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Domellöf, Magnus
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Publications (10 of 165) Show all publications
Timby, N., Domellöf, M., Hernell, O., Lönnerdal, B., Nihlen, C., Johansson, I. & Weitzberg, E. (2020). Effects of age, sex and diet on salivary nitrate and nitrite in infants. Nitric oxide, 94, 73-78
Open this publication in new window or tab >>Effects of age, sex and diet on salivary nitrate and nitrite in infants
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2020 (English)In: Nitric oxide, ISSN 1089-8603, E-ISSN 1089-8611, Vol. 94, p. 73-78Article in journal (Refereed) Published
Abstract [en]

The inorganic anions nitrate and nitrite are oxidation products from endogenous nitric oxide (NO) generation and constituents in our diet. A nitrate-nitrite-NO pathway exists in which nitrate can be serially reduced to bioactive NO. The first step of this pathway occurs in the oral cavity where oral bacteria convert salivary nitrate to nitrite, whereafter nitrite is reduced to NO systemically by several enzymatic and non-enzymatic pathways. Data are scarce regarding salivary levels and oral conversion capacity of these anions in infants. We measured salivary nitrate and nitrate in infants at 4 and 12 months of age and related values to age, sex, dietary pattern and oral microbiome. Saliva was collected from a total of 188 infants at 4 and 12 months of age. Salivary nitrate, nitrite and nitrite/nitrate ratio as a measure of oral nitrate-reducing capacity were analyzed by HPLC and related to age, sex, type of diet (breast milk or formula) and oral microbiome. There was no difference in salivary nitrate, nitrite or nitrite/nitrate ratio between boys and girls at any age. At 4 months levels of these parameters were lower than what has been described in adults but they had all increased significantly at 12 months of age. At 4 months of age salivary nitrite/nitrate ratio was lower in breast-fed compared to formula-fed infants, but these differences disappeared at 12 months. Several bacterial species were associated with oral nitrate reducing capacity including Prevotella, Veillonella, Alloprevotella and Leptotrichia. We conclude that in infants there is an increase in salivary nitrate and nitrite as well as in oral nitrate-reductase capacity during the first year of life. Differences observed at 4 months of age between breast-fed and formula-fed infants disappear at one year of age.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Oral, Saliva, Bacteria, Nitric oxide, Nutrition, Formula
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-168190 (URN)10.1016/j.niox.2019.10.012 (DOI)000508287900010 ()31682925 (PubMedID)
Available from: 2020-03-11 Created: 2020-03-11 Last updated: 2020-03-11Bibliographically approved
Chmielewska, A., Farooqi, A., Domellöf, M. & Öhlund, I. (2020). Lean Tissue Deficit in Preterm Infants Persists up to 4 Months of Age: Results from a Swedish Longitudinal Study. Neonatology, 117(1), 80-87
Open this publication in new window or tab >>Lean Tissue Deficit in Preterm Infants Persists up to 4 Months of Age: Results from a Swedish Longitudinal Study
2020 (English)In: Neonatology, ISSN 1661-7800, E-ISSN 1661-7819, Vol. 117, no 1, p. 80-87Article in journal (Refereed) Published
Abstract [en]

Background: At term-equivalent age, infants born prematurely are shorter, lighter and have more adipose tissue compared to term counterparts. Little is known on whether the differences in body composition persist in later age. 

Methods: We prospectively recruited 33 preterm infants (<32 weeks gestational age, mean gestational age 28.1 weeks) and 69 term controls. Anthropometry and body composition (air displacement plethysmography) were monitored up to 4 months of age. Nutrient intakes from preterm infants were collected from clinical records. 

Results: At 4 months of age preterm infants were lighter and shorter than term controls (mean weight-for-age z-score: –0.73 vs. 0.06, p = 0.001; mean length-for-age z-score: –1.31 vs. 0.29, p < 0.0001). The significantly greater percentage of total body fat seen in preterm infants at term-equivalent age (20.2 vs. 11.7%, p < 0.0001) was no longer observed at 4 months. A deficit of fat-free mass persisted until 4 months of age (fat-free mass at term-equivalent age: 2.71 vs. 3.18 kg, p < 0.0001; at 4 months: 4.3 vs. 4.78 kg, p < 0.0001). The fat mass index and fat-free mass index (taking length into account) did not differ between the groups. Nutrition had little effect on body composition. Higher protein intake at week 2 was a negative predictor of fat-free mass at discharge. 

Conclusions: At 4 months corrected age, preterm infants were both lighter and shorter than term controls and the absolute fat-free mass deficit remained until this age. Little effect of nutrition on body composition was observed.

Place, publisher, year, edition, pages
S. Karger, 2020
Keywords
Preterm infants, Body composition, Adiposity, Lean tissue
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-170796 (URN)10.1159/000503292 (DOI)000528674000011 ()31822002 (PubMedID)
Funder
Västerbotten County CouncilSwedish Research Council, 2016-02095
Available from: 2020-05-27 Created: 2020-05-27 Last updated: 2020-05-27Bibliographically approved
Koletzko, B., Bergmann, K., Brenna, J. T., Calder, P. C., Campoy, C., Clandinin, M. T., . . . Carlson, S. E. (2020). Should formula for infants provide arachidonic acid along with DHA?: A position paper of the European Academy of Paediatrics and the Child Health Foundation. American Journal of Clinical Nutrition, 111(1), 10-16
Open this publication in new window or tab >>Should formula for infants provide arachidonic acid along with DHA?: A position paper of the European Academy of Paediatrics and the Child Health Foundation
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2020 (English)In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 111, no 1, p. 10-16Article in journal (Refereed) Published
Abstract [en]

Recently adopted regulatory standards on infant and follow-on formula for the European Union stipulate that from February 2020 onwards, all such products marketed in the European Union must contain 20-50 mg omega-3 DHA (22:6n-3) per 100 kcal, which is equivalent to about 0.5-1% of fatty acids (FAs) and thus higher than typically found in human milk and current infant formula products, without the need to also include co-6 arachidonic acid (AA; 20:4n-6). This novel concept of infant formula composition has given rise to concern and controversy because there is no accountable evidence on its suitability and safety in healthy infants. Therefore, international experts in the field of infant nutrition were invited to review the state of scientific research on DHA and AA, and to discuss the questions arising from the new European regulatory standards. Based on the available information, we recommend that infant and follow-on formula should provide both DHA and AA. The DHA should equal at least the mean content in human milk globally (0.3% of FAs) but preferably reach 0.5% of FAs. Although optimal AA intake amounts remain to be defined, we strongly recommend that AA should be provided along with DHA. At amounts of DHA in infant formula up to similar to 0.64%, AA contents should at least equal the DHA contents. Further well-designed clinical studies should evaluate the optimal intakes of DHA and AA in infants at different ages based on relevant outcomes.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2020
Keywords
infant nutrition, breast milk substitutes, long-chain PUFAs, European Commission Formula Delegated Act 2016/127, food safety
National Category
Nutrition and Dietetics Pediatrics
Identifiers
urn:nbn:se:umu:diva-167971 (URN)10.1093/ajcn/nqz252 (DOI)000505964300005 ()31665201 (PubMedID)
Available from: 2020-02-20 Created: 2020-02-20 Last updated: 2020-02-20Bibliographically approved
Samuel, T. M., De Castro, C. A., Dubascoux, S., Affolter, M., Giuffrida, F., Billeaud, C., . . . Silva-Zolezzi, I. (2020). Subclinical Mastitis in a European Multicenter Cohort: Prevalence, Impact on Human Milk (HM) Composition, and Association with Infant HM Intake and Growth. Nutrients, 12(1), Article ID 105.
Open this publication in new window or tab >>Subclinical Mastitis in a European Multicenter Cohort: Prevalence, Impact on Human Milk (HM) Composition, and Association with Infant HM Intake and Growth
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2020 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 12, no 1, article id 105Article in journal (Refereed) Published
Abstract [en]

Background: Subclinical mastitis (SCM) is an inflammatory condition of the mammary gland. We examined the effects of SCM on human milk (HM) composition, infant growth, and HM intake in a mother–infant cohort from seven European countries. 

Methods: HM samples were obtained from 305 mothers at 2, 17, 30, 60, 90, and 120 days postpartum. SCM status was assessed using HM Sodium (Na): Potassium (K) ratio >0.6. Levels of different macro- and micronutrients were analyzed in HM. 

Results: SCM prevalence in the first month of lactation was 35.4%. Mean gestational age at delivery was lower and birth by C-section higher in SCM mothers (p ≤ 0.001). HM concentrations of lactose, DHA, linolenic acid, calcium, and phosphorous (p < 0.05 for all) was lower, while total protein, alpha-lactalbumin, lactoferrin, albumin, arachidonic acid to DHA ratio, n-6 to n-3 ratio and minerals (iron, selenium, manganese, zinc, and copper) were higher (p < 0.001 for all) in mothers with SCM. There were no differences in infant growth and HM intake between non-SCM and SCM groups. 

Conclusion: We document, for the first time, in a large European standardized and longitudinal study, a high prevalence of SCM in early lactation and demonstrate that SCM is associated with significant changes in the macro- and micronutrient composition of HM. Future studies exploring the relation of SCM with breastfeeding behaviors and developmental outcomes are warranted.

Place, publisher, year, edition, pages
MDPI, 2020
Keywords
subclinical mastitis, European population, human milk, longitudinal study, milk macronutrients
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-169446 (URN)10.3390/nu12010105 (DOI)000516825500105 ()31905959 (PubMedID)
Available from: 2020-04-06 Created: 2020-04-06 Last updated: 2020-04-06Bibliographically approved
Wackernagel, D., Gustafsson, A., Edstedt Bonamy, A.-K., Reims, A., Ahlsson, F., Elfving, M., . . . Hansen Pupp, I. (2020). Swedish national guideline for prevention and treatment of neonatal hypoglycaemia in newborn infants with gestational age ≥ 35 weeks. Acta Paediatrica, 109(1), 31-44
Open this publication in new window or tab >>Swedish national guideline for prevention and treatment of neonatal hypoglycaemia in newborn infants with gestational age ≥ 35 weeks
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2020 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, no 1, p. 31-44Article, review/survey (Refereed) Published
Abstract [en]

Aim: Postnatal hypoglycaemia in newborn infants remains an important clinical problem where prolonged periods of hypoglycaemia are associated with poor neurodevelopmental outcome. The aim was to develop an evidence-based national guideline with the purpose to optimise prevention, diagnosis and treatment of hypoglycaemia in newborn infants with a gestational age >= 35 + 0 weeks.

Methods: A PubMed search-based literature review was used to find actual and applicable evidence for all incorporated recommendations. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used for grading the evidence of the recommendations.

Results: Recommendations for the prevention of neonatal hypoglycaemia were extended and updated, focusing on promotion of breastfeeding as one prevention strategy. Oral dextrose gel as a novel supplemental therapy was incorporated in the treatment protocol. A new threshold-based screening and treatment protocol presented as a flow chart was developed.

Conclusion: An updated and evidence-based national guideline for screening and treatment of neonatal hypoglycaemia will support standardised regimes, which may prevent hypoglycaemia and the risk for hypoglycaemia-related long-term sequelae.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
breastfeeding, dextrose gel, guideline, hypoglycaemia, newborn infant
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-164535 (URN)10.1111/apa.14955 (DOI)000483888400001 ()31350926 (PubMedID)
Available from: 2019-11-15 Created: 2019-11-15 Last updated: 2020-03-24Bibliographically approved
Späth, C., Zamir, I., Stoltz Sjöström, E. & Domellöf, M. (2020). Use of concentrated parenteral nutrition solutions is associated with improved nutrient intakes and postnatal growth in very low-birth-weight infants. JPEN - Journal of Parenteral and Enteral Nutrition, 44(2), 327-336
Open this publication in new window or tab >>Use of concentrated parenteral nutrition solutions is associated with improved nutrient intakes and postnatal growth in very low-birth-weight infants
2020 (English)In: JPEN - Journal of Parenteral and Enteral Nutrition, ISSN 0148-6071, E-ISSN 1941-2444, Vol. 44, no 2, p. 327-336Article in journal (Refereed) Published
Abstract [en]

Background: Evidence showing the beneficial effects of enhanced parenteral nutrition (PN) to very low-birth-weight (VLBW,<1500 g) infants is accumulating. However, PN composition and its impact on growth outcomes are questioned. This study aimed to investigate the associations between administration of a concentrated PN regime and intakes of energy and macronutrients as well as postnatal growth in VLBW infants. 

Methods: We compared 2 cohorts of VLBW infants born before (n = 74) and after (n =44) a concentrated PN regime was introduced into clinical use. Daily nutrition and fluid intake during the first 28 postnatal days and all available growth measurements during hospitalization were retrospectively collected from clinical charts. 

Results: Infants who received concentrated PN compared with original PN had higher parenteral intakes of energy (56 vs 45 kcal/kg/d, P < 0.001), protein (2.6 vs 2.2 g/kg/d, P = 0.008), and fat (1.5 vs 0.7 g/kg/d, P < 0.001) during the first postnatal week. Changes in standard deviation scores for weight and length from birth to postnatal day 28 were more positive in the concentrated PN group (mean [95% CI]; weight change: –0.77 [–1.02 to –0.52] vs –1.29 [–1.33 to –1.05], P = 0.005; length change: –1.01 [–1.36 to –0.65] vs –1.60 [–1.95 to –1.25], P = 0.025). There were no significant differences in fluid intake and infant morbidity between the groups. 

Conclusion: Our results suggest that concentrated PN is useful and seems to be safe for improving early nutrition and growth in VLBW infants.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
amino acids, energy intake, nutrient intakes, parenteral nutrition, postnatal growth, very low-birth-weight infants
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-148009 (URN)10.1002/jpen.1522 (DOI)000514808000021 ()30747444 (PubMedID)
Available from: 2018-05-24 Created: 2018-05-24 Last updated: 2020-03-19Bibliographically approved
Sjödin, K. S., Domellöf, M., Lagerqvist, C., Hernell, O., Lönnerdal, B., Szymlek-Gay, E. A., . . . Lind, T. (2019). Administration of ferrous sulfate drops has significant effects on the gut microbiota of iron-sufficient infants: a randomised controlled study [Letter to the editor]. Gut, 68(11)
Open this publication in new window or tab >>Administration of ferrous sulfate drops has significant effects on the gut microbiota of iron-sufficient infants: a randomised controlled study
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2019 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 68, no 11Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-167039 (URN)10.1136/gutjnl-2018-316988 (DOI)000497817400023 ()30343273 (PubMedID)
Funder
Västerbotten County Council
Available from: 2020-01-09 Created: 2020-01-09 Last updated: 2020-01-09Bibliographically approved
Norman, M., Hallberg, B., Abrahamsson, T., Bjorklund, L. J., Domellöf, M., Farooqi, A., . . . Håkansson, S. (2019). Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-2016. Journal of the American Medical Association (JAMA), 321(12), 1188-1199
Open this publication in new window or tab >>Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-2016
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2019 (English)In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 321, no 12, p. 1188-1199Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE: Since 2004-2007, national guidelines and recommendations have been developed for the management of extremely preterm births in Sweden. If and how more uniform management has affected infant survival is unknown.

OBJECTIV: To compare survival of extremely preterm infants born during 2004-2007 with survival of infants born during 2014-2016.

DESIGN, SETTING AND PARTICIPANTS: All births at 22-26weeks' gestational age (n = 2205) between April 1, 2004, and March 31, 2007, and between January 1, 2014, and December 31, 2016, in Sweden were studied. Prospective data collection was used during 2004-2007. Data were obtained from the Swedish pregnancy, medical birth, and neonatal quality registries during 2014-2016. EXPOSURES Delivery at 22-26 weeks' gestational age.

MAIN OUTCOMES AND MEASURES: The primary outcomewas infant survival to the age of 1 year. The secondary outcome was 1-year survival among live-born infants who did not have any major neonatal morbidity (specifically, without intraventricular hemorrhage grade 3-4, cystic periventricular leukomalacia, necrotizing enterocolitis, retinopathy of prematurity stage 3-5, or severe bronchopulmonary dysplasia).

RESULTS: During 2004-2007, 1009 births (3.3/1000 of all births) occurred at 22-26 weeks' gestational age compared with 1196 births (3.4/1000 of all births) during 2014-2016 (P =.61). One-year survival among live-born infants at 22-26 weeks' gestational age was significantly lower during 2004-2007 (497 of 705 infants [70%]) than during 2014-2016 (711 of 923 infants [77%]) (difference, -7%[95% CI, -11% to -2.2%], P =.003). One-year survival among live-born infants at 22-26 weeks' gestational age and without any major neonatal morbidity was significantly lower during 2004-2007 (226 of 705 infants [32%]) than during 2014-2016 (355 of 923 infants [38%]) (difference, -6%[95% CI, -11% to -1.7%], P =.008).

CONCLUSIONS AND RELEVANCE: Among live births at 22-26 weeks' gestational age in Sweden, 1-year survival improved between 2004-2007 and 2014-2016.

Place, publisher, year, edition, pages
Chicago: American Medical Association, 2019
National Category
Pediatrics Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-158749 (URN)10.1001/jama.2019.2021 (DOI)000463074900015 ()30912837 (PubMedID)
Available from: 2019-05-15 Created: 2019-05-15 Last updated: 2019-11-13Bibliographically approved
Lindberg, J., Norman, M., Westrup, B., Domellöf, M. & Berglund, S. K. (2019). Cardiometabolic risk factors in children born with marginally low birth weight: A longitudinal cohort study up to 7 years-of-age. PLoS ONE, 14(4), Article ID e0215866.
Open this publication in new window or tab >>Cardiometabolic risk factors in children born with marginally low birth weight: A longitudinal cohort study up to 7 years-of-age
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 4, article id e0215866Article in journal (Refereed) Published
Abstract [en]

Introduction Low birth weight (LBW, <2500 g) may predict an increased risk of an adverse cardiometabolic profile later in life, but long-term effects in different populations and birth weight strata are still unclear. We explored laboratory markers of cardiometabolic risk in children born with marginally LBW (2000-2500 g). Methods This was a prospective longitudinal cohort study including 285 Swedish marginally LBW children and 95 normal birth weight (NBW, 2501-4500 g) controls. At 3.5 and 7 years of age, blood samples for glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), cholesterol, triglycerides, high-and low density lipoprotein (HDL and LDL), apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) were assessed and compared between the groups. Results No significant differences in levels of insulin, HOMA-IR, hs-CRP or blood lipids were observed between marginally LBW and NBW children. At 7 years there was a higher proportion of marginally LBW children with elevated levels of insulin, defined as above the 90th percentile of the control group (21% vs 8.6%, p = 0.038). This association was, however, confounded by maternal ethnicity. In marginally LBW children born small for gestational age (SGA), mean fasting glucose was significantly higher compared to controls (4.7 vs 4.5 mmol/L, p = 0.020). Conclusions There were no significant differences in insulin, insulin resistance, hs-CRP or blood lipids between the marginally LBW children and controls. The subgroup of marginally LBW children born SGA may present early signs of glucose imbalance already at school age.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-158951 (URN)10.1371/journal.pone.0215866 (DOI)000465019900056 ()31002705 (PubMedID)
Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-05-27Bibliographically approved
Klevebro, S., Westin, V., Stoltz Sjöström, E., Norman, M., Domellöf, M., Edstedt Bonamy, A.-K. & Hallberg, B. (2019). Early energy and protein intakes and associations with growth, BPD and ROP in extremely preterm infants. Clinical Nutrition, 38(3), 1289-1295
Open this publication in new window or tab >>Early energy and protein intakes and associations with growth, BPD and ROP in extremely preterm infants
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2019 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 38, no 3, p. 1289-1295Article in journal (Refereed) Published
Abstract [en]

Background & aim: Extremely preterm infants face substantial neonatal morbidity. Nutrition is important to promote optimal growth and organ development in order to reduce late neonatal complications. The aim of this study was to examine the associations of early nutritional intakes on growth and risks of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) in a high-risk population.

Methods: This population-based cohort study includes infants born before 27 0/7 weeks of gestational age without severe malformations and surviving ≥10 days. Intake of energy and protein on postnatal days 4–6 and association with weight standard deviation score (WSDS) from birth to day 7, as well as intakes of energy and protein on postnatal days 4–6 and 7 to 27, respectively, and association with composite outcome of death and BPD and separate outcomes of BPD and ROP were examined, and adjusted for potential confounders.

Results: The cohort comprised 296 infants with a median gestational age of 25 3/7 weeks. Expressed as daily intakes, every additional 10 kcal/kg/d of energy during days 4–6 was associated with 0.08 higher WSDS on day 7 (95% CI 0.06–0.11; p < 0.001). Between days 7 and 27, every 10 kcal/kg/d increase in energy intake was associated with a reduced risk of BPD of 9% (95% CI 1–16; p = 0.029) and any grade of ROP with a reduced risk of 6% (95% CI 2–9; p = 0.005) in multivariable models. This association was statistically significant in infants with ≤10 days of mechanical ventilation. In infants with >10 days of mechanical ventilation, a combined higher intake of energy and protein was associated with a reduced risk of BPD.

Conclusion: Early provision of energy and protein may reduce postnatal weight loss and risk of morbidity in extremely preterm infants.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Extremely preterm infant, Nutrition, Growth, Retinopathy of prematurity, Bronchopulmonary dysplasia
National Category
Pediatrics Nutrition and Dietetics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-147966 (URN)10.1016/j.clnu.2018.05.012 (DOI)000469891800037 ()29885776 (PubMedID)
Funder
Stockholm County Council
Available from: 2018-05-23 Created: 2018-05-23 Last updated: 2019-06-24Bibliographically approved
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