-title":"Prevalence of periodontal disease, its association with systemic diseases and prevention","volume":"11","author":"Nazir","year":"2017","journal-title":"Int. J. Health Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/prd.12270","article-title":"Diabetes as a potential risk for periodontitis: Association studies","volume":"83","author":"Genco","year":"2020","journal-title":"Periodontology 2000"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/MBC.0000000000000928","article-title":"Periodontitis, coronary heart disease and myocardial infarction: Treat one, benefit all","volume":"31","author":"Nocini","year":"2020","journal-title":"Blood Coagul. Fibrinolysis"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"852","DOI":"10.37349\/emed.2024.00260","article-title":"Oral health conditions and hygiene procedures in patients with Parkinson\u2019s disease: A systematic review","volume":"5","author":"Pardo","year":"2024","journal-title":"Explor. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Shine, B.K., Son, M., Moon, S.Y., and Han, S.H. (2024). Metabolic Dysfunction-Associated Steatotic Liver Disease and the Risk of Chronic Periodontitis: A Nationwide Cohort Study. Nutrients, 17.","DOI":"10.3390\/nu17010125"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/j.jds.2023.03.012","article-title":"The role of microbiome in the pathogenesis of oral-gut-liver axis between periodontitis and nonalcoholic fatty liver disease","volume":"18","author":"Chen","year":"2023","journal-title":"J. Dent. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Konkel, J.E., O\u2019Boyle, C., and Krishnan, S. (2019). Distal Consequences of Oral Inflammation. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.01403"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/prd.12387","article-title":"Periodontal disease-related nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: An emerging concept of oral-liver axis","volume":"87","author":"Kuraji","year":"2021","journal-title":"Periodontol. 2000"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/prd.12002","article-title":"Inflammatory and immune pathways in the pathogenesis of periodontal disease","volume":"64","author":"Cekici","year":"2014","journal-title":"Periodontol. 2000"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"20503121211002606","DOI":"10.1177\/20503121211002606","article-title":"Social innovation for life expectancy extension utilizing a platform-centered system used in the Iwaki health promotion project: A protocol paper","volume":"9","author":"Nakaji","year":"2021","journal-title":"SAGE Open Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1111\/hepr.12094","article-title":"Utility of controlled attenuation parameter measurement for assessing liver steatosis in Japanese patients with chronic liver diseases","volume":"43","author":"Masaki","year":"2013","journal-title":"Hepatol. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Takahashi, S., Tomita, J., Nishioka, K., Hisada, T., and Nishijima, M. (2014). Development of a prokaryotic universal primer for simultaneous analysis of Bacteria and Archaea using next-generation sequencing. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0105592"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e2584","DOI":"10.7717\/peerj.2584","article-title":"VSEARCH: A versatile open source tool for metagenomics","volume":"4","author":"Rognes","year":"2016","journal-title":"PeerJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"5261","DOI":"10.1128\/AEM.00062-07","article-title":"Naive Bayesian classifier for rapid assignment of rRNA sequences into the new bacterial taxonomy","volume":"73","author":"Wang","year":"2007","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1111\/jcpe.12060","article-title":"Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases","volume":"40","author":"Schenkein","year":"2013","journal-title":"J. Clin. Periodontol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.jebdp.2018.04.001","article-title":"Tumor Necrosis Factor-alpha in Gingival Crevicular Fluid as a Diagnostic Marker for Periodontal Diseases: A Systematic Review","volume":"18","author":"Madureira","year":"2018","journal-title":"J. Evid. Based Dent. Pract."},{"key":"ref_22","first-page":"244","article-title":"Potential role of periodontal infection in respiratory diseases\u2014A review","volume":"6","author":"Bansal","year":"2013","journal-title":"J. Med. Life"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/00063198-200305000-00002","article-title":"Respiratory infection: How important is oral health?","volume":"9","author":"Mojon","year":"2003","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_24","first-page":"340","article-title":"Oral health and respiratory infection","volume":"68","author":"Mojon","year":"2002","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/prd.12422","article-title":"Osteoporosis and periodontal diseases\u2014An update on their association and mechanistic links","volume":"89","author":"Yu","year":"2022","journal-title":"Periodontology 2000"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.clnesp.2022.12.030","article-title":"Oral microbiota and liver diseases","volume":"54","author":"Elghannam","year":"2023","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Lei, Y., Li, S., He, M., Ao, Z., Wang, J., Wu, Q., and Wang, Q. (2023). Oral Pathogenic Bacteria and the Oral-Gut-Liver Axis: A New Understanding of Chronic Liver Diseases. Diagnostics, 13.","DOI":"10.3390\/diagnostics13213324"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"201","DOI":"10.2334\/josnusd.16-0856","article-title":"The oral microbiome and human health","volume":"59","author":"Yamashita","year":"2017","journal-title":"J. Oral Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1038\/ismej.2008.91","article-title":"The ecological proportion of indigenous bacterial populations in saliva is correlated with oral health status","volume":"3","author":"Takeshita","year":"2009","journal-title":"Isme J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1161\/CIRCRESAHA.116.309219","article-title":"Gut Microbiome Associates With Lifetime Cardiovascular Disease Risk Profile Among Bogalusa Heart Study Participants","volume":"119","author":"Kelly","year":"2016","journal-title":"Circ. Res."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Takeshita, T., Kageyama, S., Furuta, M., Tsuboi, H., Takeuchi, K., Shibata, Y., Shimazaki, Y., Akifusa, S., Ninomiya, T., and Kiyohara, Y. (2016). Bacterial diversity in saliva and oral health-related conditions: The Hisayama Study. Sci. Rep., 6.","DOI":"10.1038\/srep22164"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Wang, M., Yan, L.-Y., Qiao, C.-Y., Zheng, C.-C., Niu, C.-G., Huang, Z.-W., and Pan, Y.-H. (2023). Ecological shifts of salivary microbiota associated with metabolic-associated fatty liver disease. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1131255"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Zhao, F., Dong, T., Yuan, K.Y., Wang, N.J., Xia, F.Z., Liu, D., Wang, Z.M., Ma, R., Lu, Y.L., and Huang, Z.W. (2020). Shifts in the Bacterial Community of Supragingival Plaque Associated With Metabolic-Associated Fatty Liver Disease. Front. Cell Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.581888"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Dong, L., Yin, J., Zhao, J., Ma, S.R., Wang, H.R., Wang, M., Chen, W., and Wei, W.Q. (2018). Microbial Similarity and Preference for Specific Sites in Healthy Oral Cavity and Esophagus. Front. Microbiol., 9.","DOI":"10.3389\/fmicb.2018.01603"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/jcpe.12811","article-title":"Do different probing depths exhibit striking differences in microbial profiles?","volume":"45","author":"McCulloch","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zaura, E., Keijser, B.J., Huse, S.M., and Crielaard, W. (2009). Defining the healthy \u201ccore microbiome\u201d of oral microbial communities. BMC Microbiol., 9.","DOI":"10.1186\/1471-2180-9-259"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.niox.2021.09.001","article-title":"Inorganic nitrate: A potential prebiotic for oral microbiota dysbiosis associated with type 2 diabetes","volume":"116","author":"Bahadoran","year":"2021","journal-title":"Nitric Oxide"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1007\/s12020-020-02269-6","article-title":"The oral microbiome profile and biomarker in Chinese type 2 diabetes mellitus patients","volume":"68","author":"Chen","year":"2020","journal-title":"Endocrine"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Li, B.Z., Zhou, H.Y., Guo, B., Chen, W.J., Tao, J.H., Cao, N.W., Chu, X.J., and Meng, X. (2020). Dysbiosis of oral microbiota is associated with systemic lupus erythematosus. Arch. Oral. Biol., 113.","DOI":"10.1016\/j.archoralbio.2020.104708"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.bj.2018.12.001","article-title":"Association between periodontal pathogens and systemic disease","volume":"42","author":"Bui","year":"2019","journal-title":"Biomed. J."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Zhai, Q., Wu, H., Zheng, S., Zhong, T., Du, C., Yuan, J., Peng, J., Cai, C., and Li, J. (2023). Association between gut microbiota and NAFLD\/NASH: A bidirectional two-sample Mendelian randomization study. Front. Cell Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1294826"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1038\/nature13568","article-title":"Alterations of the human gut microbiome in liver cirrhosis","volume":"513","author":"Qin","year":"2014","journal-title":"Nature"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Palmas, V., Pisanu, S., Madau, V., Casula, E., Deledda, A., Cusano, R., Uva, P., Vascellari, S., Loviselli, A., and Manzin, A. (2021). Gut microbiota markers associated with obesity and overweight in Italian adults. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-84928-w"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1038\/s41366-021-00904-4","article-title":"A predictive regression model of the obesity-related inflammatory status based on gut microbiota composition","volume":"45","author":"Aranaz","year":"2021","journal-title":"Int. J. Obes."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.jare.2022.03.007","article-title":"Roles of oral microbiota and oral-gut microbial transmission in hypertension","volume":"43","author":"Chen","year":"2023","journal-title":"J. Adv. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1002\/lipd.12410","article-title":"Characteristics of intestinal flora in nonobese nonalcoholic fatty liver disease patients and the impact of ursodeoxycholic acid treatment on these features","volume":"59","author":"Wang","year":"2024","journal-title":"Lipids"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Huang, F., Lyu, B., Xie, F., Li, F., Xing, Y., Han, Z., Lai, J., Ma, J., Zou, Y., and Zeng, H. (2024). From gut to liver: Unveiling the differences of intestinal microbiota in NAFL and NASH patients. Front. Microbiol., 15.","DOI":"10.3389\/fmicb.2024.1366744"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/S0929-6646(09)60060-7","article-title":"Pyogenic liver abscess with Prevotella species and Fusobacterium necrophorum as causative pathogens in an immunocompetent patient","volume":"108","author":"Lei","year":"2009","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Jiang, W., Wu, N., Wang, X., Chi, Y., Zhang, Y., Qiu, X., Hu, Y., Li, J., and Liu, Y. (2015). Dysbiosis gut microbiota associated with inflammation and impaired mucosal immune function in intestine of humans with non-alcoholic fatty liver disease. Sci. Rep., 5.","DOI":"10.1038\/srep08096"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e000329","DOI":"10.1136\/bmjgast-2019-000329","article-title":"Relationship between Streptococcus mutans expressing Cnm in the oral cavity and non-alcoholic steatohepatitis: A pilot study","volume":"6","author":"Tonomura","year":"2019","journal-title":"BMJ Open Gastroenterol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/6\/2013\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:54:36Z","timestamp":1760028876000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/6\/2013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,16]]},"references-count":50,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["jcm14062013"],"URL":"https:\/\/doi.org\/10.3390\/jcm14062013","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,16]]}}}