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Publications (10 of 55) Show all publications
Mejersjö, C., Wänman, A., Wenneberg, B. & Bergström, E.-K. (2024). Can temporomandibular disorder symptoms and headaches be prevented in 13- to 15-year-old girls by information provided in a school setting?. Journal of Oral Rehabilitation
Open this publication in new window or tab >>Can temporomandibular disorder symptoms and headaches be prevented in 13- to 15-year-old girls by information provided in a school setting?
2024 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: Temporomandibular disorders (TMD) may develop, especially among girls, during the adolescence period. The aim of this study was to study if information and advice in a school setting could prevent development of TMD symptoms and headaches during the early teenage period.

Methods: Thirteen-year-old girls, at 19 upper elementary schools were invited to participate in a study with structured information about the jaw system, TMD symptoms and risk factors, as well as advice how to manage risk factor and TMD. Six hundred and fifty-one girls enrolled, of which 507 girls were followed for 2–2.5 years. Half received information on three occasions (cases), and the other half served as controls. Included in the analysis of incidence of TMD symptoms were those without frequently occurring TMD symptoms (not including headaches) at baseline (n = 396) and included in the analysis of incidence of headaches were those without frequent headaches at baseline (n = 297).

Result: The 2-year incidence of TMD symptoms was significantly lower in the information cohort (19%) compared to the controls (28%) (p =.03). The 2-year incidence of headaches was lower among those who were allocated to information (30%) compared to controls (40%), but the difference was not statistically significant (p =.099). Cases who had headaches at baseline reported a significantly lower prevalence at follow-up compared to controls (p =.03). Conclusion: Standardized information in school settings can prevent development of TMD symptoms and headaches among young girls.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
adolescents, epidemiology, incidence, preventive intervention, temporomandibular disorders
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-226952 (URN)10.1111/joor.13773 (DOI)2-s2.0-85196116209 (Scopus ID)
Available from: 2024-06-25 Created: 2024-06-25 Last updated: 2024-06-25
Bäckström, E., Wänman, A. & Sjöström, M. (2024). The majority of patients report satisfaction more than 24 years after temporomandibular joint discectomy. Oral and Maxillofacial Surgery
Open this publication in new window or tab >>The majority of patients report satisfaction more than 24 years after temporomandibular joint discectomy
2024 (English)In: Oral and Maxillofacial Surgery, ISSN 1865-1550, E-ISSN 1865-1569Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: To retrospectively evaluate long-term outcomes after temporomandibular joint (TMJ) discectomy.

Methods: Included patients (n = 64) had undergone discectomy during 1989-1998 at Umeå University Hospital. A questionnaire was used to evaluate pre- and postoperative symptoms, postoperative complications, general pain, and subjective opinion about the outcome of the surgery.

Results: The results are based on responses from 47 patients (40 women/7 men), including 36 (30 women/6 men) who completed the questionnaire and 11 (10 women/1 man) who were contacted by telephone and answered selected questions. Seventeen patients were excluded because of death, a move abroad, declining to participate, or no available patient information. Among the respondents, 41 (87%) were satisfied with the results, five (11%) were unsatisfied, and one (2%) patient did not answer the question. The results showed a significant long-term improvement in locking, clicking/crepitation, and pain when chewing or opening the jaw (p = 0.001). The prevalence of headaches had decreased significantly at follow-up (p = 0.001). Reported impaired jaw-opening capacity showed no significant improvement (p = 0.08). Of the 47 respondents, 19 (40%) had asked for additional treatment after the discectomy, and six of the 19 patients (13%) had undergone more surgery of the joint.

Conclusion: The results of this retrospective long-term follow-up study indicate that TMJ discectomy has a high success rate, as most patients were satisfied with the postoperative results. Discectomy is thus an effective surgical intervention for patients with disabling TMJ pain and dysfunction when conservative interventions have been unsuccessful.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Discectomy, Long-term follow-up, Surgery, Temporomandibular disorder, Temporomandibular joint
National Category
Dentistry Surgery
Identifiers
urn:nbn:se:umu:diva-227934 (URN)10.1007/s10006-024-01280-9 (DOI)38985390 (PubMedID)2-s2.0-85198062290 (Scopus ID)
Available from: 2024-07-19 Created: 2024-07-19 Last updated: 2024-07-19
Wänman, A., Marklund, S. & Yekkalam, N. (2024). Treatment outcome in patients with myofascial orofacial pain: a randomized clinical trial. Journal of Oral Health and Craniofacial Science, 9(1), 001-008
Open this publication in new window or tab >>Treatment outcome in patients with myofascial orofacial pain: a randomized clinical trial
2024 (English)In: Journal of Oral Health and Craniofacial Science, E-ISSN 2573-6191, Vol. 9, no 1, p. 001-008Article in journal (Refereed) Published
Abstract [en]

Background: Temporomandibular Disorder (TMD) pain attributed to myalgia is a common condition and patients should get advice on the best treatment option. 

Objectives: The aim was to evaluate the effect of two different exercise programs, or bite splint therapy, respectively, in patients with chronic frequent primary myofascial orofacial pain. 

Methods: The study was a randomized clinical trial including patients fulϐilling criteria of chronic frequent primary myofascial orofacial pain with a reported pain intensity of ≥ 4 on a numerical rating scale (0-10). Ninety subjects were randomized to either bite splint, home exercises, or a supervised exercise program. Two examiners blinded to the treatment modality examined the same subject at baseline and a 3-month follow-up. Non-parametric statistical methods were applied for the outcome of treatment in intended-to-treat analyses. A P-value <0.05 was considered statistically signiϐicant. 

Results: The pain severity index was signiϐicantly reduced (p < 0.001) in all treatment groups. Jaw opening capacity improved signiϐicantly (p < 0.05) for those randomized to bite splint and for those in the home exercise program. About 70% of the participants reported improvement in their TMD pain severity with no signiϐicant difference between treatments. Both exercise groups improved in jaw function at the 3-month follow-up compared to baseline. Those who had a bite splint reported significantly more improvement in their headaches compared to those in the exercise programs.

Conclusion: Jaw exercise programs and bite splint treatments had similar positive effects on TMD pain severity attributed to myalgia after 3 months.

Place, publisher, year, edition, pages
Heighten Science Publications Corporation, 2024
Keywords
Oral appliance; Exercise; Myalgia; Physiotherapy; Temporomandibular disorders
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-220831 (URN)10.29328/journal.johcs.1001046 (DOI)
Available from: 2024-02-13 Created: 2024-02-13 Last updated: 2024-02-13Bibliographically approved
Yekkalam, N., Novo, M. & Wänman, A. (2024). Treatments related to temporomandibular disorders among patients with prevalent types of Ehlers-Danlos syndrome in Sweden. Cranio
Open this publication in new window or tab >>Treatments related to temporomandibular disorders among patients with prevalent types of Ehlers-Danlos syndrome in Sweden
2024 (English)In: Cranio, ISSN 0886-9634, E-ISSN 2151-0903Article in journal (Refereed) Epub ahead of print
Abstract [en]

The aim of this study was to assess the received TMD treatment modalities and the perceived outcome among the frequent types of EDS. A digital questionnaire was sent to the member of the National Swedish EDS Association during January-March 2022. The subsamples of hypermobile and classical EDS were constructed. Almost 90% reported TMD symptoms. Bite splint therapy, counselling, jaw training and occlusal adjustment were reported as the most common treatments with no statistically significant difference in terms of good effect between the two subsamples. Hypermobile and classical EDS might consider as an entity with regards to TMD.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Temporomandibular disorders, Ehlers-Danlos syndrome, hypermobility, splint therapy, jaw exercises, occlusal adjustment, counselling
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-221701 (URN)10.1080/08869634.2024.2319565 (DOI)2-s2.0-85186567425 (Scopus ID)
Available from: 2024-03-01 Created: 2024-03-01 Last updated: 2024-04-16
Lövgren, A., Ilgunas, A., Häggman-Henrikson, B., Elias, B., Roudini, O. A., Visscher, C., . . . Liv, P. (2023). Associations between screening for functional jaw disturbances and patient reported outcomes on jaw limitations and oral behaviors. Journal of Evidence-Based Dental Practice, 23(3), Article ID 101888.
Open this publication in new window or tab >>Associations between screening for functional jaw disturbances and patient reported outcomes on jaw limitations and oral behaviors
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2023 (English)In: Journal of Evidence-Based Dental Practice, ISSN 1532-3382, E-ISSN 1532-3390, Vol. 23, no 3, article id 101888Article in journal (Refereed) Published
Abstract [en]

Objectives: Temporomandibular disorders (TMDs) is a collective term for pain and functional disturbances related to the jaw muscles and the temporomandibular joint. In contrast to screening for orofacial pain, knowledge is limited on the association between patient-reported outcomes and screening for joint-related functional jaw disturbances. Therefore, our aim was to evaluate the association between a screening question for functional jaw disturbances, and disease-specific outcome measures for functional jaw limitations and oral behaviors.

Methods: This study included 299 individuals (201 women; 20-69 years, median 37.0) in a general population sample from Västerbotten, Northern Sweden in 2014. A single screening question for functional jaw disturbances “Does your jaw lock or become stuck once a week or more?” was used to categorize individuals as cases or controls. Patient-reported outcomes on functional jaw disturbances were assessed with the 20-item jaw functional limitation scale (JFLS-20) and oral behaviors with the 21-item Oral Behaviors Checklist (OBC-21).

Results: The strongest predictive probability to have a positive screening outcome was functional jaw limitations related to mobility (AUCboot=0.78, 95 CI:0.71-0.86, P <.001), followed by limitations related to communication (AUCboot = 0.74, 95 CI:0.63-0.80, P <.001) and mastication (AUCboot = 0.73, 95 CI:0.66-0.81, P <.001). The frequency of oral behaviors was not significantly associated with a positive screening outcome (AUCboot = 0.65, 95 CI:0.55-0.72, P =.223).

Conclusions: Self-reported functional limitations, but not oral behaviors, are strongly associated with a single screening question for frequent functional jaw disturbances. This finding provides support for incorporating a question on jaw catching/locking once a week or more in screening instruments for TMDs.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Clinical decision-making, Dental, General practice, Screening, Temporomandibular joint disorders
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-212835 (URN)10.1016/j.jebdp.2023.101888 (DOI)2-s2.0-85166922410 (Scopus ID)
Available from: 2023-08-15 Created: 2023-08-15 Last updated: 2023-09-28Bibliographically approved
Böthun, A., Häggman-Henrikson, B., Stålnacke, B.-M., Wänman, A., Nordh, E., Lampa, E. & Hellström, F. (2023). Clinical signs in the jaw and neck region following whiplash trauma: A 2-year follow-up. European Journal of Pain, 27(6), 699-709
Open this publication in new window or tab >>Clinical signs in the jaw and neck region following whiplash trauma: A 2-year follow-up
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2023 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 27, no 6, p. 699-709Article in journal (Refereed) Published
Abstract [en]

Background: Pain in the orofacial region is often reported after whiplash trauma. However, prospective studies evaluating clinical signs related to orofacial pain and disability in whiplash populations are rare. The aim of the present study was to evaluate clinical signs related to pain and dysfunction in orofacial and neck regions after whiplash trauma, in a short- and long-term perspective.

Methods: In total, 84 cases (48 women) diagnosed with neck distortion after a car accident and 116 controls (68 women) were examined within 1 month, and 49 cases (27 women) and 71 controls (41 women) were re-examined 2 years later. Outcome measures were pain on palpation of jaw and neck muscles and maximal jaw opening. Analysis was performed using mixed-models.

Results: Cases and women were at higher risk for pain on palpation of jaw muscles (OR:7.7; p < 0.001 and OR:3.2; p = 0.010 respectively) and neck muscles (OR:12.7; p < 0.001 and OR:2.9; p = 0.020 respectively) but with no significant effect of time. Cases and women also had lower maximal jaw opening (−3.1; p = 0.001 and −3.3; p = 0.001 respectively). There was no significant time effect, but a significant interaction between cases and time (2.2; p = 0.004).

Conclusion: Individuals with a whiplash trauma present a higher risk for pain on palpation in jaw and neck muscles both in a short- and long-term perspective, but show normal jaw movements. No time effect suggests that cases do not spontaneously improve nor get worse. Investigating pain on palpation in the jaw and neck muscles after whiplash trauma can identify individuals at risk for developing long-term orofacial pain and dysfunction.

Significance: Orofacial pain is often reported after whiplash trauma but most previous studies concerning orofacial pain in whiplash populations have been questionnaire studies. Cases with a previous whiplash trauma and women, in general, had higher risk for pain on palpation in the jaw and neck region. Investigating pain on palpation after a whiplash trauma can help to identify individuals at risk of developing long-lasting pain in the orofacial region.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-205666 (URN)10.1002/ejp.2099 (DOI)000945366500001 ()36806817 (PubMedID)2-s2.0-85150413156 (Scopus ID)
Funder
Region Västerbotten, RV-909851Region Västerbotten, VLL-324631
Available from: 2023-03-13 Created: 2023-03-13 Last updated: 2023-06-20Bibliographically approved
Holmström, A.-K., Vallin, S., Wänman, A., Lövgren, A. & Stålnacke, B.-M. (2023). Effect on orofacial pain in patients with chronic pain participating in a multimodal rehabilitation programme: a pilot study. Scandinavian Journal of Pain, 23(4), 656-661
Open this publication in new window or tab >>Effect on orofacial pain in patients with chronic pain participating in a multimodal rehabilitation programme: a pilot study
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2023 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 23, no 4, p. 656-661Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Orofacial pain in patients taking part in a multimodal rehabilitation programme (MMRP) due to chronic bodily pain is common but it is not known whether such a rehabilitation programme can also have an effect on the presence of orofacial pain. The first aim of this study was to evaluate the effect of an MMRP on orofacial pain frequency. The second aim was to evaluate differences in the effect on quality of life and on psychosocial factors related to chronic pain.

METHODS: MMRP was evaluated through validated questionnaires from the Swedish Quality Registry for Pain Rehabilitation (SQRP). Fifty-nine patients participating in MMRP filled out the two screening questions for orofacial pain in addition to the SQRP questionnaires before and after participation in MMRP during the period August 2016 to March 2018.

RESULTS: Pain intensity decreased significantly after the MMRP (p=0.005). Fifty patients (69.4 %) reported orofacial pain before MMRP and no significant decrease after the programme (p=0.228). Among individuals with orofacial pain, the self-reported level of depression decreased after participation in the programme (p=0.004).

CONCLUSIONS: Even though orofacial pain is common among patients with chronic bodily pain, participation in a multimodal pain programme was not enough to reduce frequent orofacial pain. This finding implies that specific orofacial pain management including information about jaw physiology could be a justified component of patient assessment prior to a multimodal rehabilitation programme for chronic bodily pain.

Place, publisher, year, edition, pages
Walter de Gruyter, 2023
Keywords
chronic pain, comorbidity, multimodal rehabilitation, rehabilitation medicine, specialist care, temporomandibular disorders
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-210424 (URN)10.1515/sjpain-2023-0004 (DOI)001012223400001 ()37327054 (PubMedID)2-s2.0-85163961595 (Scopus ID)
Available from: 2023-06-21 Created: 2023-06-21 Last updated: 2023-12-20Bibliographically approved
Böthun, A., Häggman-Henrikson, B., Wiesinger, B., Wänman, A., Hellström, F. & Österlund, C. (2022). Jaw–neck motor strategy during jaw‐opening with resistance load. Journal of Oral Rehabilitation, 49(5), 514-521
Open this publication in new window or tab >>Jaw–neck motor strategy during jaw‐opening with resistance load
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2022 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 49, no 5, p. 514-521Article in journal (Refereed) Published
Abstract [en]

Background:  The jaw and neck motor systems have a close functional integration but the effect of resistance load to the mandible during jaw opening on the jaw-neck integration is not known.

Objectives:  To evaluate the effect of resistance load compared to no load on integrated jaw and neck motor function in individuals free from pain and dysfunction in the jaw and neck regions.

Methods:  Jaw and head movements during continuous jaw opening were recorded with an optoelectronic system (MacReflex® ) in 26 pain-free individuals (14 women, 12 men, mean age 22 years). Jaw opening was performed with and without resistance load (1600 g) to the mandible. The relationship between jaw movement amplitude, head movement amplitude, head/jaw ratio (quotient of head and jaw movement amplitude) and resistance load were modelled using linear mixed-model analysis. A p-value <.05 was considered statistically significant.

Results:  The expected head/jaw ratio mean was increased by 0.05 (95% CI: 0.03, 0.08, p < .001) with resistance load as compared to no load. This corresponds to an increase in expected mean by 55.6%. With resistance load, expected mean head movement amplitude increased by 1.4 mm (95% CI: 0.2, 2.5, p = .018), and expected mean jaw movement amplitude decreased by 3.7 mm (95% CI: -7.0, -0.5, p = .025).

Conclusion:  There is a compensation and adaptation of integrated jaw-neck motor function with an altered jaw-neck motor strategy during jaw opening with resistance load compared to no load. The head/jaw ratio demonstrates increased proportional involvement of the neck during increased load on the jaw system.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
exercise, jaw, motor activity, motor skills, movement, neck
National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-190626 (URN)10.1111/joor.13291 (DOI)000731492000001 ()34878690 (PubMedID)2-s2.0-85121471921 (Scopus ID)
Funder
Region Västerbotten, 7003768
Available from: 2021-12-20 Created: 2021-12-20 Last updated: 2024-01-17Bibliographically approved
Lövgren, A., Visscher, C. M., Lobbezo, F., Yekkalam, N., Vallin, S., Wänman, A. & Häggman-Henrikson, B. (2022). The association between myofascial orofacial pain with and without referral and widespread pain. Acta Odontologica Scandinavica, 80(7), 481-486
Open this publication in new window or tab >>The association between myofascial orofacial pain with and without referral and widespread pain
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2022 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 80, no 7, p. 481-486Article in journal (Refereed) Published
Abstract [en]

Objectives: Pain referral on palpation has been suggested to be a clinical sign of central sensitization potentially associated with widespread pain conditions. Our aim was to evaluate if myofascial pain with referral is a better predictor for widespread pain when compared to no pain or local myofascial pain.

Materials and methods: Individuals at the Public Dental services in Västerbotten, Sweden, were randomly invited based on their answers to three screening questions for temporomandibular disorders (TMD). In total, 300 individuals (202 women, 20–69 yrs) were recruited, and examined according to the Diagnostic Criteria for TMD (DC/TMD) after completion of a body pain drawing. Widespread pain was considered present when seven or more pain sites were reported on the widespread pain index. A binary logistic regression model, adjusted for the effect of age and gender were used to evaluate the association between myofascial orofacial pain and widespread pain.

Results: Widespread pain was reported by 31.3% of the study sample. There was a 57.3% overlap with myofascial pain. Widespread pain was associated to myofascial orofacial pain with and myofascial orofacial pain (OR 4.83 95% CI 2.62–9.05 and OR 11.62 95% CI 5.18–27.88, respectively).

Conclusion: These findings reinforce the existing knowledge on the overlap between painful TMD and other chronic pain conditions.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
General practice dentistry, temporomandibular disorders, myofascial pain, widespread pain
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-183181 (URN)10.1080/00016357.2022.2036363 (DOI)000819751800001 ()35776512 (PubMedID)2-s2.0-85133290624 (Scopus ID)
Funder
Umeå UniversityRegion Västerbotten
Note

Originally included in thesis in manuscript form.

Available from: 2021-05-18 Created: 2021-05-18 Last updated: 2022-12-13Bibliographically approved
Häggman-Henrikson, B., Visscher, C. M., Wänman, A., Ljótsson, B., Peck, C. C. & Lövgren, A. (2021). Even mild catastrophic thinking is related to pain intensity in individuals with painful temporomandibular disorders. Journal of Oral Rehabilitation, 48(11), 1193-1200
Open this publication in new window or tab >>Even mild catastrophic thinking is related to pain intensity in individuals with painful temporomandibular disorders
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2021 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 48, no 11, p. 1193-1200Article in journal (Refereed) Published
Abstract [en]

Aims: Temporomandibular disorders (TMD) are often associated with psychological comorbidities. One such comorbidity is pain catastrophising, that is, exaggeration of negative consequences of a painful event. The aim was to investigate catastrophising in individuals with painful TMD compared to controls and the association between catastrophising and pain intensity, number of pain sites and functional limitations.

Methods: A community-based sample of 110 individuals (83 women; 20–69 yrs) with painful TMDs (myalgia/arthralgia as per Diagnostic Criteria for TMD) and 190 age- and gender-matched controls (119 women; 20–69 yrs) from the Public Dental services in Västerbotten, Sweden, participated. Associations between catastrophising and functional jaw limitations, respectively, and painful TMD were evaluated with ordinal regression adjusted for the effect of gender and age. Associations (Spearman's correlation) of the Pain catastrophising Scale (PCS) with Jaw Functional Limitation Scale (JFLS-20), pain site number (whole-body pain map), and characteristic pain intensity (CPI) and intergroup comparisons (Mann-Whitney U test) of these variables were also calculated.

Results: Levels of catastrophising were associated with TMD pain (OR 1.6, 95%CI 1.1–2.6). Among individuals with painful TMD, catastrophising was correlated to pain intensity (r=0.458, p<0.01) and functional limitations (r=0.294–0.321, p≤0.002), but not to number of pain sites.

Conclusion: Compared to controls, community-based individuals with painful TMD demonstrated higher levels of pain catastrophising, and this catastrophising was associated with increased pain intensity and jaw dysfunction. The relatively low scores of pain catastrophising suggest that even mild catastrophic thinking is associated with pain perception and jaw function, and should be considered in patient management.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
catastrophisation, comorbidity, oro-facial pain, pain catastrophising, temporomandibular disorders
National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-187773 (URN)10.1111/joor.13251 (DOI)000696099100001 ()34462940 (PubMedID)2-s2.0-85114887205 (Scopus ID)
Funder
Västerbotten County Council
Available from: 2021-09-21 Created: 2021-09-21 Last updated: 2024-01-17Bibliographically approved
Projects
Effect of activating the jaw motor system. Randomized controlled trials on patients with specific diagnoses related to temporomandibular disorders [2011-00300_VR]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8346-5289

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