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Sherif, Amir
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Publications (10 of 44) Show all publications
Rosenblatt, R., Sandström, G., Bahar, M., Asad, D., Forsman, R., Johansson, M., . . . Sherif, A. (2019). Blood transfusions during neoadjuvant chemotherapy for muscle-invasive urinary bladder cancer may have a negative impact on overall survival. Scandinavian journal of urology, 53, 35-36
Open this publication in new window or tab >>Blood transfusions during neoadjuvant chemotherapy for muscle-invasive urinary bladder cancer may have a negative impact on overall survival
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2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 53, p. 35-36Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Introduction: Several studies have demonstrated a decreased overall survival for patients with muscle-invasive bladder cancer (MIBC) receiving allogenic peri- and postoperative blood transfusions at cystectomy. However, the extent and the effect of blood transfusions given during neoadjuvant chemotherapy (NAC) has never been addressed. The purpose of the present study, was to assess the impact of blood transfusions given during NAC on survival in patients with MIBC undergoing NAC and radical cystectomy.

Materials and Methods: A cohort of 120 consecutive patients with MIBC (cT2-T4aN0M0) undergoing NAC and radical cystectomy at four Swedish centers was retrospectively evaluated. Clinical and pathoanatomical data was obtained, including data SCANDINAVIAN JOURNAL OF UROLOGY 35 on administeredallogenic blood at consecutive time-intervals. Overall survival was analyzed by Kaplan-Meier plotting and Cox regression.

Results: One third of the cohort (n ¼ 40) received blood transfusions during NAC-therapy. The five-year overall survival rates were significantly lower in this group compared to the non-transfused patients (39.7% and 58.9% respectively, p ¼ 0.047). In a univariate analysis, blood transfusions, nodal status and locally advanced tumor growth (pT >2), were negative prognostic factors for survival. In multivariate analysis, only pNx and pT >2 remained significant negative prognostic factors. In subgroup analysis of localized and non-disseminated patients only (n ¼ 96), blood transfused patients showed a 18,5% absolute risk increase compared to blood naïve patients (p¼ 0.197).

Conclusions: This is the first time that the extent and the effect of allogenic blood transfusions during NAC is examined in MIBC. Data suggest that there may be an association between blood transfusion and poor pathological and oncological outcome. Firm conclusions are difficult to draw due to the limited number of study participants and the retrospective nature of the study.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-161602 (URN)10.1080/21681805.2019.1619285 (DOI)000472734500073 ()
Note

Supplement: 221

Special Issue: SI

Meeting Abstract: P-16

Available from: 2019-07-18 Created: 2019-07-18 Last updated: 2019-07-18Bibliographically approved
Malmström, P.-U., Gårdmark, T., Sherif, A., Ströck, V., Hosseini-Aliabad, A., Jahnson, S., . . . Liedberg, F. (2019). Incidence, survival and mortality trends of bladder cancer in Sweden 1997-2016. Scandinavian journal of urology, 53(4), 193-199
Open this publication in new window or tab >>Incidence, survival and mortality trends of bladder cancer in Sweden 1997-2016
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2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 53, no 4, p. 193-199Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate trends in bladder cancer incidence, survival and mortality in Sweden from 1997-2016.

Patients and methods: The Swedish National Registry of Urinary Bladder Cancer is a nation-wide quality register that started in 1997. It includes information on initial tumor characteristics and treatment; 41,097 new cases were registered up to 2016. Patients were stratified into four time periods. Deaths were monitored through the national death register. Overall and relative survival in time periods were studied with respect to differences in stage, age and gender.

Results: The number of new cases increased by 38% for men and 39% for women from 1997 to 2016. The corresponding age-standardized incidence per 100,000 was less dramatic, with increases of 6% and 21%, respectively, and the increase was most evident in the oldest age group. The survival rate was stable until 2012, but thereafter a significant improvement occurred. The survival trends in stage-groups show that this improvement is found in all categories as well as irrespective of age and gender. The mortality rate during this period was stable for women, but showed a slight decrease for men. The main limitation of this study is the use of administrative data for defining some of the endpoints.

Conclusion: The most recent Swedish bladder cancer statistics show an increased incidence, improved survival, but stable mortality.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Bladder cancer, population-based, incidence, survival and mortality
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-161851 (URN)10.1080/21681805.2019.1632380 (DOI)000473940600001 ()30636472 (PubMedID)
Available from: 2019-08-07 Created: 2019-08-07 Last updated: 2019-10-24Bibliographically approved
Aljabery, F., Liedberg, F., Häggström, C., Ströck, V., Hosseini, A., Gårdmark, T., . . . Jahnson, S. (2019). Management and outcome of muscle-invasive bladder cancer with clinical lymph node metastases: a nationwide population-based study in the bladder cancer data base Sweden (BladderBaSe). Scandinavian journal of urology
Open this publication in new window or tab >>Management and outcome of muscle-invasive bladder cancer with clinical lymph node metastases: a nationwide population-based study in the bladder cancer data base Sweden (BladderBaSe)
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2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: To investigate the clinical management and outcome of patients with muscle-invasive bladder cancer with clinical lymph node involvement, using longitudinal nationwide population-based data.

Methods: In the Bladder Cancer Data Base Sweden (BladderBaSe), treatment and survival in patients with urinary bladder cancer clinical stage T2-T4 N + M0 diagnosed between 1997 and 2014 was investigated. Patients´ characteristics were studied in relation to TNM classification, curative or palliative treatment, cancer-specific (CSS) and overall survival (OS). Age at diagnosis was categorised as ≤60, 61-70, 71-80 and >80 years, and time periods were stratified as follows: 1997-2001, 2002-2005, 2006-2010 and 2011-2014.

Results: There were 786 patients (72% males) with a median age of 71 years (interquartile range = 64-79 years). The proportion of patients with high comorbidity increased over time. Despite similar low comorbidity, curative treatment was given to 44% and to 70% of those in older (>70 years) and younger age groups, respectively. Curative treatment decreased over time, but chemotherapy and cystectomy increased to 25% during the last time period. Patients with curative treatment had better survival compared to those with palliative treatment, both regarding CSS and OS in the whole cohort and in all age groups.

Conclusions: The low proportion of older patients undergoing treatment with curative intent, despite no or limited comorbidity, indicates missed chances of treatment with curative intent. The reasons for an overall decrease in curative treatment over time need to be analysed and the challenge of coping with an increasing proportion of node-positive patients with clinically significant comorbidity needs to be met.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Bladder cancer, cohort study, lymph node metastasis, management, outcome
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-165088 (URN)10.1080/21681805.2019.1681504 (DOI)000493241700001 ()31663405 (PubMedID)
Available from: 2019-11-11 Created: 2019-11-11 Last updated: 2019-11-14
Jahnson, S., Gårdmark, T., Hosseini, A., Jerlström, T., Liedberg, F., Malmström, P.-U., . . . Aljabery, F. (2019). Management and outcome of TaG3 tumours of the urinary bladder in the nationwide, population-based bladder cancer database Sweden (BladderBaSe). Scandinavian journal of urology, 1-6
Open this publication in new window or tab >>Management and outcome of TaG3 tumours of the urinary bladder in the nationwide, population-based bladder cancer database Sweden (BladderBaSe)
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2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, p. 1-6Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: To investigate the management of TaG3 tumours of the urinary bladder using nationwide population-based data in relation to the prevailing guidelines, patients' characteristics, and outcome.

Materials and methods: The Bladder Cancer Data Base Sweden (BladderBaSe), including data from the Swedish National Register for Urinary Bladder Cancer (SNRUBC), was used to study all patients with TaG3 bladder cancer diagnosed from 2008 to 2014. Patients were divided into the following management groups: (1) transurethral resection (TUR) only, (2) TUR and intravesical instillation therapy (IVIT), (3) TUR and second-look resection (SLR), and (4) TUR with both SLR and IVIT. Patient and tumour characteristics and outcome were studied.

Results: There were 831 patients (83% males) with a median age of 74 years. SLR was performed more often on younger patients, on men, and less often in the Western and Uppsala/Örebro Healthcare regions. IVIT was performed more often with younger patients, with men, in the Western Healthcare region, and less often in the Uppsala/Örebro Healthcare region. Death from bladder cancer occurred in 6% of cases within a median of 29 months (0-84 months) and was lower in the TUR/IVIT and TUR/SLR/IVIT groups compared to the other two groups.

Conclusion: In the present study, there was, according to the prevailing treatment guidelines, an under-treatment with SLR for older patients, women, and in some healthcare regions and, similarly, there was an under-treatment with IVIT for older patients. Cancer-specific survival and relative survival were lower in the TUR only group compared to the TUR/IVIT and TUR/SLR/IVIT groups.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Bladder cancer, TaG3, intravesical instillation treatment, population-based, second-look resection
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-161068 (URN)10.1080/21681805.2019.1621377 (DOI)000471561600001 ()31144582 (PubMedID)
Funder
Swedish Cancer Society, CAN 2016/470Swedish Cancer Society, CAN 278
Available from: 2019-06-27 Created: 2019-06-27 Last updated: 2019-06-28
Russell, B., Sherif, A., Häggström, C., Josephs, D., Kumar, P., Malmström, P.-U. & Van Hemelrijck, M. (2019). Neoadjuvant chemotherapy for muscle invasive bladder cancer: a nationwide investigation on survival. Scandinavian journal of urology, 1-7
Open this publication in new window or tab >>Neoadjuvant chemotherapy for muscle invasive bladder cancer: a nationwide investigation on survival
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2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, p. 1-7Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: Randomised controlled trials (RCTs) have investigated the use of neoadjuvant chemotherapy (NAC) and its effect on survival patients with non-metastatic muscle-invasive bladder cancer (MIBC). However, these RCTs have limited external validity and generalisability and, therefore, the current study aims to use real world evidence in the form of observational data to identify the effect that NAC may have on survival, compared to the use of radical cystectomy (RC) alone.

Materials and methods: The study cohort (consisting of 944 patients) was selected as a target trial from the Bladder Cancer Data Base Sweden (BladderBaSe). This study calculated 5-year survival and risk of bladder cancer (BC)-specific and overall death by Cox proportional hazard models for the study cohort and a propensity score (PS) matched cohort.

Results: Those who had received NAC had higher 5-year survival proportions and decreased risk of both overall and BC specific death (HR = 0.71, 95% CI = 0.52-0.97 and HR = 0.67, 95% CI = 0.48-0.94), respectively, as compared to patients who did not receive NAC. The PS matched cohort showed similar estimates, but with larger statistical uncertainty (Overall death: HR = 0.76, 95% CI = 0.53-1.09 and BC-specific death: HR = 0.73, 95% CI = 0.50-1.07).

Conclusion: Results from the current observational study found similar point estimates for 5-year survival and of relative risks as previous studies. However, the results based on real world evidence had larger statistical variability, resulting in a non-statistically significant effect of NAC on survival. Future studies with detailed validated data can be used to further investigate the effect of NAC in narrower patient groups.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Muscle invasive bladder cancer, neoadjuvant chemotherapy, radical cystectomy, survival
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-161069 (URN)10.1080/21681805.2019.1624611 (DOI)000472425500001 ()31174452 (PubMedID)
Available from: 2019-06-27 Created: 2019-06-27 Last updated: 2019-07-11
Jerlström, T., Chen, R., Liedberg, F., Andrén, O., Ströck, V., Aljabery, F. A., . . . Fall, K. (2019). No increased risk of short-term complications after radical cystectomy for muscle-invasive bladder cancer among patients treated with preoperative chemotherapy: a nation-wide register-based study. World journal of urology
Open this publication in new window or tab >>No increased risk of short-term complications after radical cystectomy for muscle-invasive bladder cancer among patients treated with preoperative chemotherapy: a nation-wide register-based study
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2019 (English)In: World journal of urology, ISSN 0724-4983, E-ISSN 1433-8726Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: Preoperative chemotherapy is underused in conjunction with radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) due to concerns for complications and delay of surgery. Prospective data on short-term complications from population-based settings with frequent use of preoperative chemotherapy and standardised reporting of complications is lacking.

METHODS: We identified 1,340 patients who underwent RC between 2011 and 2015 in Sweden due to MIBC according to the Swedish Cystectomy Register. These individuals were followed through linkages to several national registers. Propensity score adjusted logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for complications and death within 90 days of surgery, comparing patients receiving preoperative chemotherapy or not.

RESULTS: Minimum two cycles of preoperative chemotherapy were given to 519 (39%) of the patients, who on average tended to be younger, have higher education, better physical status, and more advanced bladder cancer than patients not receiving chemotherapy. After adjusting for these and other parameters, there was no association between treatment with preoperative chemotherapy and short-term complications (OR 1.06 95% CI 0.82-1.39) or mortality (OR 0.75 95% CI 0.36-1.55). We observed a risk reduction for gastrointestinal complications among patients who received preoperative chemotherapy compared with those who did not (OR 0.49 95% CI 0.30-0.81).

CONCLUSION: This nation-wide population-based observational study does not suggest that preoperative chemotherapy, in a setting with high utilisation of such treatment, is associated with an increased risk of short-term complications in MIBC patients treated with radical cystectomy.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Bladder cancer, Induction chemotherapy, Neoadjuvant chemotherapy, Postoperative complications, Radical cystectomy
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-158481 (URN)10.1007/s00345-019-02770-2 (DOI)31020424 (PubMedID)
Available from: 2019-04-29 Created: 2019-04-29 Last updated: 2019-04-30
Liedberg, F., Hagberg, O., Aljabery, F., Gårdmark, T., Hosseini, A., Jahnson, S., . . . Holmberg, L. (2019). Period-specific mean annual hospital volume of radical cystectomy is associated with outcome and perioperative quality of care: a nationwide population-based study. BJU International, 124(3), 449-456
Open this publication in new window or tab >>Period-specific mean annual hospital volume of radical cystectomy is associated with outcome and perioperative quality of care: a nationwide population-based study
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2019 (English)In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 124, no 3, p. 449-456Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate the association between hospital volume and overall survival (OS), cancer-specific survival (CSS), and quality of care of patients with bladder cancer who undergo radical cystectomy (RC), defined as the use of extended lymphadenectomy (eLND), continent reconstruction, neoadjuvant chemotherapy (NAC), and treatment delay of <3 months.

PATIENTS AND METHODS: We used the Bladder Cancer Data Base Sweden (BladderBaSe) to study survival and indicators of perioperative quality of care in all 3172 patients who underwent RC for primary invasive bladder cancer stage T1-T3 in Sweden between 1997 and 2014. The period-specific mean annual hospital volume (PSMAV) during the 3 years preceding surgery was applied as an exposure and analysed using univariate and multivariate mixed models, adjusting for tumour and nodal stage, age, gender, comorbidity, educational level, and NAC. PSMAV was either categorised in tertiles, dichotomised (at ≥25 RCs annually), or used as a continuous variable for every increase of 10 RCs annually.

RESULTS: PSMAV in the highest tertile (≥25 RCs annually) was associated with improved OS (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.75-1.0), whereas the corresponding HR for CSS was 0.87 (95% CI 0.73-1.04). With PSMAV as a continuous variable, OS was improved for every increase of 10 RCs annually (HR 0.95, 95% CI 0.90-0.99). Moreover, higher PSMAV was associated with increased use of eLND, continent reconstruction and NAC, but also more frequently with a treatment delay of >3 months after diagnosis.

CONCLUSIONS: The current study supports centralisation of RC for bladder cancer, but also underpins the need for monitoring treatment delays associated with referral.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
#BladderCancer, #blcsm, hospital volume, quality of care, radical cystectomy, survival
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-158482 (URN)10.1111/bju.14767 (DOI)000482452800019 ()30950568 (PubMedID)
Available from: 2019-04-29 Created: 2019-04-29 Last updated: 2019-11-20Bibliographically approved
Liedberg, F., Hagberg, O., Aljabery, F., Gårdmark, T., Hosseini, A., Jahnson, S., . . . Holmberg, L. (2019). Period-specific mean annual hospital volume of radical cystectomy is associated with outcome and perioperative quality of care in Sweden: a nationwide population-based study. Scandinavian journal of urology, 53, 20-20
Open this publication in new window or tab >>Period-specific mean annual hospital volume of radical cystectomy is associated with outcome and perioperative quality of care in Sweden: a nationwide population-based study
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2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 53, p. 20-20Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objective: To investigate the association between hospital volume on overall survival (OS), cancer-specific survival (CSS), and quality of care defined as use of extended lymphadenectomy, continent reconstruction, neoadjuvant chemotherapy and treatment delay less than 3 months.

Materials and Methods: We used Bladder Cancer Data Base Sweden (BladderBaSe) to study survival and indicators of perioperative quality of care in all 3172 patients who underwent radical cystectomy for primary invasive bladder cancer stage T1-T3 in Sweden 1997-2014. The period-specific mean annual hospital volume (PSMAV) during the 3 years preceding surgery was applied as an exposure and analysed using univariate and multivariate mixed models, adjusting for tumour and nodal stage, age, gender, comorbidity, educational level and neoadjuvant chemotherapy. PSMAV was either categorised in tertiles, dichotomised (at 25 or more cystectomies annually), or used as a continuous variable for every increase of 10 cystectomies annually.

Results: PSMAV in the highest tertile (25 or more cystectomies annually) was associated with improved overall survival (HR 0.87, 95% CI 0.751.0), with a similar trend for cancer-specific survival (HR 0.87, 95% CI 0.731.04). With PSMAV as a continuous variable, overall survival was improved for every increase of 10 cystectomies annually (HR 0.95, 95% CI 0.900.99). Moreover, higher PSMAV was associated with increased use of extended lymphadenectomy, continent reconstruction and neoadjuvant chemotherapy, but also more frequently with a treatment delay of more than 3 months after diagnosis.

Conclusions: The current study supports centralisation of radical cystectomy for bladder cancer, but also underpins the need for monitoring treatment delays associated with referral.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-161604 (URN)10.1080/21681805.2019.1619285 (DOI)000472734500041 ()
Note

Supplement: 221

Special Issue: SI

Meeting Abstract: O3-03

Available from: 2019-07-18 Created: 2019-07-18 Last updated: 2019-07-18Bibliographically approved
Sherif, A. (2019). The risk of oversimplification in risk-stratification of neoadjuvant chemotherapy-responses in muscle invasive bladder cancer. Translational Andrology and Urology, 8(Suppl 3), S337-S340
Open this publication in new window or tab >>The risk of oversimplification in risk-stratification of neoadjuvant chemotherapy-responses in muscle invasive bladder cancer
2019 (English)In: Translational Andrology and Urology, ISSN 2223-4683, Vol. 8, no Suppl 3, p. S337-S340Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
AME Publishing Company, 2019
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-161917 (URN)10.21037/tau.2019.05.03 (DOI)000475754900034 ()
Available from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-08-06Bibliographically approved
diva2:1254758
Open this publication in new window or tab >>Detection of micro-metastases by flow cytometry in lymph nodes from patients with penile cancer
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2018 (English)In: BMC Urology, ISSN 1471-2490, E-ISSN 1471-2490, Vol. 18, no 1, article id 86Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The tumor draining lymph node concept was first described in penile cancer for staging. Immunohistochemistry and histopathology evaluations are routinely used in clinical practice to examine lymph nodes for metastasis. However, these methods are time-consuming with low diagnostic accuracy and micro-metastases might be missed. In this study, we aim to evaluate detection of metastatic cells in draining lymph nodes by flow cytometry.

METHODS: To assess the sensitivity of micro-metastasis detection by FACS (Fluorescence-activated cell sorting), HeLa cells were titrated into Peripheral blood mononuclear cells (PBMCs) and expression of pan-cytokeratin AE1/AE3 was analyzed. Single cell suspensions were separately prepared from 10 regional lymph nodes obtained from 5 patients with invasive penile cancer undergoing radical surgery and lymph node dissection. Lymph node dereived cells were examined for cell surface expression of EpCAM, E-cadherin and intracellular expression of pan-cytokeratin AE1/AE3 by FACS.

RESULTS: Ten lymph nodes from 5 penile cancer patients were investigated in a head-to-head comparison between FACS and pathology examination of sections. All metastatic lymph nodes verified by pathology examination were also identified by FACS. Two additional lymph nodes with micro-metastases were diagnosed by FACS only.

CONCLUSIONS: FACS analyses of pan-cytokeratin AE1/AE3 stained single cells from tumor draining lymph nodes can be used to detect micro-metastases in patients with penile cancer patients.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Flow cytometry, Micro-metastasis detection, Pan-cytokeratin AE1/AE3, Penile cancer, Tumor draining lymph nodes
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-152536 (URN)10.1186/s12894-018-0399-3 (DOI)000446461000001 ()30290760 (PubMedID)
Funder
Swedish Cancer SocietyWallenberg FoundationsSwedish Research Council
Available from: 2018-10-10 Created: 2018-10-10 Last updated: 2018-10-31Bibliographically approved
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