1
|
Weke A, Holmes RD, McColl E, Finch R, Butcher C, Holliday R. Delivering smoking cessation interventions in NHS primary dental care - lessons from the ENHANCE-D trial. Br Dent J 2024:10.1038/s41415-024-7850-5. [PMID: 39304791 DOI: 10.1038/s41415-024-7850-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/28/2024] [Accepted: 04/08/2024] [Indexed: 09/22/2024]
Abstract
Introduction Smoking is a major contributor to health inequalities in the UK. The ENHANCE-D trial is evaluating three smoking cessation interventions (nicotine replacement therapy [NRT], electronic cigarettes [ECs] or 'very brief advice') delivered in NHS primary dental care. This qualitative study aimed to provide insight into the factors that could influence the adoption of the interventions in these settings.Methods Interviews were conducted at two timepoints. Purposive maximum variation sampling was used to recruit and interview a total of 24 dental patients, 12 dental professionals and three NHS dental commissioners. Thematic analysis was carried out using normalisation process theory as an analytical framework.Results Dental settings were perceived as an appropriate location to deliver smoking cessation interventions. Patients had several motivating and demotivating factors regarding use of NRTs or ECs; they often had negative preconceptions. Financial considerations were major influencers for both patients and dental teams. The time pressures for dental practices were identified as a major barrier. Some practical issues, such as procurement and stock supply, would need to be considered if the ENHANCE-D interventions were to be implemented in routine practice.Conclusion Primary dental care teams are well-placed to deliver smoking cessation interventions. However, a number of facilitators and deterrents have been identified and strategic changes are needed for successful implementation.
Collapse
Affiliation(s)
- Anthony Weke
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Newcastle Clinical Trials Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Richard D Holmes
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Elaine McColl
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Roland Finch
- ENHANCE‑D Trial Patient Participant Group, England, UK
| | - Chrissie Butcher
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Richard Holliday
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
| |
Collapse
|
2
|
Batista-Cárdenas D, Araya-Castillo A, Arias-Campos MP, Solís-Rivera AP, Jiménez-Matarrita J, Piedra-Hernández L, Madriz-Montero L, Ramírez K. Association of the severity and progression rate of periodontitis with systemic medication intake. FRONTIERS IN ORAL HEALTH 2024; 5:1447019. [PMID: 39157205 PMCID: PMC11328918 DOI: 10.3389/froh.2024.1447019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 07/23/2024] [Indexed: 08/20/2024] Open
Abstract
Background/purpose Information on the systemic medication profiles of patients with periodontitis is limited. Therefore, this retrospective cross-sectional study aimed to analyze the relationship between the severity and rate of progression of periodontitis and systemic medication intake using a database of patients who attended the Clinic of Periodontics of the Faculty of Dentistry of the University of Costa Rica. Methods Electronic health records of patients diagnosed with periodontitis based on the Classification of Periodontal and Peri-Implant Diseases and Conditions (2017) were evaluated. Individuals were further categorized based on the severity (stage) and rate of progression (grade). Data extracted from the patient records included age, sex, and self-reported medication intake. Results In total, 930 records were included. Most of the studied population was middle-aged (36-64 years old); 43.01% were male, and 56.99% were female. Four hundred and fifty-seven patients (49.14%) reported taking at least one systemic medication for a chronic condition. Regarding the periodontal treatment phase, 62.37% underwent steps 1-3, and 37.63% underwent step 4. The most common systemic medications taken were for cardiovascular diseases (42.28%), followed by medications for diabetes (14.46%) and neurologic disorders (14.46%). Most patients (59.35%) were diagnosed with Stage III periodontitis. Grade B (48.28%) was the most prevalent. Calcium channel blockers demonstrated a disease severity-dependent association with the periodontal stage (p = 0.021). In addition, systemic medications for diabetes mellitus were associated with periodontal disease severity and rate of progression (all Ps < 0.05). Conclusions This study provides indirect evidence of the association between systemic diseases and periodontitis. The positive association between medications used to treat diabetes and the severity and rate of progression of periodontitis may be due to the underlying disease rather than the medications per se.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Karol Ramírez
- Faculty of Dentistry, University of Costa Rica, San José, Costa Rica
| |
Collapse
|
3
|
Campelo RC, da Silva MLM, Nascimento GC, Azulay RSS, Rocha VCC, Damianse SSP, Magalhães M, Faria MDS, Rodrigues VP. Orofacial traits related to oral health-related quality of life in Brazilian acromegaly patients. Oral Dis 2024; 30:1652-1659. [PMID: 36654191 DOI: 10.1111/odi.14511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/07/2023] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To investigate orofacial traits and general factors related to oral health-related quality of life in acromegaly patients. MATERIALS AND METHODS A cross-sectional study with 34 acromegaly patients was conducted. The OHIP-14 questionnaire was used to assess oral health-related quality of life scores. To assess orofacial and occlusion morphology, an oral evaluation was performed. Correlation measures, multiple linear regression and a structural equation model (SEM) were used in the statistical analysis. RESULTS The presence of arthrosis (SC = 0.467, SE = 0.155, p = 0.003) and smoking history (SC = 0.459, SE = 0.206, p = 0.026) were associated with a negative impact on oral health-related quality of life. Mandibular protrusion was related to physical pain (β = 2.74, p = 0.029). Anterior open bite (β = 4.44, p = 0.004) and anterior crossbite (β = 2.61, p = 0.026) were related to psychological disability. Diastema was related to social disability (β = 3.42, p = 0.037) and handicap (β = 2.74, p = 0.044). CONCLUSION The findings suggest that smoking, arthrosis and orofacial alterations (mandibular protrusion, open bite, crossbite and diastema) have a negative impact on oral health-related quality of life in acromegaly patients.
Collapse
Affiliation(s)
- Renata C Campelo
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil
| | | | - Gilvan C Nascimento
- Service of Endocrinology, Presidente Dutra University Hospital, São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís, Brazil
| | - Rossana S S Azulay
- Service of Endocrinology, Presidente Dutra University Hospital, São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís, Brazil
| | - Viviane C C Rocha
- Service of Endocrinology, Presidente Dutra University Hospital, São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís, Brazil
| | - Sabrina S P Damianse
- Service of Endocrinology, Presidente Dutra University Hospital, São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís, Brazil
| | - Marcelo Magalhães
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís, Brazil
| | - Manuel Dos S Faria
- Service of Endocrinology, Presidente Dutra University Hospital, São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís, Brazil
| | - Vandilson P Rodrigues
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís, Brazil
| |
Collapse
|
4
|
Navabi N, Hashemipour MA, Ramezani R, Karimiafshar S, Najminouri F. Determining the Short-term Effects of Smoking Cessation Using Nicotine Gum on Oral Health-Related Quality of Life: A Pilot Study. ADDICTION & HEALTH 2024; 16:23-27. [PMID: 38651023 PMCID: PMC11032621 DOI: 10.34172/ahj.2024.1443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/01/2023] [Indexed: 04/25/2024]
Abstract
Background Nowadays, the adverse effects of smoking on general, oral, and dental health are reported time and again worldwide. However, evidence to quantify the effects of tobacco smoking and smoking cessation on health-related quality of life (HRQoL) and oral health-related quality of life (OHQoL) is inadequate. Accordingly, this study aimed to assess the effects of nicotine gum on HRQoL and OHQoL of cigarette smokers. Methods This pilot study was conducted on 40 smokers, half of whom received nicotine gum. HRQoL and OHQoL were measured twice at the beginning of the study and after three months using standard versions of Short Form Health Survey (SF-12) and Oral Health Impact Profile (OHIP-5) questionnaires. T-test, Fischer's exact test, and Pearson's correlation coefficient were used to compare the participants' scores on the questionnaires. Findings The mean age of the participants was 43.39±12.32 years. Using nicotine gum significantly increased the scores of general health (P=0.046) and physical functioning (P=0.021) domains of HRQoL in comparison with the cigarette smoking group. Moreover, using nicotine gum significantly increased the scores of the two questions about the reduced sense of taste (P<0.001) and difficulty doing usual jobs (P=0.071). Conclusion Using nicotine gum was associated with the improvement of HRQoL and OHQoL to some extent. To better understand the relationship between smoking cessation and improved OHQoL, it is necessary to conduct further studies in this field.
Collapse
Affiliation(s)
- Nader Navabi
- Department of Oral Medicine, Faculty of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Rana Ramezani
- General Dentist, Faculty of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Saghar Karimiafshar
- General Dentist, Faculty of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Najminouri
- Department of Community Dentistry, Faculty of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
5
|
Piedra-Hernández L, Batista-Cárdenas D, Gómez-Fernández A, Ramírez K. Dental anxiety and oral health-related quality of life before and after non-surgical periodontal treatment. Clin Oral Investig 2023; 27:5459-5474. [PMID: 37488334 DOI: 10.1007/s00784-023-05165-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES To (1) investigate dental anxiety (DA) and oral health-related quality of life (OHRQOL) before and after non-surgical periodontal treatment (NSPT) and (2) determine correlations between these patient-reported measures. MATERIALS AND METHODS Demographics, smoking habits, dental pain, Modified Corah's Dental Anxiety Scale (MDAS), and Oral Health Impact Profile (OHIP-14) were assessed in eighty-two participants. RESULTS Mean age was 48.3 years ± 11.5. At baseline, 8.5% reported being active smokers. Of non-smokers, 11% reported being an ex-smoker. After NSPT, 11.0% reported smoking. Patients' maximal pain in the last month decreased after therapy. Before treatment, participants reported higher DA. Extreme DA was observed in 8.5% of participants before therapy. Afterwards, 2.4% of participants reported extreme DA. Fear of having a foreign object in the mouth decreased after NSPT. All OHIP-14 scores, except functional limitation, improved post-treatment. Higher DA was associated with worse OHRQoL before treatment. After treatment, total MDAS score was associated with OHIP-14 global score, physical pain, psychological disability, and social disability. Worse MDAS sub-scores were associated with a higher OHIP-14 global score. Individuals with "normal/slight anxiety" had a significant improvement in OHRQoL, whereas people in the "moderate and extreme anxiety" group did not report a significant improvement. Patients diagnosed with generalized periodontitis (GP) stage III grade B and GP stage IV grade B reported less anxiety after NSPT. CONCLUSIONS Associations of MDAS subcategories with OHIP-14 domain scores were found before and after therapy. DA decreases and OHRQoL enhances after NSPT in patients with "normal/slight" anxiety to dental treatment. Dental practitioners should plan strategies to cope with anxiety to dental treatment and prevent decreases in OHRQoL. CLINICAL RELEVANCE Within the limitations of this study, DA and OHRQoL were positively correlated in patients with periodontitis, before and after NSPT, using the MDAS and OHIP-14 questionnaires. The results of our study suggest that treatment is effective in terms of alleviating DA and improving oral health, along with quality of life, in patients that report "normal/slight" anxiety to dental treatment. Nonetheless, results must be interpreted with caution since patients are generally anxious before any type of dental treatment. DA may not just be confined to NSPT per se. According to our results, evaluation of both outcomes should be an integral part of routine periodontal clinical evaluation and periodontal reevaluation of initial therapy. It is important that clinicians learn to identify patients that suffer from anxiety and take time to explain the treatment procedures to the patient, to strive for patient's emotional well-being before, during, and after dental care services. The use of specific questionnaires for both DA and OHRQoL may be more appropriate to demonstrate the psychological and quality of life differences due to periodontal disease and NSPT.
Collapse
Affiliation(s)
- Lucía Piedra-Hernández
- Faculty of Dentistry, University of Costa Rica, Finca 3 "Instalaciones Deportivas", Sabanilla, Montes de Oca, San José, 11502, Costa Rica
| | - Daniela Batista-Cárdenas
- School of Statistics, University of Costa Rica, Rodrigo Facio Campus, San Pedro, Montes de Oca, San José, 11801, Costa Rica
| | - Adrián Gómez-Fernández
- Faculty of Dentistry, University of Costa Rica, Finca 3 "Instalaciones Deportivas", Sabanilla, Montes de Oca, San José, 11502, Costa Rica
| | - Karol Ramírez
- Faculty of Dentistry, University of Costa Rica, Finca 3 "Instalaciones Deportivas", Sabanilla, Montes de Oca, San José, 11502, Costa Rica.
| |
Collapse
|
6
|
Sahoo SK, Mishra S, Chinnannavar SN, Bajoria AA, Das A, Singh DK. Assessment of Oral Health-Related Quality of Life in Patients Receiving Corticobasal Dental Implants. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S1036-S1039. [PMID: 37694072 PMCID: PMC10485463 DOI: 10.4103/jpbs.jpbs_236_23] [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: 03/11/2023] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 09/12/2023] Open
Abstract
Background Among various treatment modalities for tooth replacement, dental implants are considered the best one. This study assessed the effects of smoking, periodontitis, and diabetes on oral health-related quality of life (OHRQoL) in patients receiving corticobasal dental implants. Materials and Methods One hundred twenty patients of either gender who received corticobasal dental implants were enrolled. All were subjected to Oral Health Impact Profile-20 (OHIP-20) for dental implant patients (OHRQoL questionnaire). The patient satisfaction level was measured on a scale with points ranging from 0 to 5. The value 0 indicates no satisfaction, whereas the value 5 shows highly satisfied. Results Of 120 patients, males were 70 and females were 50. The overall satisfaction level was 4.92, articulation speech was 4.12, implants were 4.80, and construction was 4.88. The overall satisfaction, articulation speech, implants, and construction values in patients with and without diabetes were 4.90 vs 4.93, 4.56 vs 4.86, 4.76 vs 4.92, and 4.94 vs 4.83, respectively. The overall satisfaction, articulation speech, implants, and construction values in patients with and without smoking were 4.83 vs 4.91, 4.52 vs 4.88, 4.70 vs 4.82, and 4.12 vs 4.84, respectively. The overall satisfaction, articulation speech, implants, and construction values in patients with and without periodontitis were 4.72 vs 4.96, 4.52 vs 4.88, 4.73 vs 4.98, and 4.81 vs 4.95, respectively. The overall satisfaction, articulation speech, implants, and construction values in patients with one to three risk factors and control were 4.85 vs 4.96, 4.82 vs 4.94, 4.88 vs 4.97, and 4.76 vs 4.86, respectively. There was a significant difference in pain, infections and/or swelling, sleeping problems, problems with self-confidence, taste, chewing discomfort and/or difficulties, and influence on food choice before and after in patients treated with corticobasal dental implants (P < 0.05). Conclusion The satisfaction level is higher after obtaining corticobasal dental implants in patients with diabetes, smoking, and periodontitis as compared to control. Thus, corticobasal dental implants may be considered alternate treatment options for these patients.
Collapse
Affiliation(s)
- Sanjay K. Sahoo
- Department of Periodontology and Oral Implantology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Silpiranjan Mishra
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Sangamesh Ningappa Chinnannavar
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Atul A. Bajoria
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Asutosh Das
- Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Dhirendra K. Singh
- Department of Periodontology and Oral Implantology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| |
Collapse
|
7
|
Dolah S, Mohd Adnan M, Abd Rahman N. Towards Healthy Adolescents: A Review of Smoking Impact According to Dental Perspectives. JANUARY 2023 2023; 19:316-324. [DOI: 10.47836/mjmhs.19.1.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Nowadays, tobacco companies target to recruit new smokers among adolescents due to this age group was easy to be influenced by smoking behaviours. This narrative review aimed to explore the possible impact of smoking among adolescents. Knowing the negative impacts of smoking might result in avoiding continuing the habit or preventing from initiation of the habit. The literature search on PubMed, SCOPUS, and Epistemonikos database with related search terms of “adolescents”, “smoking” and “impact”. Only papers published within the year 2017 to 2021 and in the English language were included. However, articles without full text were excluded from this review. Fourteen articles were selected and divided impacts into three categories which are effect on oral health, effect on general health and other impacts. Possible impacts of smoking among adolescents were identified, and it could be beneficial in the development of customized smoking prevention or smoking cessation intervention for adolescents.
Collapse
|
8
|
Jaumet L, Hamdi Z, Julia C, Hercberg S, Touvier M, Bouchard P, Carra MC, Andreeva VA. Periodontitis assessed with a new screening tool and oral health-related quality of life: cross-sectional findings among general-population adults. Qual Life Res 2023; 32:259-272. [PMID: 35948787 PMCID: PMC9365217 DOI: 10.1007/s11136-022-03215-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Periodontitis, as a chronic, multifactorial inflammatory disease, has complex relationships with other diseases and ultimately with well-being. The aim of this cross-sectional study was to investigate the association between self-report periodontitis, as measured with the recently developed and validated modified Periodontal Screening Score (mPESS), and oral health-related quality of life (OHRQol) in a large population-based sample derived from the French NutriNet-Santé e-cohort. METHODS The sample was composed of 32,714 adults (75.5% women) with a mean age of 48.8 ± 13.9 years. Periodontitis was assessed based on age, smoking, and oral health status data obtained in 2011-2012, which allowed calculating the mPESS. An mPESS ≥ 5 was used to identify individuals at risk of severe periodontitis (main exposure). OHRQoL was measured with the Oral Health Impact Profile (OHIP-14) (main outcome) and the total score was dichotomized for analysis. Multivariable logistic regression analyses, considering physical health status, dietary and lifestyle confounding variables, were performed. RESULTS Overall, 6407 participants (19.6%) were at a high risk of severe periodontitis. A total of 7383 participants (22.6%) presented a relatively poor OHRQoL (OHIP-14 > 8, highest quartile). In the multivariable model, each of the following variables was independently and significantly associated with lower OHRQoL: older age (50-64 years), female sex, obesity, snacking between meals, frequent consumption of soft drinks and sweets/chocolate, risk of severe periodontitis, and having < 20 natural teeth were significantly. An mPESS ≥ 5 showed the highest odds for relatively poor OHRQoL (OR = 3.45; 95% CI 3.21-3.72). CONCLUSION The results support the association between periodontitis and OHRQoL in non-clinical samples. The use of mPESS could be tested in future prevention programs aiming at improving OHRQoL.
Collapse
Affiliation(s)
- Lauranne Jaumet
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France
| | - Zeineb Hamdi
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France
| | - Chantal Julia
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France ,Department of Public Health, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France
| | - Serge Hercberg
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France ,Department of Public Health, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France
| | - Mathilde Touvier
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France ,Laboratory URP 2496 Orofacial Pathologies, Imaging and Biotherapies, University of Paris Cité, Paris, France
| | - Maria Clotilde Carra
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France ,Population-Based Epidemiologic Cohorts Unit, INSERM UMS 011, Villejuif, France
| | - Valentina A. Andreeva
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France
| |
Collapse
|
9
|
Prokopidis K, Witard OC. Understanding the role of smoking and chronic excess alcohol consumption on reduced caloric intake and the development of sarcopenia. Nutr Res Rev 2022; 35:197-206. [PMID: 34027849 DOI: 10.1017/s0954422421000135] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This narrative review provides mechanistic insight into the biological link between smoking and/or chronic excess alcohol consumption, and increased risk of developing sarcopenia. Although the combination of excessive alcohol consumption and smoking is often associated with ectopic adipose deposition, this review is focused on the context of a reduced caloric intake (leading to energy deficit) that also may ensue due to either lifestyle habit. Smoking is a primary cause of periodontitis and chronic obstructive pulmonary disease that both induce swallowing difficulties, inhibit taste and mastication, and are associated with increased risk of muscle atrophy and mitochondrial dysfunction. Smoking may contribute to physical inactivity, energy deficit via reduced caloric intake, and increased systemic inflammation, all of which are factors known to suppress muscle protein synthesis rates. Moreover, chronic excess alcohol consumption may result in gut microbiota dysbiosis and autophagy-induced hyperammonemia, initiating the up-regulation of muscle protein breakdown and down-regulation of muscle protein synthesis via activation of myostatin, AMPK and REDD1, and deactivation of IGF-1. Future research is warranted to explore the link between oral healthcare management and personalised nutrition counselling in light of potential detrimental consequences of chronic smoking on musculoskeletal health outcomes in older adults. Experimental studies should investigate the impact of smoking and chronic excess alcohol consumption on the gut-brain axis, and explore biomarkers of smoking-induced oral disease progression. The implementation of behavioural change interventions and health policies regarding smoking and alcohol intake habits may mitigate the clinical and financial burden of sarcopenia on the healthcare system.
Collapse
Affiliation(s)
- Konstantinos Prokopidis
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, White City, London, UK
| | - Oliver C Witard
- Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| |
Collapse
|
10
|
Hajek A, König HH. Personality and oral health-related quality of life. Results from an online survey. BMC Oral Health 2022; 22:463. [PMID: 36324155 PMCID: PMC9632128 DOI: 10.1186/s12903-022-02486-7] [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: 03/22/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To investigate the association between personality factors and oral health-related quality of life. METHODS Data were taken from an online survey (representative for the general adult population in Germany in terms of region, sex and age group; n = 3,075) performed in late summer 2021. The well-established Oral Health Impact Profile (OHIP-G5) was used to measure oral health-related quality of life. Moreover, the established 10 Item Big Five Inventory (BFI-10) was used to quantify personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience). Sex, age, family status, educational level, smoking status, alcohol consumption, sports activities, presence of chronic diseases and self-rated health were adjusted for in multiple linear regression analysis. RESULTS Pearson correlations between oral health-related quality of life and personality factors ranged from r =- 0.17 (conscientiousness) to r = 0.17 (neuroticism). Regressions revealed that low oral health-related quality of life is associated with higher neuroticism (β = 0.39, p < 0.001) and lower conscientiousness (β=-0.51, p < 0.001). CONCLUSION This study revealed an association between personality factors (higher neuroticism and lower conscientiousness) and low oral health-related quality of life. Before dental treatment, it may be helpful to measure personality traits of patients in order to predict the expectations of patients, as well as their responses to intended treatments. This may support the identification of the most appropriate method of treatment.
Collapse
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| |
Collapse
|
11
|
Hajek A, König HH. Oral health-related quality of life, probable depression and probable anxiety: evidence from a representative survey in Germany. BMC Oral Health 2022; 22:9. [PMID: 35034663 PMCID: PMC8761375 DOI: 10.1186/s12903-022-02047-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited knowledge regarding the association between oral health-related quality of life and probable depression and anxiety. Our objective was to examine the association between oral health-related quality of life and probable depression and anxiety in the German population (stratified by sex). METHODS In sum, n = 3,075 individuals took part in a nationally representative survey (August/September 2021). The well-established Patient Health Questionnaire-9 (PHQ-9; cut-off of 10) and the Generalized Anxiety Disorder-7 (GAD-7; cut-off of 10) were used to quantify probable depression and anxiety, respectively. RESULTS The likelihood of probable depression was significantly associated with lower oral health-related quality of life in the total sample (OR: 1.21, 95% CI: 1.18-1.25) and in both women and men. Additionally, the likelihood of probable anxiety was significantly associated with lower oral health-related quality of life in the total sample (OR: 1.17, 95% CI: 1.14-1.21) and in both women and men. CONCLUSIONS Our study emphasized the association between lower oral health-related quality of life and probable depression as well as anxiety in the general adult population in Germany. Future longitudinal studies are required to confirm our findings.
Collapse
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| |
Collapse
|
12
|
Assessment of Oral Health-Related Quality of Life and Its Associated Factors among the Young Adults of Saudi Arabia: A Multicenter Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5945518. [PMID: 35071598 PMCID: PMC8776450 DOI: 10.1155/2022/5945518] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/23/2021] [Indexed: 12/15/2022]
Abstract
Oral health-related quality of life (OHRQoL) is an essential indicator of people's overall health and health-related quality of life. Poor oral health and OHRQoL among young adults lead to numerous negative consequences and an increased burden on the healthcare system. The present study is aimed at assessing the OHRQoL among the young adults of Saudi Arabia, identifying self-rated oral health, and determining the relationship between sociodemographic and lifestyle factors with the OHRQoL. The present analytical cross-sectional survey was conducted among 1152 health and non-health-related college university students from three randomly selected universities. The OHRQoL was evaluated using the validated Arabic version of the oral health impact profile-14 questionnaire (OHIP-14). Of the population studied, one-fourth of the participants (24.9%) reported poor or fair oral health, and the highest OHIP-14 score was found in the domains of physical pain (4.14), followed by psychological discomfort (4.07). Logistic regression analysis revealed that the poor oral health category was significantly associated with male gender (ref: female: adjusted OR (AOR) = 1.89, 95%CI = 1.23–2.94, p = 0.004), daily smokers (ref: nonsmokers: AOR = 3.47, 95%CI = 1.97–4.82, p < 0.001), chocolate and candies intake more than once a day (ref: never; AOR = 1.54, 95%CI = 1.10–2.19, p = 0.034), and did not seek periodical dental care (ref: periodic dental care received: AOR = 2.23, 95%CI = 1.53‐2.86, p = 0.002). The present study revealed the factors associated with poor OHRQoL. The concerned authorities should consider the implementation of periodic dental checkups for university students, especially for the high-risk group. Furthermore, it is recommended to have regular health education programs that will help to change the student's lifestyle and poor oral health behaviors.
Collapse
|
13
|
Han S, Jee D, Kang YJ, Park YJ, Cho JH. Possible association between oral health and sleep duration: A cross-sectional study based on the Korean National Health and Nutrition Examination Surveys from 2010 to 2015. Medicine (Baltimore) 2021; 100:e28035. [PMID: 35049216 PMCID: PMC9191334 DOI: 10.1097/md.0000000000028035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 11/11/2021] [Indexed: 11/25/2022] Open
Abstract
This study was performed to investigate the association between oral health and sleep duration in South Korean subjects using 2010-2015 data from the Korean National Health and Nutrition Examination Survey (KNHANES).Cross-sectional data on 35,599 adults over the age of 19 years who completed KNHANES were analyzed. All participants reported subjective oral health status and their daily average sleep duration using a self-reported questionnaire. Sleep duration and oral health status were divided into 3 categories: ≤5, 6-8, ≥9 h/day and good, fair, poor, respectively.The overall prevalence of poor oral health status was 43.8%. Univariate analysis demonstrated that poor oral health status was significantly associated with age, smoking, alcohol, diabetes, education, income, depression, marital status, and sleep duration. After adjusting for covariates (age, sex, diabetes mellitus, hypertension, obesity, smoking, income, education, marital status), sleep durations of ≤5 hours (OR = 1.42; 95% CI, 1.26-1.60) and ≥9 hours (OR = 1.21; 95% CI, 1.04-1.40) were significantly associated with poor oral health, compared to a sleep duration of 6-8 hours. Short or long sleep duration was more likely to have an impact on the development of poor oral health status in men than in women. A significant relationship between sleep duration and oral health status was found in participants younger than 60 years.This is the first report that both short and long sleep durations are significantly associated with the development of poor oral health status. The effect of short or long sleep duration on poor oral health was more significant in younger subjects and in men.
Collapse
Affiliation(s)
- Sungjun Han
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Donghyun Jee
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun-Jin Kang
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Jin Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung-Hae Cho
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
14
|
Calzada MT, Posada-López A, Gutiérrez-Quiceno B, Botero JE. Association Between Tobacco Smoking, Dental Status and Self-perceived Oral Health in Elderly Adults in Colombia. J Cross Cult Gerontol 2021; 36:187-200. [PMID: 33990901 DOI: 10.1007/s10823-021-09426-y] [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: 02/03/2021] [Indexed: 10/21/2022]
Abstract
Tobacco smoking is responsible for several health problems, including mouth diseases. The aim of the present study was to establish the association between smoking and dental status and self-perceived oral health in a large group of elderly Colombian adults. Analysis of 18,937 survey records of participants aged ≥ 60 years old was conducted. Information regarding age, sex, skin color, socioeconomic level, education, marital status, denture use, partial tooth loss or edentulism, Geriatric Oral Health Assessment Index (GOHAI) and tobacco smoking was retrieved from the database. A descriptive analysis and multivariate logistic regression analysis were performed. Half of the participants were edentulous in the maxilla while mandibular teeth were more frequently retained in more than 60% of the participants. After adjusting for sex and age, smoking consistently increased the odds of partial or complete edentulism in the maxilla (OR 1.05; 95% CI 1.02-1.09) and mandible (OR 1.04; 95% CI 1.00-1.08). Nonetheless, the increase in the odds in the mandible was not statistically significant. The habit of smoking was associated with increased tooth loss that in the long-term may result in poor oral health affecting the quality of life of elderly people.
Collapse
Affiliation(s)
- María Teresa Calzada
- Escuela de Odontología, Universidad del Valle, Calle 4B # 36-00 Campus San Fernando, Cali, Colombia
| | - Adriana Posada-López
- Facultad de Odontología, Universidad de Antioquia, Calle 70 # 52-21, Medellín, Colombia
| | - Bruno Gutiérrez-Quiceno
- Escuela de Odontología, Universidad del Valle, Calle 4B # 36-00 Campus San Fernando, Cali, Colombia
| | - Javier Enrique Botero
- Facultad de Odontología, Universidad de Antioquia, Calle 70 # 52-21, Medellín, Colombia.
| |
Collapse
|
15
|
Kutsal D, Bilgin Çetin M, Durukan E, Bulut Ş. Evaluation of the effect of periodontitis on quality of life using Oral-Dental Health-Related Quality of Life-United Kingdom scale. Int J Dent Hyg 2021; 19:305-312. [PMID: 33797852 DOI: 10.1111/idh.12501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/12/2021] [Accepted: 03/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the impact of periodontitis on oral health-related quality of life (OHQoL) using Oral-Dental Health-Related Quality of Life-United Kingdom (OHRQoL-UK) scale and evaluate the contributing factors. METHODS 50 patients with untreated periodontitis and 50 individuals without periodontitis were enrolled in the study. All subjects received detailed periodontal examination. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) measurements were examined. OHRQoL was assessed by the Oral Health Quality of Life-United Kingdom (OHRQoL-UK) scale. Symptoms of periodontitis were monitored by visual analogue scale (VAS). Socio-demographic characteristics, medical history, smoking status, hygiene habits of the participants were recorded. This study is registered at ClinicalTrials.gov as NCT04240014. RESULTS Total OHRQoL-UK scores were 38.24±6.47 in periodontitis patients and 55.88±9.38 in non-periodontitis individuals (p < 0.001). The scores of all 4 parameters were significantly lower in patients with periodontitis compared to healthy individuals (p <0.001). Higher PI, GI, PD and CAL values were associated with extensive negative impacts of periodontitis on OHRQoL (p < 0.001). According to the results of linear regression analysis, only periodontitis was found to associate with OHRQoL. Periodontal disease reduces the total quality of life score by 15.087 (ß= -15.087; 95% CI = [(-18.934)-(-11.240)]. CONCLUSIONS Individuals with periodontitis has diminished OHRQoL compared to healthy individuals.
Collapse
Affiliation(s)
- Derya Kutsal
- Karapurcek Oral and Dental Health Center, Ankara, Turkey
| | - Mehtap Bilgin Çetin
- Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Elif Durukan
- Department of Public Health, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Şule Bulut
- Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey
| |
Collapse
|
16
|
Lopes AG, Ju X, Jamieson L, Mialhe FL. Oral health-related quality of life among Brazilian adults with mental disorders. Eur J Oral Sci 2021; 129:e12774. [PMID: 33786899 DOI: 10.1111/eos.12774] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/05/2021] [Accepted: 01/19/2021] [Indexed: 01/10/2023]
Abstract
The aim of this study was to investigate associations of sociodemographic, lifestyle, medical conditions, and caries experience with oral health-related quality of life (OHRQoL) in a large sample of adults with mental disorders. A sample of 753 adults diagnosed with schizophrenia or depression, who were users of 10 public mental health outpatient clinics located in the city of São Paulo, Brazil, participated in the study. Participants provided data on sociodemographic characteristics, psychiatric diagnosis, medication use, and health behaviors. Oral examinations to evaluate dental caries (using the decayed, missing, and filled teeth ([DMFT] index) and dental plaque (using the Silness-Löe plaque index) were conducted. Oral health-related quality of life was evaluated using the 14-item Oral Health Impact Profile (OHIP-14) questionnaire. Log-Poisson regression was used to evaluate associations between the outcome and independent variables. The prevalence of one or more OHIP-14 impacts occurring fairly often/often was 72.3%. Physical pain was the OHIP domain with the highest prevalence, followed by psychological discomfort. Multivariable analysis showed that higher prevalence of the reponses 'fairly often/often' in the OHIP-14 was associated with being female, aged 35 to 54 years, having a low family income, a diagnosis of depression, a smoking habit, and fewer than 20 teeth. Adults with mental disorders had a high prevalence of impacts on their OHRQoL, which were associated with caries experience, sociodemographic characteristics, type of psychiatric diagnosis, and behavioral risk indicators.
Collapse
Affiliation(s)
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, SA, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, SA, Australia
| | - Fábio Luiz Mialhe
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| |
Collapse
|
17
|
Lazarov A. The impact of diabetes, smoking, and periodontitis on patients' oral health related quality of life after treatment with corticobasal implants - An evaluative study. Ann Maxillofac Surg 2021; 11:253-260. [PMID: 35265494 PMCID: PMC8848706 DOI: 10.4103/ams.ams_191_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/20/2021] [Accepted: 10/23/2021] [Indexed: 11/04/2022] Open
|
18
|
Ahsan I, Menon I, Gupta R, Arora V, Ashraf A, Das D. Oral health-related quality of life among adult smokeless tobacco users and nontobacco users of Ghaziabad district, Uttar Pradesh: A cross-sectional study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2021. [DOI: 10.4103/jiaphd.jiaphd_60_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
19
|
Bazargan M, Cobb S, Castro Sandoval J, Assari S. Smoking Status and Well-Being of Underserved African American Older Adults. Behav Sci (Basel) 2020; 10:bs10040078. [PMID: 32326442 PMCID: PMC7226211 DOI: 10.3390/bs10040078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose: This study investigated the association between current and past cigarette smoking, with four domains of well-being, namely, physical quality of life, mental quality of life, depressive symptoms, and self-rated health status (SRH), among older African American adults who lived in economically impoverished areas of South Los Angles. Methods: This community-based cross-sectional study included a convenience sample of economically-disadvantaged African Americans adults (n = 740) who were 55 years old and older residing in South Los Angeles. We conducted in-depth face-to-face interviews to collect data on the socioeconomic status (level of education and fiscal pressures), demographic factors (age and gender), physical health (number of chronic medical conditions), smoking (never smokers (reference group), past smokers, and current smokers), and well-being (quality of life, depressive symptoms, and self-rated health). Linear regressions were used to analyze the data. Results: Over 21% reported that they are current smokers, compared with 31% who identified as former smokers. Almost 40% perceived the quality of their health status to be fair or poor. Compared with non-smokers, current cigarette smokers reported a worse physical quality of life, depressive symptoms, and self-rated health. Current smokers also reported a marginally worse mental quality of life. Past smoker status was inconsistently associated with worse well-being in some, but not all, indicators. The association between smoking status and worse well-being was independent of gender, socioeconomic status, and physical health status. Conclusion: Current smoking is associated with worse well-being of older African American adults in economically constrained urban settings. As the same pattern could not be found for former smokers, quitting smoking may be a strategy for economically-disadvantaged African American individuals to enhance their well-being. This provides additional support for programs that help African American individuals who are smokers to quit smoking, particularly in economically-disadvantaged urban areas.
Collapse
Affiliation(s)
- Mohsen Bazargan
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Sharon Cobb
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Jessica Castro Sandoval
- Department of Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Shervin Assari
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Correspondence:
| |
Collapse
|
20
|
Al Saffan A, Alshahry R, Alrwissan S, Aljanoubi Z, Alswailem R. The effect of sports on oral health in Riyadh city: A cross-sectional study. SAUDI JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.4103/sjos.sjoralsci_75_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|