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Wiberg, Mikael
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Publications (10 of 113) Show all publications
Hardie, C., Bourke, G., salt, E., Fort-Schaale, A., Clark, S., Wiberg, M. & Bains, R. (2024). Demographics and deprivation in obstetric brachial plexus palsy: a retrospective cohort study. Journal of Hand Surgery, European Volume, 49(5), 570-575
Open this publication in new window or tab >>Demographics and deprivation in obstetric brachial plexus palsy: a retrospective cohort study
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2024 (English)In: Journal of Hand Surgery, European Volume, ISSN 1753-1934, E-ISSN 2043-6289, Vol. 49, no 5, p. 570-575Article in journal (Refereed) Published
Abstract [en]

The present study analyses the relationships between deprivation and obstetric brachial plexus palsy (OBPP). A retrospective observational study was conducted of infants with OBPP seen between 2008 and 2020 (n = 321). The index of multiple deprivation (IMD) was used to assign an IMD rank to patients based on birth postcode and the relationship with OBPP was analysed, including deprivation, gestational diabetes, age at referral and at first assessment. Quintile-based analysis demonstrated over-representation of patients from more deprived neighbourhoods (n = 109, 39%) living in the top 20% most deprived neighbourhoods. A total of 48 (15%) mothers had diabetes and 98 (31%) infants underwent surgical brachial plexus exploration (a marker of disease severity). Neither diabetes, age at referral nor age at first assessment were associated with IMD score. This suggests that neighbourhood deprivation is associated with OBPP, though the mechanisms are unclear. Further studies in this area may enable targeted health intervention for more deprived maternal and infant groups.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
brachial plexus, deprivation. socio-demographics, Erb’s palsy, high body mass index, macrosomia, maternal diabetes, Obstetric brachial plexus palsy
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-200214 (URN)10.1177/17531934231196421 (DOI)001094567100001 ()2-s2.0-85170849963 (Scopus ID)
Note

Originally published in thesis in manuscript form.

Available from: 2022-10-12 Created: 2022-10-12 Last updated: 2024-06-19Bibliographically approved
Millkvist, H., Källströmer, A., Bernspång, B. & Wiberg, M. (2024). The impact of a soft robotic glove on activity performance and body function for brachial plexus birth injury patients: a longitudinal case series. Journal of Hand Therapy
Open this publication in new window or tab >>The impact of a soft robotic glove on activity performance and body function for brachial plexus birth injury patients: a longitudinal case series
2024 (English)In: Journal of Hand Therapy, ISSN 0894-1130, E-ISSN 1545-004XArticle in journal (Refereed) Epub ahead of print
Abstract [en]

Background: A brachial plexus birth injury (BPBI) can cause reduced ability to use the arm and hand in daily activities due to reduced grip strength and endurance. A soft robotic glove can increase the number of activities performed and improve activity performance for patients with neurological disease. The use of a soft robotic glove for patients with BPBI has not been studied.

Purpose: To investigate if a soft robotic glove can improve activity performance and body function for patients with BPBI.

Study design: Longitudinal Case Series.

Methods: A convenience sample of patients with BPBI, treated by the Brachial plexus injury service in Umeå, Sweden were studied. Eight patients used a soft robotic glove, (Carbonhand®), at home for three months. Data on activity performance and satisfaction with activity performance, active range of motion and strength were collected at baseline, and at three and four months. A patient evaluation form was filled out at three months, all patients kept a diary for three out of 12 weeks.

Results: Six out of eight patients wanted to continue using the device and improved their self-perception of activity performance and satisfaction with the performance due to a more secure grip, compared to when not using the device. All patients had improved maximum strength and endurance in elbow flexion at three months. The device was useful as an assisting device and as a training tool.

Conclusion: A soft robotic glove (Carbonhand) may improve activity performance and perceived satisfaction and increase the number of activities that a person with BPBI can perform in everyday life. It is possible to increase strength in elbow flexion after using such a device. Due to this limited material, more research is needed.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Activities of daily living, Assistive technology, Brachial plexus birth injury, Occupational therapy, Physiotherapy, Soft robotic glove
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-227773 (URN)10.1016/j.jht.2024.02.009 (DOI)2-s2.0-85196967224 (Scopus ID)
Funder
Region VästerbottenStiftelsen Sunnerdahls Handikappfond
Available from: 2024-07-09 Created: 2024-07-09 Last updated: 2024-07-09
Anerillas, L. O., Wiberg, M., Kingham, P. J. & Kelk, P. (2023). Platelet lysate for expansion or osteogenic differentiation of bone marrow mesenchymal stem cells for 3D tissue constructs. Regenerative Therapy, 24, 298-310
Open this publication in new window or tab >>Platelet lysate for expansion or osteogenic differentiation of bone marrow mesenchymal stem cells for 3D tissue constructs
2023 (English)In: Regenerative Therapy, E-ISSN 2352-3204, Vol. 24, p. 298-310Article in journal (Refereed) Published
Abstract [en]

Background: The use of mesenchymal stem cells (MSCs) for the development of tissue-engineered constructs has advanced in recent years. However, future clinically approved products require following good manufacturing practice (GMP) guidelines. This includes using alternatives to xenogeneic-derived cell culture supplements to avoid rejection of the transplants. Consequently, human platelet lysate (PLT) has been adopted as an affordable and effective alternative to foetal bovine serum (FBS) in traditional 2D cultures. However, little is known about its effect in more advanced 3D culture systems.

Methods: We evaluated bone marrow MSCs (BMSCs) proliferation and CD marker expression in cells expanded in FBS or PLT-supplemented media. Differentiation capacity of the BMSCs expanded in the presence of the different supplements was evaluated in 3D type I collagen hydrogels. Furthermore, the effects of the supplements on the process of differentiation were analyzed by using qPCR and histological staining.

Results: Cell proliferation was greater in PLT-supplemented media versus FBS. BMSCs expanded in PLT showed similar osteogenic differentiation capacity in 3D compared with FBS expanded cells. In contrast, when cells were 3D differentiated in PLT they showed lower osteogenesis versus the traditional FBS protocol. This was also the case for adipogenic differentiation, in which FBS supplementation was superior to PLT.

Conclusions: PLT is a superior alternative to FBS for the expansion of MSCs without compromising their subsequent differentiation capacity in 3D. However, differentiation in PLT is impaired. Thus, PLT can be used to reduce the time required to expand the necessary cell numbers for development of 3D tissue engineered MSC constructs.

Place, publisher, year, edition, pages
Japanese Society of Regenerative Medicine, 2023
Keywords
3D, Foetal bovine serum, Human platelet lysate, Mesenchymal stem cells, Osteogenesis
National Category
Cell Biology
Identifiers
urn:nbn:se:umu:diva-213420 (URN)10.1016/j.reth.2023.07.011 (DOI)37588134 (PubMedID)2-s2.0-85167829822 (Scopus ID)
Funder
Region Västerbotten, 7003459Region Västerbotten, 7003589Umeå University
Available from: 2023-08-25 Created: 2023-08-25 Last updated: 2023-11-20Bibliographically approved
Thomson, S. E., Ng, N. Y. .., Riehle, M. O., Kingham, P. J., Dahlin, L. B., Wiberg, M. & Hart, A. M. (2022). Bioengineered nerve conduits and wraps for peripheral nerve repair of the upper limb. Cochrane Database of Systematic Reviews (12), Article ID CD012574.
Open this publication in new window or tab >>Bioengineered nerve conduits and wraps for peripheral nerve repair of the upper limb
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2022 (English)In: Cochrane Database of Systematic Reviews, E-ISSN 1469-493X, no 12, article id CD012574Article, review/survey (Refereed) Published
Abstract [en]

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess and compare the effects and complication rates of licensed bioengineered nerve conduits or wraps for surgical repair of traumatic peripheral nerve injuries of the upper limb. To compare effects and complications against the current gold surgical standard (nerve autograft).

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-202649 (URN)10.1002/14651858.CD012574.pub2 (DOI)000949395500013 ()36477774 (PubMedID)2-s2.0-85143554403 (Scopus ID)
Available from: 2023-01-16 Created: 2023-01-16 Last updated: 2024-07-04Bibliographically approved
Kumar Kuna, V., Lundgren, A., Anerillas, L. O., Kelk, P., Brohlin, M., Wiberg, M., . . . Novikov, L. N. (2022). Efficacy of Nerve-Derived Hydrogels to Promote Axon Regeneration Is Influenced by the Method of Tissue Decellularization. International Journal of Molecular Sciences, 23(15), Article ID 8746.
Open this publication in new window or tab >>Efficacy of Nerve-Derived Hydrogels to Promote Axon Regeneration Is Influenced by the Method of Tissue Decellularization
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2022 (English)In: International Journal of Molecular Sciences, ISSN 1661-6596, E-ISSN 1422-0067, Vol. 23, no 15, article id 8746Article in journal (Refereed) Published
Abstract [en]

Injuries to large peripheral nerves are often associated with tissue defects and require reconstruction using autologous nerve grafts, which have limited availability and result in donor site morbidity. Peripheral nerve-derived hydrogels could potentially supplement or even replace these grafts. In this study, three decellularization protocols based on the ionic detergents sodium dodecyl sulfate (P1) and sodium deoxycholate (P2), or the organic solvent tri-n-butyl phosphate (P3), were used to prepare hydrogels. All protocols resulted in significantly decreased amounts of genomic DNA, but the P2 hydrogel showed the best preservation of extracellular matrix proteins, cytokines, and chemokines, and reduced levels of sulfated glycosaminoglycans. In vitro P1 and P2 hydrogels supported Schwann cell viability, secretion of VEGF, and neurite outgrowth. Surgical repair of a 10 mm-long rat sciatic nerve gap was performed by implantation of tubular polycaprolactone conduits filled with hydrogels followed by analyses using diffusion tensor imaging and immunostaining for neuronal and glial markers. The results demonstrated that the P2 hydrogel considerably increased the number of axons and the distance of regeneration into the distal nerve stump. In summary, the method used to decellularize nerve tissue affects the efficacy of the resulting hydrogels to support regeneration after nerve injury.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
MRI, biosynthetic conduit, decellularized nerve tissue, diffusion tensor imaging, nerve-derived hydrogel, peripheral nerve injury
National Category
Neurosciences Surgery Cell and Molecular Biology
Identifiers
urn:nbn:se:umu:diva-199043 (URN)10.3390/ijms23158746 (DOI)000839268700001 ()35955880 (PubMedID)2-s2.0-85137098673 (Scopus ID)
Funder
Region VästerbottenVinnova, 2017-02130
Available from: 2022-09-01 Created: 2022-09-01 Last updated: 2022-10-03Bibliographically approved
Schaakxs, D., Wiberg, M., Kingham, P. J. & Kalbermatten, D. F. (2022). Intramuscular Stem Cell Injection in Combination with Bioengineered Nerve Repair or Nerve Grafting Reduces Muscle Atrophy. Plastic and reconstructive surgery (1963), 149(5), 905E-913E
Open this publication in new window or tab >>Intramuscular Stem Cell Injection in Combination with Bioengineered Nerve Repair or Nerve Grafting Reduces Muscle Atrophy
2022 (English)In: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 149, no 5, p. 905E-913EArticle in journal (Refereed) Published
Abstract [en]

Background: Peripheral nerve injuries represent a clinical challenge, especially when they are accompanied by loss of neural tissue. In this study, the authors attempted to attain a better outcome after a peripheral nerve injury by both repairing the nerve lesion and treating the denervated muscle at the same time.

Methods: Rat sciatic nerves were transected to create 10-mm gaps. Repair was performed in five groups (n = 5 rats for each), as follows: group 1, nerve repair using poly-3-hydroxybutyrate strips to connect the proximal and distal stumps, in combination with control growth medium injection in the gastrocnemius muscle; group 2, nerve repair with poly-3-hydroxybutyrate strip seeded with Schwann cell-like differentiated adipose stem cells (differentiated adipose stem cell strip) in combination with growth medium intramuscular injection; group 3, differentiated adipose stem cell strip in combination with intramuscular injection of differentiated adipose stem cells; group 4, repair using autograft (reverse sciatic nerve graft) in combination with intramuscular injection of growth medium; and group 5, autograft in combination with intramuscular injection of differentiated adipose stem cells. Six weeks after nerve injury, the effects of the stem cells on muscle atrophy were assessed.

Results: Poly-3-hydroxybutyrate strips seeded with differentiated adipose stem cells showed a high number of βIII-tubulin-positive axons entering the distal stump and abundant endothelial cells. Group 1 animals exhibited more muscle atrophy than all the other groups, and group 5 animals had the greatest muscle weights and muscle fibers size.

Conclusion: Bioengineering nerve repair in combination with intramuscular stem cell injection is a promising technique to treat nerve lesions and associated muscle atrophy. Clinical Relevance Statement: Nerve injuries and resulting muscle atrophy are a clinical challenge. To optimize functional recovery after a nerve lesion, the authors treated the nerve and muscle at the same time by using regenerative medicine with adipose stem cells and obtained encouraging results for future clinical applications.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2022
National Category
Surgery Cell and Molecular Biology
Identifiers
urn:nbn:se:umu:diva-194883 (URN)10.1097/PRS.0000000000009031 (DOI)000788119300008 ()35271540 (PubMedID)2-s2.0-85129244800 (Scopus ID)
Funder
Swedish Research CouncilEU, European Research CouncilRegion Västerbotten
Available from: 2022-06-07 Created: 2022-06-07 Last updated: 2023-05-09Bibliographically approved
Wade, R. G., Teh, I., Andersson, G., Yeh, F.-C., Wiberg, M. & Bourke, G. (2021). Fractional anisotropy thresholding for deterministic tractography of the roots of the brachial plexus. Scientific Reports, 11(1), Article ID 80.
Open this publication in new window or tab >>Fractional anisotropy thresholding for deterministic tractography of the roots of the brachial plexus
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2021 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 80Article in journal (Refereed) Published
Abstract [en]

Diffusion tensor imaging (DTI) metrics, such as the fractional anisotropy (FA) and estimates of diffusivity are sensitive to the microstructure of peripheral nerves and may be displayed as tractograms. However, the ideal conditions for tractography of the roots of the brachial plexus are unclear, which represents the rationale for this study. Ten healthy adults were scanned using a Siemens Prisma (3T) and single-shot echo-planar imaging (b-value 0/1000 s/mm2, 64 directions, 2.5 mm3 with 4 averages; repeated in opposing phase encoding directions). Susceptibility correction and tractography were performed in DSI Studio by two independent raters. The effect of FA thresholding at increments of 0.01 (from 0.04 to 0.10) were tested. The mean FA varied between subjects by 2% (95% CI 1%, 3%). FA thresholds of 0.04, 0.05 and 0.06 all propagated 96% of tracts representing the roots; thresholding at 0.07 yielded 4% fewer tracts (p = 0.2), 0.08 yielded 11% fewer tracts (p = 0.008), 0.09 yielded 15% fewer tracts (p = 0.001) and 0.1 yielded 20% fewer tracts (p < 0.001). There was < 0.1% inter-rater variability in the measured FA and 99% agreement for tractography (κ = 0.92, p < 0.001). The fractional anisotropy thresholds required to generate tractograms of the roots of the brachial plexus appears to be lower than those used in the brain. We provide estimates of the probability of generating true tracts for each spinal nerve root of the brachial plexus, at different fractional anisotropy thresholds.

Place, publisher, year, edition, pages
Nature Publishing Group, 2021
National Category
Medical Image Processing
Identifiers
urn:nbn:se:umu:diva-186286 (URN)10.1038/s41598-020-79840-8 (DOI)000634375500010 ()33420207 (PubMedID)2-s2.0-85098998192 (Scopus ID)
Funder
Knut and Alice Wallenberg Foundation
Available from: 2021-07-20 Created: 2021-07-20 Last updated: 2022-09-15Bibliographically approved
Jones, I., Novikova, L. N., Wiberg, M., Carlsson, L. & Novikov, L. N. (2021). Human Embryonic Stem Cell-derived Neural Crest Cells Promote Sprouting and Motor Recovery Following Spinal Cord Injury in Adult Rats. Cell Transplantation, 30
Open this publication in new window or tab >>Human Embryonic Stem Cell-derived Neural Crest Cells Promote Sprouting and Motor Recovery Following Spinal Cord Injury in Adult Rats
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2021 (English)In: Cell Transplantation, ISSN 0963-6897, E-ISSN 1555-3892, Vol. 30Article in journal (Refereed) Published
Abstract [en]

Spinal cord injury results in irreversible tissue damage and permanent sensorimotor impairment. The development of novel therapeutic strategies that improve the life quality of affected individuals is therefore of paramount importance. Cell transplantation is a promising approach for spinal cord injury treatment and the present study assesses the efficacy of human embryonic stem cell-derived neural crest cells as preclinical cell-based therapy candidates. The differentiated neural crest cells exhibited characteristic molecular signatures and produced a range of biologically active trophic factors that stimulated in vitro neurite outgrowth of rat primary dorsal root ganglia neurons. Transplantation of the neural crest cells into both acute and chronic rat cervical spinal cord injury models promoted remodeling of descending raphespinal projections and contributed to the partial recovery of forelimb motor function. The results achieved in this proof-of-concept study demonstrates that human embryonic stem cell-derived neural crest cells warrant further investigation as cell-based therapy candidates for the treatment of spinal cord injury.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
hESCs, motor recovery, neural crest cells, spinal cord injury, transplantation, vertical cylinder test
National Category
Cell and Molecular Biology Neurosciences
Identifiers
urn:nbn:se:umu:diva-180766 (URN)10.1177/0963689720988245 (DOI)000617264000001 ()33522309 (PubMedID)2-s2.0-85100676539 (Scopus ID)
Available from: 2021-02-25 Created: 2021-02-25 Last updated: 2024-04-18Bibliographically approved
Anerillas, L. O., Kingham, P. J., Lammi, M., Wiberg, M. & Kelk, P. (2021). Three-dimensional osteogenic differentiation of bone marrow mesenchymal stem cells promotes matrix metallopeptidase 13 (Mmp13) expression in type i collagen hydrogels. International Journal of Molecular Sciences, 22(24), Article ID 13594.
Open this publication in new window or tab >>Three-dimensional osteogenic differentiation of bone marrow mesenchymal stem cells promotes matrix metallopeptidase 13 (Mmp13) expression in type i collagen hydrogels
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2021 (English)In: International Journal of Molecular Sciences, ISSN 1661-6596, E-ISSN 1422-0067, Vol. 22, no 24, article id 13594Article in journal (Refereed) Published
Abstract [en]

Autologous bone transplantation is the principal method for reconstruction of large bone defects. This technique has limitations, such as donor site availability, amount of bone needed and morbidity. An alternative to this technique is tissue engineering with bone marrow-derived mesenchymal stem cells (BMSCs). In this study, our aim was to elucidate the benefits of culturing BMSCs in 3D compared with the traditional 2D culture. In an initial screening, we combined BMSCs with four different biogels: unmodified type I collagen (Col I), type I collagen methacrylate (ColMa), an alginate and cellulose-based bioink (CELLINK) and a gelatin-based bioink containing xanthan gum (GelXA-bone). Col I was the best for structural integrity and maintenance of cell morphology. Osteogenic, adipogenic, and chondrogenic differentiations of the BMSCs in 2D versus 3D type I collagen gels were investigated. While the traditional pellet culture for chondrogenesis was superior to our tested 3D culture, Col I hydrogels (i.e., 3D) favored adipogenic and osteogenic differentiation. Further focus of this study on osteogenesis were conducted by comparing 2D and 3D differentiated BMSCs with Osteoimage® (stains hydroxyapatite), von Kossa (stains anionic portion of phosphates, carbonates, and other salts) and Alizarin Red (stains Ca2+ deposits). Multivariate gene analysis with various covariates showed low variability among donors, successful osteogenic differentiation, and the identification of one gene (matrix metallopeptidase 13, MMP13) significantly differentially expressed in 2D vs. 3D cultures. MMP13 protein expression was confirmed with immunohistochemistry. In conclusion, this study shows evidence for the suitability of type I collagen gels for 3D osteogenic differentiation of BMSCs, which might improve the production of tissue-engineered constructs for treatment of bone defects.

Place, publisher, year, edition, pages
MDPI, 2021
Keywords
3D culture, Biogel, Cell differentiation, Mesenchymal stem cells, MMP13, MSCs, Osteogenesis, Type I collagen
National Category
Medical Materials
Identifiers
urn:nbn:se:umu:diva-190846 (URN)10.3390/ijms222413594 (DOI)000737916100001 ()2-s2.0-85121319833 (Scopus ID)
Available from: 2021-12-29 Created: 2021-12-29 Last updated: 2024-07-02Bibliographically approved
Lauvrud, A. T., Gümüsçü, R., Wiberg, R., Brohlin, M., Kelk, P., Wiberg, M. & Kingham, P. J. (2021). Water jet-assisted lipoaspiration and Sepax cell separation system for the isolation of adipose stem cells with high adipogenic potential. Journal of Plastic, Reconstructive & Aesthetic Surgery, 74(10), 2759-2767
Open this publication in new window or tab >>Water jet-assisted lipoaspiration and Sepax cell separation system for the isolation of adipose stem cells with high adipogenic potential
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2021 (English)In: Journal of Plastic, Reconstructive & Aesthetic Surgery, ISSN 1748-6815, E-ISSN 1878-0539, Vol. 74, no 10, p. 2759-2767Article in journal (Refereed) Published
Abstract [en]

Introduction: Water jet-assisted liposuction has gained popularity due to favourable fat grafting outcomes. In this study, we compared stem cells obtained from fat isolated with manual or the water jet-assisted procedure.

Methods: Liposuction of abdominal fat was performed using the two methods on each donor (n = 10). Aspirate samples were collagenase digested and the isolated cells seeded in vitro prior to proliferation, adipogenic differentiation and angiogenic activity analyses.

Results: Cells from either procedure proliferated at similar rates and exhibited a similar colony-forming ability. The cells expressed stem cell markers CD73, CD90 and CD105. In the water jet cell preparations, there were higher numbers of cells expressing CD146. Robust adipogenic differentiation was observed in cultures expanded from both manual and water jet lipoaspirates. Gene analysis showed higher expression of the adipocyte markers aP2 and GLUT4 in the adipocyte-differentiated water jet cell preparations, and ELISA indicated increased secretion of adiponectin from these cells. Both cell groups expressed vasculogenic factors and the water jet cells promoted the highest levels of in vitro angiogenesis. Given these positive results, we further characterised the water jet cells when prepared using an automated closed cell processing unit, the Sepax-2 system (Cytiva). The growth and stem cell properties of the Sepax-processed cells were similar to the standard centrifugation protocol, but there was evidence for greater adipogenic differentiation in the Sepax-processed cells.

Conclusions: Water jet lipoaspirates yield cells with high adipogenic potential and angiogenic activity, which may be beneficial for use in cell-assisted lipotransfers.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
adipogenesis, angiogenesis, differentiation, fat grafting, stem cells
National Category
Cell and Molecular Biology
Identifiers
urn:nbn:se:umu:diva-183242 (URN)10.1016/j.bjps.2021.03.025 (DOI)000709899500011 ()33994109 (PubMedID)2-s2.0-85105758965 (Scopus ID)
Funder
Vinnova, 2017-02130Region Västerbotten
Available from: 2021-05-19 Created: 2021-05-19 Last updated: 2024-07-02Bibliographically approved
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