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Zugman A, Alliende L, Medel V, Bethlehem RA, Seidlitz J, Ringlein G, Arango C, Arnatkevičiūtė A, Asmal L, Bellgrove M, Benegal V, Bernardo M, Billeke P, Bosch-Bayard J, Bressan R, Busatto G, Castro M, Chaim-Avancini T, Compte A, Costanzi M, Czepielewski L, Dazzan P, de la Fuente-Sandoval C, Di Forti M, Díaz-Caneja C, María Díaz-Zuluaga A, Du Plessis S, Duran F, Fittipaldi S, Fornito A, Freimer N, Gadelha A, Gama C, Garani R, Garcia-Rizo C, Gonzalez Campo C, Gonzalez-Valderrama A, Guinjoan S, Holla B, Ibañez A, Ivanovic D, Jackowski A, Leon-Ortiz P, Lochner C, López-Jaramillo C, Luckhoff H, Massuda R, McGuire P, Miyata J, Mizrahi R, Murray R, Ozerdem A, Pan P, Parellada M, Phahladira L, Ramirez-Mahaluf J, Reckziegel R, Reis Marques T, Reyes-Madrigal F, Roos A, Rosa P, Salum G, Scheffler F, Schumann G, Serpa M, Stein D, Tepper A, Tiego J, Ueno T, Undurraga J, Undurraga E, Valdes-Sosa P, Valli I, Villarreal M, Winton-Brown T, Yalin N, Zamorano F, Zanetti M, Winkler A, Pine D, Evans-Lacko S, Crossley N. Country-level gender inequality is associated with structural differences in the brains of women and men. Proc Natl Acad Sci U S A 2023; 120:e2218782120. [PMID: 37155867 PMCID: PMC10193926 DOI: 10.1073/pnas.2218782120] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/15/2023] [Indexed: 05/10/2023] Open
Abstract
Gender inequality across the world has been associated with a higher risk to mental health problems and lower academic achievement in women compared to men. We also know that the brain is shaped by nurturing and adverse socio-environmental experiences. Therefore, unequal exposure to harsher conditions for women compared to men in gender-unequal countries might be reflected in differences in their brain structure, and this could be the neural mechanism partly explaining women's worse outcomes in gender-unequal countries. We examined this through a random-effects meta-analysis on cortical thickness and surface area differences between adult healthy men and women, including a meta-regression in which country-level gender inequality acted as an explanatory variable for the observed differences. A total of 139 samples from 29 different countries, totaling 7,876 MRI scans, were included. Thickness of the right hemisphere, and particularly the right caudal anterior cingulate, right medial orbitofrontal, and left lateral occipital cortex, presented no differences or even thicker regional cortices in women compared to men in gender-equal countries, reversing to thinner cortices in countries with greater gender inequality. These results point to the potentially hazardous effect of gender inequality on women's brains and provide initial evidence for neuroscience-informed policies for gender equality.
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Affiliation(s)
- André Zugman
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (E & D), National Institute of Mental Health, National Institutes of Health, BethesdaMD20894
| | - Luz María Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
- Department of Psychology, Northwestern University, Evanston, IL60208
| | - Vicente Medel
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago7941169, Chile
| | - Richard A.I. Bethlehem
- Autism Research Centre, Department of Psychiatry, University of Cambridge, CambridgeCB2 8AH, United Kingdom
- Department of Psychology, University of Cambridge, CambridgeCB2 3EB, United Kingdom
| | - Jakob Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA19104
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
- Penn-Children’s Hospital of Philadelphia Lifespan Brain Institute, University of Pennsylvania, Philadelphia, PA19104
| | - Grace Ringlein
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (E & D), National Institute of Mental Health, National Institutes of Health, BethesdaMD20894
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), School of Medicine, Universidad Complutense, Madrid28009, Spain
| | - Aurina Arnatkevičiūtė
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC3168, Australia
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
| | - Mark Bellgrove
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
| | - Vivek Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka560029, India
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d’Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Barcelona08036, Spain
| | - Pablo Billeke
- Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago7610658, Chile
| | - Jorge Bosch-Bayard
- McGill Centre for Integrative Neuroscience, Ludmer Centre for Neuroinformatics and Mental Health, Montreal Neurological Institute, Montreal, QCH3A 2B4, Canada
- McGill University, Montreal, QCH3A 2B4, Canada
| | - Rodrigo Bressan
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo04039-032, Brazil
| | - Geraldo F. Busatto
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo05403-903, Brazil
| | - Mariana N. Castro
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (INAAC), Fleni-Consejo Nacional de Investigaciones Científicas y Técnicas Neurosciences Institute (INEU), Ciudad Autónoma de Buenos AiresC1428, Argentina
- Department of Psychiatry and Mental Health, School of Medicine, University of Buenos Aires, Ciudad Autónoma de Buenos AiresC1114AAD, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
| | - Tiffany Chaim-Avancini
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
| | - Albert Compte
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona08036, Spain
| | - Monise Costanzi
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
| | - Leticia Czepielewski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
- Programa de Pós-Graduação em Psicologia, Instituto Psicologia, Universidade Federal do Rio Grande do Sul, Porto AlegreRS90040-060, Brazil
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Direction of Research, Instituto Nacional de Neurología y Neurocirugía, Mexico City14269, Mexico
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- National Institute for Health Research (NIHR), Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, LondonSE5 8AZ, United Kingdom
| | - Covadonga M. Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), School of Medicine, Universidad Complutense, Madrid28009, Spain
| | - Ana María Díaz-Zuluaga
- Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín050011, Colombia
- Center for Neurobehavioral Genetics, Jane and Terry Semel Institute for Neuroscience and Human Behavior Los Angeles, University of California Los Angeles (UCLA), Los Angeles, CA90024
| | - Stefan Du Plessis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
- South African Medical Research Council (SA MRC), Genomics of Brain Disorders Unit, Cape Town7505, South Africa
| | - Fabio L. S. Duran
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
| | - Sol Fittipaldi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago7941169, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Victoria, Ciudad Autónoma de Buenos AiresB1644BID, Argentina
- Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), DublinDO2 PN40, Ireland
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA94158
| | - Alex Fornito
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC3168, Australia
| | - Nelson B. Freimer
- Center for Neurobehavioral Genetics, Jane and Terry Semel Institute for Neuroscience and Human Behavior Los Angeles, University of California Los Angeles (UCLA), Los Angeles, CA90024
| | - Ary Gadelha
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo04039-032, Brazil
| | - Clarissa S. Gama
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clinicas de Porto Alegre, Porto Alegre, RS90035903, Brazil
| | - Ranjini Garani
- Integrated Program in Neuroscience, McGill University, Montreal, QuebecH3A 1A12B4Canada
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d’Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Barcelona08036, Spain
| | - Cecilia Gonzalez Campo
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Victoria, Ciudad Autónoma de Buenos AiresB1644BID, Argentina
| | - Alfonso Gonzalez-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago8431621, Chile
- School of Medicine, Universidad Finis Terrae, Santiago7501015, Chile
| | - Salvador Guinjoan
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Laureate Institute for Brain Research, Tulsa, OK74136
| | - Bharath Holla
- Department of Integrative Medicine, NIMHANS, Bengaluru, Karnataka560029, India
- Accelerator Program for Discovery in Brain disorders using Stem cells, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka560029, India
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago7941169, Chile
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Victoria, Ciudad Autónoma de Buenos AiresB1644BID, Argentina
- Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), DublinDO2 PN40, Ireland
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA94158
| | - Daniza Ivanovic
- Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago7610658, Chile
| | - Andrea Jackowski
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo04038-000, Brazil
- Department of Education, Information and Communications Technology (ICT) and Learning, Østfold University College, Halden1757, Norway
| | - Pablo Leon-Ortiz
- Laboratory of Experimental Psychiatry, Direction of Research, Instituto Nacional de Neurología y Neurocirugía, Mexico City14269, Mexico
| | - Christine Lochner
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch7505, South Africa
| | - Carlos López-Jaramillo
- Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín050011, Colombia
| | - Hilmar Luckhoff
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
| | - Raffael Massuda
- Department of Psychiatry, Universidade Federal do Paraná (UFPR), CuritibaPR 80060-000, Brazil
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, OxfordOX3 7JX, United Kingdom
- Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, OxfordOX3 9DU, United Kingdom
- NIHR Oxford Health Biomedical Research Centre, OxfordOX3 7JX, United Kingdom
- Oxford HealthNational Health Service (NHS), Foundation Trust, OxfordOX4 4XN, United Kingdom
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto606-8507, Japan
| | - Romina Mizrahi
- Integrated Program in Neuroscience, McGill University, Montreal, QuebecH3A 1A12B4Canada
- Clinical and Translational Sciences Lab, McGill University, Douglas Mental Health University Institute, Montreal, QCH4A 1R3, Canada
- Department of Psychiatry, McGill University,Montreal, QCH3A 1A1, Canada
| | - Robin Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaMN55905
| | - Pedro M. Pan
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo04039-032, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo04038-000, Brazil
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), School of Medicine, Universidad Complutense, Madrid28009, Spain
| | - Lebogan Phahladira
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
| | - Juan P. Ramirez-Mahaluf
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
| | - Ramiro Reckziegel
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Direction of Research, Instituto Nacional de Neurología y Neurocirugía, Mexico City14269, Mexico
| | - Annerine Roos
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town7925, South Africa
| | - Pedro Rosa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
| | - Giovanni Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clinicas de Porto Alegre, Porto Alegre, RS90035903, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo04038-000, Brazil
| | - Freda Scheffler
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town7925, South Africa
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Institute for Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai200433, China
- PONS-Centre, Charité Mental Health, Dept of Psychiatry and Psychotherapy, Charité Campus Mitte, Berlin10117, Germany
| | - Mauricio Serpa
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo05403-903, Brazil
| | - Dan J. Stein
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town7925, South Africa
| | - Angeles Tepper
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
| | - Jeggan Tiego
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC3168, Australia
| | - Tsukasa Ueno
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto606-8507, Japan
- Integrated Clinical Education Center, Kyoto University Hospital, Kyoto606-8397, Japan
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago8431621, Chile
- Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del DesarrolloVitacura, Santiago7650568, Chile
| | - Eduardo A. Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago7820436, Chile
- Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago7820436, Chile
- Canadian Institute for Advanced Research (CIFAR), Azrieli Global Scholars Program, CIFAR, Toronto, ONM5G 1M1, Canada
| | - Pedro Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu610054, China
- Centro de Neurociencias de Cuba, La Habana11600, Cuba
| | - Isabel Valli
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona08036, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Mirta Villarreal
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (INAAC), Fleni-Consejo Nacional de Investigaciones Científicas y Técnicas Neurosciences Institute (INEU), Ciudad Autónoma de Buenos AiresC1428, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Department of Physics, Universidad de Buenos Aires, Ciudad Autónoma deBuenos AiresC1428EGA, Argentina
| | - Toby T. Winton-Brown
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC3004, Australia
- Department of Psychiatry, Alfred Health, Melbourne, VIC3004, Australia
| | - Nefize Yalin
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- South London and Maudsley National Health Service (NHS), Foundation Trust, LondonSE5 8AZ, United Kingdom
| | - Francisco Zamorano
- Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago7650568, Chile
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago7510602, Chile
| | - Marcus V. Zanetti
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
- Hospital Sírio-Libanês, São Paulo01308-050, Brazil
| | | | - Anderson M. Winkler
- Department of Human Genetics, University of Texas Rio Grande Valley, Brownsville, Texas TX78520
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (E & D), National Institute of Mental Health, National Institutes of Health, BethesdaMD20894
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, School of Economics and Political Science, LondonWC2A 2AE, United Kingdom
| | - Nicolas A. Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
- Department of Psychiatry, University of Oxford, OxfordOX3 7JX, United Kingdom
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