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We are analyzing https://link.springer.com/article/10.1007/s00125-018-4659-2.

Title:
Identification of novel high-impact recessively inherited type 2 diabetes risk variants in the Greenlandic population | Diabetologia
Description:
Aims/hypothesis In a recent study using a standard additive genetic model, we identified a TBC1D4 loss-of-function variant with a large recessive impact on risk of type 2 diabetes in Greenlanders. The aim of the current study was to identify additional genetic variation underlying type 2 diabetes using a recessive genetic model, thereby increasing the power to detect variants with recessive effects. Methods We investigated three cohorts of Greenlanders (B99, nโ€‰=โ€‰1401; IHIT, nโ€‰=โ€‰3115; and BBH, nโ€‰=โ€‰547), which were genotyped using Illumina MetaboChip. Of the 4674 genotyped individuals passing quality control, 4648 had phenotype data available, and type 2 diabetes association analyses were performed for 317 individuals with type 2 diabetes and 2631 participants with normal glucose tolerance. Statistical association analyses were performed using a linear mixed model. Results Using a recessive genetic model, we identified two novel loci associated with type 2 diabetes in Greenlanders, namely rs870992 in ITGA1 on chromosome 5 (OR 2.79, pโ€‰=โ€‰1.8โ€‰ร—โ€‰10โˆ’8), and rs16993330 upstream of LARGE1 on chromosome 22 (OR 3.52, pโ€‰=โ€‰1.3โ€‰ร—โ€‰10โˆ’7). The LARGE1 variant did not reach the conventional threshold for genome-wide significance (pโ€‰<โ€‰5โ€‰ร—โ€‰10โˆ’8) but did withstand a study-wide Bonferroni-corrected significance threshold. Both variants were common in Greenlanders, with minor allele frequencies of 23% and 16%, respectively, and were estimated to have large recessive effects on risk of type 2 diabetes in Greenlanders, compared with additively inherited variants previously observed in European populations. Conclusions/interpretation We demonstrate the value of using a recessive genetic model in a historically small and isolated population to identify genetic risk variants. Our findings give new insights into the genetic architecture of type 2 diabetes, and further support the existence of high-effect genetic risk factors of potential clinical relevance, particularly in isolated populations. Data availability The Greenlandic MetaboChip-genotype data are available at European Genome-Phenome Archive (EGA; https://ega-archive.org/ ) under the accession EGAS00001002641.
Website Age:
28 years and 1 months (reg. 1997-05-29).

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  • Education
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๐ŸŒ  Phenomenal Traffic: 5M - 10M visitors per month


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Keywords {๐Ÿ”}

diabetes, type, pubmed, genetic, article, association, google, scholar, variants, model, cas, itga, study, recessive, large, risk, variant, insulin, individuals, health, greenlandic, central, data, glucose, samples, population, effect, studies, research, analyses, traits, allele, loci, table, genet, greenlanders, effects, performed, european, estimated, yupik, additive, identified, power, statistical, results, nat, gwas, denmark, esm,

Topics {โœ’๏ธ}

oluf pedersenย &ย torben hansen genome-wide trans-ancestry meta-analysis emil jรธrsboe cohort profile oluf pedersen uk/resources/downloads/human/hapmap3 genome-wide association study genome-wide association studies anti-human insulin-specific antibody study-wide significance threshold transcriptomic profiles genome-wide significant variant original author genome-wide significance bonferroni-corrected significance threshold institutional review boards cross-sectional pooled study european genome-phenome archive human beta-cell adhesion article download pdf islet-specific epigenome maps 125i-iodinated insulin tracer large-scale association analysis trans-ethnic meta-analysis uk/genetics_software/snptest/snptest canhr yupโ€™ik samples chronic disease-related protective left y-axis shows diabetes-related mechanisms underlying article grarup present-day greenlandic population rare sequence variants quantitative diabetes-related traits diabetes-related quantitative traits transethnic gwas meta-analysis population-based association studies recessive model-based test exome sequencing-driven discovery fast model-based estimation yupโ€™ik people yup'ik people recessive model-based tests recessive genetic model analysed diabetes-related traits org/mammals/haploreg/haploreg org/collaboration/giant/index correct genetic model additive genetic model yupโ€™ik studies ฮฑ1-integrin subunit

Schema {๐Ÿ—บ๏ธ}

WebPage:
      mainEntity:
         headline:Identification of novel high-impact recessively inherited type 2 diabetes risk variants in the Greenlandic population
         description:In a recent study using a standard additive genetic model, we identified a TBC1D4 loss-of-function variant with a large recessive impact on risk of type 2 diabetes in Greenlanders. The aim of the current study was to identify additional genetic variation underlying type 2 diabetes using a recessive genetic model, thereby increasing the power to detect variants with recessive effects. We investigated three cohorts of Greenlanders (B99, nโ€‰=โ€‰1401; IHIT, nโ€‰=โ€‰3115; and BBH, nโ€‰=โ€‰547), which were genotyped using Illumina MetaboChip. Of the 4674 genotyped individuals passing quality control, 4648 had phenotype data available, and type 2 diabetes association analyses were performed for 317 individuals with type 2 diabetes and 2631 participants with normal glucose tolerance. Statistical association analyses were performed using a linear mixed model. Using a recessive genetic model, we identified two novel loci associated with type 2 diabetes in Greenlanders, namely rs870992 in ITGA1 on chromosome 5 (OR 2.79, pโ€‰=โ€‰1.8โ€‰ร—โ€‰10โˆ’8), and rs16993330 upstream of LARGE1 on chromosome 22 (OR 3.52, pโ€‰=โ€‰1.3โ€‰ร—โ€‰10โˆ’7). The LARGE1 variant did not reach the conventional threshold for genome-wide significance (pโ€‰&lt;โ€‰5โ€‰ร—โ€‰10โˆ’8) but did withstand a study-wide Bonferroni-corrected significance threshold. Both variants were common in Greenlanders, with minor allele frequencies of 23% and 16%, respectively, and were estimated to have large recessive effects on risk of type 2 diabetes in Greenlanders, compared with additively inherited variants previously observed in European populations. We demonstrate the value of using a recessive genetic model in a historically small and isolated population to identify genetic risk variants. Our findings give new insights into the genetic architecture of type 2 diabetes, and further support the existence of high-effect genetic risk factors of potential clinical relevance, particularly in isolated populations. The Greenlandic MetaboChip-genotype data are available at European Genome-Phenome Archive (EGA; https://ega-archive.org/ ) under the accession EGAS00001002641.
         datePublished:2018-06-20T00:00:00Z
         dateModified:2018-06-20T00:00:00Z
         pageStart:2005
         pageEnd:2015
         sameAs:https://doi.org/10.1007/s00125-018-4659-2
         keywords:
            Genetic association
            Genome-wide association study
            Greenlanders
            Inuit
             ITGA1
             LARGE1
            Recessive genetic model
            Type 2 diabetes
            Internal Medicine
            Metabolic Diseases
            Human Physiology
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            name:Diabetologia
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               1432-0428
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            name:Springer Berlin Heidelberg
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         author:
               name:Niels Grarup
               url:http://orcid.org/0000-0001-5526-1070
               affiliation:
                     name:University of Copenhagen
                     address:
                        name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                        type:PostalAddress
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               name:Ida Moltke
               affiliation:
                     name:University of Copenhagen
                     address:
                        name:The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Mette K. Andersen
               affiliation:
                     name:University of Copenhagen
                     address:
                        name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                        type:PostalAddress
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               type:Person
               name:Peter Bjerregaard
               affiliation:
                     name:University of Southern Denmark
                     address:
                        name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
                        type:PostalAddress
                     type:Organization
                     name:University of Greenland
                     address:
                        name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Christina V. L. Larsen
               affiliation:
                     name:University of Southern Denmark
                     address:
                        name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
                        type:PostalAddress
                     type:Organization
                     name:University of Greenland
                     address:
                        name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
                        type:PostalAddress
                     type:Organization
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               name:Inger K. Dahl-Petersen
               affiliation:
                     name:University of Southern Denmark
                     address:
                        name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Emil Jรธrsboe
               affiliation:
                     name:University of Copenhagen
                     address:
                        name:The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Hemant K. Tiwari
               affiliation:
                     name:University of Alabama at Birmingham
                     address:
                        name:Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, USA
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Scarlett E. Hopkins
               affiliation:
                     name:University of Alaska Fairbanks
                     address:
                        name:Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, USA
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Howard W. Wiener
               affiliation:
                     name:University of Alabama at Birmingham
                     address:
                        name:Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, USA
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Bert B. Boyer
               affiliation:
                     name:University of Alaska Fairbanks
                     address:
                        name:Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, USA
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Allan Linneberg
               affiliation:
                     name:Bispebjerg and Frederiksberg Hospital, The Capital Region
                     address:
                        name:Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
                        type:PostalAddress
                     type:Organization
                     name:University of Copenhagen
                     address:
                        name:Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Oluf Pedersen
               affiliation:
                     name:University of Copenhagen
                     address:
                        name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Marit E. Jรธrgensen
               affiliation:
                     name:University of Southern Denmark
                     address:
                        name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
                        type:PostalAddress
                     type:Organization
                     name:University of Greenland
                     address:
                        name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
                        type:PostalAddress
                     type:Organization
                     name:Steno Diabetes Center Copenhagen
                     address:
                        name:Steno Diabetes Center Copenhagen, Gentofte, Denmark
                        type:PostalAddress
                     type:Organization
               type:Person
               name:Anders Albrechtsen
               affiliation:
                     name:University of Copenhagen
                     address:
                        name:The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
                        type:PostalAddress
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               email:[email protected]
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               name:Torben Hansen
               affiliation:
                     name:University of Copenhagen
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                        name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                        type:PostalAddress
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                     name:University of Southern Denmark
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                        name:Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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ScholarlyArticle:
      headline:Identification of novel high-impact recessively inherited type 2 diabetes risk variants in the Greenlandic population
      description:In a recent study using a standard additive genetic model, we identified a TBC1D4 loss-of-function variant with a large recessive impact on risk of type 2 diabetes in Greenlanders. The aim of the current study was to identify additional genetic variation underlying type 2 diabetes using a recessive genetic model, thereby increasing the power to detect variants with recessive effects. We investigated three cohorts of Greenlanders (B99, nโ€‰=โ€‰1401; IHIT, nโ€‰=โ€‰3115; and BBH, nโ€‰=โ€‰547), which were genotyped using Illumina MetaboChip. Of the 4674 genotyped individuals passing quality control, 4648 had phenotype data available, and type 2 diabetes association analyses were performed for 317 individuals with type 2 diabetes and 2631 participants with normal glucose tolerance. Statistical association analyses were performed using a linear mixed model. Using a recessive genetic model, we identified two novel loci associated with type 2 diabetes in Greenlanders, namely rs870992 in ITGA1 on chromosome 5 (OR 2.79, pโ€‰=โ€‰1.8โ€‰ร—โ€‰10โˆ’8), and rs16993330 upstream of LARGE1 on chromosome 22 (OR 3.52, pโ€‰=โ€‰1.3โ€‰ร—โ€‰10โˆ’7). The LARGE1 variant did not reach the conventional threshold for genome-wide significance (pโ€‰&lt;โ€‰5โ€‰ร—โ€‰10โˆ’8) but did withstand a study-wide Bonferroni-corrected significance threshold. Both variants were common in Greenlanders, with minor allele frequencies of 23% and 16%, respectively, and were estimated to have large recessive effects on risk of type 2 diabetes in Greenlanders, compared with additively inherited variants previously observed in European populations. We demonstrate the value of using a recessive genetic model in a historically small and isolated population to identify genetic risk variants. Our findings give new insights into the genetic architecture of type 2 diabetes, and further support the existence of high-effect genetic risk factors of potential clinical relevance, particularly in isolated populations. The Greenlandic MetaboChip-genotype data are available at European Genome-Phenome Archive (EGA; https://ega-archive.org/ ) under the accession EGAS00001002641.
      datePublished:2018-06-20T00:00:00Z
      dateModified:2018-06-20T00:00:00Z
      pageStart:2005
      pageEnd:2015
      sameAs:https://doi.org/10.1007/s00125-018-4659-2
      keywords:
         Genetic association
         Genome-wide association study
         Greenlanders
         Inuit
          ITGA1
          LARGE1
         Recessive genetic model
         Type 2 diabetes
         Internal Medicine
         Metabolic Diseases
         Human Physiology
      image:
         https://media.springernature.com/lw1200/springer-static/image/art%3A10.1007%2Fs00125-018-4659-2/MediaObjects/125_2018_4659_Fig1_HTML.png
         https://media.springernature.com/lw1200/springer-static/image/art%3A10.1007%2Fs00125-018-4659-2/MediaObjects/125_2018_4659_Fig2_HTML.png
      isPartOf:
         name:Diabetologia
         issn:
            1432-0428
            0012-186X
         volumeNumber:61
         type:
            Periodical
            PublicationVolume
      publisher:
         name:Springer Berlin Heidelberg
         logo:
            url:https://www.springernature.com/app-sn/public/images/logo-springernature.png
            type:ImageObject
         type:Organization
      author:
            name:Niels Grarup
            url:http://orcid.org/0000-0001-5526-1070
            affiliation:
                  name:University of Copenhagen
                  address:
                     name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Ida Moltke
            affiliation:
                  name:University of Copenhagen
                  address:
                     name:The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Mette K. Andersen
            affiliation:
                  name:University of Copenhagen
                  address:
                     name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Peter Bjerregaard
            affiliation:
                  name:University of Southern Denmark
                  address:
                     name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
                  name:University of Greenland
                  address:
                     name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Christina V. L. Larsen
            affiliation:
                  name:University of Southern Denmark
                  address:
                     name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
                  name:University of Greenland
                  address:
                     name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Inger K. Dahl-Petersen
            affiliation:
                  name:University of Southern Denmark
                  address:
                     name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Emil Jรธrsboe
            affiliation:
                  name:University of Copenhagen
                  address:
                     name:The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Hemant K. Tiwari
            affiliation:
                  name:University of Alabama at Birmingham
                  address:
                     name:Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, USA
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Scarlett E. Hopkins
            affiliation:
                  name:University of Alaska Fairbanks
                  address:
                     name:Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, USA
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Howard W. Wiener
            affiliation:
                  name:University of Alabama at Birmingham
                  address:
                     name:Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, USA
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Bert B. Boyer
            affiliation:
                  name:University of Alaska Fairbanks
                  address:
                     name:Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, USA
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Allan Linneberg
            affiliation:
                  name:Bispebjerg and Frederiksberg Hospital, The Capital Region
                  address:
                     name:Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
                  name:University of Copenhagen
                  address:
                     name:Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Oluf Pedersen
            affiliation:
                  name:University of Copenhagen
                  address:
                     name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Marit E. Jรธrgensen
            affiliation:
                  name:University of Southern Denmark
                  address:
                     name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
                  name:University of Greenland
                  address:
                     name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
                     type:PostalAddress
                  type:Organization
                  name:Steno Diabetes Center Copenhagen
                  address:
                     name:Steno Diabetes Center Copenhagen, Gentofte, Denmark
                     type:PostalAddress
                  type:Organization
            type:Person
            name:Anders Albrechtsen
            affiliation:
                  name:University of Copenhagen
                  address:
                     name:The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
            email:[email protected]
            type:Person
            name:Torben Hansen
            affiliation:
                  name:University of Copenhagen
                  address:
                     name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
                     type:PostalAddress
                  type:Organization
                  name:University of Southern Denmark
                  address:
                     name:Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
                     type:PostalAddress
                  type:Organization
            email:[email protected]
            type:Person
      isAccessibleForFree:1
["Periodical","PublicationVolume"]:
      name:Diabetologia
      issn:
         1432-0428
         0012-186X
      volumeNumber:61
Organization:
      name:Springer Berlin Heidelberg
      logo:
         url:https://www.springernature.com/app-sn/public/images/logo-springernature.png
         type:ImageObject
      name:University of Copenhagen
      address:
         name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
         type:PostalAddress
      name:University of Copenhagen
      address:
         name:The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
         type:PostalAddress
      name:University of Copenhagen
      address:
         name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
         type:PostalAddress
      name:University of Southern Denmark
      address:
         name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
         type:PostalAddress
      name:University of Greenland
      address:
         name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
         type:PostalAddress
      name:University of Southern Denmark
      address:
         name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
         type:PostalAddress
      name:University of Greenland
      address:
         name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
         type:PostalAddress
      name:University of Southern Denmark
      address:
         name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
         type:PostalAddress
      name:University of Copenhagen
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            name:University of Southern Denmark
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      name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
      name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
      name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
      name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
      name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
      name:The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
      name:Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, USA
      name:Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, USA
      name:Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, USA
      name:Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, USA
      name:Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
      name:Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
      name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
      name:National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
      name:Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
      name:Steno Diabetes Center Copenhagen, Gentofte, Denmark
      name:The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
      name:Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
      name:Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark

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