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  1. Article ; Online: Influence of eating disorder psychopathology and general psychopathology on the risk of involuntary treatment in anorexia nervosa.

    Mac Donald, Benjamin / Bulik, Cynthia M / Petersen, Liselotte V / Clausen, Loa

    Eating and weight disorders : EWD

    2022  Volume 27, Issue 8, Page(s) 3157–3172

    Abstract: Purpose: We explored associations between clinical factors, including eating disorder psychopathology and more general psychopathology, and involuntary treatment in patients with anorexia nervosa. Our intention was to inform identification of patients ... ...

    Abstract Purpose: We explored associations between clinical factors, including eating disorder psychopathology and more general psychopathology, and involuntary treatment in patients with anorexia nervosa. Our intention was to inform identification of patients at risk of involuntary treatment.
    Methods: This was a retrospective cohort study combining clinical data from a specialized eating disorder hospital unit in Denmark with nationwide Danish register-based data. A sequential methodology yielding two samples (212 and 278 patients, respectively) was adopted. Descriptive statistics and regression analyses were used to explore associations between involuntary treatment and clinical factors including previous involuntary treatment, patient cooperation, and symptom-level psychopathology (Eating Disorder Inventory-2 (EDI-2) and Symptom Checklist-90-Revised (SCL-90-R)).
    Results: Somatization (SCL-90-R) (OR = 2.60, 95% CI 1.16-5.81) and phobic anxiety (SCL-90-R) (OR = 0.43, 95% CI 0.19-0.97) were positively and negatively, respectively, associated with the likelihood of involuntary treatment. Furthermore, somatization (HR = 1.77, 95% CI 1.05-2.99), previous involuntary treatment (HR = 5.0, 95% CI 2.68-9.32), and neutral (HR = 2.92, 95% CI 1.20-7.13) or poor (HR = 3.97, 95% CI 1.49-10.59) patient cooperation were associated with decreased time to involuntary treatment. Eating disorder psychopathology measured by the EDI-2 was not significantly associated with involuntary treatment.
    Conclusions: Clinical questionnaires of psychopathology appear to capture specific domains relevant to involuntary treatment. Poor patient cooperation and previous involuntary treatment being associated with shorter time to involuntary treatment raise important clinical issues requiring attention. Novel approaches to acute anorexia nervosa care along with unbiased evaluation upon readmission could mitigate the cycle of repeat admissions with involuntary treatment.
    Level of evidence: Level III, cohort study.
    MeSH term(s) Humans ; Anorexia Nervosa/complications ; Anorexia Nervosa/therapy ; Anorexia Nervosa/diagnosis ; Cohort Studies ; Retrospective Studies ; Psychopathology ; Feeding and Eating Disorders/therapy ; Feeding and Eating Disorders/complications ; Involuntary Treatment
    Language English
    Publishing date 2022-07-21
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2038625-4
    ISSN 1590-1262 ; 1124-4909
    ISSN (online) 1590-1262
    ISSN 1124-4909
    DOI 10.1007/s40519-022-01446-y
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  2. Article ; Online: Latent anxiety and depression dimensions differ amongst patients with eating disorders: A Swedish nationwide investigation.

    Hübel, Christopher / Birgegård, Andreas / Johansson, Therese / Petersen, Liselotte V / Isomaa, Rasmus / Herle, Moritz

    International journal of methods in psychiatric research

    2023  Volume 32, Issue 3, Page(s) e1961

    Abstract: Objective: Anxiety and depression symptoms are common in individuals with eating disorders. To study these co-occurrences, we need high-quality self-report questionnaires. The 19-item self-rated Comprehensive Psychopathological Rating Scale for ... ...

    Abstract Objective: Anxiety and depression symptoms are common in individuals with eating disorders. To study these co-occurrences, we need high-quality self-report questionnaires. The 19-item self-rated Comprehensive Psychopathological Rating Scale for Affective Syndromes (CPRS-S-A) is not validated in patients with eating disorders. We tested its factor structure, invariance, and differences in its latent dimensions.
    Method: Patients were registered by 45 treatment units in the Swedish nationwide Stepwise quality assurance database for specialised eating disorder care (n = 9509). Patients self-reported their anxiety and depression symptoms on the CPRS-S-A. Analyses included exploratory and confirmatory factor analyses (CFA) in split samples, and testing of invariance and differences in subscales across eating disorder types.
    Results: Results suggested a four-factor solution: Depression, Somatic and fear symptoms, Disinterest, and Worry. Multigroup CFA indicated an invariant factor structure. We detected the following differences: Patients with anorexia nervosa binge-eating/purging subtype scored the highest and patients with unspecified feeding and eating disorders the lowest on all subscales. Patients with anorexia nervosa or purging disorder show more somatic and fear symptoms than individuals with either bulimia nervosa or binge-eating disorder.
    Conclusion: Our four-factor solution of the CPRS-S-A is suitable for patients with eating disorders and may help to identify differences in anxiety and depression dimensions amongst patients with eating disorders.
    MeSH term(s) Humans ; Depression/epidemiology ; Depression/psychology ; Sweden/epidemiology ; Feeding and Eating Disorders/epidemiology ; Binge-Eating Disorder/diagnosis ; Binge-Eating Disorder/psychology ; Anorexia Nervosa/epidemiology ; Anorexia Nervosa/diagnosis ; Anxiety/epidemiology
    Language English
    Publishing date 2023-02-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1078002-6
    ISSN 1557-0657 ; 1049-8931
    ISSN (online) 1557-0657
    ISSN 1049-8931
    DOI 10.1002/mpr.1961
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  3. Article ; Online: Pharmacotherapy in anorexia nervosa: A Danish nation-wide register-based study.

    Clausen, Loa / Semark, Birgitte D / Helverskov, Janne / Bulik, Cynthia M / Petersen, Liselotte V

    Journal of psychosomatic research

    2022  Volume 164, Page(s) 111077

    Abstract: Objective: No medications have been indicated for the treatment of anorexia nervosa (AN). Nonetheless, individuals with AN are frequently treated pharmacologically. The present study maps nationwide pharmacotherapy two years before to five years after ... ...

    Abstract Objective: No medications have been indicated for the treatment of anorexia nervosa (AN). Nonetheless, individuals with AN are frequently treated pharmacologically. The present study maps nationwide pharmacotherapy two years before to five years after first AN diagnosis.
    Methods: We identified all medication prescriptions in a national register-based study of patients with a first diagnosis of AN between 1998 and 2011, and age and gender matched controls (1:10). Medication classes were compared using odds ratios (OR) between patients and controls; between patients below and above 15 years; between patients with and without comorbidity; and between those diagnosed before or after 2005.
    Results: The odds of pharmacotherapy were increased in patients for all classes of medication except a small residual class. Highest odds were found for alimentary (OR 2.8, p < 0.001) and psychopharmacological (OR 5.5, p < 0.001) medication. The former peaked one year prior to first diagnosis and the latter one year after. Older patients had increased risk of almost all medication classes with cardiovascular medication showing a fivefold OR (p < 0.001). Patients with psychiatric comorbidity had a threefold OR for psychopharmacological medication (p < 0.001) compared to patients without psychiatric comorbidity. Calendar year showed few and small differences.
    Conclusion: The extended use of all medication classes both prior to and after first diagnosis of AN highlights the severe cause and complexity of AN. The results encourage clinical caution of pharmacotherapy, highlight the need for pharmacotherapy guidelines for AN, and emphasize the urgency of research in pharmacotherapy in AN.
    MeSH term(s) Humans ; Anorexia Nervosa/drug therapy ; Anorexia Nervosa/epidemiology ; Comorbidity ; Denmark/epidemiology
    Language English
    Publishing date 2022-11-04
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 80166-5
    ISSN 1879-1360 ; 0022-3999
    ISSN (online) 1879-1360
    ISSN 0022-3999
    DOI 10.1016/j.jpsychores.2022.111077
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  4. Article ; Online: Interplay of polygenic liability with birth-related, somatic, and psychosocial factors in anorexia nervosa risk: a nationwide study.

    Papini, Natalie M / Presseller, Emily / Bulik, Cynthia M / Holde, Katrine / Larsen, Janne T / Thornton, Laura M / Albiñana, Clara / Vilhjálmsson, Bjarni J / Mortensen, Preben B / Yilmaz, Zeynep / Petersen, Liselotte V

    Psychological medicine

    2024  , Page(s) 1–14

    Abstract: Background: Although several types of risk factors for anorexia nervosa (AN) have been identified, including birth-related factors, somatic, and psychosocial risk factors, their interplay with genetic susceptibility remains unclear. Genetic and ... ...

    Abstract Background: Although several types of risk factors for anorexia nervosa (AN) have been identified, including birth-related factors, somatic, and psychosocial risk factors, their interplay with genetic susceptibility remains unclear. Genetic and epidemiological interplay in AN risk were examined using data from Danish nationwide registers. AN polygenic risk score (PRS) and risk factor associations, confounding from AN PRS and/or parental psychiatric history on the association between the risk factors and AN risk, and interactions between AN PRS and each level of target risk factor on AN risk were estimated.
    Methods: Participants were individuals born in Denmark between 1981 and 2008 including nationwide-representative data from the iPSYCH2015, and Danish AN cases from the Anorexia Nervosa Genetics Initiative and Eating Disorder Genetics Initiative cohorts. A total of 7003 individuals with AN and 45 229 individuals without a registered AN diagnosis were included. We included 22 AN risk factors from Danish registers.
    Results: Risk factors showing association with PRS for AN included urbanicity, parental ages, genitourinary tract infection, and parental socioeconomic factors. Risk factors showed the expected association to AN risk, and this association was only slightly attenuated when adjusted for parental history of psychiatric disorders or/and for the AN PRS. The interaction analyses revealed a differential effect of AN PRS according to the level of the following risk factors: sex, maternal age, genitourinary tract infection, C-section, parental socioeconomic factors and psychiatric history.
    Conclusions: Our findings provide evidence for interactions between AN PRS and certain risk-factors, illustrating potential diverse risk pathways to AN diagnosis.
    Language English
    Publishing date 2024-02-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 217420-0
    ISSN 1469-8978 ; 0033-2917
    ISSN (online) 1469-8978
    ISSN 0033-2917
    DOI 10.1017/S0033291724000175
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  5. Article ; Online: Infectious mononucleosis as a risk factor for depression: A nationwide cohort study.

    Vindegaard, Nina / Petersen, Liselotte V / Lyng-Rasmussen, Bodil Ingrid / Dalsgaard, Søren / Benros, Michael Eriksen

    Brain, behavior, and immunity

    2021  Volume 94, Page(s) 259–265

    Abstract: Background: Infectious mononucleosis is a clinical diagnosis characterized by fever, sore throat, lymph node enlargement and often prolonged fatigue, most commonly caused by Epstein-Barr virus infection. Previous studies have indicated that infectious ... ...

    Abstract Background: Infectious mononucleosis is a clinical diagnosis characterized by fever, sore throat, lymph node enlargement and often prolonged fatigue, most commonly caused by Epstein-Barr virus infection. Previous studies have indicated that infectious mononucleosis can be followed by depression; however, large-scale studies are lacking. We used nationwide registry data to investigate the association between infectious mononucleosis and subsequent depression in this first large-scale study.
    Methods: Prospective cohort study using nationwide Danish registers covering all 1,440,590 singletons born (1977-2005) in Denmark by Danish born parents (21,830,542 person-years' follow-up until 2016); where 12,510 individuals had a hospital contact with infectious mononucleosis. The main outcome measures were a diagnosis of major depressive disorder (ICD-8: 296.09, 298.09, 300.4; ICD-10: F32) requiring hospital contact.
    Results: Infectious mononucleosis was associated with a 40% increased hazard ratio (HR) for a subsequent depression diagnosis in the fully adjusted model (HR: 1.40, 95% CI: 1.26-1.56;n = 358), when compared to unexposed individuals. The increased risk of being diagnosed with depression was significant to the periods one to four years after the infectious mononucleosis diagnosis (HR: 1.40, 95% CI: 1.17-1.67;n = 121) and ≥ five years (HR: 1.40, 95% CI: 1.22-1.61;n = 207). We did not find any differences according to age (p = 0.61) nor sex (p = 0.30).
    Conclusion: In this largest study to date, infectious mononucleosis in childhood or adolescence was associated with an increased risk of a subsequent depression. Our findings have important clinical implications and identifies youth with infectious mononucleosis as a group at high risk of later depression in young adulthood.
    MeSH term(s) Adolescent ; Adult ; Cohort Studies ; Depression/epidemiology ; Depressive Disorder, Major ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Humans ; Infectious Mononucleosis/epidemiology ; Prospective Studies ; Risk Factors ; Young Adult
    Language English
    Publishing date 2021-02-09
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639219-2
    ISSN 1090-2139 ; 0889-1591
    ISSN (online) 1090-2139
    ISSN 0889-1591
    DOI 10.1016/j.bbi.2021.01.035
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  6. Article ; Online: Polygenic association with severity and long-term outcome in eating disorder cases.

    Johansson, Therese / Birgegård, Andreas / Zhang, Ruyue / Bergen, Sarah E / Landén, Mikael / Petersen, Liselotte V / Bulik, Cynthia M / Hübel, Christopher

    Translational psychiatry

    2022  Volume 12, Issue 1, Page(s) 61

    Abstract: About 20% of individuals with anorexia nervosa (AN) remain chronically ill. Therefore, early identification of poor outcome could improve care. Genetic research has identified regions of the genome associated with AN. Patients with anorexia nervosa were ... ...

    Abstract About 20% of individuals with anorexia nervosa (AN) remain chronically ill. Therefore, early identification of poor outcome could improve care. Genetic research has identified regions of the genome associated with AN. Patients with anorexia nervosa were identified via the Swedish eating disorder quality registers Stepwise and Riksät and invited to participate in the Anorexia Nervosa Genetics Initiative. First, we associated genetic information longitudinally with eating disorder severity indexed by scores on the Clinical Impairment Assessment (CIA) in 2843 patients with lifetime AN with or without diagnostic migration to other forms of eating disorders followed for up to 16 years (mean = 5.3 years). Second, we indexed the development of a severe and enduring eating disorder (SEED) by a high CIA score plus a follow-up time ≥5 years. We associated individual polygenic scores (PGSs) indexing polygenic liability for AN, schizophrenia, and body mass index (BMI) with severity and SEED. After multiple testing correction, only the BMI PGS when calculated with traditional clumping and p value thresholding was robustly associated with disorder severity (β
    MeSH term(s) Anorexia Nervosa/genetics ; Body Mass Index ; Feeding and Eating Disorders/genetics ; Genome-Wide Association Study ; Humans ; Multifactorial Inheritance
    Language English
    Publishing date 2022-02-16
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2609311-X
    ISSN 2158-3188 ; 2158-3188
    ISSN (online) 2158-3188
    ISSN 2158-3188
    DOI 10.1038/s41398-022-01831-2
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  7. Article ; Online: Bidirectional Associations Between Asthma and Types of Mental Disorders.

    Liu, Xiaoqin / Plana-Ripoll, Oleguer / McGrath, John J / Petersen, Liselotte V / Dharmage, Shyamali C / Momen, Natalie C

    The journal of allergy and clinical immunology. In practice

    2022  Volume 11, Issue 3, Page(s) 799–808.e14

    Abstract: Background: Asthma and mental disorders frequently co-occur. Studies of their comorbidity have generally focused on associations related to a subset of mental disorders.: Objective: To estimate bidirectional associations between asthma and 10 broad ... ...

    Abstract Background: Asthma and mental disorders frequently co-occur. Studies of their comorbidity have generally focused on associations related to a subset of mental disorders.
    Objective: To estimate bidirectional associations between asthma and 10 broad types of mental disorders.
    Methods: In a population-based cohort study, including all individuals born in Denmark between 1955 and 2011 (N = 5,053,471), we considered diagnoses of comorbid mental disorders among those with asthma, and vice versa, between 2000 and 2016. We used Cox regression models to calculate overall and time-dependent hazard ratios for mental disorder-asthma pairs and competing-risks survival analyses to estimate absolute risks.
    Results: Altogether, 376,756 individuals were identified as having an incident mental disorder and 364,063 incident asthma during follow-up. An increased risk was seen for all bidirectional mental disorder-asthma pairs. Following an asthma diagnosis, adjusted hazard ratios for different subsequent mental disorders ranged from 1.75 (95% CI, 1.64-1.87) for organic disorders to 2.75 (95% CI, 2.69-2.81) for personality disorders. Following a prior mental disorder diagnosis, hazard ratios for asthma ranged from 1.06 (95% CI, 1.00-1.12) for developmental disorders to 2.33 (95% CI, 2.28-2.39) for substance use disorders. Risks varied with time since prior disorder diagnosis but remained elevated. Cumulative incidence of (1) asthma after a mental disorder and (2) a mental disorder after asthma was higher in those with prior disorders than in matched reference groups.
    Conclusions: Our findings provide evidence of bidirectional associations between asthma and each of the mental disorder types, suggesting possible shared etiological factors or pathophysiologic processes.
    MeSH term(s) Humans ; Cohort Studies ; Mental Disorders/epidemiology ; Substance-Related Disorders ; Comorbidity ; Asthma/epidemiology ; Denmark/epidemiology
    Language English
    Publishing date 2022-12-05
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2022.11.027
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  8. Article ; Online: Vagotomy and the risk of mental disorders: A nationwide population-based study.

    Bunyoz, Artemis H / Christensen, Rune H B / Orlovska-Waast, Sonja / Nordentoft, Merete / Mortensen, Preben B / Petersen, Liselotte V / Benros, Michael E

    Acta psychiatrica Scandinavica

    2021  Volume 145, Issue 1, Page(s) 67–78

    Abstract: Objective: To investigate vagotomy, the severance of the vagus nerve, and its association with mental disorders, as gut-brain communication partly mediated by the vagus nerve have been suggested as a risk factor.: Methods: Nationwide population-based ...

    Abstract Objective: To investigate vagotomy, the severance of the vagus nerve, and its association with mental disorders, as gut-brain communication partly mediated by the vagus nerve have been suggested as a risk factor.
    Methods: Nationwide population-based Danish register study of all individuals alive and living in Denmark during the study period 1977-2016 and who had a hospital contact for ulcer with or without vagotomy. Follow-up was until any diagnosis of mental disorders requiring hospital contact, emigration, death, or end of follow-up on December 31, 2016, whichever came first. Data were analyzed using survival analysis and adjusted for sex, age, calendar year, ulcer type, and Charlson comorbidity index score.
    Results: During the study period, 113,086 individuals had a hospital contact for ulcer. Of these, 5,408 were exposed to vagotomy where 375 (6.9%) subsequently developed a mental disorder. Vagotomy overall was not associated with mental disorders (HR: 1.10; 95%CI: 0.99-1.23), compared to individuals with ulcer not exposed to vagotomy. However, truncal vagotomy was associated with an increased HR of 1.22 (95%CI: 1.06-1.41) for mental disorders, whereas highly selective vagotomy was not associated with mental disorders (HR: 0.98; 95%CI: 0.84-1.15). Truncal vagotomy was also associated with higher risk of mental disorders when compared to highly selective vagotomy (p = 0.034).
    Conclusions: Overall, vagotomy did not increase the risk of mental disorders; however, truncal vagotomy specifically was associated with a small risk increase in mental disorders, whereas no association was found for highly selective vagotomy. Thus, the vagus nerve does not seem to have a major impact on the development of mental disorders.
    MeSH term(s) Hospitals ; Humans ; Mental Disorders/epidemiology ; Risk Factors ; Vagotomy ; Vagus Nerve
    Language English
    Publishing date 2021-07-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 103-x
    ISSN 1600-0447 ; 0001-690X
    ISSN (online) 1600-0447
    ISSN 0001-690X
    DOI 10.1111/acps.13343
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  9. Article ; Online: Involuntary treatment in patients with anorexia nervosa: utilization patterns and associated factors.

    Mac Donald, Benjamin / Bulik, Cynthia M / Larsen, Janne T / Carlsen, Anders H / Clausen, Loa / Petersen, Liselotte V

    Psychological medicine

    2021  Volume 53, Issue 5, Page(s) 1999–2007

    Abstract: Background: A subgroup of patients with anorexia nervosa (AN) undergoing involuntary treatment (IT) seems to account for most of the IT events. Little is known about these patients and their treatment including the temporal distribution of IT events and ...

    Abstract Background: A subgroup of patients with anorexia nervosa (AN) undergoing involuntary treatment (IT) seems to account for most of the IT events. Little is known about these patients and their treatment including the temporal distribution of IT events and factors associated with subsequent utilization of IT. Hence, this study explores (1) utilization patterns of IT events, and (2) factors associated with subsequent utilization of IT in patients with AN.
    Methods: In this nationwide Danish register-based retrospective exploratory cohort study patients were identified from their first (index) hospital admission with an AN diagnosis and followed up for 5 years. We explored data on IT events including estimated yearly and total 5-year rates, and factors associated with subsequent increased IT rates and restraint, using regression analyses and descriptive statistics.
    Results: IT utilization peaked in the initial few years starting at or following the index admission. A small percentage (1.0%) of patients accounted for 67% of all IT events. The most frequent measures reported were mechanical and physical restraint. Factors associated with subsequent increased IT utilization were female sex, lower age, previous admissions with psychiatric disorders before index admission, and IT related to those admissions. Factors associated with subsequent restraint were lower age, previous admissions with psychiatric disorders, and IT related to these.
    Conclusions: High IT utilization in a small percentage of individuals with AN is concerning and can lead to adverse treatment experiences. Exploring alternative approaches to treatment that reduce the need for IT is an important focus for future research.
    MeSH term(s) Humans ; Female ; Male ; Anorexia Nervosa/therapy ; Cohort Studies ; Retrospective Studies ; Hospitalization ; Involuntary Treatment
    Language English
    Publishing date 2021-09-28
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 217420-0
    ISSN 1469-8978 ; 0033-2917
    ISSN (online) 1469-8978
    ISSN 0033-2917
    DOI 10.1017/S003329172100372X
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  10. Article ; Online: Publisher Correction: Genetic correlates of vitamin D-binding protein and 25-hydroxyvitamin D in neonatal dried blood spots.

    Albiñana, Clara / Zhu, Zhihong / Borbye-Lorenzen, Nis / Boelt, Sanne Grundvad / Cohen, Arieh S / Skogstrand, Kristin / Wray, Naomi R / Revez, Joana A / Privé, Florian / Petersen, Liselotte V / Bulik, Cynthia M / Plana-Ripoll, Oleguer / Musliner, Katherine L / Agerbo, Esben / Børglum, Anders D / Hougaard, David M / Nordentoft, Merete / Werge, Thomas / Mortensen, Preben Bo /
    Vilhjálmsson, Bjarni J / McGrath, John J

    Nature communications

    2024  Volume 15, Issue 1, Page(s) 1741

    Language English
    Publishing date 2024-02-26
    Publishing country England
    Document type Published Erratum
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-024-46199-7
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