Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Publications (10 of 45) Show all publications
Fransson, F., Werneke, U., Öhlund, L., Jonsson, A. P. & Ott, M. (2025). Kidney function decline improves after lithium discontinuation. Journal of Internal Medicine, 297(3), 289-299
Open this publication in new window or tab >>Kidney function decline improves after lithium discontinuation
Show others...
2025 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 297, no 3, p. 289-299Article in journal (Refereed) Published
Abstract [en]

Background: Long-term lithium treatment decreases kidney function. However, it remains unclear whether stopping lithium improves kidney function.

Objectives: To study kidney function in patients who stopped and subsequently restarted lithium treatment.

Methods: Mirror-image design using data from the LiSIE retrospective cohort study. The mirror was set to when lithium was stopped with a 5-year pre- and post-mirror period. Adult patients with bipolar, schizoaffective disorder or unipolar depression, who had lithium ≥4.5 years in the pre-mirror period, were included. Creatinine measurements were available from 1997 to 2017. The main outcome was the difference in mean annual change of the estimated glomerular filtration rate (eGFR) adjusted for sex, hypertension and diabetes mellitus.

Results: A total of 168 participants (94 women, 74 men) were included. Mean annual eGFR change was −1.58 (−1.87 to −1.28) mL/min/1.73 m2/year before and −0.023 (−0.49 to +0.44) mL/min/1.73 m2/year after lithium discontinuation (p < 0.0001 for difference). The improvement was 0.77 (0.35–1.20) mL/min/173 m2/year in participants with eGFR >60 mL/min/1.73 m2, and 3.03 (2.15–3.92) mL/min/1.73 m2/year for participants with eGFR <30 mL/min/1.73 m2. The effect was persistent over the 5-year post-mirror study period. For participants restarting lithium, the mean annual eGFR change was −1.71 (−2.26 to −1.16) mL/min/1.73 m2/year, a setback compared to their lithium-free post-mirror period (p < 0.0001). We did not see any difference compared to the pre-mirror period (p = 0.51).

Conclusions: Stopping lithium slowed down mean eGFR decline. This effect was more pronounced in participants with lower eGFR at the time of lithium discontinuation. In participants who restarted lithium, the annual decline of eGFR reverted to pre-lithium discontinuation levels.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
Keywords
bipolar disorder, chronic kidney disease, lithium, renal function
National Category
Nephrology Psychiatry
Identifiers
urn:nbn:se:umu:diva-234681 (URN)10.1111/joim.20054 (DOI)001400429200001 ()39829336 (PubMedID)2-s2.0-85215500430 (Scopus ID)
Funder
Region VästerbottenVisare Norr
Available from: 2025-02-04 Created: 2025-02-04 Last updated: 2025-05-28Bibliographically approved
Truedson, P., Vallianatou, K., Ott, M., Maripuu, M., Lindmark, K., Taylor, D. M. & Werneke, U. (2025). Reasons for discontinuing and restarting lithium multiple times: a case-register study based on the South London and Maudsley NHS Foundation Trust Clinical Record Interactive Search system. Therapeutic Advances in Psychopharmacology, 15, 1-16
Open this publication in new window or tab >>Reasons for discontinuing and restarting lithium multiple times: a case-register study based on the South London and Maudsley NHS Foundation Trust Clinical Record Interactive Search system
Show others...
2025 (English)In: Therapeutic Advances in Psychopharmacology, ISSN 2045-1253, E-ISSN 2045-1261, Vol. 15, p. 1-16Article in journal (Refereed) Published
Abstract [en]

Background: Despite the therapeutic benefits, non-adherence to lithium is common. One recent study showed that most patients discontinue lithium due to adverse effects. Little is known about individuals starting and discontinuing lithium repeatedly.

Objectives: We aimed to determine reasons for discontinuing and restarting lithium multiple times in patients with bipolar or schizoaffective disorder.

Design: Retrospective cohort study based on psychiatric case records of the SLaM Biomedical Research Centre Case Register (SLaM BRC case register).

Method: Anonymised clinical data were extracted via the Clinical Record Interactive Search (CRIS) application. Patients with at least three events of lithium discontinuation between 2012 and 2022 were included.

Results: Of 2888 eligible patients, 123 patients had discontinued lithium on at least three occasions. Psychiatric reasons, such as suspected lack of insight, feeling subjectively well or disagreeing with diagnosis, were the most common reasons for lithium discontinuations. They accounted for 77.2% of cases in the first event of discontinuation, 73.2% in the second and 72.3% in the third event. Adverse physical effects accounted for 19.5% of cases in the first event of discontinuation, 25.2% in the second and 26.0% in the third event. Relapse into the underlying affective disorder accounted for 83.7% each of reinstatements in the first and second events and 82.1% in the third event.

Discussion: In our sample, lithium was discontinued due to adverse effects in only a minority of patients. In most cases, the reasons for lithium discontinuation were considered psychiatric. Lithium was mainly restarted due to relapse. This warrants a better understanding of the reasons for repeatedly discontinuing lithium and the best way to promote lithium adherence to prevent a perpetual cycle of remitting when on lithium and relapsing when off lithium.

Place, publisher, year, edition, pages
Sage Publications, 2025
Keywords
bipolar disorder, drug-related side effects and adverse reactions, lithium, medication adherence, schizoaffective disorder
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-238720 (URN)10.1177/20451253251332275 (DOI)001475942400001 ()40296869 (PubMedID)2-s2.0-105003963759 (Scopus ID)
Funder
Norrbotten County Council
Available from: 2025-05-16 Created: 2025-05-16 Last updated: 2025-05-16Bibliographically approved
Stegmayr, B., Vrielink, H., Witt, V., Derfler, K., Deeren, D., Bojanic, I., . . . Newman, E. (2025). Update of data from the world apheresis association (WAA) registry. Transfusion and apheresis science, 64(3), Article ID 104132.
Open this publication in new window or tab >>Update of data from the world apheresis association (WAA) registry
Show others...
2025 (English)In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 64, no 3, article id 104132Article, review/survey (Refereed) Published
Abstract [en]

The WAA registry has been active since 2002. It allows bed side registration of safety and efficacy data. The data each center enters is accessible for its own use but also used for merged analysis. Most types of procedures are represented. Treatments of many severe diseases as well as the collection of autologous and donor cells for therapeutic use especially in oncologic diseases are recorded. Previous reports have shown a successive reduction in adverse events (AE) over the years. The aim of the present report is to update data of the risk for AE during the years from 2013 to Oct 2024. Contributions of 44 centers from 20 countries were analysed. Over these years, more than 169,000 apheresis procedures have been registered in more than 26,000 patients. During the study period the mean incidence of AE, merged for all types of procedures, was 1.6 /100 procedures for mild, 2.0/100 for moderate and 0.20/100 for severe AE, and reduced since 2013. Since 2002, death due to apheresis could not be excluded in one patient. There was an increased risk of hypotension during apheresis in patients with neurological diagnoses (ICD-10 chapter G) versus those with diseases of the musculoskeletal or connective tissue (ICD-10 chapter M) and vice versa for urticaria and tingling. In conclusion, the present data show the risk for various degrees of AE in apheresis procedures. Many patients suffer from severe illness and apheresis is often offered as a rescue therapy. Although the risk of death due to the apheresis procedure is extremely rare the concomitant severe disease itself poses a risk for severe events.

Place, publisher, year, edition, pages
Elsevier, 2025
Keywords
Adverse events, Apheresis, Fluid replacement, Risks
National Category
Hematology
Identifiers
urn:nbn:se:umu:diva-238603 (URN)10.1016/j.transci.2025.104132 (DOI)40328001 (PubMedID)2-s2.0-105003996809 (Scopus ID)
Available from: 2025-05-09 Created: 2025-05-09 Last updated: 2025-05-09Bibliographically approved
Gunnerlind, O., Lundqvist, R., Ott, M. & Werneke, U. (2024). Alcohol consumption under lockdown measures during the COVID-19 pandemic in three Nordic countries. International Journal of Social Psychiatry, 70(1), 48-58
Open this publication in new window or tab >>Alcohol consumption under lockdown measures during the COVID-19 pandemic in three Nordic countries
2024 (English)In: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 70, no 1, p. 48-58Article in journal (Refereed) Published
Abstract [en]

Background: At the beginning of the COVID-19 pandemic, concerns arose about a possible rise in alcohol consumption. Early surveys, however, more commonly pointed towards a decrease of alcohol use. But studies based on self-reports may underestimate alcohol use. They also depend on the population sampled. Because of border closures and gastronomy restrictions, countries with centralised alcohol sales provided a unique opportunity to study total domestic consumption during the pandemic without influence of private import or reliance on self-reports.

Aims: We examined the correlation between alcohol sales and national COVID-19 restrictions in three such countries, Finland, Norway and Sweden.

Method: We conducted this study as a mirror image study, comparing alcohol sales during the first 2 years of the COVID-19 pandemic with the two preceding years. We explored hours of daylight/season as potential confounders.

Results: We found no relevant change in alcohol sales during the pandemic years for Finland or Sweden. For Norway, there was a level-change in sales, which could be explained by decreased imports. Sales followed a seasonal pattern. In all three countries, the initial pandemic increase in alcohol sales coincided with an underlying annually recurring seasonal variation.

Conclusions: The COVID-19 pandemic had less of an impact on alcohol consumption in the three Nordic countries than could intuitively be expected. The increase of alcohol sales at the beginning of the COVID-19 pandemic coincided with a seasonal rise following a pre-pandemic pattern. Therefore, caution should be exercised with drawing conclusions from data with a short time perspective to avoid attribution bias.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
alcohol, COVID-19, Nordic countries, pandemic, seasonal
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-214292 (URN)10.1177/00207640231194486 (DOI)001062482400001 ()37650471 (PubMedID)2-s2.0-85169672716 (Scopus ID)
Available from: 2023-09-11 Created: 2023-09-11 Last updated: 2025-02-20Bibliographically approved
Ott, M. & Werneke, U. (2024). Metformin-associated lactic acidosis may be treatable with thiamine. Medical Hypotheses, 189, Article ID 111416.
Open this publication in new window or tab >>Metformin-associated lactic acidosis may be treatable with thiamine
2024 (English)In: Medical Hypotheses, ISSN 0306-9877, E-ISSN 1532-2777, Vol. 189, article id 111416Article in journal (Refereed) Published
Abstract [en]

Metformin is a biguanide antidiabetic and a first-line therapy for type-2 diabetes mellitus. It is highly effective, cheap, and easily available since taken in tablet form. Metformin-associated lactic acidosis (MALA) is a serious adverse event with high mortality. It is currently treated with bicarbonate and haemodialysis. The mechanism by which metformin can precipitate lactic acidosis remains subject to debate. Lactic acidosis has also been reported in thiamine (vitamin B1) deficiency. Thiamine deficiency results in a switch from aerobic to anaerobic metabolism with accumulation of lactate. MALA and thiamine-associated lactic acidosis are usually considered separate entities. Both, thiamine and metformin are competitive substrates of the organ cation and thiamine transporters. This way, metformin could cause thiamine deficiency in liver cells. We hypothesize that MALA may be treatable with thiamine. High-dose intravenous thiamine treatment is used routinely for the treatment of Wernicke's encephalopathy and is regarded as safe. Thiamine has been reported to have improved MALA in four cases, who had been refractory to haemodialysis. Thiamine is widely available, easy to administer, and cheap. Thiamine could already be given while waiting for dialysis. Above all, thiamine could prove life-saving in the treatment of MALA in clinical settings in which dialysis is not available.

Place, publisher, year, edition, pages
Elsevier, 2024
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-227760 (URN)10.1016/j.mehy.2024.111416 (DOI)001264246800001 ()2-s2.0-85197096050 (Scopus ID)
Available from: 2024-07-09 Created: 2024-07-09 Last updated: 2025-04-24Bibliographically approved
Goto, J., Ott, M. & Stegmayr, B. (2024). Myocardial markers are highly altered by higher rates of fluid removal during hemodialysis. Hemodialysis International, 28(1), 17-23
Open this publication in new window or tab >>Myocardial markers are highly altered by higher rates of fluid removal during hemodialysis
2024 (English)In: Hemodialysis International, ISSN 1492-7535, E-ISSN 1542-4758, Vol. 28, no 1, p. 17-23Article in journal (Refereed) Published
Abstract [en]

Introduction: Although hemodialysis is lifesaving in patients with kidney failure extensive interdialytic weight gain (IDWG) between dialyses worsens the prognosis. We recently showed a strong correlation between IDWG and predialytic values of cardiac markers. The aim of the present study was to evaluate if the cardiac markers N-terminal pro-B-type natriuretic peptide (proBNP) and troponin T were influenced by IDWG and speed of fluid removal (ultrafiltration-rate).

Methods: Twenty hemodialysis patients performed in total 60 hemodialysis (three each). Predialytic values of proBNP and troponin T and changes from predialysis to 180 min hemodialysis (180–0 min) were compared with the IDWG calculated in percent of body weight. The ultrafiltration-rate was adjusted (UF-rateadj) to IDWG: (100 × weight gain between dialysis [kg])/(estimated body dry weight [kg] × length of hemodialysis session [hours]).

Results: UF-rateadj correlated (Spearman) with (1) predialytic values of IDWG (r = 0.983, p < 0.001), proBNP (r = 0.443, p < 0.001), and troponin T (r = 0.296, p = 0.025); and (2) differences in proBNP180–0min (r = 0.572, p < 0.001) and troponin T180–0min (r = 0.400, p = 0.002). UF-ratesadj above a breakpoint of 0.60 caused more release of proBNP180–0min (p = 0.027). Remaining variables in multiple regression analysis with ProBNP180–0min as dependent factor were predialytic proBNP (p < 0.001) and the ultrafiltration-rate (p < 0.001).

Conclusion: Higher UF-rateadj during dialysis was correlated to increased levels of cardiac markers. Data support a UF-rateadj lower than 0.6 to limit such increase. Further studies may confirm if limited fluid intake and a lower UF-rateadj should be recommended to prevent cardiac injury during dialysis.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
biocompatibility, embolies, heart, hemodialysis, interdialytic weight gain
National Category
Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-215930 (URN)10.1111/hdi.13124 (DOI)001091396400001 ()37875435 (PubMedID)2-s2.0-85174612023 (Scopus ID)
Funder
Umeå University
Available from: 2023-11-02 Created: 2023-11-02 Last updated: 2025-02-18Bibliographically approved
Weinstein, T., Vogelsang, N., Sonkodi, S., Slotki, I., Martín-Carro, B., Lappin, D., . . . the UEMS Renal Section and Board, . (2024). Perception of nephrology in Europe: a strategy to improve recruitment of motivated fellows. Clinical Kidney Journal, 17(12), Article ID sfae326.
Open this publication in new window or tab >>Perception of nephrology in Europe: a strategy to improve recruitment of motivated fellows
Show others...
2024 (English)In: Clinical Kidney Journal, ISSN 2048-8505, E-ISSN 2048-8513, Vol. 17, no 12, article id sfae326Article in journal (Refereed) Published
Abstract [en]

Background: The shortage of applications for fellowships in nephrology is a worldwide challenge. This is the first survey to explore in Europe the reasons physicians choose (and do not choose) a career in nephrology.

Methods: An anonymous questionnaire was sent to the presidents of societies that are members of the European Renal Association (ERA), who invited trainees and nephrologists to respond. Statistical analysis was performed using SPSS v.26. (SPSS Inc., Chicago, IL, USA). Continuous variables were compared by Student's t-test or by one-way ANOVA.

Results: Responders included 516 (49%) females and 542 (51%) males. They comprised 278 (26%) trainees, and 780 (74%) nephrologists. The majority (64%) believe that students have an unfavourable perception of nephrology. For trainees, nephrology is not considered an attractive option due to ‘chronically ill patients’ (35%), ‘lack of contact during undergraduate training’ (37%), ‘nephrology is too challenging’ (38%), ‘poor remuneration’ (22%), ‘negative role models’ (15%), and ‘long working hours’ (14%). The factors with the greatest impact on choosing a career include a positive role model (46%), practical experience during medical school and early postgraduate training (42%).

Conclusion:Trainees emphasize that work–life balance is very important for the younger generation. A strong mentorship along with early engagement is associated with a higher likelihood of pursuing a career in nephrology. It is crucial to create a strategy that will provide a positive experience, renew the interest in nephrology careers and ensure enough nephrologists to treat the growing number of patients with kidney disease.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
medical training, mentorship, motivated recruitment, nephrology career
National Category
Nephrology
Identifiers
urn:nbn:se:umu:diva-235761 (URN)10.1093/ckj/sfae326 (DOI)001376321400001 ()
Available from: 2025-02-21 Created: 2025-02-21 Last updated: 2025-02-21Bibliographically approved
Truedson, P., Ott, M., Wahlström, L., Lundqvist, R., Maripuu, M., Lindmark, K., . . . Werneke, U. (2024). Serious adverse drug events associated with psychotropic treatment of bipolar or schizoaffective disorder: a 17-year follow-up on the LiSIE retrospective cohort study. Frontiers in Psychiatry, 15, Article ID 1358461.
Open this publication in new window or tab >>Serious adverse drug events associated with psychotropic treatment of bipolar or schizoaffective disorder: a 17-year follow-up on the LiSIE retrospective cohort study
Show others...
2024 (English)In: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 15, article id 1358461Article in journal (Refereed) Published
Abstract [en]

Introduction: Mood stabilisers and other psychotropic drugs can lead to serious adverse drug events (ADEs). However, the incidence remains unknown. We aimed to (a) determine the incidence of serious ADEs in patients with bipolar or schizoaffective disorders, (b) explore the role of lithium exposure, and (c) describe the aetiology.

Methods: This study is part of the LiSIE (Lithium—Study into Effects and Side Effects) retrospective cohort study. Between 2001 and 2017, patients in the Swedish region of Norrbotten, with a diagnosis of bipolar or schizoaffective disorder, were screened for serious ADEs to psychotropic drugs, having resulted in critical, post-anaesthesia, or intensive care. We determined the incidence rate of serious ADEs/1,000 person-years (PY).

Results: In 1,521 patients, we identified 41 serious ADEs, yielding an incidence rate of 1.9 events per 1,000 PY. The incidence rate ratio (IRR) between ADEs with lithium present and causally implicated and ADEs without lithium exposure was significant at 2.59 (95% CI 1.20–5.51; p = 0.0094). The IRR of ADEs in patients <65 and ≥65 years was significant at 3.36 (95% CI 1.63–6.63; p = 0.0007). The most common ADEs were chronic lithium intoxication, oversedation, and cardiac/blood pressure-related events.

Discussion: Serious ADEs related to treatment of bipolar (BD) or schizoaffective disorder (SZD) were uncommon but not rare. Older individuals were particularly at risk. The risk was higher in individuals exposed to lithium. Serum lithium concentration should always be checked when patients present with new or unclear somatic symptoms. However, severe ADEs also occurred with other mood stabilisers and other psychotropic drugs.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2024
Keywords
adverse drug events, bipolar disorder, incidence, intoxication, lithium, neuroleptic malignant syndrome, psychotropic drugs, serotonin syndrome
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-223627 (URN)10.3389/fpsyt.2024.1358461 (DOI)001203542400001 ()2-s2.0-85190497315 (Scopus ID)
Funder
Norrbotten County CouncilRegion Västerbotten, RV-939217Umeå University
Available from: 2024-04-29 Created: 2024-04-29 Last updated: 2024-04-29Bibliographically approved
Ott, M. & Werneke, U. (2023). Comment on Liu et al. Hemodialysis treatment for patients with lithium poisoning. Int. J. Environ. Res. Public health 2022, 19, 10044 [Letter to the editor]. International Journal of Environmental Research and Public Health, 20(10), Article ID 5843.
Open this publication in new window or tab >>Comment on Liu et al. Hemodialysis treatment for patients with lithium poisoning. Int. J. Environ. Res. Public health 2022, 19, 10044
2023 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 10, article id 5843Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
MDPI, 2023
National Category
Public Health, Global Health and Social Medicine Pharmacology and Toxicology
Identifiers
urn:nbn:se:umu:diva-209154 (URN)10.3390/ijerph20105843 (DOI)37239569 (PubMedID)2-s2.0-85160303519 (Scopus ID)
Funder
Norrbotten County Council
Note

Special issue: The Fascinating World of Lithium.

Available from: 2023-06-20 Created: 2023-06-20 Last updated: 2025-02-20Bibliographically approved
Lieber, I., Ott, M., Lundqvist, R., Eliasson, M. & Werneke, U. (2023). Incidence of hyperthyroidism in patients with bipolar or schizoaffective disorder with or without lithium: 21-year follow-up from the LiSIE retrospective cohort study. Therapeutic Advances in Psychopharmacology, 13, Article ID 20451253231151514.
Open this publication in new window or tab >>Incidence of hyperthyroidism in patients with bipolar or schizoaffective disorder with or without lithium: 21-year follow-up from the LiSIE retrospective cohort study
Show others...
2023 (English)In: Therapeutic Advances in Psychopharmacology, ISSN 2045-1253, E-ISSN 2045-1261, Vol. 13, article id 20451253231151514Article in journal (Refereed) Published
Abstract [en]

Background: Lithium-associated hyperthyroidism is much rarer than lithium-associated hypothyroidism. Yet, it may be of substantial clinical significance for affected individuals. For instance, lithium-associated hyperthyroidism could destabilise mood, mimic manic episodes and impact physical health. Only few studies have explored incidence rates of lithium-associated hyperthyroidism. Even fewer studies have compared incidence rates according to lithium exposure history.

Objectives: To determine the impact of lithium treatment on the incidence rate of hyperthyroidism in patients with bipolar or schizoaffective disorder and assess its aetiology.

Design: This study is part of the LiSIE (Lithium - Study into Effects and Side Effects) retrospective cohort study.

Methods: Between 1997 and 2017, patients in the Swedish region of Norrbotten with a diagnosis of bipolar or schizoaffective disorder were screened for all episodes of overt hyperthyroidism in form of thyrotoxicosis or thyroiditis. Incidence rates of episodes of hyperthyroidism per 1000 person-years (PY) were compared in relation to lithium exposure; concurrent, previous, or no exposure ever (lithium-naïve patients).

Results: In 1562 patients, we identified 16 episodes of hyperthyroidism corresponding to an incidence rate of 0.88 episodes per 1000 PY. Ninety-four percent of episodes had occurred in women. Patients who had concurrently been exposed to lithium, had an incidence rate of 1.35 episodes per 1000 PY. Patients who had previously been exposed to lithium had an incidence rate of 0.79 per 1000 PY. Patients who had never been exposed to lithium had an incidence rate of 0.47 per 1000 PY. There were no significant differences in the risk ratios for patients with concurrent or previous exposure compared with lithium-naïve patients, neither for hyperthyroidism overall, thyrotoxicosis, or thyroiditis.

Conclusion: Lithium-associated hyperthyroidism seems uncommon. The risk of hyperthyroidism does not seem significantly higher in patients with current or previous lithium exposure than in lithium-naïve patients.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
bipolar disorder, hyperthyroidism, incidence rate, lithium, schizoaffective disorder, thyroiditis, thyrotoxicosis
National Category
Psychiatry Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-203909 (URN)10.1177/20451253231151514 (DOI)000928749700001 ()36776622 (PubMedID)2-s2.0-85174272670 (Scopus ID)
Funder
Visare Norr, 847881Visare Norr, 939391
Note

Originally included in thesis in manuscript form.

Available from: 2023-01-23 Created: 2023-01-23 Last updated: 2023-10-27Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2393-9750

Search in DiVA

Show all publications