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BETA
Ludvigsson, Jonas F.ORCID iD iconorcid.org/0000-0003-1024-5602
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Publications (10 of 200) Show all publications
Bergman, D., Clemente, M. S., Khalili, F., Agréus, L., Hultcrantz, R. & Ludvigsson, J. F. (2019). A nationwide cohort study of the incidence of microscopic colitis in Sweden. Alimentary Pharmacology and Therapeutics, 49(11), 1395-1400
Open this publication in new window or tab >>A nationwide cohort study of the incidence of microscopic colitis in Sweden
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2019 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 49, no 11, p. 1395-1400Article in journal (Refereed) Published
Abstract [en]

Background: Epidemiological studies of microscopic colitis have shown varying but increasing incidence rates. Aim To assess the incidence of microscopic colitis in Sweden.

Methods: Nationwide cohort study performed in 1995-2015 based on biopsy reports. Age-specific and age-standardised incidence rates were calculated.

Results: We identified 13 844 patients with an incident diagnosis of microscopic colitis. Lymphocytic colitis (n = 9238) constituted 67% and collagenous colitis (n = 4606) 33% of microscopic colitis. The mean age at time of diagnosis of microscopic colitis was 60.2 years (58.6 for lymphocytic colitis, 63.3 for collagenous colitis). The lifetime risk of developing microscopic colitis was 0.87% in women (95% confidence interval, CI: 0.85-0.88) and 0.35% in men (95% CI: 0.34-0.36). From 2006, the overall incidence of microscopic colitis was approximately 10.5 cases per 100 000 person-years (95% CI: 9.8-11.3) with higher rates in women (72% of cases, incidence rate ratio = 2.4 (95% CI: 2.3-2.5) and the elderly with increasing rates up to 75-79 years. From 2006-2015, there was a significant increase of 1% per year (P = 0.02) in the overall microscopic colitis incidence rate in women; the estimated annual percent change was similar, although not statistically significant, in men (P = 0.15).

Conclusions: In Sweden, the incidence of microscopic colitis is still increasing in women, although the rate appears to be stabilising. The incidence is particularly high in women and the elderly up to age 75-79 years. Finally, across a lifetime, 1 in 115 females and 1 in 286 males are expected to be diagnosed with microscopic colitis and thus posing a considerable disease burden.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Gastroenterology and Hepatology Pharmacology and Toxicology
Identifiers
urn:nbn:se:oru:diva-74404 (URN)10.1111/apt.15246 (DOI)000467578300003 ()30983010 (PubMedID)2-s2.0-85064439743 (Scopus ID)
Funder
Stockholm County Council, 20150405
Available from: 2019-05-28 Created: 2019-05-28 Last updated: 2019-05-28Bibliographically approved
Visuri, I., Eriksson, C., Mårdberg, E., Grip, O., Gustavsson, A., Hjortswang, H., . . . Halfvarson, J. (2019). Anti-TNF agent drug survival in patients with IBD: real-world comparisons of individual anti-TNF agents based on the Swedish National Quality Registry for IBD (SWIBREG). Journal of Crohn's & Colitis, 13(Suppl. 1), S443-S444
Open this publication in new window or tab >>Anti-TNF agent drug survival in patients with IBD: real-world comparisons of individual anti-TNF agents based on the Swedish National Quality Registry for IBD (SWIBREG)
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2019 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 13, no Suppl. 1, p. S443-S444Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2019
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-73336 (URN)10.1093/ecco-jcc/jjy222.773 (DOI)000460544502205 ()
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-03-26Bibliographically approved
Weimers, P., Halfvarson, J., Sachs, M. C., Ludvigsson, J. F., Peter, I., Olén, O. & Burisch, J. (2019). Association between inflammatory bowel disease and Parkinson's disease: seek and you shall find? [Letter to the editor]. Gut, 68(1), 175-176
Open this publication in new window or tab >>Association between inflammatory bowel disease and Parkinson's disease: seek and you shall find?
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2019 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 68, no 1, p. 175-176Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
Epidemiology, inflammatory bowel disease
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-71215 (URN)10.1136/gutjnl-2018-316937 (DOI)000455727900023 ()30021791 (PubMedID)2-s2.0-85050249090 (Scopus ID)
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-02-04Bibliographically approved
Chen, Q., Larsson, H., Almqvist, C., Chang, Z., Lichtenstein, P., D'Onofrio, B. M. & Ludvigsson, J. F. (2019). Association between pharmacotherapy for ADHD in offspring and depression-related specialty care visits by parents with a history of depression. BMC Psychiatry, 19, Article ID 224.
Open this publication in new window or tab >>Association between pharmacotherapy for ADHD in offspring and depression-related specialty care visits by parents with a history of depression
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2019 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 19, article id 224Article in journal (Refereed) Published
Abstract [en]

Background: Pharmacotherapy is effective in reducing the core symptoms of attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate the concurrent association between pharmacotherapy for ADHD in offspring and depression-related specialty care visits by the parents with a history of depression.

Methods: Using data from a variety of Swedish national registers, we conducted a cohort study with 8-year follow-up of 5605 parents (3872 mothers and 1733 fathers) who had a history of depression and an offspring diagnosed with ADHD. The hazard rate for parental depression-related specialty care visits during exposed periods when the offspring was on medication for treatment of ADHD was compared with the hazard rate during unexposed periods when the offspring was off medication. Within-individual comparisons were employed to control for time-constant confounding factors.

Results: Among mothers, the crude rates of depression-related specialty care visits during exposed and unexposed periods were 61.33 and 63.95 per 100 person-years, respectively. The corresponding rates among fathers were 49.23 and 54.65 per 100 person-years. When the same parent was compared with him or herself, fathers showed a decreased hazard rate for depression-related visits during exposed periods when the offspring was on medication for treatment of ADHD as compared to unexposed periods (hazard ratio, 0.79 [95% confidence interval, 0.70 to 0.90]). No statistically significant associations were observed in mothers.

Conclusions: Among parents with a history of depression, pharmacotherapy for ADHD in offspring is concurrently associated with a decreased rate of depression-related specialty care visits in fathers but not in mothers. Future research with refined measures of parental depression and other time-varying familial factors is needed to better understand the mechanisms underlying the association.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
ADHD, Pharmacotherapy, Depression, Offspring, Parents
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-75725 (URN)10.1186/s12888-019-2211-7 (DOI)000475947500001 ()31315609 (PubMedID)2-s2.0-85069537504 (Scopus ID)
Funder
Swedish Research Council, 2013-2280
Note

Funding Agencies:

Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM)  340-2013-5867 

National Institute of Mental Health (NIMH)  1R01MH102221 

Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-08-13Bibliographically approved
Wintzell, V., Svanström, H., Olén, O., Melbye, M., Ludvigsson, J. F. & Pasternak, B. (2019). Association between use of azathioprine and risk of acute pancreatitis in children with inflammatory bowel disease: a Swedish-Danish nationwide cohort study. Lancet Child and Adolescent Health, 3(3), 158-165
Open this publication in new window or tab >>Association between use of azathioprine and risk of acute pancreatitis in children with inflammatory bowel disease: a Swedish-Danish nationwide cohort study
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2019 (English)In: Lancet Child and Adolescent Health, E-ISSN 2352-4642, Vol. 3, no 3, p. 158-165Article in journal (Refereed) Published
Abstract [en]

Background: Studies have shown an association between use of azathioprine and increased risk of acute pancreatitis in adult inflammatory bowel disease. However, whether an association exists among paediatric patients is not known. We aimed to investigate whether use of azathioprine is associated with the risk of acute pancreatitis in children with inflammatory bowel disease.

Methods: We did a nationwide register-based cohort study in Sweden (2006-16) and Denmark (2000-16). All paediatric patients (<18 years of age) with inflammatory bowel disease during the study period were identified through hospital records. Episodes of incident azathioprine use and no use of any thiopurine were matched (1:1) using propensity scores, controlling for sociodemographic characteristics, comorbidities, previous treatment, indicators of disease severity, and health care use. Incident acute pancreatitis (physician-assigned diagnosis with ICD-10 code K85) occurring in the 90 days following treatment initiation were identified through outpatient and inpatient hospital records.

Findings: We identified 3574 azathioprine episodes and 18 700 no-use episodes, which resulted in 3374 pairs after propensity score matching; baseline characteristics in the matched cohort were well balanced. Among the matched azathioprine episodes, mean age was 14.3 years (SD 3.1), 1854 (54.9%) were male, 1923 (57.0%) had Crohn's disease, and 1451 (43.0%) had ulcerative colitis or unclassified inflammatory bowel disease. Within the first 90 days following initiation of azathioprine, 40 acute pancreatitis events occurred (incidence rate 49.1 events per 1000 person-years) compared with six events in the no-use group (8.4 events per 1000 person-years). Azathioprine use was associated with an increased risk of acute pancreatitis (incidence rate ratio 5.82 [95% CI 2.47-13.72]; absolute difference 1.0 [95% CI 0.3-2.6] events per 100 patients) during the 90-day risk period.

Interpretation: Use of azathioprine was associated with an increased risk of acute pancreatitis in children with inflammatory bowel disease during the first 90 days following treatment initiation, suggesting the need for regular and rigorous monitoring. The risk of acute pancreatitis needs to be considered when deciding on optimal treatment strategies.

Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:oru:diva-72869 (URN)10.1016/S2352-4642(18)30401-2 (DOI)000458662400016 ()30685366 (PubMedID)2-s2.0-85061370852 (Scopus ID)
Funder
Swedish Research Council, 2016-01974Åke Wiberg Foundation
Note

Funding Agencies:

Frimurare Barnhuset Foundation

Strategic Research Area Epidemiology programme at Karolinska Institutet

Available from: 2019-03-01 Created: 2019-03-01 Last updated: 2019-03-01Bibliographically approved
Hedman, A., Breithaupt, L., Hübel, C., Thornton, L. M., Tillander, A., Norring, C., . . . Bulik, C. M. (2019). Bidirectional relationship between eating disorders and autoimmune diseases. Journal of Child Psychology and Psychiatry and Allied Disciplines, 60(7), 803-812
Open this publication in new window or tab >>Bidirectional relationship between eating disorders and autoimmune diseases
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2019 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 60, no 7, p. 803-812Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Immune system dysfunction may be associated with eating disorders (ED) and could have implications for detection, risk assessment, and treatment of both autoimmune diseases and EDs. However, questions regarding the nature of the relationship between these two disease entities remain. We evaluated the strength of associations for the bidirectional relationships between EDs and autoimmune diseases.

METHODS: In this nationwide population-based study, Swedish registers were linked to establish a cohort of more than 2.5 million individuals born in Sweden between January 1, 1979 and December 31, 2005 and followed up until December 2013. Cox proportional hazard regression models were used to investigate: (a) subsequent risk of EDs in individuals with autoimmune diseases; and (b) subsequent risk of autoimmune diseases in individuals with EDs.

RESULTS: We observed a strong, bidirectional relationship between the two illness classes indicating that diagnosis in one illness class increased the risk of the other. In women, the diagnoses of autoimmune disease increased subsequent hazards of anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders (OED). Similarly, AN, BN, and OED increased subsequent hazards of autoimmune diseases.Gastrointestinal-related autoimmune diseases such as, celiac disease and Crohn's disease showed a bidirectional relationship with AN and OED. Psoriasis showed a bidirectional relationship with OED. The previous occurence of type 1 diabetes increased the risk for AN, BN, and OED. In men, we did not observe a bidirectional pattern, but prior autoimmune arthritis increased the risk for OED.

CONCLUSIONS: The interactions between EDs and autoimmune diseases support the previously reported associations. The bidirectional risk pattern observed in women suggests either a shared mechanism or a third mediating variable contributing to the association of these illnesses.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019
Keywords
anorexia nervosa, autoimmunity, bulimia nervosa, cox regression, hazard, immune system, risk
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychiatry Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:oru:diva-68740 (URN)10.1111/jcpp.12958 (DOI)000472977400010 ()30178543 (PubMedID)2-s2.0-85052927975 (Scopus ID)
Funder
Swedish Research Council, 538-2013-8864
Note

Funding Agencies:

Anorexia Nervosa Genetics Initiative (ANGI), an initiative of the Klarman Family Foundation  

National Science Foundation Graduate Research Fellowship  1000183151 

Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM)  340-2013-5867 

Stockholm County Council (ALF-projects)  

Shire  

Foundation of Hope: Research and Treatment of Mental Illness 

Available from: 2018-09-10 Created: 2018-09-10 Last updated: 2019-08-08Bibliographically approved
Hagström, H., Höijer, J., Andreasson, A., Bottai, M., Johansson, K., Ludvigsson, J. F. & Stephansson, O. (2019). Body mass index in early pregnancy and future risk of severe liver disease: a population-based cohort study. Alimentary Pharmacology and Therapeutics, 49(6), 789-796
Open this publication in new window or tab >>Body mass index in early pregnancy and future risk of severe liver disease: a population-based cohort study
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2019 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 49, no 6, p. 789-796Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In young men, high body mass index (BMI) has been linked to liver disease later in life, but it is unclear if this also applies to women.

AIM: To study the association between BMI early in life and development of liver disease later in life in women.

METHODS: We obtained data on early pregnancy BMI from 1 139 458 Swedish women between 1992 and 2015. National registers were used to ascertain incident severe liver disease, defined as cirrhosis, decompensated liver disease (hepatocellular carcinoma, oesophageal varices, hepatorenal syndrome or hepatic encephalopathy) or liver failure. A Cox regression model was used to investigate associations of BMI with incident severe liver disease adjusting for maternal age, calendar year, country of birth, smoking, civil status and education.

RESULTS: (95% CI 1.02-1.05). A diagnosis of diabetes was associated with an increased risk of severe liver disease independent of baseline BMI.

CONCLUSION: A high BMI early in life in women is associated with a dose-dependent, increased risk for future severe liver disease.

Place, publisher, year, edition, pages
Blackwell Science Ltd., 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-72885 (URN)10.1111/apt.15162 (DOI)000459827800015 ()30714185 (PubMedID)2-s2.0-85060992724 (Scopus ID)
Note

Funding Agencies:

Stockholm County (Clinical Postdoctorial Appointment)  

Bengt Ihre Fellowship 

Available from: 2019-03-04 Created: 2019-03-04 Last updated: 2019-06-19Bibliographically approved
Everhov, Å. H., Sachs, M. C., Malmborg, P., Nordenvall, C., Myrelid, P., Khalili, H., . . . Olén, O. (2019). Changes in inflammatory bowel disease subtype during follow-up and over time in 44,302 patients. Scandinavian Journal of Gastroenterology, 54(1), 55-63
Open this publication in new window or tab >>Changes in inflammatory bowel disease subtype during follow-up and over time in 44,302 patients
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2019 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 54, no 1, p. 55-63Article in journal (Refereed) Published
Abstract [en]

AIM: To investigate inflammatory bowel disease (IBD) register-based subtype classifications over a patient's disease course and over time.

METHODS: We examined International Classification of Diseases coding in patients with ≥2 IBD diagnostic listings in the National Patient Register 2002-2014 (n = 44,302).

RESULTS: 18% of the patients changed diagnosis (17% of adults, 29% of children) during a median follow-up of 3.8 years. Of visits with diagnoses of Crohn's disease (CD) or ulcerative colitis (UC), 97% were followed by the same diagnosis, whereas 67% of visits with diagnosis IBD-unclassified (IBD-U) were followed by another IBD-U diagnosis. Patients with any diagnostic change changed mostly once (47%) or twice (31%), 39% from UC to CD, 33% from CD to UC and 30% to or from IBD-U. Using a classification algorithm based on the first two diagnoses ('incident classification'), suited for prospective cohort studies, the proportion adult patients with CD, UC, and IBD-U 2002-2014 were 29%, 62%, and 10% (43%, 45%, and 12% in children). A classification model incorporating additional information from surgeries and giving weight to the last 5 years of visits ('prevalent classification'), suited for description of a study population at end of follow-up, classified 31% of adult cases as CD, 58% as UC and 11% as IBD-U (44%, 38%, and 18% in children).

CONCLUSIONS: IBD subtype changed in 18% during follow-up. The proportion with CD increased and UC decreased from definition at start to end of follow-up. IBD-U was more common in children.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Crohn’s disease, IBD-U, Inflammatory bowel disease, indeterminate colitis, inflammatory bowel disease unclassified, register-based definition, ulcerative colitis
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-72038 (URN)10.1080/00365521.2018.1564361 (DOI)000462902700008 ()30700170 (PubMedID)2-s2.0-85060872917 (Scopus ID)
Funder
The Swedish Medical AssociationSwedish Research CouncilSwedish Cancer SocietyThe Karolinska Institutet's Research FoundationStockholm County Council
Note

Funding Agencies:

Bengt Ihre foundation  

Mag-tarmfonden 

Karolinska Institutet (ALF)

Available from: 2019-02-12 Created: 2019-02-12 Last updated: 2019-06-19Bibliographically approved
Ludvigsson, J. F. & Lashkariani, M. (2019). Cohort profile: ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden). Clinical Epidemiology, 11, 101-114
Open this publication in new window or tab >>Cohort profile: ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden)
2019 (English)In: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 11, p. 101-114Article in journal (Refereed) Published
Abstract [en]

The ESPRESSO study constitutes a novel approach to examine the etiology and prognosis of gastrointestinal disease in which histopathology plays a prominent role. Between 2015 and 2017, all pathology departments (n=28) in Sweden were contacted and asked to procure histopathology record data from the gastrointestinal tract (pharynx to anus), liver, gallbladder, and pancreas. For each individual, local histopathology IT personnel retrieved data on personal identity number, date of histopathology, topography (where the biopsy is taken), morphology (biopsy appearance), and where available free text. In total, between 1965 and 2017, histopathology record data were available in 2.1 million unique individuals, but the number of data entries was 6.1 million because more than one biopsy was performed in many of the study participants. Index individuals with histopathology data were matched with up to five controls from the general population. We also identified all first-degree relatives (parents, children, full siblings), and the index individual's first spouse. The total study population consisted of 13.0 million individuals. Data from all the study participants have been linked to Swedish National Healthcare Registers allowing research not only on such aspects as fetal and perinatal conditions and the risk of future gastrointestinal disease but also on the risk of comorbidity and complications (including cancer and death). Furthermore, the ESPRESSO database allows researchers and practitioners to identify diagnoses and disease phenotypes not currently indexed in national registers (including disease precursors). The ESPRESSO database increases the sensitivity and specificity of already-recorded diseases in the national health registers. This paper is an overview of the ESPRESSO database.

Place, publisher, year, edition, pages
DOVE Medical Press Ltd., 2019
Keywords
cohort, gallbladder, gut, liver, pancreas, population-based, colon, pathology, endoscopy, celiac, inflammatory bowel disease, colitis, esophagus
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-72188 (URN)10.2147/CLEP.S191914 (DOI)000456428300001 ()30679926 (PubMedID)
Available from: 2019-02-07 Created: 2019-02-07 Last updated: 2019-02-07Bibliographically approved
Ho, P. J., Tan, C. S., Shawon, S. R., Eriksson, M., Lim, L. Y., Miao, H., . . . Li, J. (2019). Comparison of self-reported and register-based hospital medical data on comorbidities in women. Scientific Reports, 9(1), Article ID 3527.
Open this publication in new window or tab >>Comparison of self-reported and register-based hospital medical data on comorbidities in women
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2019 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, no 1, article id 3527Article in journal (Refereed) Published
Abstract [en]

Breast cancer patients commonly present with comorbidities which are known to influence treatment decisions and survival. We aim to examine agreement between self-reported and register-based medical records (National Patient Register [NPR]). Ascertainment of nine conditions, using individually-linked data from 64,961 women enrolled in the Swedish KARolinska MAmmography Project for Risk Prediction of Breast Cancer (KARMA) study. Agreement was assessed using observed proportion of agreement (overall agreement), expected proportion of agreement, and Cohen's Kappa statistic. Two-stage logistic regression models taking into account chance agreement were used to identify potential predictors of overall agreement. High levels of overall agreement (i.e. ≥86.6%) were observed for all conditions. Substantial agreement (Cohen's Kappa) was observed for myocardial infarction (0.74), diabetes (0.71) and stroke (0.64) between self-reported and NPR data. Moderate agreement was observed for preeclampsia (0.51) and hypertension (0.46). Fair agreement was observed for heart failure (0.40) and polycystic ovaries or ovarian cysts (0.27). For hyperlipidemia (0.14) and angina (0.10), slight agreement was observed. In most subgroups we observed negative specific agreement of >90%. There is no clear reference data source for ascertainment of conditions. Negative specific agreement between NPR and self-reported data is consistently high across all conditions.

Place, publisher, year, edition, pages
Nature Publishing Group, 2019
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-73200 (URN)10.1038/s41598-019-40072-0 (DOI)000460381600100 ()30837593 (PubMedID)2-s2.0-85062585961 (Scopus ID)
Note

Funding Agencies:

Marit and Hans Rausing's Initiative Against Breast Cancer  

Kamprad Family Foundation  

Singapore National Research Foundation Fellowship  NRF-NRFF2017-02 

National Medical Research Council Clinician Scientist Award  NMRC/CSA-SI/0015/2017 

National University Cancer Institute Singapore Centre Grant Programme  CGAug16M005 

Breast Cancer Prevention Programme under SSHSPH-Res-Prog 

Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-06-19Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-1024-5602

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