Publications by authors named "Francisco J Rodríguez"

78 Publications

Anti-VEGF intravitreal injections in the era of COVID-19: responding to different levels of epidemic pressure.

Graefes Arch Clin Exp Ophthalmol 2021 Mar 2;259(3):567-574. Epub 2021 Feb 2.

Macula, Vitreous and Retina Associates of Costa Rica, San José, Costa Rica.

Purpose: Following the first wave of the COVID-19 pandemic in early 2020, the easing of strict measures to reduce its spread has led to a resurgence of cases in many countries at both the national and local level. This article addresses how guidance for ophthalmologists on managing patients with retinal disease receiving intravitreal injections of anti-vascular endothelial growth factor (VEGF) during the pandemic should be adapted to the local epidemic pressure, with more or less stringent measures implemented according to the ebb and flow of the pandemic.

Methods: The Vision Academy's membership of international retinal disease experts analyzed guidance for anti-VEGF intravitreal injections during the COVID-19 pandemic and graded the recommendations according to three levels of increasing epidemic pressure. The revised recommendations were discussed, refined, and voted on by the 14-member Vision Academy Steering Committee for consensus.

Results: Protocols to minimize the exposure of patients and healthcare staff to COVID-19, including use of personal protective equipment, physical distancing, and hygiene measures, should be routinely implemented and intensified according to local infection rates and pressure on the hospital/clinic or healthcare system. In areas with many COVID-19-positive clusters, additional measures including pre-screening of patients, postponement of non-urgent appointments, and simplification of complex intravitreal anti-VEGF regimens should be considered. Treatment prioritization for those at greatest risk of irreversible vision loss should be implemented in areas where COVID-19 cases are increasing exponentially and healthcare resources are strained.

Conclusion: Consistency in monitoring of local infection rates and adjustment of clinical practice accordingly will be required as we move forward through the COVID-19 era. Ophthalmologists must continue to carefully weigh the risk-benefits to minimize the exposure of patients and healthcare staff to COVID-19, ensure that patients receive sight-saving treatment, and avoid the potential long-term impact of prolonged treatment postponement.
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http://dx.doi.org/10.1007/s00417-021-05097-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7852054PMC
March 2021

Macular and choroidal thicknesses in a healthy Hispanic population evaluated by high-definition spectral-domain optical coherence tomography (SD-OCT).

Int J Retina Vitreous 2020 Dec 7;6(1):66. Epub 2020 Dec 7.

Fundación Oftalmológica Nacional, Calle 50 # 13-50, Bogotá, Bogota, Colombia.

Purpose: To report normal values of macular and choroidal thickness obtained from a healthy Hispanic population using Optovue (Optovue Inc, Freemont CA, USA) spectral domain optical coherence tomography (SD-OCT).

Design: Observational, cross-sectional, correlation study.

Methods: A total of 290 eyes (145 healthy subjects) were included; 69% of subjects were female. The median age was 39 ± 29 years (IQR), with a range between 18 and 89 years. The study sample was stratified into three age groups: Group 1, 18-40 years (50.3%), Group 2, 41-60 years (30.7%), and Group 3, older than 61 years (19%). Central macular, perifoveal (inner quadrants), and parafoveal (outer quadrants) thicknesses were estimated. In addition, central and peripheral choroidal thicknesses were estimated. Data analysis was performed to calculate the standardized mean difference according to the variance (Student's t-test) and its differences with Epidat 4.1.

Results: Median macular central thickness was 250 ±30 µm (IQR) with Optovue. Median central choroidal thickness was 263 ± 48 µm (IQR). Median central choroidal thickness was greater than mean peripheral thickness. Macular evaluation showed a statistically significant difference in central, perifoveal, and parafoveal thicknesses, with lower values being recorded for the study sample compared with the manufacturer's data.

Conclusions: SD-OCT has become a useful tool to obtain high-resolution images of the macula and choroid. This method allows precise assessment of the retinal and choroidal layers to diagnose and follow up posterior segment diseases. We are reporting normal cut-off values of macular and choroidal thicknesses in healthy Hispanic subjects evaluated with Optovue SD-OCT as new diagnostic normal parameters for research and clinical activities.
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http://dx.doi.org/10.1186/s40942-020-00270-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7720541PMC
December 2020

Management of retinal pigment epithelium tear during anti-VEGF therapy.

Retina 2020 Dec 16;Publish Ahead of Print. Epub 2020 Dec 16.

Centre for Vision Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia Fundación Oftalmologica Nacional, Universidad del Rosario, Bogotá, Colombia Charité - University Medicine Berlin, Berlin, Germany; Camden Medical Centre, Singapore Department of Ophthalmology, University of Münster Medical Center, Münster, Germany Unity Health Toronto, St. Michael's Hospital, University of Toronto, Canada Service d'ophtalmologie, CHU Bordeaux, Bordeaux, France; University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team LEHA, UMR 1219, Bordeaux, France Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.

Purpose: This article aims to review current evidence on the development, diagnosis, and management of retinal pigment epithelium (RPE) tear during anti-vascular endothelial growth factor (VEGF) therapy.

Methods: Literature searches were performed using MEDLINE/PubMed databases (cut-off date: August 2019).

Results: Three key recommendations were made based on existing literature and clinical experience.

Multimodal imaging with color fundus photography, optical coherence tomography (OCT), near-infrared reflectance imaging, fundus autofluorescence imaging, OCT-angiography and/or fluorescein angiography are recommended to diagnose RPE tear and assess risk factors. RPE tears can be graded by size and foveal involvement.

Patients at high risk of developing RPE tear should be monitored following each anti-VEGF injection. If risk factors worsen, it is not yet definitively known whether anti-VEGF administration should be more frequent, or alternatively stopped in such patients. Prospective research into high-risk characteristics is needed.

After RPE tear develops, anti-VEGF treatment should be continued in patients with active disease (as indicated by presence of intra- or subretinal fluid), although cessation of therapy should be considered in eyes with multilobular tears.

Conclusion: While evidence to support the assumption that anti-VEGF treatment contributes to development of RPE tear is not definitive, some data suggest this link.
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http://dx.doi.org/10.1097/IAE.0000000000003083DOI Listing
December 2020

Central serous chorioretinopathy imaging biomarkers.

Br J Ophthalmol 2020 Dec 7. Epub 2020 Dec 7.

UPMC Eye Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

Purpose: To identify the factors predicting the visual and anatomical outcomes in eyes with central serous chorioretinopathy (CSCR) through 12 months.

Methods: Patients with diagnosis of CSCR, either acute or chronic, were included in this multicentric, retrospective study. Demographic factors; systemic risk factors; central macular thickness (CMT), subfoveal choroidal thickness (SFCT), linear extent of ellipsoid zone (EZ) and interdigitation zone damage on optical coherence tomography; details of leak on fluorescein angiography and indocyanine green angiography were included as predictors of anatomical and visual outcomes. Regression analysis was performed to correlate the changes in best corrected visual acuity (BCVA) and resolution of disease activity.

Results: A total of 231 eyes of 201 patients with a mean age (49.7±11.8 years) were analysed. A total of 97 and 134 eyes were classified as acute and chronic CSCR. BCVA (0.35±0.31 to 0.24±0.34; p<0.001), baseline optical coherence tomography (OCT) parameters including CMT (p<0.001), subretinal fluid (SRF) height (p<0.001) and SFCT (p=0.05) showed a significant change through 12 months. Multivariate regression analysis showed change in CMT (p≤0.01) and SRF height at baseline (p=0.05) as factors predictive of good visual outcome. Logistic regression analysis revealed changes in both CMT (p=0.009) and SFCT (p=0.01) through 12 months to correlate with the resolution of disease.

Conclusion: OCT parameters such as changes in both CMT and SFCT along with subfoveal EZ damage can be predictive of disease resolution whereas changes in CMT and baseline SRF height correlate well with changes in BCVA through 12 months.
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http://dx.doi.org/10.1136/bjophthalmol-2020-317422DOI Listing
December 2020

Describing the status of reproductive ageing simply and precisely: A reproductive ageing score based on three questions and validated with hormone levels.

PLoS One 2020 30;15(6):e0235478. Epub 2020 Jun 30.

Department of Clinical Science, University of Bergen, Bergen, Norway.

Objective: Most women live to experience menopause and will spend 4-8 years transitioning from fertile age to full menstrual stop. Biologically, reproductive ageing is a continuous process, but by convention, it is defined categorically as pre-, peri- and postmenopause; categories that are sometimes supported by measurements of sex hormones in blood samples. We aimed to develop and validate a new tool, a reproductive ageing score (RAS), that could give a simple and yet precise description of the status of reproductive ageing, without hormone measurements, to be used by health professionals and researchers.

Methods: Questionnaire data on age, menstrual regularity and menstrual frequency was provided by the large multicentre population-based RHINE cohort. A continuous reproductive ageing score was developed from these variables, using techniques of fuzzy mathematics, to generate a decimal number ranging from 0.00 (nonmenopausal) to 1.00 (postmenopausal). The RAS was then validated with sex hormone measurements (follicle stimulating hormone and 17β-estradiol) and interview-data provided by the large population-based ECRHS cohort, using receiver-operating characteristics (ROC).

Results: The RAS, developed from questionnaire data of the RHINE cohort, defined with high precision and accuracy the menopausal status as confirmed by interview and hormone data in the ECRHS cohort. The area under the ROC curve was 0.91 (95% Confidence interval (CI): 0.90-0.93) to distinguish nonmenopausal women from peri- and postmenopausal women, and 0.85 (95% CI: 0.83-0.88) to distinguish postmenopausal women from nonmenopausal and perimenopausal women.

Conclusions: The RAS provides a useful and valid tool for describing the status of reproductive ageing accurately, on a continuous scale from 0.00 to 1.00, based on simple questions and without requiring blood sampling. The score allows for a more precise differentiation than the conventional categorisation in pre-, peri- and postmenopause. This is useful for epidemiological research and clinical trials.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235478PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326235PMC
September 2020

Guidance for anti-VEGF intravitreal injections during the COVID-19 pandemic.

Graefes Arch Clin Exp Ophthalmol 2020 Jun 23;258(6):1149-1156. Epub 2020 Apr 23.

Macula, Vitreous and Retina Associates of Costa Rica, San José, Costa Rica.

Purpose: There is an urgent need to address how to best provide ophthalmic care for patients with retinal disease receiving intravitreal injections with anti-vascular endothelial growth factor agents during the ongoing global COVID-19 pandemic. This article provides guidance for ophthalmologists on how to deliver the best possible care for patients while minimizing the risk of infection.

Methods: The Vision Academy's Steering Committee of international retinal disease experts convened to discuss key considerations for managing patients with retinal disease during the COVID-19 pandemic. After reviewing the existing literature on the issue, members put forward recommendations that were systematically refined and voted on to develop this guidance.

Results: The considerations focus on the implementation of steps to minimize the exposure of patients and healthcare staff to COVID-19. These include the use of personal protective equipment, adherence to scrupulous hygiene and disinfection protocols, pre-screening to identify symptomatic patients, and reducing the number of people in waiting rooms. Other important measures include triaging of patients to identify those at the greatest risk of irreversible vision loss and prioritization of treatment visits over monitoring visits where possible. In order to limit patient exposure, ophthalmologists should refrain from using treatment regimens that require frequent monitoring.

Conclusion: Management of patients with retinal disease receiving intravitreal injections during the COVID-19 pandemic will require adjustment to regular clinical practice to minimize the risk of exposure of patients and healthcare staff, and to prioritize those with the greatest medical need. The safety of patients and healthcare staff should be of paramount importance in all decision-making.
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http://dx.doi.org/10.1007/s00417-020-04703-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7179379PMC
June 2020

Breastfeeding practices in Masaya, Nicaragua: a facility based cross-sectional study.

Int Breastfeed J 2020 04 22;15(1):31. Epub 2020 Apr 22.

Pediatrics, University of Nebraska Medical Center, 985525 Nebraska Medical Center, Omaha, NE, USA.

Background: The World Health Organization recommends exclusive breastfeeding for 6 months and total breastfeeding for at least 2 years. Despite this and multiple interventions promoting breastfeeding, early breastfeeding cessation remains high with little data as to the ongoing barriers contributing to early cessation.

Methods: Two groups of Nicaraguan mothers in an urban hospital were approached to complete a questionnaire to determine what newborn, maternal, and socioeconomic factors contributed to early cessation of breastfeeding. Group 1 participants were mothers of newborns in the newborn units, while group 2 were mothers of children 5 years or younger in the emergency room and pediatric ward. Descriptive statistics summarized the data. Fisher's exact test evaluated factors associated with early breastfeeding cessation.

Results: In group 1, 97 participants were enrolled with 81% of mothers planning to fulfill the guideline for exclusive breastfeeding for 6 months. In group 2, there were 139 mothers of which 58% reported they had exclusively breastfed for 6 months. Only 25 and 27% of mothers in group 1 and 2 respectively planned to breastfeed or breastfed for 2 years. In group 1, mothers reported lack of knowledge regarding breastfeeding techniques and older mothers tended to plan for early cessation of exclusive breastfeeding. In group 2, mothers reported feeling uncomfortable with breastfeeding in public or had difficulty with latching. Cessation of any breastfeeding prior to 12 months was associated with being uncomfortable breastfeeding in public and knowing the WHO guidelines. In both groups, social media represented an expanding platform for receiving breastfeeding information.

Conclusions: Interventions focusing on reaching younger mothers and addressing breastfeeding knowledge and techniques while leveraging the increasing influence of social media platforms may help improve compliance with breastfeeding recommendations.
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http://dx.doi.org/10.1186/s13006-020-00273-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178974PMC
April 2020

Efficacy of human HC016 cell transplants on neuroprotection and functional recovery in a rat model of acute spinal cord injury.

J Tissue Eng Regen Med 2020 02 26;14(2):319-333. Epub 2019 Dec 26.

Laboratory of Molecular Neurology, Hospital Nacional de Parapléjicos, Toledo, Spain.

Spinal cord injury (SCI) is a devastating event with huge personal and social costs, for which there is no effective treatment. Cell therapy constitutes a promising therapeutic approach for SCI; however, its clinical potential is seriously limited by their low survival in the hostile conditions encompassing the acute phase of SCI. Human HC016 (hHC016) cells, generated from expanded human adipose mesenchymal stem cells (hAMSCs) and pulsed with a patented protocol with hydrogen peroxide (H O ), are expected to acquire improved resistance to oxidative environments which appears as a major limiting factor hampering the engrafting success. Our specific aim was to assess whether H O -pulsed hHC016 cells had an improved survival and thus therapeutic efficacy in a rat contusion model of acute SCI when grafted 48 hr after injury. Functional recovery was evaluated up to 56 days post-injury (dpi) by locomotor (open field test and CatWalk) and sensory (Von Frey and Hargreaves) tests. Besides, histological evaluation of transplanted cell survival and tissue protection/regeneration was also performed. Functional results showed a statistically significant improvement on locomotor recovery outcomes with hHC016 cells. Accordingly, superior cell survival in correlation with long-term neuroprotection, higher axonal regeneration, and reduced astroglial and microglial reactivity was also observed with hHC016 cells. These results demonstrate an enhanced survival capacity of hHC016 cells resulting in improved functional and histological outcomes as compared with hAMSCs, indicating that hHC016 cell transplants may constitute a promising cell therapy for acute SCI.
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http://dx.doi.org/10.1002/term.2995DOI Listing
February 2020

Social Navigation in a Cognitive Architecture Using Dynamic Proxemic Zones.

Sensors (Basel) 2019 Nov 27;19(23). Epub 2019 Nov 27.

Robotics Group, University of León, Campus de Vegazana, s/n, 24071 León, Spain.

Robots have begun to populate the everyday environments of human beings. These social robots must perform their tasks without disturbing the people with whom they share their environment. This paper proposes a navigation algorithm for robots that is acceptable to people. Robots will detect the personal areas of humans, to carry out their tasks, generating navigation routes that have less impact on human activities. The main novelty of this work is that the robot will perceive the moods of people to adjust the size of proxemic areas. This work will contribute to making the presence of robots in human-populated environments more acceptable. As a result, we have integrated this approach into a cognitive architecture designed to perform tasks in human-populated environments. The paper provides quantitative experimental results in two scenarios: controlled, including social navigation metrics in comparison with a traditional navigation method, and non-controlled, in robotic competitions where different studies of social robotics are measured.
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http://dx.doi.org/10.3390/s19235189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928844PMC
November 2019

Synthetic bioresorbable poly-α-hydroxyesters as peripheral nerve guidance conduits; a review of material properties, design strategies and their efficacy to date.

Biomater Sci 2019 Nov;7(12):4912-4943

The Charles Institute of Dermatology, School of Medicine, University College Dublin, Belfield, Dublin, Ireland.

Implantable tubular devices known as nerve guidance conduits (NGCs) have drawn considerable interest as an alternative to autografting in the repair of peripheral nerve injuries. At present, there exists a lack of biodegradable, biocompatible materials for the fabrication of NGCs with physical properties which suitably match the native nerve tissue. Most of the existing reports have been confined to the traditional synthetic aliphatic polyesters due to their naturally-occurring degradation by-products, suitably slow in vivo resorption timeframes and relatively diverse and tailorable range of material properties. Moreover, these thermoplastic polymers can be processed into NGCs from various methods and further tweaking of physical properties can be achieved during fabrication. Although there have been many successful reports of nerve gap repair using NGCs made from these materials, the majority have been confined to basic tubular designs across short to medium nerve gaps with at best equivalent outcomes to autografts. This article reviews the performance of poly-α-hydroxyester tubes to date (including modifications to basic hollow conduits) and is intended to aid researchers as they aim to create biomimetic NGCs capable of bridging larger nerve gaps with superior results to autografting. Based on the existing reports, a next-generation bioresorbable NGC should involve a highly flexible poly-α-hydroxyester outer tube, most suitably from a lactide-caprolactone co-polymer, with some combination of internal lumen contact guidance and bioactive neurotrophic factors. However, detailed further experimentation and an interdisciplinary approach will be required to arrive at an ideal final configuration.
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http://dx.doi.org/10.1039/c9bm00246dDOI Listing
November 2019

Players' selection for basketball teams, through Performance Index Rating, using multiobjective evolutionary algorithms.

PLoS One 2019 4;14(9):e0221258. Epub 2019 Sep 4.

Facultad de Educación, Universidad Autónoma de Chile, Santiago de Chile, Chile.

In any sport the selection of players for a team is fundamental for its subsequent performance. Many factors condition the selection process from the characteristics of the sport discipline to financial limitations, including a long list of restrictions associated with the environment of the competitions in which the team takes part. All of this makes the process of selecting a roster of players very complex, as it is affected by multiple variables and in many cases marked by a great deal of subjectivity. The purpose of this article was to objectively select the players for a basketball team using an evolutionary algorithm, the Non-dominated Sorting Genetic Algorithm II (NSGA-II) that uses stochastic search methods based on the imitation of natural biological evolution. The sample was composed of the players from the teams competing in the top Spanish basketball league, the Association of Basketball Clubs (ACB). To assess the quality of the solutions obtained, the results were compared with the teams in the ACB playing in the same competition as the players used in the study. The results make it possible to obtain different solutions for composing teams rendering financial resources profitable and taking into account the restrictions of the competition and of each sport management.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0221258PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726145PMC
March 2020

Classification of diabetes-related retinal diseases using a deep learning approach in optical coherence tomography.

Comput Methods Programs Biomed 2019 Sep 14;178:181-189. Epub 2019 Jun 14.

MindLab Research Group, Universidad Nacional de Colombia, Edificio 453, Laboratorio 207, Bogotá, Colombia. Electronic address: https://sites.google.com/a/unal.edu.co/mindlab/.

Background And Objectives: Spectral Domain Optical Coherence Tomography (SD-OCT) is a volumetric imaging technique that allows measuring patterns between layers such as small amounts of fluid. Since 2012, automatic medical image analysis performance has steadily increased through the use of deep learning models that automatically learn relevant features for specific tasks, instead of designing visual features manually. Nevertheless, providing insights and interpretation of the predictions made by the model is still a challenge. This paper describes a deep learning model able to detect medically interpretable information in relevant images from a volume to classify diabetes-related retinal diseases.

Methods: This article presents a new deep learning model, OCT-NET, which is a customized convolutional neural network for processing scans extracted from optical coherence tomography volumes. OCT-NET is applied to the classification of three conditions seen in SD-OCT volumes. Additionally, the proposed model includes a feedback stage that highlights the areas of the scans to support the interpretation of the results. This information is potentially useful for a medical specialist while assessing the prediction produced by the model.

Results: The proposed model was tested on the public SERI-CUHK and A2A SD-OCT data sets containing healthy, diabetic retinopathy, diabetic macular edema and age-related macular degeneration. The experimental evaluation shows that the proposed method outperforms conventional convolutional deep learning models from the state of the art reported on the SERI+CUHK and A2A SD-OCT data sets with a precision of 93% and an area under the ROC curve (AUC) of 0.99 respectively.

Conclusions: The proposed method is able to classify the three studied retinal diseases with high accuracy. One advantage of the method is its ability to produce interpretable clinical information in the form of highlighting the regions of the image that most contribute to the classifier decision.
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http://dx.doi.org/10.1016/j.cmpb.2019.06.016DOI Listing
September 2019

Antifungal and physicochemical properties of inclusion complexes based on β-cyclodextrin and essential oil derivatives.

Food Res Int 2019 07 14;121:127-135. Epub 2019 Mar 14.

Institute of Food Technology (ITAL), Packaging Technology Center (CETEA), Campinas-SP, Brazil.

Inclusion complexes based on β-cyclodextrin (β-CD) and antimicrobial compounds, were prepared by co-precipitation method, and characterized by entrapment efficiency (EE), thermal analysis, X-ray diffraction, H NMR spectroscopy, and water sorption. In addition, experiments associated to evaluate the effect of relative humidity on the release of active compounds and antifungal tests were performed. The analysis evidenced the encapsulation of active compounds into the β-CD structure with EE of 91 ± 4.1% and 66 ± 2.1% for β-CD/cinnamaldehyde and β-CD/eugenol complexes, respectively. Additionally, high relative humidities favored the release of active compounds from inclusion complexes. On the other hand, inclusion complexes were able to control the growth of B. cinerea, which was evidenced by a reduction of its mycelialradial growth. Finally, specific interactions between the active compounds and β-CD were evaluated through molecular dynamics simulation techniques. According to the obtained results, these complexes could be applied as additives in the design of antifungal packaging.
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http://dx.doi.org/10.1016/j.foodres.2019.03.026DOI Listing
July 2019

The role of OCT-A in retinal disease management.

Graefes Arch Clin Exp Ophthalmol 2018 Nov 3;256(11):2019-2026. Epub 2018 Sep 3.

Department of Ophthalmology, York Teaching Hospital NHS Foundation Trust, York, UK.

Optical coherence tomography angiography (OCT-A) is a non-invasive, non-dye-based imaging modality that has the potential to enhance our understanding of retinal diseases. While this rapidly advancing imaging modality offers great potential, there is a need for community-wide understanding of the range of technologies and methods for interpreting the images, as well as a need to enhance understanding of images from disease-free eyes for reference when screening for retinal diseases. Importantly, clinical trials have been designed without OCT-A-based endpoints; therefore, caution is required when making treatment decisions based on OCT-A imaging alone. With this in mind, a full understanding of the advantages and limitations of OCT-A will be vital for effective development of the technique within the field of ophthalmology. On behalf of the Vision Academy Steering Committee (sponsored by Bayer), this publication summarizes the views of the authors on the current use of OCT-A imaging and explores its potential for future applications in research and clinical practice.
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http://dx.doi.org/10.1007/s00417-018-4109-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208724PMC
November 2018

Efficacy and safety of fluocinolone acetonide 0.025% otic solution in patients with otic eczema: a randomized, double-blind, placebo-controlled clinical trial.

J Int Med Res 2018 Oct 24;46(10):4050-4060. Epub 2018 Aug 24.

10 Otolaryngology Department, Hospital Comarcal de Blanes, Blanes, Spain.

Objectives To assess the efficacy and safety of fluocinolone acetonide 0.025% otic solution versus placebo in treating patients with otic eczema. Methods In this multicentre, randomized, double-blind, parallel-group phase 3 clinical trial, conducted at 12 Spanish centres between March 2012 and March 2013, patients received fluocinolone acetonide 0.025% or placebo otic solution twice daily for 7 days (days 1-7) with an 8-day follow-up (days 9-15). Outcome measures included change in itching from baseline (day 1) to study days 4-8 and 9-15, and change in otoscopic signs (erythema, oedema, and scaling) from baseline to the end of treatment (day 8) and end of follow-up (day 15). Results Patients treated with fluocinolone acetonide 0.025% (n = 66), as compared with placebo-treated patients (n = 69), showed significantly higher reductions in itching from baseline to study days 4-8 and 9-15, and in individual and global otoscopic signs from baseline to the end of treatment (day 8) and end of follow-up (day 15). Incidence and severity of adverse events was similar between the fluocinolone and placebo groups. Conclusions Fluocinolone acetonide 0.025% otic solution, administered twice daily for 7 days, is an effective and safe treatment for otic eczema.
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http://dx.doi.org/10.1177/0300060518765333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166331PMC
October 2018

Further observations on a bilateral IRVAN syndrome case.

Int Ophthalmol 2019 May 14;39(5):1179-1186. Epub 2018 Jun 14.

Fundación Oftalmológica Nacional, Carrera 13 #13-50, Bogotá D.C., Colombia.

Purpose: Reporting clinical features of the late course of the disease after long-term follow-up in a bilaterally affected patient with idiopathic retinitis, vasculitis, retinal aneurysms and neuroretinitis (IRVAN) and new peripheral retinal findings on wide-field angiography and multimodal imaging.

Methods: This was a retrospective observational study, based on current diagnostic studies including wide-field fluorescein angiography, optical coherence tomography (OCT) and treatment of aneurysms with argon laser photocoagulation.

Results: A 21-year-old female with bilateral IRVAN syndrome-stage 2 in the right eye and stage 3 in the left eye-previously treated bilaterally with laser photocoagulation for retinal macroaneurysms and ischemic areas between 1985 and 1992. Follow-up interrupted on two occasions, with subsequent fundus re-examinations confirming the prevention of retinal neovascularization in both eyes, as recently evidenced on wide-field angiography.

Conclusions: A case of bilateral IRVAN disease with multiple retinal aneurysms, neuroretinitis and peripheral capillary nonperfusion successfully treated with laser photocoagulation, maintaining normal visual acuity in one eye and preventing retinal neovascular complications.
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http://dx.doi.org/10.1007/s10792-018-0917-zDOI Listing
May 2019

When Violence Can Appear With Different Male Partners: Identification of Resilient and Non-resilient Women in the European Union.

Front Psychol 2018 1;9:877. Epub 2018 Jun 1.

Department of Psychology, University of Oviedo, Oviedo, Spain.

Little scholarly attention has been paid to the analysis of the history of intimate partner violence (IPV) against women with different male partners and how it could be related to levels of IPV with the current male partner. From this point of view, been a victim of IPV could increase the vulnerability of women and, therefore, exert a negative influence on the selection of partners over time, thus increasing the odds of potentially mating with abusive male partners. Alternatively, for some women victims of IPV in previous relationships, there may be additional resources that reduce their vulnerability to victimization by new partners. The present study analyzes levels of IPV in different partners of 2376 heterosexual women from the 28 countries of the European Union living together as a couple who had previously lived with a different male partner. Multilevel regression results indicated that resilient women were younger, more satisfied with household income, and were involved in shorter relationships. As for their previous levels of victimization, they scored lower on child abuse and non-partner adult victimization. Also, their levels of victimization from previous partners were the same as those of the non-resilient women, with the exception of physical IPV victimization where resilient women scored higher than non-resilient women. Resilient women also informed the interviewer to have ended the abusive relationship because of the violence to a greater extent than non-resilient women and seemed to suffer fewer psychological difficulties due to previous violent relationships. Finally, countries scoring higher on human development index (HDI) showed a larger proportion of resilient women. Resilient women are mostly characterized by fewer psychological difficulties and lower frequency of adverse situations (in childhood or in adulthood) when compared to non-resilient women. Although resilient women reported a higher physical IPV, they nevertheless show fewer psychological sequelae and a greater ability to end abusive relationships. In addition, the human development of the countries in which they live also seems to reinforce their resilience, which suggests combining intervention policies at the individual and contextual levels.
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http://dx.doi.org/10.3389/fpsyg.2018.00877DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992675PMC
June 2018

Child Abuse, Risk in Male Partner Selection, and Intimate Partner Violence Victimization of Women of the European Union.

Prev Sci 2018 11;19(8):1102-1112

University of Oviedo, Despacho 211. Plaza Feijoo s/n, 33003, Oviedo, Spain.

The revictimization of women during the life cycle has attracted the interest of many researchers in recent years. In this study, we examined the relationship between the experience of child abuse and the subsequent victimization by a male partner in adulthood. Specifically, we proposed that childhood abuse experiences negatively affect the development of healthy interpersonal relationships in adulthood. Thus, some female victims of child abuse are more likely to select potentially abusive intimate male partners. Data from 23,863 heterosexual women from the 28 countries of the European Union who were living with their partners at the time of the study were used. We investigated the association between child abuse, partner's adherence to traditional gender roles, and general violence and intimate partner violence (IPV) against women. Multilevel structural equation modeling (MSEM) results indicated that child abuse is positively related to the partner's traditional gender role and general violence, which in turn predict IPV. Countries' level of human development was found to affect this process. We found support for the hypothesis that child abuse is related to IPV partially because it influences partner selection in adulthood. Thus, when they become adults, girls abused in childhood tend to select partners who are either traditional or generally violent. There is a persistent influence of social structural conditions (i.e., country's human development) throughout this process.
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http://dx.doi.org/10.1007/s11121-018-0911-8DOI Listing
November 2018

Yellow (577 nm) micropulse laser versus half-dose verteporfin photodynamic therapy in eyes with chronic central serous chorioretinopathy: results of the Pan-American Collaborative Retina Study (PACORES) Group.

Br J Ophthalmol 2018 12 8;102(12):1696-1700. Epub 2018 Feb 8.

Clinica Oftalmologica Centro Caracas and the Arevalo-Coutinho Foundation for Research in Ophthalmology, Caracas, Venezuela.

Purpose: To compare the functional and anatomical outcomes of eyes with chronic central serous chorioretinopathy treated with yellow micropulse (MP) laser versus half-dose verteporfin photodynamic therapy (PDT).

Methods: This is a multicentre, retrospective comparative study of 92 eyes treated with yellow MP laser (duty cycle of 5%, zero spacing between spots, spot size varied from 100 to 200 µm, power varied from 320 to 660 mW, and the pulse burst duration was 200 ms) and 67 eyes treated with PDT (half-dose verteporfin (3 mg/m) infused over 10 min), followed by laser activation for 83 s. Spot sizes varied from 400 to 2000 µm.

Results: In the MP group, at 12 months of follow-up, the mean best corrected visual acuity (BCVA) improved from the logarithm of the minimum angle of resolution (logMAR) of 0.41±0.27 at baseline to 0.21±0.26 (P<0.0001), 48.9% (45/92) of eyes had an improvement of ≥3 lines of BCVA from baseline, 48.9% (45/92) of eyes remained within 2 lines of baseline BCVA, and only 2.2% (2/92) of eyes lost ≥3 lines of BCVA from baseline. In the PDT group, at 12 months of follow-up, the mean BCVA changed from logMAR of 0.50±0.34 at baseline to 0.47±0.34 (P=0.89), 19% (13/67) of eyes had an improvement of ≥3 lines of BCVA from baseline, 73% (49/67) of eyes remained within 2 lines of baseline BCVA, and 7% (5/67) of eyes lost ≥3 lines of BCVA from baseline. There were no adverse events attributable to the yellow MP laser treatment. One eye in the PDT group developed choroidal neovascularisation, which was treated with three intravitreal bevacizumab injections.

Conclusions: Both PDT and MP are effective in restoring the macular anatomy. In places where PDT is not available, yellow MP laser may be an adequate treatment alternative.
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http://dx.doi.org/10.1136/bjophthalmol-2017-311291DOI Listing
December 2018

Giant photoeffect in proton transport through graphene membranes.

Nat Nanotechnol 2018 04 22;13(4):300-303. Epub 2018 Jan 22.

School of Physics & Astronomy, University of Manchester, Manchester, UK.

Graphene has recently been shown to be permeable to thermal protons , the nuclei of hydrogen atoms, which sparked interest in its use as a proton-conducting membrane in relevant technologies. However, the influence of light on proton permeation remains unknown. Here we report that proton transport through Pt-nanoparticle-decorated graphene can be enhanced strongly by illuminating it with visible light. Using electrical measurements and mass spectrometry, we find a photoresponsivity of ∼10 A W, which translates into a gain of ∼10 protons per photon with response times in the microsecond range. These characteristics are competitive with those of state-of-the-art photodetectors that are based on electron transport using silicon and novel two-dimensional materials. The photo-proton effect could be important for graphene's envisaged use in fuel cells and hydrogen isotope separation. Our observations may also be of interest for other applications such as light-induced water splitting, photocatalysis and novel photodetectors.
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http://dx.doi.org/10.1038/s41565-017-0051-5DOI Listing
April 2018

FUNCTIONAL AND ANATOMICAL SIGNIFICANCE OF THE ECTOPIC INNER FOVEAL LAYERS IN EYES WITH IDIOPATHIC EPIRETINAL MEMBRANES: Surgical Results at 12 Months.

Retina 2019 Feb;39(2):347-357

Retina Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California.

Purpose: To describe the functional and anatomical outcomes of pars plana vitrectomy with epiretinal membrane and internal limiting membrane peel in eyes with and without ectopic inner foveal layers (EIFLs).

Methods: In this retrospective multicenter study, patients diagnosed with idiopathic epiretinal membranes who underwent pars plana vitrectomy with epiretinal membrane and internal limiting membrane peel were enrolled, with a minimum follow-up of 12 months. Preoperative and postoperative spectral domain optical coherence tomography scans were qualitatively and quantitatively evaluated. The association of the EIFL and other spectral domain optical coherence tomography parameters with preoperative and postoperative best-corrected visual acuity (BCVA) was analyzed.

Results: One hundred eleven eyes of 107 patients were included. Preoperatively, the EIFLs were present in 56 of 111 eyes (50.4%). The presence of EIFL was significantly associated with lower preoperative and postoperative BCVA (P < 0.001). Ectopic inner foveal layer thickness was negatively correlated with preoperative BCVA (r = 0.58, P < 0.001). Postoperatively, the EIFL persisted in 51 of 56 eyes (91%) with Stage 3 and 4 epiretinal membranes. Ectopic inner foveal layer thickness decreased significantly after surgery (P < 0.001), but postoperative EIFL thinning had no direct effect on postoperative change in BCVA. At 12 months from surgery, EIFL thickness maintained a significant negative correlation with BCVA (r = 0.55, P < 0.001).

Conclusion: The presence of EIFL should be considered a negative prognostic factor for postoperative anatomical and functional recovery.
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http://dx.doi.org/10.1097/IAE.0000000000001940DOI Listing
February 2019

High Yield of Adult Oligodendrocyte Lineage Cells Obtained from Meningeal Biopsy.

Front Pharmacol 2017 12;8:703. Epub 2017 Oct 12.

Section of Pharmacology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.

Oligodendrocyte loss can lead to cognitive and motor deficits. Current remyelinating therapeutic strategies imply either modulation of endogenous oligodendrocyte precursors or transplantation of expanded oligodendrocytes. Cell therapy, however, still lacks identification of an adequate source of oligodendrocyte present in adulthood and able to efficiently produce transplantable cells. Recently, a neural stem cell-like population has been identified in meninges. We developed a protocol to obtain high yield of oligodendrocyte lineage cells from one single biopsy of adult rat meningeal tissue. From 1 cm of adult rat spinal cord meninges, we efficiently expanded a homogenous culture of 10 millions of meningeal-derived oligodendrocyte lineage cells in a short period of time (approximately 4 weeks). Meningeal-derived oligodendrocyte lineage cells show typical mature oligodendrocyte morphology and express specific oligodendrocyte markers, such as galactosylceramidase and myelin basic protein. Moreover, when transplanted in a chemically demyelinated spinal cord model, meningeal-derived oligodendrocyte lineage cells display -remyelinating potential. This oligodendrocyte lineage cell population derives from an accessible and adult source, being therefore a promising candidate for autologous cell therapy of demyelinating diseases. In addition, the described method to differentiate meningeal-derived neural stem cells into oligodendrocyte lineage cells may represent a valid model to dissect oligodendrocyte differentiation and to screen for drugs capable to promote oligodendrocyte regeneration.
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http://dx.doi.org/10.3389/fphar.2017.00703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643910PMC
October 2017

New Treatment Modalities for Neovascular Age-Related Macular Degeneration.

Asia Pac J Ophthalmol (Phila) 2017 Nov-Dec;6(6):514-519. Epub 2017 Sep 14.

Asociados de Macula Vítreo y Retina de Costa Rica, San José, Costa Rica.

Age-related macular degeneration (AMD) is considered one of the main causes of severe vision loss in older adults. The neovascular form (nAMD) is an advanced stage, which is responsible for the most severe vision loss. Vascular endothelial growth factor (VEGF) is at present the main factor that leads to the development of a neovascular membrane and the increased leakage from the membrane to the retina. At present, anti-VEGF therapy is the only treatment that achieves vision gains in many patients and halts progression in most of them. VEGF blockade can be achieved with several molecules and various treatment regimens, which have been studied with excellent results. Unfortunately, real-world data has shown to be far less efficacious than clinical trials. This gap between clinical trials and real-world results is an unmet medical need that supports the necessity of new treatment modalities for nAMD. Of the various treatments being studied, anti-VEGFs of higher efficacy and longer durability are those more advanced in their development. Brolucizumab and abicipar pegol are 2 new anti-VEGF drugs that had positive results in phase 2 studies and are being tested in phase 3 trials at present. Other promising therapies are antiangiopoietin 2 molecules, which are in phase 2 development. At earlier stages of development but with promising results are squalamine, anti-VEGF-C and -D, and gene therapy. The future will give retina specialists a broad armamentarium with which patients may achieve high visual gains for the long term with a low treatment burden.
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http://dx.doi.org/10.22608/APO.2017258DOI Listing
December 2017

Plasmon-induced nanoscale quantised conductance filaments.

Sci Rep 2017 06 6;7(1):2878. Epub 2017 Jun 6.

School of Physics and Astronomy, University of Manchester, Manchester, M13 9PL, UK.

Plasmon-induced phenomena have recently attracted considerable attention. At the same time, relatively little research has been conducted on electrochemistry mediated by plasmon excitations. Here we report plasmon-induced formation of nanoscale quantized conductance filaments within metal-insulator-metal heterostructures. Plasmon-enhanced electromagnetic fields in an array of gold nanodots provide a straightforward means of forming conductive CrO bridges across a thin native chromium oxide barrier between the nanodots and an underlying metallic Cr layer. The existence of these nanoscale conducting filaments is verified by transmission electron microscopy and contact resistance measurements. Their conductance was interrogated optically, revealing quantised relative transmission of light through the heterostructures across a wavelength range of 1-12 μm. Such plasmon-induced electrochemical processes open up new possibilities for the development of scalable devices governed by light.
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http://dx.doi.org/10.1038/s41598-017-02976-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460164PMC
June 2017

Solid-State Electrolyte-Gated Graphene in Optical Modulators.

Adv Mater 2017 May 15;29(19). Epub 2017 Mar 15.

School of Physics and Astronomy, The University of Manchester, Manchester, M13 9PL, UK.

The gate-tunable wide-band absorption of graphene makes it suitable for light modulation from terahertz to visible light. The realization of graphene-based modulators, however, faces challenges connected with graphene's low absorption and the high electric fields necessary to change graphene's optical conductivity. Here, a solid-state supercapacitor effect with the high-k dielectric hafnium oxide is demonstrated that allows modulation from the near-infrared to shorter wavelengths close to the visible spectrum with remarkably low voltages (≈3 V). The electroabsorption modulators are based on a Fabry-Perot-resonator geometry that allows modulation depths over 30% for free-space beams.
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http://dx.doi.org/10.1002/adma.201606372DOI Listing
May 2017

Late development of a lamellar macular hole after the spontaneous separation of vitreoretinal traction: case report.

Eur J Ophthalmol 2016 Nov 4;26(6):e168-e170. Epub 2016 Nov 4.

Fundación Oftalmológica Nacional, Universidad del Rosario, Bogotá - Colombia.

Purpose: To report a case of epiretinal macular membrane and a lamellar macular hole developing after the spontaneous separation of an idiopathic vitreoretinal traction.

Methods: Retrospective, observational, long follow-up of a case evaluated and documented with optical coherence tomography and managed with current therapies including pars plana vitrectomy.

Results: Good anatomic and functional results with stable 20/30 best-corrected visual acuity.

Conclusions: The natural course of idiopathic vitreomacular traction has been documented during prolonged observation after its spontaneous separation from the fovea leading to the development of an epiretinal membrane and a lamellar macular hole.
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http://dx.doi.org/10.5301/ejo.5000785DOI Listing
November 2016

Wnts Are Expressed in the Ependymal Region of the Adult Spinal Cord.

Mol Neurobiol 2017 Oct 8;54(8):6342-6355. Epub 2016 Oct 8.

Laboratory of Neuroinflammation, Hospital Nacional de Paraplejicos (SESCAM), Finca La Peraleda s/n, 45071, Toledo, Spain.

The Wnt family of proteins plays key roles during central nervous system development and in several physiological processes during adulthood. Recently, experimental evidence has linked Wnt-related genes to regulation and maintenance of stem cells in the adult neurogenic niches. In the spinal cord, the ependymal cells surrounding the central canal form one of those niches, but little is known about their Wnt expression patterns. Using microdissection followed by TaqMan® low-density arrays, we show here that the ependymal regions of young, mature rats and adult humans express several Wnt-related genes, including ligands, conventional and non-conventional receptors, co-receptors, and soluble inhibitors. We found 13 genes shared between rats and humans, 4 exclusively expressed in rats and 9 expressed only in humans. Also, we observed a reduction with age on spontaneous proliferation of ependymal cells in rats paralleled by a decrease in the expression of Fzd1, Fzd8, and Fzd9. Our results suggest a role for Wnts in the regulation of the adult spinal cord neurogenic niche and provide new data on the specific differences in this region between humans and rodents.
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http://dx.doi.org/10.1007/s12035-016-0132-8DOI Listing
October 2017

Influence of preozonation on the adsorptivity of humic substances onto activated carbon.

Environ Sci Pollut Res Int 2016 Nov 18;23(21):21980-21988. Epub 2016 Aug 18.

Department of Chemistry, Faculty of Sciences, University of Burgos, Spain, Pz. Misael Bañuelos s/n, 09001, Burgos, Spain.

This research aims to study the influence of preozonation on the adsorptivity of humic substances onto activated carbon, which are usual stages in drinking water treatment. Three different types of humic substances were used in this study: natural fulvic and humic acids extracted from the Úzquiza Reservoir (Burgos, Spain) and a commercially supplied humic acid. The fractionation of the humic substances by ultrafiltration showed a very different molecular weight (MW) distribution for them: the lowest fraction of <1 kDa comprises the vast majority of the fulvic acids (around 86 %), whereas the main fraction for the commercial humic acids was the highest one of >30 kDa (around 40 %). The natural humic acids show an intermediate distribution between the two aforementioned humic substances. The 1-5-kDa fraction turned out to be the most reactive toward trihalomethane formation for the commercial humic acids. The adsorptive capacity of activated carbon for the humic substances was in the following order: natural fulvic acids > natural humic acids > commercial humic acids. The most adsorbable fraction was that of <1 kDa for the fulvic acids, whereas the 5-10-kDa fraction was the most adsorbable for both humic acids. Preozonation changes the MW distribution of the humic substances, decreasing the abundance of the high MW fractions and generating smaller molecules within the low to medium MW range. Adsorption isotherms show that preozonation has a beneficial effect on the adsorptivity of the commercial humic acids onto activated carbon, whereas no appreciable effect was observed for the case of the fulvic acids.
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http://dx.doi.org/10.1007/s11356-016-7414-6DOI Listing
November 2016

Successful catheter ablation in a patient with Scimitar and Wolff-Parkinson-White syndromes.

Int J Cardiol 2016 Oct 30;221:1048-50. Epub 2016 Jun 30.

Albarregas Clinic, Mérida, Venezuela.

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http://dx.doi.org/10.1016/j.ijcard.2016.06.321DOI Listing
October 2016

Acceptability of Partner Violence in 51 Societies: The Role of Sexism and Attitudes Toward Violence in Social Relationships.

Violence Against Women 2017 Mar 9;23(3):351-367. Epub 2016 Jul 9.

1 University of Oviedo, Oviedo, Spain.

Sexist attitudes have been claimed to play an important role in acceptability of intimate partner violence (IPV). Empirical evidence suggests that sexist individuals are also more accepting of violence in social relationships than non-sexist individuals. Results from multilevel regression models of data from 72,730 respondents of 51 countries around the world showed that (a) both sexism and acceptability of general violence in social relationships were positively related to acceptability of IPV and (b) the highest levels of acceptability of IPV were found among those sexist individuals who also present positive attitudes toward the use of violence in social relationships.
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http://dx.doi.org/10.1177/1077801216642870DOI Listing
March 2017