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Ludvigsson, Jonas F.ORCID iD iconorcid.org/0000-0003-1024-5602
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Publications (10 of 217) Show all publications
Tjernberg, A. R., Woksepp, H., Sandholm, K., Johansson, M., Dahle, C., Ludvigsson, J. F., . . . Ekdahl, K. N. (2020). Celiac disease and complement activation in response to Streptococcus pneumoniae. European Journal of Pediatrics, 179(1), 133-140
Open this publication in new window or tab >>Celiac disease and complement activation in response to Streptococcus pneumoniae
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2020 (English)In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 179, no 1, p. 133-140Article in journal (Refereed) Published
Abstract [en]

Individuals with celiac disease (CD) are at increased risk of invasive pneumococcal disease (IPD). The aim of this study was to explore whether the complement response to Streptococcus pneumoniae differed according to CD status, and could serve as an explanation for the excess risk of IPD in CD. Twenty-two children with CD and 18 controls, born 1999-2008, were included at Kalmar County Hospital, Sweden. The degree of complement activation was evaluated by comparing levels of activation products C3a and sC5b-9 in plasma incubated for 30 min with Streptococcus pneumoniae and in non-incubated plasma. Complement analyses were performed with enzyme-linked immunosorbent assay (ELISA). Pneumococcal stimulation caused a statistically significant increase in C3a as well as sC5b-9 in both children with CD and controls but there was no difference in response between the groups. After incubation, C3a increased on average 4.6 times and sC5b-9 22 times in both the CD and the control group (p = 0.497 and p = 0.724 respectively). Conclusion: Complement response to Streptococcus pneumoniae seems to be similar in children with and without CD and is thus unlikely to contribute to the increased susceptibility to invasive pneumococcal disease in CD.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Coeliac, Pneumococcal, Infection, Innate immunity, MBL
National Category
Pediatrics
Identifiers
urn:nbn:se:oru:diva-77992 (URN)10.1007/s00431-019-03490-w (DOI)000494392200001 ()31691001 (PubMedID)2-s2.0-85074845938 (Scopus ID)
Funder
Swedish Research Council, 522-2A09-195 2016-2075-5.1 2018-04087
Note

Funding Agencies:

Medical Research Council of Southeast Sweden  658741

Region Kalmar County 

Swedish Celiac Society 

Fulbright Commission  

Linnaeus University  

Research Council of Norway 274332

Örebro University 

Available from: 2019-11-22 Created: 2019-11-22 Last updated: 2020-01-13Bibliographically approved
Olén, O., Erichsen, R., Sachs, M. C., Pedersen, L., Halfvarson, J., Askling, J., . . . Ludvigsson, J. F. (2020). Colorectal cancer in ulcerative colitis: a Scandinavian population-based cohort study. The Lancet, 395(10218), 123-131
Open this publication in new window or tab >>Colorectal cancer in ulcerative colitis: a Scandinavian population-based cohort study
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2020 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 395, no 10218, p. 123-131Article in journal (Refereed) Published
Abstract [en]

Background: Ulcerative colitis (UC) is a risk factor for colorectal cancer (CRC). However, available studies reflect older treatment and surveillance paradigms, and most have assessed risks for incident CRC without taking surveillance and lead-time bias into account, such as by assessing CRC incidence by tumour stage, or stage-adjusted mortality from CRC. We aimed to compare both overall and country-specific risks of CRC mortality and incident CRC among patients with UC.

Methods: In this population-based cohort study of 96 447 patients with UC in Denmark (n=32 919) and Sweden (n=63 528), patients were followed up for CRC incidence and CRC mortality between Jan 1, 1969, and Dec 31, 2017, and compared with matched reference individuals from the general population (n=949 207). Patients with UC were selected from national registers and included in the analysis if they had two or more records with a relevant International Classification of Disease in the patient register (in the country in question) or one such record plus a colorectal biopsy report with a morphology code suggestive of inflammatory bowel disease. For every patient with UC, we selected matched reference individuals from the total population registers of Denmark and Sweden, who were matched for sex, age, birth year, and place of residence. We used Cox regression to compute hazard ratios (HRs) for incident CRC, and for CRC mortality, taking tumour stage into account.

Findings: During follow-up, we observed 1336 incident CRCs in the UC cohort (1.29 per 1000 person-years) and 9544 incident CRCs in reference individuals (0.82 per 1000 person-years; HR 1.66, 95% CI 1.57-1.76). In the UC cohort, 639 patients died from CRC (0.55 per 1000 person-years), compared with 4451 reference individuals (0.38 per 1000 person-years; HR 1.59, 95% CI 1.46-1.72) during the same time period. The CRC stage distribution in people with UC was less advanced (p<0.0001) than in matched reference individuals, but taking tumour stage into account, patients with UC and CRC remained at increased risk of CRC death (HR 1.54, 95% CI 1.33-1.78). The excess risks declined over calendar periods: during the last 5 years of follow-up (2013-17, Sweden only), the HR for incident CRC in people with UC was 1.38 (95% CI 1.20-1.60, or one additional case per 1058 patients with UC per 5 years) and the HR for death from CRC was 1.25 (95% CI 1.03-1.51, or one additional case per 3041 patients with UC per 5 years).

Interpretation: Compared with those without UC, individuals with UC are at increased risk of developing CRC, are diagnosed with less advanced CRC, and are at increased risk of dying from CRC, although these excess risks have declined substantially over time. There still seems to be room for improvement in international surveillance guidelines.

Place, publisher, year, edition, pages
Elsevier, 2020
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-79372 (URN)000506652400029 ()31929014 (PubMedID)
Funder
Stockholm County CouncilSwedish Cancer SocietySwedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareThe Karolinska Institutet's Research FoundationSwedish Foundation for Strategic Research
Note

Funding Agencies:

Swedish Medical Society (Fund for Research in Gastroenterology)  

Swedish Medical Society (Ihre Foundation)  

Mag-tarmfonden  

Young Scholar Award from the Strategic Research Area Epidemiology programme at Karolinska Institutet 

Independent Research Fund Denmark

Available from: 2020-01-27 Created: 2020-01-27 Last updated: 2020-01-27Bibliographically approved
Wernroth, M.-L., Fall, K., Svennblad, B., Ludvigsson, J. F., Sjölander, A., Almqvist, C. & Fall, T. (2020). Early Childhood Antibiotic Treatment for Otitis Media and Other Respiratory Tract Infections Is Associated With Risk of Type 1 Diabetes: A Nationwide Register-Based Study With Sibling Analysis. Diabetes Care, Article ID dc191162.
Open this publication in new window or tab >>Early Childhood Antibiotic Treatment for Otitis Media and Other Respiratory Tract Infections Is Associated With Risk of Type 1 Diabetes: A Nationwide Register-Based Study With Sibling Analysis
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2020 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, article id dc191162Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: The effect of early life antibiotic treatment on the risk of type 1 diabetes is debated. This study assessed this question, applying a register-based design in children up to age 10 years including a large sibling-control analysis.

RESEARCH DESIGN AND METHODS: = 797,318) born in Sweden between 1 July 2005 and 30 September 2013 were included and monitored to 31 December 2014. Cox proportional hazards models, adjusted for parental and perinatal characteristics, were applied, and stratified models were used to account for unmeasured confounders shared by siblings.

RESULTS: for interaction = 0.016). The association was driven by exposure to antibiotics primarily used for acute otitis media and respiratory tract infections. Further, we found an association of antibiotic prescriptions in pregnancy (22.5%) with type 1 diabetes (adjusted HR 1.15 [95% CI 1.00-1.32]). In general, sibling analysis supported these results, albeit often with statistically nonsignificant associations.

CONCLUSIONS: Dispensed prescription of antibiotics, mainly for acute otitis media and respiratory tract infections, in the 1st year of life is associated with an increased risk of type 1 diabetes before age 10, most prominently in children delivered by cesarean section.

Place, publisher, year, edition, pages
American Diabetes Association, 2020
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-80480 (URN)10.2337/dc19-1162 (DOI)32132008 (PubMedID)
Available from: 2020-03-09 Created: 2020-03-09 Last updated: 2020-03-09Bibliographically approved
Reilly, N. R., Hammer, M. L., Ludvigsson, J. F. & Green, P. H. (2020). Frequency and Predictors of Successful Transition of Care for Young Adults with Childhood Celiac Disease. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 70(2), 190-194
Open this publication in new window or tab >>Frequency and Predictors of Successful Transition of Care for Young Adults with Childhood Celiac Disease
2020 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 70, no 2, p. 190-194Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Transition from pediatric to adult care for individuals with chronic conditions is important to prevent gaps in care, though this has not been well-studied in celiac disease (CD). The aim of this study was to discern rates and predictors of successful transition of care for young adults with childhood-diagnosed CD.

METHODS: An anonymous 21-question online survey was sent to individuals on our center's email contact list seeking responses from those aged 18-25 years diagnosed with CD before age 18 years. Information collected included method of diagnosis, demographics, CD-related care, reasons for not seeking care, and symptoms.

RESULTS: Respondents (n = 98), 70% female, had a median age of 21 years (IQR 19-23 y). The majority were full or part-time students (67%; 95%CI = 59-77%). Only 31% of respondents had successfully transitioned to an adult CD provider. Some 37% (95%CI = 29-48%)) were not receiving any CD medical care. An older age at diagnosis was associated with successful transition to adult gastroenterology (p = 0.002) as well as with greater symptom scores (p = 0.002). Receiving a referral for ongoing adult CD care predicted successful transition to an adult provider (OR 3.92, 95% CI 1.58- 9.72).

CONCLUSIONS: Transition of care for young adults with CD is inconsistent, particularly among asymptomatic patients. Receipt of a referral for an adult provider significantly improves follow-up rates.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2020
National Category
Pediatrics
Identifiers
urn:nbn:se:oru:diva-78543 (URN)10.1097/MPG.0000000000002568 (DOI)31821231 (PubMedID)2-s2.0-85078228884 (Scopus ID)
Available from: 2019-12-13 Created: 2019-12-13 Last updated: 2020-02-17Bibliographically approved
Morgan, D. M., Cao, Y., Miller, K., McGoldrick, J., Bellavance, D., Chin, S. M., . . . Khalili, H. (2020). Microscopic Colitis is Characterized by Intestinal Dysbiosis. Clinical Gastroenterology and Hepatology, 18(4), 984-986
Open this publication in new window or tab >>Microscopic Colitis is Characterized by Intestinal Dysbiosis
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2020 (English)In: Clinical Gastroenterology and Hepatology, ISSN 1542-3565, E-ISSN 1542-7714, Vol. 18, no 4, p. 984-986Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2020
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-75611 (URN)10.1016/j.cgh.2019.06.035 (DOI)31254673 (PubMedID)2-s2.0-85081928179 (Scopus ID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2020-03-27Bibliographically approved
Olen, O., Askling, J., Sachs, M. C., Neovius, M., Smedby, K. E., Ekbom, A. & Ludvigsson, J. F. (2020). Mortality in adult-onset and elderly-onset IBD: a nationwide register-based cohort study 1964-2014. Gut, 69(3), 453-461
Open this publication in new window or tab >>Mortality in adult-onset and elderly-onset IBD: a nationwide register-based cohort study 1964-2014
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2020 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 69, no 3, p. 453-461Article in journal (Refereed) Published
Abstract [en]

Objectives: To examine all-cause and cause-specific mortality in adult-onset and elderly-onset IBD and to describe time trends in mortality over the past 50 years.

Design: Swedish nationwide register-based cohort study 1964-2014, comparing mortality in 82 718 incident IBD cases (inpatient and non-primary outpatient care) with 10 times as many matched general population reference individuals (n=801 180) using multivariable Cox regression to estimate HRs. Among patients with IBD, the number of participants with elderly-onset (>= 60 years) IBD was 17 873.

Results: During 984 330 person-years of follow-up, 15 698/82 718 (19%) of all patients with IBD died (15.9/1000 person-years) compared with 121 095/801 180 (15.1%) of reference individuals, corresponding to an HR of 1.5 for IBD (95% CI=1.5 to 1.5 (HR=1.5; 95% CI=1.5 to 1.5 in elderly-onset IBD)) or one extra death each year per 263 patients. Mortality was increased specifically for UC (HR=1.4; 95% CI=1.4 to 1.5), Crohn's disease (HR=1.6; 95% CI=1.6 to 1.7) and IBD-unclasssified (HR=1.6; 95% CI=1.5 to 1.8). IBD was linked to increased rates of multiple causes of death, including cardiovascular disease (HR=1.3; 1.3 to 1.3), malignancy (HR=1.4; 1.4 to 1.5) and digestive disease (HR=5.2; 95% CI=4.9 to 5.5). Relative mortality during the first 5 years of follow-up decreased significantly over time. Incident cases of 2002-2014 had 2.3 years shorter mean estimated life span than matched comparators.

Conclusions: Adult-onset and elderly-onset patients with UC, Crohn's disease and IBD-unclassified were all at increased risk of death. The increased mortality remained also after the introduction of biological therapies but has decreased over time.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2020
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-80935 (URN)10.1136/gutjnl-2018-317572 (DOI)000519270100007 ()31092591 (PubMedID)2-s2.0-85065792924 (Scopus ID)
Funder
Swedish Society of Medicine, SLS-789611Swedish Foundation for Strategic Research , 20170720 20170424Stockholm County CouncilThe Karolinska Institutet's Research Foundation, 20170720 20170424Swedish Cancer SocietySwedish Research CouncilForte, Swedish Research Council for Health, Working Life and Welfare, 83278
Available from: 2020-04-01 Created: 2020-04-01 Last updated: 2020-04-01Bibliographically approved
Sundelin, H. E. K., Stephansson, O., Johansson, S. & Ludvigsson, J. F. (2020). Pregnancy outcome in women with cerebral palsy: A nationwide population-based cohort study. Acta Obstetricia et Gynecologica Scandinavica, 99(4), 518-524
Open this publication in new window or tab >>Pregnancy outcome in women with cerebral palsy: A nationwide population-based cohort study
2020 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 99, no 4, p. 518-524Article in journal (Refereed) Published
Abstract [en]

Introduction: Cerebral palsy (CP) is a lifelong disorder with a high rate of comorbidities and complications. We hypothesized that women with CP are at increased risk of adverse pregnancy outcome.

Material and methods: In this nationwide population-based cohort study 1997-2011, we examined the outcome of 770 births in women with CP vs 1 247 408 births in women without a CP diagnosis using the Swedish Medical Birth Register. We used unconditional logistic regression, adjusting for maternal age, smoking, parity, year of birth and epilepsy, to calculate adjusted odds ratios for adverse pregnancy outcome. Main adverse outcome was preterm birth. Secondary outcomes were cesarean section, induction of labor, low 5-min Apgar score, small for gestational age, large for gestational age, and stillbirth.

Results: After adjusting for potential confounders, maternal CP was associated with increased risk of preterm birth (12.9% vs 4.9%; adjusted odds ratio [aOR] 2.8, 95% CI 2.3-3.5), cesarean delivery (aOR 1.9, 95% CI 1.6-2.2), induced delivery (aOR 1.4, 95% CI 1.1-1.6), low 5-min Apgar score (aOR 1.8, 95% CI 1.1-2.9) and small of gestational age birth (aOR 1.6, 95% CI 1.2-2.3). We found no increased risk of large for gestational age or stillbirth.

Conclusions: Women with CP are at increased risk of preterm birth and other adverse pregnancy outcomes, suggesting that they deserve extra surveillance during antenatal care. Further studies, with information on type of CP and gross motor function, are warranted to better understand the association between CP and pregnancy outcome.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
Adverse pregnancy outcome, cerebral palsy, child, obstetric-cohort study, pregnancy, preterm birth
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:oru:diva-78714 (URN)10.1111/aogs.13773 (DOI)000501289200001 ()31738455 (PubMedID)2-s2.0-85076367949 (Scopus ID)
Funder
Swedish Research Council, 2013-2429Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-01369Stockholm County Council, 20130156
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2020-04-01Bibliographically approved
Canova, C., Ludvigsson, J. F., Barbiellini Amidei, C., Zanier, L. & Zingone, F. (2020). The risk of epilepsy in children with celiac disease: a population-based cohort study. European Journal of Neurology
Open this publication in new window or tab >>The risk of epilepsy in children with celiac disease: a population-based cohort study
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2020 (English)In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background and purpose: The purpose was to estimate the risk of epilepsy in a cohort of young individuals with celiac disease (CD) compared to that of matched references.

Methods: The cohort consists of 213,635 individuals born during 1989-2011 and residing in Friuli-Venezia Giulia (Italy). We identified 1,215 individuals affected by CD and 6,075 reference individuals matched by sex and age. Epilepsy was defined by means of hospital diagnosis or drug prescriptions. Conditional logistic regression was used to estimate the odds ratios (ORs) of having epilepsy among individuals with CD, before CD diagnosis and in the entire period, compared with those of their matched references. Cox regression was used to calculate the hazard ratios (HRs) for epilepsy diagnosed after CD diagnosis. Different definitions of epilepsy were used for sensitivity analyses.

Results: Thirty-one (2.6%) individuals with CD and 78 (1.3%) reference individuals had epilepsy (adjusted OR: 2.03 95%CI: 1.33-3.10). The risk of epilepsy was increased prior to CD (adjusted OR: 2.29; 95%CI: 1.33-3.94), with similar estimates after CD diagnosis (adjusted HR 1.96; 95%CI: 0.95-4.02). The increased risk of epilepsy was not explained by a peak in epilepsy diagnosis just around CD diagnosis. Sex stratification found a significantly higher risk of epilepsy among female individuals with CD. Sensitivity analyses confirmed the positive association between CD and epilepsy.

Conclusion: Children and youths with CD were at increased risk of epilepsy. Patients with epilepsy without a clear etiology should be screened for CD since an early diagnosis and treatment might improve the response to antiepileptic therapies.

Place, publisher, year, edition, pages
Blackwell Publishing, 2020
Keywords
Antiepileptic drugs, celiac disease, children, cohort study, epilepsy, epileptic seizure
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-79957 (URN)10.1111/ene.14160 (DOI)000520870800001 ()31994800 (PubMedID)
Note

Funding Agency:

University of Padua  F.S. 4.18.01.05

Available from: 2020-02-18 Created: 2020-02-18 Last updated: 2020-04-01Bibliographically approved
Ludvigsson, J. F. & Lebwohl, B. (2020). Three papers indicate that amount of gluten play a role for celiac disease: But only a minor role. Acta Paediatrica, 109(1), 8-10
Open this publication in new window or tab >>Three papers indicate that amount of gluten play a role for celiac disease: But only a minor role
2020 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, no 1, p. 8-10Article in journal, Editorial material (Refereed) Published
Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2020
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:oru:diva-77878 (URN)10.1111/apa.15057 (DOI)000495084200001 ()31701547 (PubMedID)2-s2.0-85074843156 (Scopus ID)
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2020-03-17Bibliographically approved
Everhov, Å., Sachs, M. C., Ludvigsson, J. F., Khalili, H., Askling, J., Neovius, M., . . . Olén, O. (2020). Work loss in relation to pharmacological and surgical treatment for Crohn’s disease: A population-based cohort study. Clinical Epidemiology, 12, 273-285
Open this publication in new window or tab >>Work loss in relation to pharmacological and surgical treatment for Crohn’s disease: A population-based cohort study
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2020 (English)In: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 12, p. 273-285Article in journal (Refereed) Published
Abstract [en]

Purpose: Patients with Crohn’s disease have increased work loss. We aimed to describe changes in work ability in relation to pharmacological and surgical treatments.

Patients and Methods: We linked data from the Swedish National Patient Register, The Swedish Quality Register for Inflammatory Bowel Disease SWIBREG, The Prescribed Drug Register, The Longitudinal Integrated Database for Health Insurance and Labour Market Studies, and the Social Insurance Database. We identified working-age (19–59 years) patients with incident Crohn’s disease 2006–2013 and population comparator subjects matched by sex, birth year, region, and education level. We assessed the number of lost workdays due to sick leave and disability pension before and after treatments.

Results: Of 3956 patients (median age 34 years, 51% women), 39% were treated with aminosalicylates, 52% with immunomodulators, 22% with TNF inhibitors, and 18% with intestinal surgery during a median follow-up of 5.3 years. Most patients had no work loss during the study period (median=0 days). For all treatments, the mean number of lost workdays increased during the months before treatment initiation, peaked during the first month of treatment and decreased thereafter, and was heavily influenced by sociodemo-graphic factors and amount of work loss before first Crohn’s disease diagnosis. The mean increase in work loss days compared to pre-therapeutic level was ~3 days during the first month of treatment for all pharmacological therapies and 11 days for intestinal surgery. Three months after treatment initiation, 88% of patients treated surgically and 90–92% of patients treated pharmacologically had the same amount of work loss as before treatment start. Median time to return to work was 2 months for all treatments.

Conclusion: In this regular clinical setting, patients treated surgically had more lost workdays than patients treated pharmacologically, but return to work was similar between all treatments.

Place, publisher, year, edition, pages
Dove Medical Press Ltd., 2020
Keywords
Aminosalicylate, Disability pension, Immunomodulator, Inflammatory bowel disease, Sick leave, TNF inhibitor
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-80878 (URN)10.2147/CLEP.S244011 (DOI)000519251900001 ()2-s2.0-85081542785 (Scopus ID)
Funder
The Karolinska Institutet's Research FoundationSwedish Research CouncilSwedish Cancer SocietySwedish Foundation for Strategic Research Stockholm County Council
Note

Funding Agencies:

Bengt Ihre Research Foundation 

Bengt Ihre Research Fellowship 

Ferring 

Available from: 2020-03-27 Created: 2020-03-27 Last updated: 2020-04-01Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-1024-5602

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