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Wang J, Wang Y, Li H, Wang W, Zhang D. Associations between oral health and depression and anxiety: A cross-sectional and prospective cohort study from the UK Biobank. J Clin Periodontol 2024. [PMID: 38952070 DOI: 10.1111/jcpe.14039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/12/2024] [Accepted: 06/21/2024] [Indexed: 07/03/2024]
Abstract
AIM To investigate the associations between oral health and depression, anxiety and their comorbidity in the UK Biobank cohort. MATERIALS AND METHODS Oral health problems were self-reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ-4) in a cross-sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety. RESULTS A total of 305,188 participants were included in the cross-sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73-1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10-1.19), depression (HR: 1.19, 95% CI: 1.13-1.25) and anxiety (HR: 1.13, 95% CI: 1.07-1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16-1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C-reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow-up (N = 10,673) were not significant. CONCLUSIONS Periodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity.
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Affiliation(s)
- Jingjing Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
| | - Yani Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
| | - Huihui Li
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
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Cebrino J, Portero de la Cruz S. Factors related to depression in adults with oral health problems in Spain (2017 to 2020). Front Public Health 2024; 12:1364119. [PMID: 38476497 PMCID: PMC10927730 DOI: 10.3389/fpubh.2024.1364119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Background The need to study the link between gender, depression, and oral health is becoming increasingly evident. This study therefore aimed to determine the prevalence and evolution over time of depression among women and men with oral health problems and to evaluate the association between depression status, lifestyle-related variables health-related variables and use of dental health services in those people. Methods We performed a nationwide cross-sectional study on 25,631 adults with oral health problems residing in Spain from the Spanish National Health Survey 2017 and the European Health Survey of Spain 2020, including as the main variable self-reported diagnosis of depression. We analysed independent variables such as lifestyle-related variables, health-related variables, and variables related to dental health services. Sociodemographic characteristics were considered as control variables. Results The prevalence of depression among adults with oral health problems in Spain was 7.81% (10.14% for women, 5.39% for men), with a notable decrease from 2017 to 2020 in women. Depressed women had a slightly higher percentage of filled or capped teeth, and had more covers (crowns), bridges or other types of prostheses or dentures, while men had more caries. Women also made more frequent, regular dental visits for check-ups and mouth cleaning, whereas men often needed extractions. Unfavourable associated factors in both genders were: perceiving their health as good, average, poor, or very poor, and having 1-2 and ≥ 3 comorbidities. Conversely, not being a current smoker was related to less likelihood of depression. In women only, not engaging in leisure-time physical activity produced more unfavourable associated factors. Conclusion The prevalence of depression among adults with oral health problems in Spain from 2017 to 2020 was 7.81%, but this figure has been steadily decreasing over time. In addition, the favourable and unfavourable associated factors could help us inform health professionals and authorities in order to prevent depression and enhance the care of this population according to gender.
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Affiliation(s)
- Jesús Cebrino
- Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain
| | - Silvia Portero de la Cruz
- Department of Nursing, Pharmacology and Physiotherapy, University of Córdoba, Córdoba, Spain
- Research Group GE10 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Córdoba, Spain
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Ibigbami OI, Folayan MO, Oginni O, Lusher J, Sam-Agudu NA. Moderating effects of resilience and self-esteem on associations between self-reported oral health problems, quality of oral health, and mental health among adolescents and adults in Nigeria. PLoS One 2023; 18:e0285521. [PMID: 37172037 PMCID: PMC10180595 DOI: 10.1371/journal.pone.0285521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 04/25/2023] [Indexed: 05/14/2023] Open
Abstract
BACKGROUND There is an intersection between oral and mental health though the studies on these intersections are few. This study investigated associations between self-reported oral health problems, quality of oral health, and depression and general anxiety among adolescents and adults in Nigeria; and analysed the moderating effects of resilience and self-esteem on these associations. METHODS In this secondary analysis, data were extracted from the database of an online survey conducted among participants 13 years and older and living in Nigeria about their self-reported psychological wellbeing. The data was collected between September and October 2020. Dependent variables were self-reported presence of oral health problems (yes/no) and self-reported quality of oral health (using a five-item scale ranging from "very good" to "very poor"). Independent variables were depressive and anxiety symptoms. Moderating factors evaluated were resilience and self-esteem. Multivariable logistic regression analysis was used to determine the associations between the dependent and independent variables after adjusting for confounders (age, sex, employment status and educational status). A path analysis was conducted to determine the moderating effects of self-esteem and resilience on associations between dependent and independent variables. RESULTS We extracted data for 2,757 adolescents and adults aged 13 to 62 years, of which 2,062 (74.8%) reported having oral health problems and 925 (33.6%) reported poor quality of oral health. Higher levels of depressive symptoms were significantly associated with higher odds of oral health problems (AOR: 1.07; 95% CI: 1.04-1.10; p<0.001). Higher levels of depressive symptoms (AOR: 1.05; 95% CI: 1.03-1.07; p<0.001), and higher levels of anxiety symptoms (AOR: 1.07; 95% CI: 1.04-1.11; p<0.001) were significantly associated with poor quality of oral health. Resilience significantly moderated the association between anxiety symptoms and oral health problems (AOR = -0.004; 95% CI: -0.006 --0.001; p = 0.002). CONCLUSION Depression may be a risk indicator for self-reported oral health problems, while depression and anxiety appear to be risk indicators for self-reported poor quality of oral health. These factors could be included as confounders in future studies on oral health problems and quality of oral health among adolescents and adults in Nigeria.
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Affiliation(s)
| | - Morenike Oluwatoyin Folayan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Nigeria Institute of Medical Research, Yaba, Lagos State, Nigeria
- Community Oral Health Department, Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Olakunle Oginni
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Joanne Lusher
- Provost's Group, Regent's University, London, United Kingdom
| | - Nadia A Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States of America
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Muacevic A, Adler JR. Associations Between Mental Health and Oral Health in Saudi Arabia: An Online Survey-Based Cross-Sectional Study. Cureus 2022; 14:e31732. [PMID: 36569720 PMCID: PMC9769782 DOI: 10.7759/cureus.31732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Mental disorders cause psychological stress and lead to poor lifestyle behaviors and an increased risk of poor oral health. This study aims to explore the potential association between mental illnesses with oral health and personal oral care in the Saudi population. Methodology Saudi Arabians aged ≥18 years were eligible to participate in this cross-sectional study. The study questionnaire had the following five sections: demographics, a brief depression severity measure (Patient Health Questionnaire-9), a brief generalized anxiety disorder measurement tool (Generalized Anxiety Disorder-7), an oral health measurement tool, and personal oral health care. The data were analyzed using SPSS software version 26 (IBM Corp., Armonk, NY, USA). The results were presented as numbers and (percentages) or mean and standard deviations (SD). Results This study included a total of 522 participants. The mean score for dental health and care was 4 (SD = 1.9) and 13.6 (SD = 1.9), respectively, reflecting a moderate level of dental health and positive dental care. Males had better oral health, whereas females had better dental care. A college degree or higher was linked to better dental care, and chronic diseases were linked to lower dental health scores. Minimal depression had a significantly higher dental care score than mild-to-severe depression. Depression and anxiety did not affect dental health. Conclusions This study showed that minimal depression was associated with a higher dental care score than mild-to-severe depression. However, the degree of depression was not associated with dental health. Furthermore, anxiety had no association with dental health or care.
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Gender Differences in the Association between Physical Inactivity and Mental-Health Conditions in People with Vision or Hearing Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063307. [PMID: 35328994 PMCID: PMC8953773 DOI: 10.3390/ijerph19063307] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 12/04/2022]
Abstract
This study aimed to examine associations between physical inactivity and mental health in Spanish adults with vision or hearing difficulties and explored differences between men and women. Data from the Spanish National Health Survey in 2017 were analyzed (n = 23,089 adults, 15−103 years, mean age 53.4 ± 18.9 years, 45.9% men). Physical inactivity (exposure) was evaluated with the International Physical Activity Questionnaire Short Form. Participants self-reported whether they had previously suffered from depression, chronic anxiety and other mental-health complications (outcomes). Associations between physical inactivity and mental-health complications were assessed with multivariable logistic regression in people with difficulty seeing and hearing, after grouping by gender and adjusting for age, body-mass index, education level, living as a couple, smoking and alcohol consumption. The overall multivariable logistic-regression analyses showed that women with vision impairment showed significant associations between physical inactivity and depression (OR 1.403, 95% CI 1.015−1.940) and other mental-health complications (OR 2.959, 95% CI 1.434−6.104). In the overall analyses, there were no significant associations in men and in people with hearing impairment. The age-stratified analyses showed that inactive people with visual impairment who were <65 years old had a higher risk of mental-health conditions. In conclusion, physical activity has been shown to be important in the prevention of mental-health complications. Healthcare practitioners and policy makers should look at appropriate strategies to increase levels of physical activity in people with vision loss, especially in women and in those <65 years old.
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López Sánchez GF, Smith L, Jacob L, Shin JI, Koyanagi A, Pardhan S. Gender Differences in the Association Between Cataract and Mental Health in Adults With Diabetes: A Cross-Sectional Analysis From the Spanish National Health Survey 2017. Front Public Health 2021; 9:769155. [PMID: 34950629 PMCID: PMC8688691 DOI: 10.3389/fpubh.2021.769155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to explore gender differences in the associations between cataracts and self-reported depression and chronic anxiety in Spanish adults with diabetes. Methods: Cross-sectional data from the Spanish Health Survey 2017 were analyzed. Inclusion criterion was a positive response to the question “Have you ever been diagnosed with diabetes?” Diabetes, cataracts, depression and chronic anxiety were based on self-reported lifetime diagnosis. Multivariable logistic regression was conducted to assess the association between cataracts and depression or anxiety among respondents with diabetes, stratifying by gender. Results: Out of a total 23,089 respondents, 2,266 people self-reported suffering from diabetes (50.2% women; average age 69.7 ± 12.7 years; age range 15-98 years). In people with diabetes, the presence of cataracts was associated with significantly higher odds for depression (OR = 1.655; 95% CI = 1.295-2.115). Gender-stratified analyses showed that only women with cataracts were significantly associated with higher odds for depression (OR = 1.762; 95% CI = 1.307-2.374) and chronic anxiety (OR = 1.519; 95% CI = 1.067-2.163). Conclusion: Cataracts are a significant risk factor for depression and chronic anxiety in Spanish women with diabetes, but not in men. Women with both diabetes and cataracts require assessment for depression and chronic anxiety, and possibly earlier interventions in order to reduce the potential risk of further mental health complications.
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Affiliation(s)
- Guillermo F López Sánchez
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Shahina Pardhan
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
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Association of Oral Health with Multimorbidity among Older Adults: Findings from the Longitudinal Ageing Study in India, Wave-1, 2017-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312853. [PMID: 34886581 PMCID: PMC8657905 DOI: 10.3390/ijerph182312853] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 01/05/2023]
Abstract
India is witnessing an increase in the prevalence of multimorbidity. Oral health is related to overall health but is seldom included in the assessment of multimorbidity. Hence, this study aimed to estimate the prevalence of oral morbidity and explore its association with physical multimorbidity using data from Longitudinal Ageing Study in India (LASI). LASI is a nationwide survey amongst adults aged ≥ 45 years conducted in 2018. Descriptive analysis was performed on included participants (n = 59,764) to determine the prevalence of oral morbidity. Multivariable logistic regression assessed the association between oral morbidity and physical multimorbidity. Self-rated health was compared between multimorbid participants with and without oral morbidity. Oral morbidity was prevalent in 48.56% of participants and physical multimorbidity in 50.36%. Those with multimorbidity were at a higher risk of having any oral morbidity (AOR: 1.60 (1.48–1.73)) than those without multimorbidity. Participants who had only oral morbidity rated their health to be good more often than those who had physical multimorbidity and oral morbidity (40.84% vs. 32.98%). Oral morbidity is significantly associated with physical multimorbidity. Multimorbid participants perceived their health to be inferior to those with only oral morbidity. The findings suggest multidisciplinary health teams in primary care should include the management of oral morbidity and physical multimorbidity.
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Cirkel LL, Jacob L, Smith L, López-Sánchez GF, Konrad M, Kostev K. Relationship between chronic gingivitis and subsequent depression in 13,088 patients followed in general practices. J Psychiatr Res 2021; 138:103-106. [PMID: 33839578 DOI: 10.1016/j.jpsychires.2021.03.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/20/2021] [Accepted: 03/24/2021] [Indexed: 11/30/2022]
Abstract
GOAL The aim of this study was to analyze the association between chronic gingivitis and subsequent depression in patients aged ≥14 years who were followed up in general practices in the UK. METHODS This study included patients aged ≥14 years who had received an initial diagnosis of chronic gingivitis in one of 256 general practices in the United Kingdom between January 2000 and December 2016 (index date). Patients without chronic gingivitis were matched (1:1) to those with chronic gingivitis by sex, age, index year, treating physician, and Charlson Comorbidity Index (CCI). For patients without chronic gingivitis, the index date was a randomly selected visit date between 2000 and 2016. The association between chronic gingivitis and the incidence of depression was investigated using Kaplan-Meier curves and Cox regression analyses. RESULTS This study included 6544 patients with chronic gingivitis and 6544 patients without chronic gingivitis [49.2% were women; mean (standard deviation) age 40.3 (19.1) years]. A total of 16.3% of individuals with chronic gingivitis and 8.8% of those without chronic gingivitis received an initial diagnosis of depression within 10 years of the index date (log-rank p-value<0.001). There was a positive and significant association between chronic gingivitis and depression in the overall sample [hazard ratio (HR) = 1.82, 95% confidence interval (CI) = 1.55-2.48]. These findings were corroborated in men and women and in all age groups with the exception of patients aged >65 years. CONCLUSIONS Our study demonstrated an association between chronic gingivitis and subsequent depression.
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Affiliation(s)
- Lisa Lotta Cirkel
- Center of Dental, Oral and Maxillofacial Surgery, University Clinic Jena, Germany
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Marcel Konrad
- FOM University of Applied Sciences for Economics and Management, Frankfurt, Germany
| | - Karel Kostev
- Epidemiology, IQVIA, Unterschweinstiege 2-14, 60549 Frankfurt am Main, Germany.
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Pardhan S, Smith L, Bourne R, Davis A, Leveziel N, Jacob L, Koyanagi A, López-Sánchez GF. Combined Vision and Hearing Difficulties Results in Higher Levels of Depression and Chronic Anxiety: Data From a Large Sample of Spanish Adults. Front Psychol 2021; 11:627980. [PMID: 33536989 PMCID: PMC7848112 DOI: 10.3389/fpsyg.2020.627980] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/23/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Individually, vision and hearing impairments have been linked to higher levels of anxiety and depression. We investigated the effect of dual sensory impairment (difficulty seeing and hearing) in a large representative sample of Spanish adults. METHODS Data from a total of 23,089 adults (age range: 15-103 years, 45.9% men) from the Spanish National Health Survey 2017 were analyzed. Self-reported difficulty of seeing and hearing (exposures), and depression and chronic anxiety (outcomes) were analyzed. Multivariable logistic regression was assessed for difficulty with vision alone, hearing alone and with difficulty with both, adjusting for gender, age, marital status, living as a couple, education, smoking, alcohol consumption, BMI, physical activity, use of glasses/contact lenses, and hearing aid. RESULTS Visual difficulty, hearing difficulty, and dual difficulties were all associated with significantly higher odds for depression (ORs 2.367, 2.098, and 3.852, respectively) and for chronic anxiety (ORs 1.983, 1.942, and 3.385, respectively). Dual sensory difficulty was associated with higher odds ratios for depression and anxiety when compared to either impairment alone. CONCLUSION Dual sensory difficulty is associated with significantly higher odds of anxiety and depression when compared to either vision or hearing difficulty alone. Appropriate interventions are needed to address any reversible causes of vision and hearing as well as anxiety and depression in people in these specific groups.
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Affiliation(s)
- Shahina Pardhan
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Rupert Bourne
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
| | - Adrian Davis
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
- ENT and Audiology, Imperial College London, London, United Kingdom
| | - Nicolas Leveziel
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Guillermo F. López-Sánchez
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
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