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Publikationer (10 of 24) Visa alla publikationer
Sundbaum, J., Eriksson, N., Hallberg, P., Lehto, N., Wadelius, M. & Baecklund, E. (2019). Methotrexate treatment in rheumatoid arthritis and elevated liver enzymes: A long‐term follow‐up of predictors, surveillance, and outcome in clinical practice. International Journal of Rheumatic Diseases, 22(7), 1226-1232
Öppna denna publikation i ny flik eller fönster >>Methotrexate treatment in rheumatoid arthritis and elevated liver enzymes: A long‐term follow‐up of predictors, surveillance, and outcome in clinical practice
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2019 (Engelska)Ingår i: International Journal of Rheumatic Diseases, E-ISSN 1756-185X, Vol. 22, nr 7, s. 1226-1232Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aim

To assess predictors of alanine aminotransferase (ALT) elevation in methotrexate (MTX) treated rheumatoid arthritis (RA) patients, and to describe the monitoring of liver enzymes, including handling and outcome of elevated ALT.

Methods

All RA patients starting MTX in January, 2005 to April, 2013 at a rheumatology clinic, (Uppsala University Hospital, Sweden) were identified from electronic medical records. Clinical and laboratory data were obtained from medical records, supplemented by telephone interviews. Predictors for ALT >1.5× over the upper limit of normal (ULN) were identified by multiple regression analysis.

Results

The study comprised 213 RA patients starting MTX. During a mean follow‐up of 4.3 years, 6288 ALT tests were performed; 7% of tests with ALT were >ULN. ALT >1.5× ULN was observed in 44 (21%) patients and the strongest predictor was a pre‐treatment elevation of ALT (adjusted odds ratio = 6.8, 95% CI 2.2‐20.5). Recurrent elevations occurred in 70% of patients who continued treatment, and the proportion was similar in those with and without interventions, for example MTX dose reduction (67% vs 73%, P = 0.43). Seven patients (3%) permanently stopped MTX due to ALT elevation, and two were eventually diagnosed with non‐alcoholic fatty liver disease. No patient developed hepatic failure.

Conclusion

Only a small number of ALT tests performed during MTX therapy in RA capture an elevation. A pre‐treatment elevation of ALT was the strongest predictor for early and recurrent ALT elevations during therapy. This study supports a more individualized approach to monitoring and handling of ALT elevations during MTX therapy in RA than recommended in current guidelines.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2019
Nyckelord
liver toxicity, liver transaminases, methotrexate, non‐alcoholic fatty liver disease, rheumatoid arthritis
Nationell ämneskategori
Annan hälsovetenskap Annan fysik
Forskningsämne
Hälsovetenskap; Tillämpad fysik
Identifikatorer
urn:nbn:se:ltu:diva-73727 (URN)10.1111/1756-185X.13576 (DOI)000476560400008 ()31012257 (PubMedID)
Anmärkning

Validerad;2019;Nivå 2;2019-08-19 (johcin)

Tillgänglig från: 2019-04-23 Skapad: 2019-04-23 Senast uppdaterad: 2019-08-19Bibliografiskt granskad
Röijezon, U., Løvoll, G., Henriksson, A., Tonkonogi, M. & Lehto, N. (2017). An Initial Study on the Coordination of Rod and Line Hauling Movements in Distance Fly Casting. Annals of Applied Sport Science, 5(2), 61-72
Öppna denna publikation i ny flik eller fönster >>An Initial Study on the Coordination of Rod and Line Hauling Movements in Distance Fly Casting
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2017 (Engelska)Ingår i: Annals of Applied Sport Science, ISSN 2476-4981, Vol. 5, nr 2, s. 61-72Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background. The double haul is a unique feature of single-handed fly casting and is used in both fly fishing and fly casting competition. The movement behaviour during the double haul has not been investigated in previous research.

Objectives. Describe the coordination of the rod and line hauling movements during distance fly casting.

Methods. Elite fly casters performed distance casting with four different fly rod and fly line set-ups used in fly fishing and fly casting competition. Rod and hauling movements were measured with a 3D motion analysis system.

Results. The rod and line hauling movements were coordinated in an order whereby peak translational speed of the rod occurs prior to the peak speed of the angular rotation of the rod, and the peak speed of the angular rotation of the rod occurs prior to the peak speed of the line haul. This was consistent for all cast sequences, i.e., the back and forward false casts and the delivery cast, and for all four equipment set-ups, i.e., a shooting-head line cast with a relatively stiff fly rod and a long-belly line cast with three different fly rods with different stiffness and action curves. Results also showed differences in movement coordination between cast sequences and rod and line set-ups.

Conclusion. Among elite casters, single-handed fly casting with double haul is coordinated in an order of events whereby the peak speed occurs first for the translation of the rod, then for the rotation of the rod and finally for the line haul.

Ort, förlag, år, upplaga, sidor
Asian Exercise and Sport Science Association, 2017
Nyckelord
Fly Fishing, Long-Belly Line, Movement Behaviour, Shooting-Head Line
Nationell ämneskategori
Idrottsvetenskap Sjukgymnastik Annan hälsovetenskap
Forskningsämne
Fysioterapi; Hälsovetenskap
Identifikatorer
urn:nbn:se:ltu:diva-63976 (URN)10.18869/acadpub.aassjournal.5.2.61 (DOI)000418323000008 ()2-s2.0-85034451089 (Scopus ID)
Projekt
Projekt: Rörelsekontroll och effektivitet vid flugkastning
Anmärkning

Validerad;2018;Nivå 2;2018-01-09 (andbra)

Tillgänglig från: 2017-06-13 Skapad: 2017-06-13 Senast uppdaterad: 2018-03-05Bibliografiskt granskad
Leijon-Sundqvist, K., Tegner, Y., Olsson, F., Karp, K. & Lehto, N. (2017). Relation between dorsal and palmar hand skin temperatures during a cold stress test. Journal of Thermal Biology, 66, 87-92
Öppna denna publikation i ny flik eller fönster >>Relation between dorsal and palmar hand skin temperatures during a cold stress test
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2017 (Engelska)Ingår i: Journal of Thermal Biology, ISSN 0306-4565, E-ISSN 1879-0992, Vol. 66, s. 87-92Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Hand skin temperature measurements have previously been performed on either dorsal or palmar sides and it is possible to find arguments for the advantage of both locations. Therefore, the aim of this study was to use dynamic infrared (IR) imaging to examine the relationship between dorsal and palmar hand skin temperature. The palmar and dorsal hand skin temperature before and after a cold stress test was measured with IR thermography in 112 healthy participants. Calculation of surface average temperature was made from nine regions of interest on each hand's dorsal and palmar side. Temperature values were recorded at baseline, directly after immersion of hands in vinyl gloves for one minute in water at 20 °C ± 0.5 °C (gloves removed), and after eight minutes rewarming. Results showed that: a) the skin temperatures on the dorsal and palmar sides of the hand are strongly correlated; b) the correlation is stronger on the fingers than on the carpometacarpal (CMC) area; c) the palmar side of the CMC area is warmer than the dorsal side, but this is reversed in the fingers so that the nail bed is warmer than the finger pad; and d) the temperature difference ∆T∆T between the dorsal and palmar sides of the fingers is independent of the skin temperature, though ∆T∆T on the CMC area of the hand is temperature dependent. Such differences can be important in detailed investigations of thermal phenomena in the hand. In conclusion, results showed a strong correlation between the dorsal and palmar temperatures. If both sides cannot be measured, the purpose of the investigation should determine which side of the hand should be measured.

Ort, förlag, år, upplaga, sidor
Elsevier, 2017
Nationell ämneskategori
Annan hälsovetenskap Annan medicinteknik
Forskningsämne
Hälsovetenskap; Medicinsk teknik för hälsovård
Identifikatorer
urn:nbn:se:ltu:diva-63050 (URN)10.1016/j.jtherbio.2017.04.003 (DOI)000401388300012 ()28477914 (PubMedID)2-s2.0-85017527831 (Scopus ID)
Anmärkning

Validerad; 2017; Nivå 2; 2017-04-28 (andbra)

Tillgänglig från: 2017-04-18 Skapad: 2017-04-18 Senast uppdaterad: 2018-09-13Bibliografiskt granskad
Lehto, N. (2016). Effects of age on marathon finishing time among male amateur runners in Stockholm marathon 1979-2014 (ed.). Journal of Sport and Health Science, 5(3), 349-354
Öppna denna publikation i ny flik eller fönster >>Effects of age on marathon finishing time among male amateur runners in Stockholm marathon 1979-2014
2016 (Engelska)Ingår i: Journal of Sport and Health Science, ISSN 2095-2546, E-ISSN 2213-2961, Vol. 5, nr 3, s. 349-354Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

PurposeThe purpose of the present study was to investigate the age-related changes in the endurance performance among male amateur marathon runners.MethodsSubjects were taken from the 36 Stockholm Marathons heldfrom 1979 through 2014, and age and finishing time were analyzed for a total of 312,342male runners.ResultsThe relation was found to be a second-order polynomial, t = a + bx + cx2, which models 99.7% of the variation in the average running time t as a function of age x. The model shows that the marathon performance of the average runner improves up to age 34.3 ± 2.6 years, thereafter, the performance starts to decline. Aquantification of the age’s influence on running time shows that it accounts for 4.5% of the total variance seen in the performance data.ConclusionThese outcomes indicate that the effect of age on performance in endurance running events is clearly measurable, quantifiable and possible to describe. At the same time the findings indicate that other factors, such as training, affect the performance more. A comparison with the elite showed peak performance at the same age, but the rates of change in performance with age, improvement as well as degradation, was found to be higher among the elite.

Nationell ämneskategori
Annan hälsovetenskap
Forskningsämne
Hälsovetenskap
Identifikatorer
urn:nbn:se:ltu:diva-11914 (URN)10.1016/j.jshs.2015.01.008 (DOI)000388415100015 ()2-s2.0-84995486539 (Scopus ID)af274c3f-694e-47ec-b2d9-8e3bd7eca149 (Lokalt ID)af274c3f-694e-47ec-b2d9-8e3bd7eca149 (Arkivnummer)af274c3f-694e-47ec-b2d9-8e3bd7eca149 (OAI)
Anmärkning

Validerad; 2016; Nivå 2; 2016-11-16 (rokbeg)

Tillgänglig från: 2016-09-29 Skapad: 2016-09-29 Senast uppdaterad: 2018-07-10Bibliografiskt granskad
Leijon-Sundqvist, K., Tegner, Y., Juntti, U., Karp, K. & Lehto, N. (2016). Hand skin temperature: are there warm and cold rewarming patterns after cold stress test? (ed.). Thermology International, 26(3), 81-87
Öppna denna publikation i ny flik eller fönster >>Hand skin temperature: are there warm and cold rewarming patterns after cold stress test?
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2016 (Engelska)Ingår i: Thermology International, ISSN 1560-604X, Vol. 26, nr 3, s. 81-87Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

In 116 thermographic measurements of 66 healthy male participants, 44 of whom were measured at least twice, hand skin temperature distributions before and after a cold stress test (CST) were examined to identify any typical characteristics of hand skin rewarming. On each hand, measurements from 18 regions of interest recorded every 10 s were used to calculate the surface average temperature. Temperatures at baseline (Tb), directly after cooling (Tc), and after 15 min of rewarming (Tf) were used for comparison and the averages of each finger, palm, and hand were analyzed. Using fits of normal distribution for the measured data, final hand skin temperatures were divided into two groups, A and B, with a calculated boundary at 25.4 °C. Digital analyses of all thermograms were performed to describe the process, and each group's rewarming patterns were observed. Group A was considered to demonstrate warm rewarming, since the whole hands reached a Tf approximately equal to the Tb. By contrast, Group B demonstrated cold rewarming and had whole hand Tf less than Tb. The predictive value of Tc was lower than that of Tb in Group A, whereas the opposite occurred in Group B. Altogether, the findings suggest different hand skin temperature rewarming patterns in healthy males.

Nationell ämneskategori
Annan hälsovetenskap
Forskningsämne
Hälsovetenskap
Identifikatorer
urn:nbn:se:ltu:diva-11572 (URN)2-s2.0-85005987231 (Scopus ID)a94b21bd-cfa7-4507-ab07-0baf7a860395 (Lokalt ID)a94b21bd-cfa7-4507-ab07-0baf7a860395 (Arkivnummer)a94b21bd-cfa7-4507-ab07-0baf7a860395 (OAI)
Anmärkning

Validerad; 2016; Nivå 1; 2016-11-21 (andbra)

Tillgänglig från: 2016-09-29 Skapad: 2016-09-29 Senast uppdaterad: 2018-03-05Bibliografiskt granskad
Shahim, P., Tegner, Y., Gustafsson, B., Gren, M., Ärlig, J., Olsson, M., . . . Blennow, K. (2016). Neurochemical Aftermath of Repetitive Mild Traumatic Brain Injury. JAMA Neurology, 73(11), 1308-1315
Öppna denna publikation i ny flik eller fönster >>Neurochemical Aftermath of Repetitive Mild Traumatic Brain Injury
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2016 (Engelska)Ingår i: JAMA Neurology, ISSN 2168-6149, E-ISSN 2168-6157, Vol. 73, nr 11, s. 1308-1315Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Importance:

Evidence is accumulating that repeated mild traumatic brain injury (mTBI) incidents can lead to persistent, long-term debilitating symptoms and in some cases a progressive neurodegenerative condition referred to as chronic traumatic encephalopathy. However, to our knowledge, there are no objective tools to examine to which degree persistent symptoms after mTBI are caused by neuronal injury.

Objective:

To determine whether persistent symptoms after mTBI are associated with brain injury as evaluated by cerebrospinal fluid biochemical markers for axonal damage and other aspects of central nervous system injury.

Design, Settings, and Participants:

A multicenter cross-sectional study involving professional Swedish ice hockey players who have had repeated mTBI, had postconcussion symptoms for more than 3 months, and fulfilled the criteria for postconcussion syndrome (PCS) according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) matched with neurologically healthy control individuals. The participants were enrolled between January 2014 and February 2016. The players were also assessed with Rivermead Post Concussion Symptoms Questionnaire and magnetic resonance imaging.

Main Outcomes and Measures:

Neurofilament light protein, total tau, glial fibrillary acidic protein, amyloid β, phosphorylated tau, and neurogranin concentrations in cerebrospinal fluid.

Results:

A total of 31 participants (16 men with PCS; median age, 31 years; range, 22-53 years; and 15 control individuals [11 men and 4 women]; median age, 25 years; range, 21-35 years) were assessed. Of 16 players with PCS, 9 had PCS symptoms for more than 1 year, while the remaining 7 returned to play within a year. Neurofilament light proteins were significantly increased in players with PCS for more than 1 year (median, 410 pg/mL; range, 230-1440 pg/mL) compared with players whose PCS resolved within 1 year (median, 210 pg/mL; range, 140-460 pg/mL) as well as control individuals (median 238 pg/mL, range 128-526 pg/mL; P = .04 and P = .02, respectively). Furthermore, neurofilament light protein concentrations correlated with Rivermead Post Concussion Symptoms Questionnaire scores and lifetime concussion events (ρ = 0.58, P = .02 and ρ = 0.52, P = .04, respectively). Overall, players with PCS had significantly lower cerebrospinal fluid amyloid-β levels compared with control individuals (median, 1094 pg/mL; range, 845-1305 pg/mL; P = .05).

Conclusions and Relevance:

Increased cerebrospinal fluid neurofilament light proteins and reduced amyloid β were observed in patients with PCS, suggestive of axonal white matter injury and amyloid deposition. Measurement of these biomarkers may be an objective tool to assess the degree of central nervous system injury in individuals with PCS and to distinguish individuals who are at risk of developing chronic traumatic encephalopathy.

Nationell ämneskategori
Annan hälsovetenskap Omvårdnad
Forskningsämne
Hälsovetenskap; Omvårdnad
Identifikatorer
urn:nbn:se:ltu:diva-59751 (URN)10.1001/jamaneurol.2016.2038 (DOI)000388578600011 ()27654934 (PubMedID)2-s2.0-84996761426 (Scopus ID)
Anmärkning

Validerad; 2016; Nivå 2; 2016-11-22 (andbra)

Tillgänglig från: 2016-10-14 Skapad: 2016-10-14 Senast uppdaterad: 2018-07-10Bibliografiskt granskad
Lestander, Ö., Lehto, N. & Engström, Å. (2016). Nursing students' perceptions of learning after High Fidelity simulation: Effects of a Three-step Post-Simulation Reflection Model (ed.). Nurse Education Today, 40, 219-224
Öppna denna publikation i ny flik eller fönster >>Nursing students' perceptions of learning after High Fidelity simulation: Effects of a Three-step Post-Simulation Reflection Model
2016 (Engelska)Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 40, s. 219-224Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

High-fidelity simulation (HFS) has become a bridge between theoretical knowledge and practical skills. A safe and realistic environment is commonly used in nursing education to improve cognitive, affective and psychomotor abilities. Debriefing following a simulation experience provides opportunities for students to analyse and begin to reflect upon their decisions, actions and results. The nursing literature highlights the need to promote the concept of reflective practice and to assist students in reflection, and research indicates the need to refine and develop debriefing strategies, which is the focus of the current paper.

Nationell ämneskategori
Annan hälsovetenskap Omvårdnad
Forskningsämne
Hälsovetenskap; Omvårdnad
Identifikatorer
urn:nbn:se:ltu:diva-15149 (URN)10.1016/j.nedt.2016.03.011 (DOI)000376051200035 ()27125176 (PubMedID)2-s2.0-84961885099 (Scopus ID)ea0cd235-2b70-49d1-bac2-e339806cb963 (Lokalt ID)ea0cd235-2b70-49d1-bac2-e339806cb963 (Arkivnummer)ea0cd235-2b70-49d1-bac2-e339806cb963 (OAI)
Anmärkning

Validerad; 2016; Nivå 2; 20160315 (andbra)

Tillgänglig från: 2016-09-29 Skapad: 2016-09-29 Senast uppdaterad: 2018-07-10Bibliografiskt granskad
Kruse, J., Lehto, N., Riklund, K., Tegner, Y. & Engström, Å. (2016). Scrutinized with inadequate control and support Interns' experiences communicating with and writing referrals to hospital radiology departments: a qualitative study (ed.). Radiography, 22(4), 313-318
Öppna denna publikation i ny flik eller fönster >>Scrutinized with inadequate control and support Interns' experiences communicating with and writing referrals to hospital radiology departments: a qualitative study
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2016 (Engelska)Ingår i: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 22, nr 4, s. 313-318Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

IntroductionInterns' experiences communicating with and writing referrals to hospital radiology departments are important for patient safety, image quality, and decision-making in the diagnostic process. Understanding roles within the department and in the diagnostic process is important for communication. This study aimed to describe interns' experiences communicating with and writing referrals to their hospital's radiology department.MethodA qualitative study design was used. Data was collected from focus discussions with ten interns in three focus groups in Northern Sweden during 2012. The data were subjected to qualitative content analysis.ResultsOne theme, “a feeling of being scrutinized and lacking control”, was identified in the final categories. The interns experienced that the radiology department placed high demands on them and desired more diagnostic skills training, resources and feedback. The interns suggested the following improvements: enhanced dialogue and feedback, improved education, handy guidelines, and practice writing referrals.ConclusionInterns need more feedback from, and dialogue with, members of the Department of Radiology. They also need more knowledge of referral guidelines, appropriateness criteria and more practice to develop their knowledge and skill for writing referrals. They describe feelings of inadequate support and feel scrutinized in demanding work conditions and need more collaboration. They also need more time and more control of radiology outcomes, and they are eager to learn.

Nationell ämneskategori
Annan hälsovetenskap Omvårdnad
Forskningsämne
Hälsovetenskap; Omvårdnad
Identifikatorer
urn:nbn:se:ltu:diva-15317 (URN)10.1016/j.radi.2016.04.004 (DOI)000386871700019 ()2-s2.0-84975761278 (Scopus ID)ed0df6d9-80e6-418c-907d-44425ef79e54 (Lokalt ID)ed0df6d9-80e6-418c-907d-44425ef79e54 (Arkivnummer)ed0df6d9-80e6-418c-907d-44425ef79e54 (OAI)
Anmärkning

Validerad; 2016; Nivå 2; 2016-11-16 (rokbeg)

Tillgänglig från: 2016-09-29 Skapad: 2016-09-29 Senast uppdaterad: 2018-07-10Bibliografiskt granskad
Leijon-Sundqvist, K., Lehto, N., Juntti, U., Karp, K. & Tegner, Y. (2015). Cold-water provocation of hands: An evaluation of different provocations (ed.). Paper presented at European Association of Thermology : 02/09/2015 - 05/09/2015. Thermology International, 25(3), 122-123
Öppna denna publikation i ny flik eller fönster >>Cold-water provocation of hands: An evaluation of different provocations
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2015 (Engelska)Ingår i: Thermology International, ISSN 1560-604X, Vol. 25, nr 3, s. 122-123Artikel i tidskrift, Meeting abstract (Refereegranskat) Published
Nationell ämneskategori
Annan hälsovetenskap
Forskningsämne
Hälsovetenskap
Identifikatorer
urn:nbn:se:ltu:diva-30277 (URN)409b4f7c-8aab-486b-babf-2c6d62467189 (Lokalt ID)409b4f7c-8aab-486b-babf-2c6d62467189 (Arkivnummer)409b4f7c-8aab-486b-babf-2c6d62467189 (OAI)
Konferens
European Association of Thermology : 02/09/2015 - 05/09/2015
Anmärkning
Godkänd; 2015; 20151115 (yelteg)Tillgänglig från: 2016-09-30 Skapad: 2016-09-30 Senast uppdaterad: 2018-03-05Bibliografiskt granskad
Leijon-Sundqvist, K., Lehto, N., Juntti, U., Karp, K., Andersson, S. & Tegner, Y. (2015). Thermal response after cold-water provocation of hands in healthy young men (ed.). Thermology International, 25(2), 48-53
Öppna denna publikation i ny flik eller fönster >>Thermal response after cold-water provocation of hands in healthy young men
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2015 (Engelska)Ingår i: Thermology International, ISSN 1560-604X, Vol. 25, nr 2, s. 48-53Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The thermal response in hands provoked by cold water was investigated with infrared thermography. In 26 healthy young men, the response of hand skin temperature to cold water provocation was measured twice on consecutive days. An infrared thermographic camera was used and data were processed in real time. The software divides each hand into 18 predefined regions of interest (ROI). The average temperature in each ROI was stored every 10th second. Baseline hand skin temperature was recorded for two minutes. The bare hands were then immersed for 30 seconds in water at 10°C × 0.5°C and carefully dried. Thereafter, the cooled and final hand skin temperature was measured. The baseline showed a higher average temperature of 0.3°C on day 2 and the 95% limits of agreement (LOA) were - 5.2-5.8, the cooled average temperatures showed no significant difference between the two days (LOA: - 4.8-4.6) and the average final hand skin temperature was 0.8°C higher on day 2 (LOA: - 5.2-6.4). In conclusion, there was variability between the two measurements, small differences in the temperature response to the reaction to cold-water provocation - probably due to Day 1 stress factor.

Nationell ämneskategori
Annan hälsovetenskap
Forskningsämne
Hälsovetenskap
Identifikatorer
urn:nbn:se:ltu:diva-2973 (URN)2-s2.0-85004011406 (Scopus ID)0b7f1b85-c28d-4031-8b3b-2715eb8a79d9 (Lokalt ID)0b7f1b85-c28d-4031-8b3b-2715eb8a79d9 (Arkivnummer)0b7f1b85-c28d-4031-8b3b-2715eb8a79d9 (OAI)
Anmärkning

Validerad; 2015; Nivå 1; 20150521 (nikle)

Tillgänglig från: 2016-09-29 Skapad: 2016-09-29 Senast uppdaterad: 2018-03-05Bibliografiskt granskad
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-1655-6658

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