{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:29:23Z","timestamp":1784780963299,"version":"3.55.0"},"reference-count":58,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Cognitive impairment is a prevalent non-motor manifestation of Parkinson\u2019s disease (PD), yet early detection remains limited by the sensitivity of conventional cognitive assessments. Emerging evidence suggests that motor dysfunction, particularly gait and balance abnormalities, reflects underlying cognitive vulnerability. This study examined motor\u2013cognitive associations and evaluated whether motor-derived features can be used to classify low-MoCA status in PD without direct cognitive testing. Data from 102 individuals with PD were analyzed, incorporating clinical assessments, physical function measures, lifestyle factors, and gait-derived biomarkers. Multiple regression identified Unified Parkinson\u2019s Disease Rating Scale Part III, stride length of the more affected side during 360\u00b0 turning at preferred speed, and maximum ankle jerk on the less affected side during forward walking as independent predictors of Montreal Cognitive Assessment scores, collectively explaining 34.7% of the variance. Network analysis revealed integrative relationships among global motor severity, gait smoothness, and cognitive performance. Using a compact motor-based feature set, logistic regression achieved a mean accuracy of 65.8% and an AUC of 0.737 in classifying low-MoCA status under cross-validation. These findings demonstrate that motor-derived digital biomarkers capture clinically meaningful information about cognitive status in PD and may serve as adjunctive tools for identifying cognitive vulnerability in clinical settings.<\/jats:p>","DOI":"10.3390\/s26082503","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:24:23Z","timestamp":1776673463000},"page":"2503","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Motor-Derived Digital Biomarkers for Identifying Low-MoCA Status in People with Parkinson\u2019s Disease"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0012-5615","authenticated-orcid":false,"given":"Bohyun","family":"Kim","sequence":"first","affiliation":[{"name":"Biomechanics Laboratory, Dong-A University, Saha-gu, Busan 49315, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7574-5259","authenticated-orcid":false,"given":"Changhong","family":"Youm","sequence":"additional","affiliation":[{"name":"Biomechanics Laboratory, Dong-A University, Saha-gu, Busan 49315, Republic of Korea"},{"name":"Department of Health Sciences, The Graduate School, Dong-A University, Saha-gu, Busan 49315, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5905-2188","authenticated-orcid":false,"given":"Sang-Myung","family":"Cheon","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Dong-A University, Seo-gu, Busan 49201, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4625-9021","authenticated-orcid":false,"given":"Hwayoung","family":"Park","sequence":"additional","affiliation":[{"name":"Biomechanics Laboratory, Dong-A University, Saha-gu, Busan 49315, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6323-1453","authenticated-orcid":false,"given":"Hyejin","family":"Choi","sequence":"additional","affiliation":[{"name":"Biomechanics Laboratory, Dong-A University, Saha-gu, Busan 49315, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juseon","family":"Hwang","sequence":"additional","affiliation":[{"name":"Biomechanics Laboratory, Dong-A University, Saha-gu, Busan 49315, Republic of Korea"},{"name":"Department of Health Sciences, The Graduate School, Dong-A University, Saha-gu, Busan 49315, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsoo","family":"Kim","sequence":"additional","affiliation":[{"name":"Biomechanics Laboratory, Dong-A University, Saha-gu, Busan 49315, Republic of Korea"},{"name":"Department of Health Sciences, The Graduate School, Dong-A University, Saha-gu, Busan 49315, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1177\/0891988712464823","article-title":"Cognitive impairment in Parkinson disease: Impact on quality of life, disability, and caregiver burden","volume":"25","author":"Leroi","year":"2012","journal-title":"J. Geriatr. Psychiatry Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Sasikumar, S., and Strafella, A.P. (2020). Imaging mild cognitive impairment and dementia in Parkinson\u2019s disease. Front. Neurol., 11.","DOI":"10.3389\/fneur.2020.00047"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1212\/WNL.0b013e3181f39d0e","article-title":"Mild cognitive impairment in Parkinson disease: A multicenter pooled analysis","volume":"75","author":"Aarsland","year":"2010","journal-title":"Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"576091","DOI":"10.1155\/2013\/576091","article-title":"Mild cognitive impairment in Parkinson\u2019s disease: A review of current concepts","volume":"2013","author":"Palavra","year":"2013","journal-title":"Neurol. Res. Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"103347","DOI":"10.1016\/j.compbiomed.2019.103347","article-title":"Optimized machine learning methods for prediction of cognitive outcome in Parkinson\u2019s disease","volume":"111","author":"Salmanpour","year":"2019","journal-title":"Comput. Biol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1038\/s41531-022-00409-5","article-title":"Machine learning-based prediction of cognitive outcomes in de novo Parkinson\u2019s disease","volume":"8","author":"Harvey","year":"2022","journal-title":"npj Park. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e157074","DOI":"10.1172\/JCI157074","article-title":"Predicting cognitive decline in Parkinson\u2019s disease using FDG-PET-based supervised learning","volume":"132","author":"Booth","year":"2022","journal-title":"J. Clin. Investig."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"17485","DOI":"10.1038\/s41598-019-54029-w","article-title":"Parkinson\u2019s disease prognostic scores for progression of cognitive decline","volume":"9","author":"Gramotnev","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Hayete, B., Wuest, D., Laramie, J., McDonagh, P., Church, B., Eberly, S., Lang, A., Marek, K., Runge, K., and Shoulson, I. (2017). A Bayesian mathematical model of motor and cognitive outcomes in Parkinson\u2019s disease. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0178982"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1002\/gps.4261","article-title":"Mild cognitive impairment in Parkinson\u2019s disease and its progression onto dementia: A 16-year outcome evaluation of the Denbighshire cohort","volume":"30","author":"Hobson","year":"2015","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1212\/WNL.0000000000002001","article-title":"Longitudinal study of normal cognition in Parkinson disease","volume":"85","author":"Pigott","year":"2015","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"15027","DOI":"10.1038\/npjparkd.2015.27","article-title":"Different PD-MCI criteria and risk of dementia in Parkinson\u2019s disease: 4-year longitudinal study","volume":"2","author":"Wood","year":"2016","journal-title":"npj Park. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Gorji, A., and Jouzdani, A.F. (2024). Machine learning for predicting cognitive decline within five years in Parkinson\u2019s disease: Comparing cognitive assessment scales with DAT SPECT and clinical biomarkers. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0304355"},{"key":"ref_14","first-page":"91","article-title":"Prediction of cognitive progression in Parkinson\u2019s disease using three cognitive screening measures","volume":"1","author":"Kim","year":"2019","journal-title":"Clin. Park Relat. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"13193","DOI":"10.1038\/s41598-023-37644-6","article-title":"Machine learning-based prediction of longitudinal cognitive decline in early Parkinson\u2019s disease using multimodal features","volume":"13","author":"Almgren","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1590\/s1980-5764-2016dn1004015","article-title":"Comparison of the use of screening tools for evaluating cognitive impairment in patients with Parkinson\u2019s disease","volume":"10","author":"Camargo","year":"2016","journal-title":"Dement. Neuropsychol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1038\/s41531-018-0055-3","article-title":"Cognitive impairment in Parkinson\u2019s disease: A report from a multidisciplinary symposium on unmet needs and future directions to maintain cognitive health","volume":"4","author":"Goldman","year":"2018","journal-title":"npj Park. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1038\/nrn2915","article-title":"Goal-directed and habitual control in the basal ganglia: Implications for Parkinson\u2019s disease","volume":"11","author":"Redgrave","year":"2010","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1590\/s1980-5764-2016dn1004005","article-title":"Gait, posture and cognition in Parkinson\u2019s disease","volume":"10","author":"Barbosa","year":"2016","journal-title":"Dement. Neuropsychol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/alz.12298","article-title":"Gait variability across neurodegenerative and cognitive disorders: Results from the Canadian Consortium of Neurodegeneration in Aging (CCNA) and the Gait and Brain Study","volume":"17","author":"Black","year":"2021","journal-title":"Alzheimers Dement."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Coates, L., Shi, J., Rochester, L., Del Din, S., and Pantall, A. (2020). Entropy of real-world gait in Parkinson\u2019s disease determined from wearable sensors as a digital marker of altered ambulatory behavior. Sensors, 20.","DOI":"10.3390\/s20092631"},{"key":"ref_23","first-page":"1099","article-title":"Digital biomarkers of mobility in Parkinson\u2019s disease during daily living","volume":"10","author":"Shah","year":"2020","journal-title":"J. Park. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1038\/s41746-024-01163-z","article-title":"Wearable sensor-based quantitative gait analysis in Parkinson\u2019s disease patients with different motor subtypes","volume":"7","author":"Zhang","year":"2024","journal-title":"npj Digit. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1002\/mds.26718","article-title":"Free-living monitoring of Parkinson\u2019s disease: Lessons from the field","volume":"31","author":"Godfrey","year":"2016","journal-title":"Mov. Disord."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1038\/s41531-022-00344-5","article-title":"Cognition as a mediator for gait and balance impairments in GBA-related Parkinson\u2019s disease","volume":"8","author":"Morris","year":"2022","journal-title":"npj Park. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1038\/s41746-024-01217-2","article-title":"Digital biomarkers for precision diagnosis and monitoring in Parkinson\u2019s disease","volume":"7","author":"Sun","year":"2024","journal-title":"npj Digit. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.parkreldis.2022.07.014","article-title":"Unraveling Parkinson\u2019s disease heterogeneity using subtypes based on multimodal data","volume":"102","author":"Albrecht","year":"2022","journal-title":"Park. Relat. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/s41531-024-00759-2","article-title":"MRI subtypes in Parkinson\u2019s disease across diverse populations and clustering approaches","volume":"10","author":"Inguanzo","year":"2024","journal-title":"npj Park. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Amboni, M., Ricciardi, C., Adamo, S., Nicolai, E., Volzone, A., Erro, R., Cuoco, S., Cesarelli, G., Basso, L., and D\u2019Addio, G. (2022). Machine learning can predict mild cognitive impairment in Parkinson\u2019s disease. Front Neurol., 13.","DOI":"10.3389\/fneur.2022.1010147"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2676","DOI":"10.1109\/TNSRE.2024.3431234","article-title":"Kinematic and kinetic gait features associated with mild cognitive impairment in Parkinson\u2019s disease","volume":"32","author":"Russo","year":"2024","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Ghosh, D., Pal, S., Lutz, M., and Luo, S. (2025). Ensemble survival analysis for preclinical cognitive decline prediction in Alzheimer\u2019s disease using longitudinal biomarkers. arXiv.","DOI":"10.1177\/13872877251365621"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1038\/s41746-024-01144-2","article-title":"Digital biomarkers for non-motor symptoms in Parkinson\u2019s disease: The state of the art","volume":"7","author":"Prins","year":"2024","journal-title":"npj Digit. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"28482","DOI":"10.1038\/s41598-024-79303-4","article-title":"Cognitive reorganization in patients with Parkinson\u2019s disease and Mild Cognitive Impairment: A neuropsychological network approach","volume":"14","author":"Longo","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_35","first-page":"e70091","article-title":"A network perspective on cognition in individuals with Parkinson\u2019s disease","volume":"17","author":"Scharfenberg","year":"2025","journal-title":"Alzheimers Dement."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"103488","DOI":"10.1016\/j.nicl.2023.103488","article-title":"Parkinson\u2019s disease progression: Increasing expression of an invariant common core subnetwork","volume":"39","author":"Spetsieris","year":"2023","journal-title":"NeuroImage Clin."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Igual, L., and Segu\u00ed, S. (2024). Network Analysis. Introduction to Data Science, Springer. [2nd ed.]. A Python Approach to Concepts, Techniques and Applications.","DOI":"10.1007\/978-3-031-48956-3"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/jgs.19238","article-title":"Motor signs and incident dementia with Lewy bodies in older adults with mild cognitive impairment","volume":"73","author":"Liampas","year":"2025","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_39","first-page":"220","article-title":"Cognitive Reserve proxies can modulate motor and non-motor basal ganglia circuits in early Parkinson\u2019s disease","volume":"18","author":"Isernia","year":"2024","journal-title":"Brain Imaging Behav."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1038\/s41531-024-00866-0","article-title":"Key shifts in frontoparietal network activity in Parkinson\u2019s disease","volume":"11","author":"Sosnik","year":"2025","journal-title":"npj Park. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s00702-019-02125-6","article-title":"Predict cognitive decline with clinical markers in Parkinson\u2019s disease (PRECODE-1)","volume":"127","author":"Wilson","year":"2020","journal-title":"J. Neural Transm."},{"key":"ref_42","first-page":"100393","article-title":"Cognition is associated with daily-life mobility in people with Parkinson\u2019s disease","volume":"13","author":"Burgos","year":"2025","journal-title":"Clin. Park Relat. Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"29522","DOI":"10.1038\/s41598-024-80144-4","article-title":"Predicting executive functioning from walking features in Parkinson\u2019s disease using machine learning","volume":"14","author":"Piet","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Lander, J.J., Moran, M.F., and Alexanian, H.R. (2025). Correlations of gait kinematics and cognitive skills in Parkinson disease. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0317389"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Mohammadi, H., Maghsoudpour, A., Noroozian, M., and Mohammadian, F. (2025). Talking during walking: The diagnostic potential of turn dynamics in Alzheimer\u2019s disease, mild cognitive impairment and cognitive aging. Front. Aging Neurosci., 17.","DOI":"10.3389\/fnagi.2025.1533573"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"4373","DOI":"10.1007\/s00415-024-12379-0","article-title":"Gait asymmetry and symptom laterality in Parkinson\u2019s disease: Two of a kind?","volume":"271","author":"Seuthe","year":"2024","journal-title":"J. Neurol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1152\/jn.00813.2013","article-title":"Parkinson\u2019s disease patients compensate for balance control asymmetry","volume":"112","author":"Boonstra","year":"2014","journal-title":"J. Neurophysiol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Caronni, A., Amadei, M., Diana, L., Sangalli, G., Scarano, S., Perucca, L., Rota, V., and Bolognini, N. (2025). In Parkinson\u2019s disease, dual-tasking reduces gait smoothness during the straight-walking and turning-while-walking phases of the Timed Up and Go test. BMC Sports Sci. Med. Rehabil., 17.","DOI":"10.1186\/s13102-025-01068-8"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.gaitpost.2024.03.002","article-title":"Associations of dual-task walking costs with cognition in Parkinson\u2019s disease","volume":"110","author":"Kazemi","year":"2024","journal-title":"Gait Posture"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"103399","DOI":"10.1016\/j.humov.2025.103399","article-title":"Inter-limb gait asymmetry in people with Parkinson\u2019s disease","volume":"103","author":"Barbieri","year":"2025","journal-title":"Hum. Mov. Sci."},{"key":"ref_51","first-page":"100363","article-title":"Gait and balance dysfunction are associated with cognitive performance only in men with Parkinson\u2019s disease","volume":"13","author":"Amara","year":"2025","journal-title":"Clin. Park Relat. Disord."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.parkreldis.2019.06.014","article-title":"Cognitive associations with comprehensive gait and static balance measures in Parkinson\u2019s disease","volume":"69","author":"Morris","year":"2019","journal-title":"Park. Relat. Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s12984-016-0205-y","article-title":"Global cognitive function and processing speed are associated with gait and balance dysfunction in Parkinson\u2019s disease","volume":"13","author":"Pal","year":"2016","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Lord, S., Galna, B., Coleman, S., Yarnall, A., Burn, D., and Rochester, L. (2014). Cognition and gait show a selective pattern of association dominated by phenotype in incident Parkinson\u2019s disease. Front. Aging Neurosci., 6.","DOI":"10.3389\/fnagi.2014.00249"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/S1474-4422(19)30044-4","article-title":"Gait impairments in Parkinson\u2019s disease","volume":"18","author":"Mirelman","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1002\/mds.25674","article-title":"Cognitive contributions to gait and falls: Evidence and implications","volume":"28","author":"Amboni","year":"2013","journal-title":"Mov. Disord."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1177\/1545968316650426","article-title":"The role of the frontal lobe in complex walking among patients with Parkinson\u2019s disease and healthy older adults: An fNIRS study","volume":"30","author":"Maidan","year":"2016","journal-title":"Neurorehabilit. Neural Repair."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"L\u00f6fgren, N., Lenholm, E., Conradsson, D., St\u00e5hle, A., and Franz\u00e9n, E. (2014). The Mini-BESTest-a clinically reproducible tool for balance evaluations in mild to moderate Parkinson\u2019s disease?. BMC Neurol., 14.","DOI":"10.1186\/s12883-014-0235-7"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/8\/2503\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T04:25:55Z","timestamp":1777091155000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/8\/2503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,18]]},"references-count":58,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["s26082503"],"URL":"https:\/\/doi.org\/10.3390\/s26082503","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,18]]}}}