{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:07:11Z","timestamp":1784264831568,"version":"3.55.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e0 degli Studi di Roma La Sapienza"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Graefes Arch Clin Exp Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the effect of 20% autologous serum eye drops (ASED) in improving ocular surface condition and promoting corneal nerve regeneration in patients with Paralytic Lagophthalmos (PL) and Neurotrophic Keratitis (NK).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective study included 11 patients with unilateral NK and PL treated with 20% ASED for 2 months. Ocular surface assessment included Schirmer I test, non-invasive tear film break-up time (NIBUT), Oxford staining score, Ocular Surface Disease Index (OSDI) and corneal esthesiometry. In vivo confocal microscopy (IVCM) was used to quantify changes in corneal subbasal nerve plexus, evaluating corneal nerve fiber length (CNFL), nerve fiber density (CNFD), and nerve branch density (CNBD). Pre- and post-treatment values were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten patients completed the study. ASED treatment significantly improved Schirmer I values (mean: 10.3\u2009\u00b1\u20094.7\u00a0mm to 19.7\u2009\u00b1\u200912.1\u00a0mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041), OSDI scores (21.1\u2009\u00b1\u200912.9 to 17.0\u2009\u00b1\u200910.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), and corneal sensitivity readings (central esthesiometry: 3.4\u2009\u00b1\u20091.9\u00a0mm to 5.0\u2009\u00b1\u20091.2\u00a0mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). IVCM revealed significant increases in CNFL (11.1\u2009\u00b1\u20096.4 to 14.7\u2009\u00b1\u20097.3\u00a0mm\/mm\u00b2;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) and CNFD (23.1\u2009\u00b1\u200913.2 to 33.8\u2009\u00b1\u200911.9 fibers\/mm\u00b2;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). One patient discontinued treatment due to ocular discomfort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Topical 20% ASED improved both functional and structural parameters in patients with PL and NK, suggesting neuroregenerative potential. These findings support the use of ASED as a therapeutic option in complex ocular surface disease, with IVCM as a valuable tool for monitoring nerve recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00417-026-07388-w","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:47:05Z","timestamp":1784263625000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Corneal nerve regeneration and ocular surface restoration following treatment with autologous serum eye drops in patients with paralytic lagophthalmos and neurotrophic keratitis"],"prefix":"10.1007","author":[{"given":"Luca","family":"Lucchino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9280-5153","authenticated-orcid":false,"given":"Elvia","family":"Mastrogiuseppe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Giovannetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"D\u2019Andrea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Mecarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Bruscolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Lambiase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marenco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"issue":"9","key":"7388_CR1","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1016\/j.amjmed.2020.04.023","volume":"133","author":"E George","year":"2020","unstructured":"George E, Richie MB, Glastonbury CM (2020) Facial nerve palsy: clinical practice and cognitive errors. Am J Med 133(9):1039\u20131044. https:\/\/doi.org\/10.1016\/j.amjmed.2020.04.023","journal-title":"Am J Med"},{"issue":"3","key":"7388_CR2","doi-asserted-by":"publisher","first-page":"72","DOI":"10.3109\/08820538.2010.488578","volume":"25","author":"MV Correia Pereira","year":"2010","unstructured":"Correia Pereira MV, Firmato AL, Gl\u00f3ria (2010) Lagophthalmos Semin Ophthalmol 25(3):72\u201378. https:\/\/doi.org\/10.3109\/08820538.2010.488578","journal-title":"Lagophthalmos Semin Ophthalmol"},{"key":"7388_CR3","doi-asserted-by":"publisher","first-page":"100762","DOI":"10.1016\/j.preteyeres.2019.05.003","volume":"73","author":"MA Al-Aqaba","year":"2019","unstructured":"Al-Aqaba MA, Dhillon VK, Mohammed I, Said DG, Dua HS (2019) Corneal nerves in health and disease. Prog Retin Eye Res 73:100762. https:\/\/doi.org\/10.1016\/j.preteyeres.2019.05.003","journal-title":"Prog Retin Eye Res"},{"key":"7388_CR4","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.jtos.2024.03.009","volume":"32","author":"F Giovannetti","year":"2024","unstructured":"Giovannetti F et al (2024) New disposable esthesiometer (KeraSense\u00ae) to improve diagnosis and management of neurotrophic keratitis. Ocul Surf 32:192\u2013197. https:\/\/doi.org\/10.1016\/j.jtos.2024.03.009","journal-title":"Ocul Surf"},{"issue":"8","key":"7388_CR5","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1038\/sj.eye.6700616","volume":"17","author":"S Bonini","year":"2003","unstructured":"Bonini S, Rama P, Olzi D, Lambiase A (2003) Neurotrophic keratitis. Eye 17(8):989\u2013995. https:\/\/doi.org\/10.1038\/sj.eye.6700616","journal-title":"Eye"},{"issue":"12","key":"7388_CR6","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1001\/jamaophthalmol.2013.5064","volume":"131","author":"A Lambiase","year":"2013","unstructured":"Lambiase A, Sacchetti M, Mastropasqua A, Bonini S (2013) Corneal changes in neurosurgically induced neurotrophic keratitis. JAMA Ophthalmol 131(12):1547. https:\/\/doi.org\/10.1001\/jamaophthalmol.2013.5064","journal-title":"JAMA Ophthalmol"},{"issue":"02","key":"7388_CR7","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1055\/s-0035-1549292","volume":"31","author":"M Sohrab","year":"2015","unstructured":"Sohrab M, Abugo U, Grant M, Merbs S (2015) Management of the eye in facial paralysis. Facial Plast Surg 31(02):140\u2013144. https:\/\/doi.org\/10.1055\/s-0035-1549292","journal-title":"Facial Plast Surg"},{"issue":"2","key":"7388_CR8","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.survophthal.2006.12.009","volume":"52","author":"I Rahman","year":"2007","unstructured":"Rahman I, Sadiq SA (2007) Ophthalmic management of facial nerve palsy: a review. Surv Ophthalmol 52(2):121\u2013144. https:\/\/doi.org\/10.1016\/j.survophthal.2006.12.009","journal-title":"Surv Ophthalmol"},{"issue":"6","key":"7388_CR9","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1097\/APO.0000000000000331","volume":"9","author":"L Lim","year":"2020","unstructured":"Lim L, Lim EWL (2020) Therapeutic contact lenses in the treatment of corneal and ocular surface diseases\u2014a review. Asia-Pacific J Ophthalmol 9(6):524\u2013532. https:\/\/doi.org\/10.1097\/APO.0000000000000331","journal-title":"Asia-Pacific J Ophthalmol"},{"key":"7388_CR10","doi-asserted-by":"crossref","unstructured":"Quinto GG, Campos M, Behrens A (2008) Autologous serum for ocular surface diseases., Arq. Bras. Oftalmol 71(Suppl6):47\u201354","DOI":"10.1590\/S0004-27492008000700010"},{"key":"7388_CR11","doi-asserted-by":"publisher","unstructured":"Anitua E et al (2015) Autologous serum and plasma rich in growth factors in ophthalmology: preclinical and clinical studies. Acta Ophthalmol 93(8). https:\/\/doi.org\/10.1111\/aos.12710","DOI":"10.1111\/aos.12710"},{"issue":"1","key":"7388_CR12","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1136\/bjophthalmol-2015-306934","volume":"100","author":"R Alzubaidi","year":"2016","unstructured":"Alzubaidi R, Sharif MS, Qahwaji R, Ipson S, Brahma A (2016) In vivo confocal microscopic corneal images in health and disease with an emphasis on extracting features and visual signatures for corneal diseases: a review study. Br J Ophthalmol 100(1):41\u201355. https:\/\/doi.org\/10.1136\/bjophthalmol-2015-306934","journal-title":"Br J Ophthalmol"},{"issue":"3","key":"7388_CR13","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1016\/j.jtos.2019.01.009","volume":"17","author":"S Aggarwal","year":"2019","unstructured":"Aggarwal S, Colon C, Kheirkhah A, Hamrah P (2019) Efficacy of autologous serum tears for treatment of neuropathic corneal pain. Ocul Surf 17(3):532\u2013539. https:\/\/doi.org\/10.1016\/j.jtos.2019.01.009","journal-title":"Ocul Surf"},{"issue":"6","key":"7388_CR14","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1136\/bjophthalmol-2015-307167","volume":"100","author":"R Malhotra","year":"2016","unstructured":"Malhotra R, Ziahosseini K, Litwin A, Nduka C, El-Shammah N (2016) CADS grading scale: towards better grading of ophthalmic involvement in facial nerve paralysis. Br J Ophthalmol 100(6):866\u2013870. https:\/\/doi.org\/10.1136\/bjophthalmol-2015-307167","journal-title":"Br J Ophthalmol"},{"key":"7388_CR15","first-page":"452","volume-title":"Current Ocular Therapy","author":"IA Mackie","year":"1995","unstructured":"Mackie IA (1995) Neuroparalytic keratitis. In: Fraunfelder F, Roy FH, Meyer SM (eds) in Current Ocular Therapy. WB Saunders, Philadelphia, PA, pp 452\u2013454"},{"issue":"1","key":"7388_CR16","doi-asserted-by":"publisher","first-page":"2516","DOI":"10.1038\/s41598-024-52686-0","volume":"14","author":"F Zeri","year":"2024","unstructured":"Zeri F, Rizzo GC, Ponzini E, Tavazzi S (2024) Comparing automated and manual assessments of tear break-up time using different non-invasive devices and a fluorescein procedure. Sci Rep 14(1):2516. https:\/\/doi.org\/10.1038\/s41598-024-52686-0","journal-title":"Sci Rep"},{"key":"7388_CR17","doi-asserted-by":"publisher","unstructured":"Mangiantini P et al (2024) Corneal alterations in patients with osteogenesis imperfecta: an in vivo corneal confocal microscopy study. Clin Ophthalmol 18:3977\u20133988. https:\/\/doi.org\/10.2147\/OPTH.S470183","DOI":"10.2147\/OPTH.S470183"},{"issue":"3","key":"7388_CR18","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.jtos.2015.01.005","volume":"13","author":"S Aggarwal","year":"2015","unstructured":"Aggarwal S et al (2015) Autologous serum tears for treatment of photoallodynia in patients with corneal neuropathy: efficacy and evaluation with in vivo confocal microscopy. Ocul Surf 13(3):250\u2013262. https:\/\/doi.org\/10.1016\/j.jtos.2015.01.005","journal-title":"Ocul Surf"},{"key":"7388_CR19","doi-asserted-by":"publisher","unstructured":"Liu L, Hartwig D, Harloff S, Herminghaus P, Wedel T, Geerling G (2005) An optimised protocol for the production of autologous serum eyedrops, Graefe\u2019s Archive for Clinical and Experimental Ophthalmology. 243(7):706\u2013714. https:\/\/doi.org\/10.1007\/s00417-004-1106-5","DOI":"10.1007\/s00417-004-1106-5"},{"issue":"7","key":"7388_CR20","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1038\/sj.bmt.1703862","volume":"31","author":"Y Ogawa","year":"2003","unstructured":"Ogawa Y et al (2003) Autologous serum eye drops for the treatment of severe dry eye in patients with chronic graft-versus-host disease. Bone Marrow Transpl 31(7):579\u2013583. https:\/\/doi.org\/10.1038\/sj.bmt.1703862","journal-title":"Bone Marrow Transpl"},{"issue":"12","key":"7388_CR21","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/ICO.0000000000000271","volume":"33","author":"M Hussain","year":"2014","unstructured":"Hussain M et al (2014) Long-term use of autologous serum 50% eye drops for the treatment of dry eye disease. Cornea 33(12):1245\u20131251. https:\/\/doi.org\/10.1097\/ICO.0000000000000271","journal-title":"Cornea"},{"issue":"6","key":"7388_CR22","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1016\/j.ophtha.2003.10.019","volume":"111","author":"Y MATSUMOTO","year":"2004","unstructured":"Matsumoto Y (2004) Autologous serum application in the treatment of neurotrophic keratopathy*1. Ophthalmol 111(6):1115\u20131120. https:\/\/doi.org\/10.1016\/j.ophtha.2003.10.019","journal-title":"Ophthalmology"},{"issue":"11","key":"7388_CR23","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.1136\/bjo.2004.044347","volume":"88","author":"G Geerling","year":"2004","unstructured":"Geerling G (2004) Autologous serum eye drops for ocular surface disorders. Br J Ophthalmol 88(11):1467\u20131474. https:\/\/doi.org\/10.1136\/bjo.2004.044347","journal-title":"Br J Ophthalmol"},{"key":"7388_CR24","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009327","volume-title":"Cochrane Database of Systematic Reviews","author":"Q Pan","year":"2011","unstructured":"Pan Q et al (2011) Autologous serum eye drops for dry eye syndrome. In: Pan Q (ed) in Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd, Chichester, UK. https:\/\/doi.org\/10.1002\/14651858.CD009327."},{"issue":"4","key":"7388_CR25","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1097\/00004397-200010000-00009","volume":"40","author":"K Tsubota","year":"2000","unstructured":"Tsubota K, Higuchi A (2000) Serum application for the treatment of ocular surface disorders. Int Ophthalmol Clin 40(4):113\u2013122. https:\/\/doi.org\/10.1097\/00004397-200010000-00009","journal-title":"Int Ophthalmol Clin"},{"issue":"7","key":"7388_CR26","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1097\/ICO.0000000000000147","volume":"33","author":"J Hwang","year":"2014","unstructured":"Hwang J, Chung S-H, Jeon S, Kwok S-K, Park S-H, Kim M-S (2014) Comparison of clinical efficacies of autologous serum eye drops in patients with primary and secondary sj\u00f6gren syndrome. Cornea 33(7):663\u2013667. https:\/\/doi.org\/10.1097\/ICO.0000000000000147","journal-title":"Cornea"},{"key":"7388_CR27","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/j.bjps.2023.10.102","volume":"87","author":"MC Moncaliano","year":"2023","unstructured":"Moncaliano MC, Ding P, Goshe JM, Genther DJ, Ciolek PJ, Byrne PJ (2023) Clinical features, evaluation, and management of ophthalmic complications of facial paralysis: A review. J Plast Reconstr Aesthetic Surg 87:361\u2013368. https:\/\/doi.org\/10.1016\/j.bjps.2023.10.102","journal-title":"J Plast Reconstr Aesthetic Surg"},{"key":"7388_CR28","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000003637","author":"L Lucchino","year":"2024","unstructured":"Lucchino L et al (2024) Influence of opacity depth on big bubble formation during deep anterior lamellar keratoplasty in corneal stromal scars. Cornea. https:\/\/doi.org\/10.1097\/ICO.0000000000003637","journal-title":"Cornea Jul"},{"key":"7388_CR29","doi-asserted-by":"publisher","unstructured":"Sacchetti M, Lambiase A (2014) Diagnosis and management of neurotrophic keratitis. Clin Ophthalmol p. 571. https:\/\/doi.org\/10.2147\/OPTH.S45921","DOI":"10.2147\/OPTH.S45921"},{"issue":"6","key":"7388_CR30","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1007\/s40123-022-00575-y","volume":"11","author":"HJ Kim","year":"2022","unstructured":"Kim HJ, Youn HC, Hyun JJ, Kim SW (2022) Efficacy of autologous serum gel in neurotrophic persistent corneal epithelial defects combined with lagophthalmos. Ophthalmol Ther 11(6):2129\u20132139. https:\/\/doi.org\/10.1007\/s40123-022-00575-y","journal-title":"Ophthalmol Ther"},{"issue":"9","key":"7388_CR31","doi-asserted-by":"publisher","first-page":"1771","DOI":"10.1007\/s00417-017-3680-3","volume":"255","author":"TC Tepelus","year":"2017","unstructured":"Tepelus TC et al (2017) Correlation between corneal innervation and inflammation evaluated with confocal microscopy and symptomatology in patients with dry eye syndromes: a preliminary study. Graefe\u2019s Archive Clin Experimental Ophthalmol 255(9):1771\u20131778. https:\/\/doi.org\/10.1007\/s00417-017-3680-3","journal-title":"Graefe\u2019s Archive Clin Experimental Ophthalmol"},{"issue":"1","key":"7388_CR32","doi-asserted-by":"publisher","first-page":"e0029","DOI":"10.1097\/coa.0000000000000029","volume":"3","author":"A Abazari","year":"2024","unstructured":"Abazari A, Abbouda A, Cruzat A, Cavalcanti B, Pavan-Langston D, Hamrah P (2024) Corneal reinnervation in patients with severe neurotrophic keratopathy secondary to herpes zoster ophthalmicus after treatment with autologous serum tear drops. Cornea Open 3(1):e0029. https:\/\/doi.org\/10.1097\/coa.0000000000000029","journal-title":"Cornea Open"},{"key":"7388_CR33","doi-asserted-by":"publisher","unstructured":"Bradley JC, Bradley RH, McCartney DL, Mannis MJ (2008) Serum growth factor analysis in dry eye syndrome. Clin Exp Ophthalmol 36(8):717\u2013720. https:\/\/doi.org\/10.1111\/j.1442-9071.2008.01895.x","DOI":"10.1111\/j.1442-9071.2008.01895.x"},{"issue":"4","key":"7388_CR34","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1097\/ICU.0b013e3283543b61","volume":"23","author":"A Lambiase","year":"2012","unstructured":"Lambiase A, Sacchetti M, Bonini S (2012) Nerve growth factor therapy for corneal disease. Curr Opin Ophthalmol 23(4):296\u2013302. https:\/\/doi.org\/10.1097\/ICU.0b013e3283543b61","journal-title":"Curr Opin Ophthalmol"},{"issue":"1","key":"7388_CR35","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1186\/1479-5876-10-239","volume":"10","author":"L Aloe","year":"2012","unstructured":"Aloe L, Rocco ML, Bianchi P, Manni L (2012) Nerve growth factor: from the early discoveries to the potential clinical use. J Transl Med 10(1):239. https:\/\/doi.org\/10.1186\/1479-5876-10-239","journal-title":"J Transl Med"},{"key":"7388_CR36","doi-asserted-by":"publisher","first-page":"101105","DOI":"10.1016\/j.preteyeres.2022.101105","volume":"91","author":"M Wu","year":"2022","unstructured":"Wu M, Hill LJ, Downie LE, Chinnery HR (2022) Neuroimmune crosstalk in the cornea: The role of immune cells in corneal nerve maintenance during homeostasis and inflammation. Prog Retin Eye Res 91:101105. https:\/\/doi.org\/10.1016\/j.preteyeres.2022.101105","journal-title":"Prog Retin Eye Res"},{"key":"7388_CR37","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.ajo.2024.03.015","volume":"265","author":"C Liu","year":"2024","unstructured":"Liu C et al (2024) Neuropathic corneal pain: tear proteomic and neuromediator profiles, imaging features, and clinical manifestations. Am J Ophthalmol 265:6\u201320. https:\/\/doi.org\/10.1016\/j.ajo.2024.03.015","journal-title":"Am J Ophthalmol"}],"container-title":["Graefe's Archive for Clinical and Experimental Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00417-026-07388-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00417-026-07388-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00417-026-07388-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:47:15Z","timestamp":1784263635000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00417-026-07388-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":37,"alternative-id":["7388"],"URL":"https:\/\/doi.org\/10.1007\/s00417-026-07388-w","relation":{},"ISSN":["0721-832X","1435-702X"],"issn-type":[{"value":"0721-832X","type":"print"},{"value":"1435-702X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]},"assertion":[{"value":"4 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 March 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Sapienza University of Rome and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No Conflicts of Interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers\u2019 bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.","order":3,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}