{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:26:56Z","timestamp":1787286416727,"version":"build-2736575974"},"reference-count":43,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002428","name":"Austrian Science Fund","doi-asserted-by":"publisher","award":["V907-B"],"award-info":[{"award-number":["V907-B"]}],"id":[{"id":"10.13039\/501100002428","id-type":"DOI","asserted-by":"publisher"}]},{"award":["V907-B"],"award-info":[{"award-number":["V907-B"]}],"id":[{"id":"https:\/\/ror.org\/013tf3c58","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006012","name":"Christian Doppler Research Association","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006012","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/00mv8h305","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Peritoneal dialysis (PD) effluent of kidney failure patients represents an accessible liquid biopsy of the peritoneal cavity, yet the mechanisms determining its molecular composition remain poorly understood. We applied an integrative multi-omics approach to characterize the composition, transport dynamics, and molecular origin of the PD effluentome. Methods: Cell-free effluent, effluent cells, and plasma were collected from stable PD patients during standardized peritoneal equilibration tests in a randomized clinical trial. Targeted metabolomics, proteomics, and transcriptomic profiling were integrated with a reference human plasma proteome to investigate temporal molecular changes, peritoneal transport characteristics, and protein origin. Results: A total of 207 metabolites and 2970 proteins were identified in PD effluent. Metabolites exhibited distinct class-specific transport kinetics, with rapid equilibration of amino acids and biogenic amines, whereas lipids remained markedly underrepresented despite prolonged dwell times, indicating that transport is governed by physicochemical properties beyond molecular size alone. The effluent proteome underwent concordant alteration, with dwell time-dependent enrichment of pathways related to extracellular matrix organization, angiogenesis, coagulation, and tissue repair. Integrative analysis of the effluent proteome, effluent-cell transcriptome, and human plasma proteome resolved distinct plasma-associated, effluent cell-associated, resident peritoneal tissue-associated, and mixed-origin protein populations. Conclusions: This study establishes the first systems-level approach describing the composition, transport dynamics, and molecular origin of the PD effluentome. By transforming PD effluent into a biologically interpretable molecular readout of peritoneal membrane biology, this work provides a reference for the mechanistic interpretation of effluent-derived biomarkers and supports future therapeutic monitoring and precision medicine in PD.<\/jats:p>","DOI":"10.3390\/medsci14040496","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:07:34Z","timestamp":1787148454000},"page":"496","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The PD Effluentome\u2014A Multi-Omics Atlas Defining the Composition, Transport Dynamics, and Molecular Origin of Peritoneal Dialysis Effluent"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1946-7770","authenticated-orcid":false,"given":"Rebecca","family":"Herzog","sequence":"first","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Christian Doppler Laboratory for Peritoneal Regulation of the Immune-Metabolic Ecosystem in Peritoneal Dialysis (CDL-PRIME-PD), Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5012-3082","authenticated-orcid":false,"given":"Fabian","family":"Eibensteiner","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Christian Doppler Laboratory for Peritoneal Regulation of the Immune-Metabolic Ecosystem in Peritoneal Dialysis (CDL-PRIME-PD), Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian M.","family":"Wiesenhofer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Daniel-Fischer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Christian Doppler Laboratory for Peritoneal Regulation of the Immune-Metabolic Ecosystem in Peritoneal Dialysis (CDL-PRIME-PD), Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Wagner","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Core Facility Proteomics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0401-1872","authenticated-orcid":false,"given":"Markus","family":"Unterwurzacher","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Core Facility Proteomics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel J.","family":"Sobieszek","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Christian Doppler Laboratory for Peritoneal Regulation of the Immune-Metabolic Ecosystem in Peritoneal Dialysis (CDL-PRIME-PD), Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Manuel","family":"Sacnun","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4897-6953","authenticated-orcid":false,"given":"Michael","family":"B\u00f6hm","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Vychytil","sequence":"additional","affiliation":[{"name":"Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Aufricht","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0803-614X","authenticated-orcid":false,"given":"Klaus","family":"Kratochwill","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Core Facility Proteomics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1038\/s41581-024-00820-6","article-title":"Chronic kidney disease and the global public health agenda: An international consensus","volume":"20","author":"Francis","year":"2024","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1007\/s00467-021-05145-1","article-title":"Epidemiology of pediatric chronic kidney disease\/kidney failure: Learning from registries and cohort studies","volume":"37","author":"Harada","year":"2022","journal-title":"Pediatr. Nephrol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1038\/nrneph.2016.181","article-title":"Changes in the worldwide epidemiology of peritoneal dialysis","volume":"13","author":"Li","year":"2017","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1056\/NEJMra2100152","article-title":"Peritoneal Dialysis","volume":"385","author":"Teitelbaum","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1053\/j.ajkd.2013.01.031","article-title":"Current status and practical use of effluent biomarkers in peritoneal dialysis patients","volume":"62","author":"Krediet","year":"2013","journal-title":"Am. J. Kidney Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Sutherland, T.E., Shaw, T.N., Lennon, R., Herrick, S.E., and R\u00fcckerl, D. (2021). Ongoing Exposure to Peritoneal Dialysis Fluid Alters Resident Peritoneal Macrophage Phenotype and Activation Propensity. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.715209"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"106342","DOI":"10.1016\/j.ekir.2026.106342","article-title":"Local Immunometabolic Intervention With Alanyl-Glutamine Resolves Peritoneal Dialysis-Induced Immune Cell Dysfunction","volume":"11","author":"Herzog","year":"2026","journal-title":"Kidney Int. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2622256","DOI":"10.1080\/0886022X.2026.2622256","article-title":"The peritoneum in perspective: Extracellular vesicles and the future of peritoneal dialysis","volume":"48","author":"Stepanova","year":"2026","journal-title":"Ren. Fail."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1097\/MAT.0000000000000105","article-title":"Can the three pore model correctly describe peritoneal transport of protein?","volume":"60","author":"Waniewski","year":"2014","journal-title":"ASAIO J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1093\/ndt\/gfn049","article-title":"Free water transport, small pore transport and the osmotic pressure gradient three-pore model of peritoneal transport","volume":"23","author":"Rippe","year":"2008","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1177\/089686080402400102","article-title":"Fluid and electrolyte transport across the peritoneal membrane during CAPD according to the three-pore model","volume":"24","author":"Rippe","year":"2004","journal-title":"Perit. Dial. Int."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Wiesenhofer, F.M., Herzog, R., Boehm, M., Wagner, A., Unterwurzacher, M., Kasper, D.C., Alper, S.L., Vychytil, A., Aufricht, C., and Kratochwill, K. (2018). Targeted Metabolomic Profiling of Peritoneal Dialysis Effluents Shows Anti-oxidative Capacity of Alanyl-Glutamine. Front. Physiol., 9.","DOI":"10.3389\/fphys.2018.01961"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"eady2586","DOI":"10.1126\/scisignal.ady2586","article-title":"Deep secretome analysis reveals the effects of LiCl on fibroangiogenic remodeling in coculture and mouse models of peritoneal dialysis","volume":"19","author":"Sacnun","year":"2026","journal-title":"Sci. Signal."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1159\/000368972","article-title":"Ultrafiltration failure in peritoneal dialysis: A pathophysiologic approach","volume":"39","author":"Teitelbaum","year":"2015","journal-title":"Blood Purif."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"6229","DOI":"10.1038\/s41598-017-05872-2","article-title":"Functional and Transcriptomic Characterization of Peritoneal Immune-Modulation by Addition of Alanyl-Glutamine to Dialysis Fluid","volume":"7","author":"Herzog","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S120","DOI":"10.1093\/joneph\/26.S21.S120","article-title":"Functional assessment of the peritoneal membrane","volume":"26","author":"Virga","year":"2013","journal-title":"J. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1177\/0896860820982218","article-title":"ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention","volume":"41","author":"Morelle","year":"2021","journal-title":"Perit. Dial. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1074\/mcp.RA117.000186","article-title":"Effects of Alanyl-Glutamine Treatment on the Peritoneal Dialysis Effluent Proteome Reveal Pathomechanism-Associated Molecular Signatures","volume":"17","author":"Herzog","year":"2018","journal-title":"Mol. Cell. Proteom."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4299","DOI":"10.1021\/acs.jproteome.7b00467","article-title":"The Human Plasma Proteome Draft of 2017: Building on the Human Plasma PeptideAtlas from Mass Spectrometry and Complementary Assays","volume":"16","author":"Schwenk","year":"2017","journal-title":"J. Proteome Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"eaaz0274","DOI":"10.1126\/scisignal.aaz0274","article-title":"The human secretome","volume":"12","author":"Uhlen","year":"2019","journal-title":"Sci. Signal."},{"key":"ref_21","unstructured":"R Core Team (2018). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: https:\/\/www.R-project.org\/."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1021\/acs.jproteome.5c00719","article-title":"Expanding the Proteomics and Metabolomics Toolkit with Methods for Differential Expression Analysis from Transcriptomics","volume":"25","author":"Caruso","year":"2026","journal-title":"J. Proteome Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1038\/nature10098","article-title":"Global quantification of mammalian gene expression control","volume":"473","author":"Schwanhausser","year":"2011","journal-title":"Nature"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/j.kint.2017.02.037","article-title":"Biomarker research to improve clinical outcomes of peritoneal dialysis: Consensus of the European Training and Research in Peritoneal Dialysis (EuTRiPD) network","volume":"92","author":"Aufricht","year":"2017","journal-title":"Kidney Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s10157-018-1611-1","article-title":"Differences in peritoneal solute transport rates in peritoneal dialysis","volume":"23","author":"Asano","year":"2019","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"244","DOI":"10.2215\/CJN.0000000000000282","article-title":"The Peritoneal Membrane and Its Role in Peritoneal Dialysis","volume":"19","author":"Morelle","year":"2024","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Swapnasrita, S., de Vries, J.C., Stachowska-Pietka, J., Oberg, C.M., Gerritsen, K.G.F., and Carlier, A. (2025). Comparing Computational Peritoneal Dialysis Models in Pigs and Patients. Toxins, 17.","DOI":"10.3390\/toxins17070329"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"431","DOI":"10.3934\/mbe.2025017","article-title":"Computational modeling of peritoneal dialysis: An overview","volume":"22","author":"Swapnasrita","year":"2025","journal-title":"Math. Biosci. Eng."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2337\/db12-0466","article-title":"Acylcarnitines: Reflecting or inflicting insulin resistance?","volume":"62","author":"Schooneman","year":"2013","journal-title":"Diabetes"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1080\/0886022X.2020.1719847","article-title":"Association between carnitine deficiency and the erythropoietin resistance index in patients undergoing peritoneal dialysis: A cross-sectional observational study","volume":"42","author":"Kaneko","year":"2020","journal-title":"Ren. Fail."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Takashima, H., Maruyama, T., and Abe, M. (2021). Significance of Levocarnitine Treatment in Dialysis Patients. Nutrients, 13.","DOI":"10.3390\/nu13041219"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.semnephrol.2016.10.009","article-title":"Peritoneal Membrane Preservation","volume":"37","author":"Bajo","year":"2017","journal-title":"Semin. Nephrol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Masola, V., Bonomini, M., Borrelli, S., Di Liberato, L., Vecchi, L., Onisto, M., Gambaro, G., Palumbo, R., and Arduini, A. (2022). Fibrosis of Peritoneal Membrane as Target of New Therapies in Peritoneal Dialysis. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23094831"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.34067\/KID.0000000000000516","article-title":"Aryl Hydrocarbon Receptor Pathway Augments Peritoneal Fibrosis in a Murine CKD Model Exposed to Peritoneal Dialysate","volume":"5","author":"Lotfollahzadeh","year":"2024","journal-title":"Kidney360"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0009-2797(02)00067-4","article-title":"Induction of cellular oxidative stress by aryl hydrocarbon receptor activation","volume":"141","author":"Dalton","year":"2002","journal-title":"Chem. Biol. Interact."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.immuni.2017.12.012","article-title":"Regulation of the Immune Response by the Aryl Hydrocarbon Receptor","volume":"48","author":"Quintana","year":"2018","journal-title":"Immunity"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1038\/nature10491","article-title":"An endogenous tumour-promoting ligand of the human aryl hydrocarbon receptor","volume":"478","author":"Opitz","year":"2011","journal-title":"Nature"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1253\/circj.CJ-12-0647","article-title":"Activation of aryl hydrocarbon receptor mediates indoxyl sulfate-induced monocyte chemoattractant protein-1 expression in human umbilical vein endothelial cells","volume":"77","author":"Watanabe","year":"2013","journal-title":"Circ. J."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Bonomini, M., Borras, F.E., Troya-Saborido, M., Carreras-Planella, L., Di Liberato, L., and Arduini, A. (2020). Proteomic Research in Peritoneal Dialysis. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21155489"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1111\/1744-9987.70052","article-title":"Biomarkers Related to Peritoneal Transfer Function and Dialysis Adequacy","volume":"29","author":"Pu","year":"2025","journal-title":"Ther. Apher. Dial."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"sfaf378","DOI":"10.1093\/ckj\/sfaf378","article-title":"Peritoneal dialysis effluent biomarkers from a multi-omics and artificial intelligence perspective: Advances and challenges","volume":"19","author":"Li","year":"2026","journal-title":"Clin. Kidney J."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Teitelbaum, I. (2026). Preserving Peritoneal Membrane Performance. Clin. J. Am. Soc. Nephrol., Publish Ahead of Print.","DOI":"10.2215\/CJN.0000001174"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3164","DOI":"10.1016\/j.ekir.2025.06.049","article-title":"The Role of Peritoneal IL-6 in Predicting Patient Survival on PD","volume":"10","author":"Elphick","year":"2025","journal-title":"Kidney Int. Rep."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/496\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:22:03Z","timestamp":1787286123000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":43,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["medsci14040496"],"URL":"https:\/\/doi.org\/10.3390\/medsci14040496","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]}}}