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Acknowledgements
This thesis would not have been possible without the inspiration and support of a number of wonderful individuals. At the end of this fascinating and inspiring road, I want to express my gratitude to many people involved in this journey during the last years. This time of continued learning and intense research work has contributed substantially to my personal development and growth. After a lot of work and frustrations too, I am happy to acknowledge those persons that motivate, guide and inspire this journey.
Firstly, I would like to express my sincere gratitude to my promotors Prof. D. van der Heijde and Prof. R. Landewé. Dear Désirée and Robert, thank you so much for the continuous support and assistance in the elaboration of this thesis and related research, for your patience, motivation, and immense knowledge. Your advice helped me during all the time of research and writing this thesis. Your helpful comments were highly valuable to increase readability and reduce ambiguity. I appreciate your warm encouragement and thoughtful guidance. I feel privileged to have the opportunity to share with you special moments and also being part of the select group of PhD students under your mentorship. Really, I could not have imagined better advisors and mentors. I really hope it will be the beginning of many projects we will do together.
My sincere thanks also go to Dr. Rafael Valle, Dra Consuelo Romero, Dr Jhon Londoño and many others Colombian rheumatologist and health professionals, who provided me an opportunity to join their team as fellow, and who introduced me to the exciting world of research. Without their trust, continuous support and persistent motivation it would not have been possible to conduct this research. Thanks for helping me to build a clinical academic career in Colombia.
This thesis would never have been possible without the contribution of those people I have met during my stay in Leiden. It is a pleasure to thank a number of inspiring people in the LUMC. Dear Prof. Dr. T. Huizinga, thank you for your hospitality and collaboration. Dear Floris and Rosaline, it was a pleasure working with you having fantastic discussions within the “SpA team”. Dear Sofia and Manouk my paranymphs, I really appreciate your advice and guidance, especially when I had a lot of questions. Dear Victoria, I will always be thankful for hosting me and my family in Leiden. Your hospitality and advice helped us to know how daily things work in the Netherlands. All of you have made my stay in the Netherlands memorable.
Last but not least, I would like to thank my family for their continuous and unparalleled love and help. The love of my life Sonia, we have lived great moments and also difficult situations together. Our experience living abroad was fantastic and unforgettable. My deep and sincere gratitude for always being there for me and for listening to me all the time. The encouragement and support from you and our always positive and joyful children Nicolas and Valeria, is a truly and powerful source of inspiration and energy that motivates me to move forward. A special gratitude is devoted to my parents and to my brothers for their never- ending support throughout my life in general. All of you have inspired me to achieve the excellence in everything and to explore new directions in life.
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