{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:34:10Z","timestamp":1791855250386,"version":"4.3.4"},"reference-count":51,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: MiRNAs have emerged as minimally invasive biomarkers with considerable potential for the early detection of oral squamous cell carcinoma (OSCC). Although numerous studies have evaluated circulating miRNAs across different biofluids, the comparative diagnostic performance of saliva-, serum-, and plasma-derived miRNAs has not been systematically clarified. Methods: A meta-analysis was performed by screening PubMed, MEDLINE, Scopus, CINAHL, and related databases. Nineteen eligible studies evaluating miRNA-based assays in saliva, serum, or plasma were included. A random-effects bivariate model was used to calculate pooled sensitivity, specificity, and area under the HSROC curve. Meta-regression using log diagnostic odds ratio (lnDOR) examined whether biofluid type significantly influenced diagnostic performance. Results: Salivary miRNAs showed a pooled sensitivity of 0.76 (95% CI: 0.68\u20130.82; I2 = 84.69%), specificity of 0.79 (95% CI: 0.70\u20130.85; I2 = 70.41%), and an AUC of 0.84 (95% CI: 0.80\u20130.87). Plasma miRNAs produced comparable results with a pooled sensitivity of 0.77 (95% CI: 0.61\u20130.88; I2 = 90.45%), specificity of 0.79 (95% CI: 0.63\u20130.89; I2 = 80.20%), and an AUC of 0.85 (95% CI: 0.81\u20130.89). Serum-derived miRNAs demonstrated the highest accuracy with a pooled sensitivity of 0.82 (95% CI: 0.70\u20130.90; I2 = 76.92%), specificity of 0.88 (95% CI: 0.75\u20130.95; I2 = 74.87%), and an AUC of 0.91 (95% CI: 0.89\u20130.94). Despite serum\u2019s numerically superior performance, meta-regression revealed no significant matrix effect (Wald \u03c72 = 0.20, p = 0.903). Conclusions: Although serum-derived miRNAs performed best overall, biofluid type was not a statistically significant determinant of diagnostic performance.<\/jats:p>","DOI":"10.3390\/jpm16010052","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T11:39:37Z","timestamp":1768563577000},"page":"52","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparative Meta-Analysis: Salivary, Plasma, and Serum miRNA Profiles for Oral Squamous Cell Carcinoma Detection"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1345-4450","authenticated-orcid":false,"given":"Arbi","family":"Wijaya","sequence":"first","affiliation":[{"name":"Division of Oral Oncology and Surgical Sciences, Graduate School of Dentistry, Tohoku University, Sendai 908-0872, Miyagi, Japan"},{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Indonesia, Central Jakarta 10430, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6182-5688","authenticated-orcid":false,"given":"Vera","family":"Julia","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Indonesia, Central Jakarta 10430, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0402-7468","authenticated-orcid":false,"given":"Nurtami","family":"Soedarsono","sequence":"additional","affiliation":[{"name":"Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Central Jakarta 10430, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turmidzi","family":"Fath","sequence":"additional","affiliation":[{"name":"Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Central Jakarta 10430, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayu","family":"Brahma","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Dharmais National Cancer Center Hospital, West Jakarta 11420, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9371-5351","authenticated-orcid":false,"given":"Alif Rizqy","family":"Soeratman","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Dharmais National Cancer Center Hospital, West Jakarta 11420, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3609-7281","authenticated-orcid":false,"given":"Denni Joko","family":"Purwanto","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Dharmais National Cancer Center Hospital, West Jakarta 11420, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaro","family":"Higashi","sequence":"additional","affiliation":[{"name":"Division of Oral Oncology and Surgical Sciences, Graduate School of Dentistry, Tohoku University, Sendai 908-0872, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Miyakoshi","sequence":"additional","affiliation":[{"name":"Division of Oral Oncology and Surgical Sciences, Graduate School of Dentistry, Tohoku University, Sendai 908-0872, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9964-1785","authenticated-orcid":false,"given":"Tsuyoshi","family":"Sugiura","sequence":"additional","affiliation":[{"name":"Division of Oral Oncology and Surgical Sciences, Graduate School of Dentistry, Tohoku University, Sendai 908-0872, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12957-018-1550-z","article-title":"Improved survival among oral cancer patients: Findings from a retrospective study at a tertiary care cancer centre in rural Kerala, India","volume":"17","author":"Thavarool","year":"2019","journal-title":"World J. Surg. Oncol."},{"key":"ref_2","first-page":"394","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"178","DOI":"10.5114\/wo.2017.68628","article-title":"The prevalence of squamous cell carcinoma in different sites of oral cavity at our Rural Health Care Centre in Loni, Maharashtra\u2013a retrospective 10-year study","volume":"2","author":"Tandon","year":"2017","journal-title":"Wsp\u00f3\u0142czesna Onkol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Su, Y.F., Chen, Y.J., Tsai, F.T., Li, W.C., Hsu, M.L., Wang, D.H., and Yang, C.C. (2021). Current insights into oral cancer diagnostics. Diagnostics, 11.","DOI":"10.3390\/diagnostics11071287"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3365","DOI":"10.1038\/s41598-021-82635-0","article-title":"Identification of potential salivary biomarker panels for oral squamous cell carcinoma","volume":"11","author":"Jain","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Bouaoud, J., Bossi, P., Elkabets, M., Schmitz, S., van Kempen, L.C., Martinez, P., and Saintigny, P. (2022). Unmet Needs and Perspectives in Oral Cancer Prevention. Cancers, 14.","DOI":"10.3390\/cancers14071815"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e1754","DOI":"10.1002\/wrna.1754","article-title":"Noncoding RNAs in oral cancer","volume":"14","author":"Balakittnen","year":"2023","journal-title":"Wiley Interdiscip. Rev. RNA"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Ortiz-Quintero, B. (2020). Extracellular micrornas as intercellular mediators and noninvasive biomarkers of cancer. Cancers, 12.","DOI":"10.3390\/cancers12113455"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Khan, S., Zhang, D.Y., Zhang, J.Y., Hayat, M.K., Ren, J., Nasir, S., and Bai, Q. (2022). The Key Role of microRNAs in Initiation and Progression of Hepatocellular Carcinoma. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.950374"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Pekarek, L., Torres-Carranza, D., Fraile-Martinez, O., Garc\u00eda-Montero, C., Pekarek, T., Saez, M.A., and Ortega, M.A. (2023). An Overview of the Role of MicroRNAs on Carcinogenesis: A Focus on Cell Cycle, Angiogenesis and Metastasis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24087268"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Higashi, Y., Nakamura, K., Takaoka, R., Tani, M., Noma, Y., Mori, K., and Sugiura, T. (2023). Identification of Neck Lymph Node Metastasis-Specific microRNA\u2014Implication for Use in Monitoring or Prediction of Neck Lymph Node Metastasis. Cancers, 15.","DOI":"10.3390\/cancers15153769"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e1662","DOI":"10.1002\/wrna.1662","article-title":"microRNA-based diagnostic and therapeutic applications in cancer medicine","volume":"12","author":"Sempere","year":"2021","journal-title":"Wiley Interdiscip. Rev. RNA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"10306","DOI":"10.1038\/s41598-018-28748-5","article-title":"Stability of Circulating Exosomal miRNAs in Healthy Subjects article","volume":"8","author":"Gil","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_14","first-page":"117","article-title":"The power of microRNAs as diagnostic and prognostic biomarkers in liquid biopsies","volume":"3","author":"Quirico","year":"2020","journal-title":"Cancer Drug Resist."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1038\/s41598-024-52681-5","article-title":"Analysis of the longitudinal stability of human plasma miRNAs and implications for disease biomarkers","volume":"14","author":"Sandau","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ncrna.2025.08.001","article-title":"Stability of microRNAs in serum and plasma reveal promise as a circulating biomarker","volume":"15","author":"Katayama","year":"2025","journal-title":"Noncoding RNA Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Kupec, T., Bleilevens, A., Iborra, S., Najjari, L., Wittenborn, J., Maurer, J., and Stickeler, E. (2022). Stability of circulating microRNAs in serum. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0268958"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Liu, D., Xin, Z., Guo, S., Li, S., Cheng, J., and Jiang, H. (2021). Blood and Salivary MicroRNAs for Diagnosis of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. J. Oral Maxillofac. Surg., 79.","DOI":"10.1016\/j.joms.2020.12.043"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1038\/s41368-023-00273-w","article-title":"A novel saliva-based miRNA profile to diagnose and predict oral cancer","volume":"16","author":"Balakittnen","year":"2024","journal-title":"Int. J. Oral. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Tarrad, N.A.F., Hassan, S., Shaker, O.G., and AbdelKawy, M. (2023). \u201cSalivary LINC00657 and miRNA-106a as diagnostic biomarkers for oral squamous cell carcinoma, an observational diagnostic study\u201d. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03726-0"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1007\/s12105-023-01600-7","article-title":"Evaluation of Diagnostic Significance of Salivary miRNA-184 and miRNA-21 in Oral Squamous Cell Carcinoma and Oral Potentially Malignant Disorders","volume":"17","author":"Garg","year":"2023","journal-title":"Head. Neck Pathol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Scholtz, B., Horv\u00e1th, J., Tar, I., Kiss, C., and M\u00e1rton, I.J. (2022). Salivary miR-31-5p, miR-345-3p, and miR-424-3p Are Reliable Biomarkers in Patients with Oral Squamous Cell Carcinoma. Pathogens, 11.","DOI":"10.3390\/pathogens11020229"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Mehterov, N., Sacconi, A., Pulito, C., Vladimirov, B., Haralanov, G., Pazardjikliev, D., and Sarafian, V. (2022). A novel panel of clinically relevant miRNAs signature accurately differentiates oral cancer from normal mucosa. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.1072579"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2987","DOI":"10.7150\/thno.45157","article-title":"Genome-wide study of salivary miRNAs identifies miR-423-5p as promising diagnostic and prognostic biomarker in oral squamous cell carcinoma","volume":"11","author":"Romani","year":"2021","journal-title":"Theranostics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"109553","DOI":"10.1016\/j.biopha.2019.109553","article-title":"Salivary exosomal miR-24-3p serves as a potential detective biomarker for oral squamous cell carcinoma screening","volume":"121","author":"He","year":"2020","journal-title":"Biomed. Pharmacother."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"99990","DOI":"10.18632\/oncotarget.21725","article-title":"Salivary miRNA panel to detect HPV-positive and HPV-negative head and neck cancer patients","volume":"8","author":"Wan","year":"2017","journal-title":"Oncotarget"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s13402-015-0259-z","article-title":"Identification of miR-139-5p as a saliva biomarker for tongue squamous cell carcinoma: A pilot study","volume":"39","author":"Duz","year":"2016","journal-title":"Cell. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1111\/odi.12340","article-title":"Salivary microRNAs in oral cancer","volume":"21","author":"Zahran","year":"2015","journal-title":"Oral. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.1038\/s41598-023-28550-y","article-title":"A circulating microRNA panel as a novel dynamic monitor for oral squamous cell carcinoma","volume":"13","author":"Piao","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"105627","DOI":"10.1016\/j.archoralbio.2023.105627","article-title":"MiRNAs as non-invasive biomarkers in the serum of Oral Squamous Cell Carcinoma (OSCC) and Oral Potentially Malignant Disorder (OPMD) patients","volume":"147","author":"Mazumder","year":"2023","journal-title":"Arch Oral Biol"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Nakamura, K., Hiyake, N., Hamada, T., Yokoyama, S., Mori, K., Yamashiro, K., and Sugiura, T. (2021). Circulating microRNA panel as a potential novel biomarker for oral squamous cell carcinoma diagnosis. Cancers, 13.","DOI":"10.3390\/cancers13030449"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"8169","DOI":"10.1111\/jcmm.16598","article-title":"MicroRNA-206 has a bright application prospect in the diagnosis of cases with oral cancer","volume":"25","author":"Wang","year":"2021","journal-title":"J. Cell. Mol. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/jop.12959","article-title":"Evaluation of circulating serum 3 types of microRNA as biomarkers of oral squamous cell carcinoma; A pilot study","volume":"49","author":"Karimi","year":"2020","journal-title":"J. Oral Pathol. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"333","DOI":"10.3233\/CBM-181265","article-title":"Diagnostic and prognostic value of serum miR-99a expression in oral squamous cell carcinoma","volume":"23","author":"Chen","year":"2018","journal-title":"Cancer Biomark."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Chang, Y.A., Weng, S.L., Yang, S.F., Chou, C.H., Huang, W.C., Tu, S.J., and Huang, H.D. (2018). A three\u2013MicroRNA signature as a potential biomarker for the early detection of oral cancer. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19030758"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Tachibana, H., Sho, R., Takeda, Y., Zhang, X., Yoshida, Y., Narimatsu, H., and Iino, M. (2016). Circulating miR-223 in oral cancer: Its potential as a novel diagnostic biomarker and therapeutic target. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0159693"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.clinbiochem.2014.11.020","article-title":"Combined determination of circulating miR-196a and miR-196b levels produces high sensitivity and specificity for early detection of oral cancer","volume":"48","author":"Lu","year":"2015","journal-title":"Clin. Biochem."},{"key":"ref_38","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41368-023-00249-w","article-title":"Oral squamous cell carcinomas: State of the field and emerging directions","volume":"15","author":"Tan","year":"2023","journal-title":"Int. J. Oral Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1038\/nrclinonc.2017.14","article-title":"Integrating liquid biopsies into management of cancer","volume":"14","author":"Siravegna","year":"2017","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1007\/s11684-017-0526-7","article-title":"Application of liquid biopsy in precision medicine: Opportunities and challanges","volume":"11","author":"Wang","year":"2017","journal-title":"Front. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s12957-025-03732-2","article-title":"An update on the molecular mechanisms underlying the progression of miR-21 in oral cancer","volume":"23","author":"Prasad","year":"2025","journal-title":"World J. Surg. Oncol."},{"key":"ref_43","first-page":"44893201","article-title":"The clinical role of microRNA-21 as a promising biomarker in the diagnosis and prognosis of colorectal cancer: A systematic review and meta-analysis","volume":"8","author":"Peng","year":"2017","journal-title":"Oncotarget"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Padroni, L., De Marco, L., Dansero, L., Fiano, V., Milani, L., Vasapolli, P., and Sacerdote, C. (2023). An Epidemiological Systematic Review with Meta-Analysis on Biomarker Role of Circulating MicroRNAs in Breast Cancer Incidence. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24043910"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Ruiz-Pozo, V.A., Cadena-Ullauri, S., Guevara-Ram\u00edrez, P., Paz-Cruz, E., Tamayo-Trujillo, R., and Zambrano, A.K. (2023). Differential microRNA expression for diagnosis and prognosis of papillary thyroid cancer. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1139362"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"4107","DOI":"10.1038\/s41598-022-08175-3","article-title":"Expression of whole blood miR-126-3p, -30a-5p, -1299, -182-5p and -30e-3p in chronic kidney disease in a South African community-based sample","volume":"12","author":"Motshwari","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e00376","DOI":"10.1016\/j.plabm.2024.e00376","article-title":"Differences in serum and plasma levels of microRNAs and their time-course changes after blood collection","volume":"39","author":"Wakabayashi","year":"2024","journal-title":"Pract. Lab. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s10238-024-01476-z","article-title":"MicroRNA signatures in the pathogenesis and therapy of inflammatory bowel disease","volume":"24","author":"Ramadan","year":"2024","journal-title":"Clin. Exp. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1038\/s41398-024-03075-8","article-title":"MicroRNAs: Pioneering regulators in Alzheimer\u2019s disease pathogenesis, diagnosis, and therapy","volume":"14","author":"Li","year":"2024","journal-title":"Transl. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Noor Eddin, A., Hamsho, K., Adi, G., Al-Rimawi, M., Alfuwais, M., Abdul Rab, S., and Yaqinuddin, A. (2023). Cerebrospinal fluid microRNAs as potential biomarkers in Alzheimer\u2019s disease. Front. Aging Neurosci., 15.","DOI":"10.3389\/fnagi.2023.1210191"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Nelson, M.C., and O\u2019Connell, R.M. (2020). MicroRNAs: At the Interface of Metabolic Pathways and Inflammatory Responses by Macrophages. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.01797"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/1\/52\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:07:57Z","timestamp":1768565277000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/1\/52"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jpm16010052"],"URL":"https:\/\/doi.org\/10.3390\/jpm16010052","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]}}}