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Trial registered on ANZCTR
Registration number
ACTRN12619000505101
Ethics application status
Approved
Date submitted
11/03/2019
Date registered
28/03/2019
Date last updated
16/04/2021
Date data sharing statement initially provided
28/03/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Antibiotics in sinus surgery
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Scientific title
A pilot study of post-operative antibiotics in patients undergoing Endoscopic Sinus Surgery in the treatment of Chronic Rhinosinusitis and their effect on sino-nasal outcomes
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Secondary ID [1]
297686
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None
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Universal Trial Number (UTN)
U1111-1229-8735
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic rhinosinusitis
311968
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Condition category
Condition code
Surgery
310542
310542
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0
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Other surgery
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Respiratory
310651
310651
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Doxycycline 100mg tablets by mouth twice daily for 4 weeks, commencing on the morning after surgery. Patients will be asked to return any unused tablets to monitor adherence.
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Intervention code [1]
313918
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Treatment: Drugs
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Comparator / control treatment
Microcellulose placebo tablet by mouth twice daily for 4 weeks starting on the morning after surgery
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Control group
Placebo
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Outcomes
Primary outcome [1]
319405
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Proportional change in 22-item Sino Nasal Outcome Tool (SNOT-22) compared with pre-operative SNOT-22 score
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Assessment method [1]
319405
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Timepoint [1]
319405
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3 months after surgery
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Secondary outcome [1]
368033
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Modified Lund Mckay Postoperative Endoscopy Score (MLMES) Reference: Snidvongs et al. Rhinology. 2013
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Assessment method [1]
368033
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Timepoint [1]
368033
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3 months after surgery
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Secondary outcome [2]
368034
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Proportional change in 22-item Sino Nasal Outcome Tool (SNOT-22) compared with pre-operative SNOT-22 score
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Assessment method [2]
368034
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Timepoint [2]
368034
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12 months after surgery
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Secondary outcome [3]
368035
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Change in sinus mucus microbial ecology assessing the resident microflora of sinus tissue and sinus mucus using PCR to amplify microbial DNA
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Assessment method [3]
368035
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Timepoint [3]
368035
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2 weeks after surgery
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Secondary outcome [4]
368036
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Change in sinus mucus microbial ecology assessing the resident microflora of sinus tissue and sinus mucus using PCR to amplify microbial DNA
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Assessment method [4]
368036
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Timepoint [4]
368036
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3 months after surgery
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Secondary outcome [5]
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Patient reported adverse events including but not limited to rash, diarrhoea, vomiting, abdominal pain
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Assessment method [5]
368037
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Timepoint [5]
368037
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Entire time course over which study drug and placebo are administered
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Eligibility
Key inclusion criteria
Patient undergoing Bilateral Comprehensive Endoscopic Sinus Surgery for the treatment of chronic rhinosinusitis as defined by the European Position Statement, 2012.
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Prior sinus surgery
Predisposing condition (e.g. Aspirin exacerbated respiratory disease, Granulomatosis with Polyangitis, Cystic fibrosis)
Antibiotic usage in the 12 weeks prior to recruitment
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
This is intended as a pilot study with a view to future power analysis and a larger, definitive study
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/05/2019
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Actual
21/11/2019
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Date of last participant enrolment
Anticipated
31/12/2019
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Actual
1/10/2020
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Date of last data collection
Anticipated
31/12/2020
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Actual
23/12/2020
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Sample size
Target
12
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Accrual to date
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Final
12
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Recruitment outside Australia
Country [1]
21339
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New Zealand
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State/province [1]
21339
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Waikato
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Funding & Sponsors
Funding source category [1]
302212
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Charities/Societies/Foundations
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Name [1]
302212
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Waikato Medical Research Foundation
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Address [1]
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Mail:
Waikato Medical Research Foundation
Peter Rothwell Academic Centre
Waikato Hospital
Pembroke Street
Private Bag 3200
Waikato Mail Centre
Hamilton 3240
Email:
[email protected]
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Country [1]
302212
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New Zealand
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Primary sponsor type
Individual
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Name
Dr. Andrew James Wood
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Address
Department of Surgery
Waikato Clinical School
Waikato Hospital
Pembroke Street
Hamilton 3204
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Country
New Zealand
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Secondary sponsor category [1]
302061
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None
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Name [1]
302061
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Address [1]
302061
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Country [1]
302061
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Other collaborator category [1]
280600
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Individual
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Name [1]
280600
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Dr. Charles Lee
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Address [1]
280600
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University of Waikato
Te Whare Wananga o Waikato
Gate 1, Knighton Road
Hamilton 3240
Private Bag 3105
Hamilton 3240
New Zealand
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Country [1]
280600
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302891
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HDEC
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Ethics committee address [1]
302891
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Email: hdecs@moh.govt.nz Postal address: Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140 Street address: 133 Molesworth Street Thorndon Wellington 6011
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Ethics committee country [1]
302891
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New Zealand
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Date submitted for ethics approval [1]
302891
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29/03/2019
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Approval date [1]
302891
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01/10/2019
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Ethics approval number [1]
302891
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19/NTA/64/AM01
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Summary
Brief summary
Chronic rhinosinusitis (CRS) produces an enormous health burden being common, morbid and expensive. It is characterised by chronic (i.e. more than 12 weeks of) sinus and nasal inflammation causing nasal obstruction and discharge as well as facial pain / pressure and smell disruption with consequent implications for both sleep and daytime productivity. A large European study reported a prevalence of CRS of 10.9% The pathophysiology of CRS is a matter of significant debate and ongoing research. The Principle Investigator has previously completed a Doctoral Thesis on this topic titled “Characterising host microbe interactions in chronic rhinosinusitis”. Despite ongoing study, the role of bacteria in the disease process remains poorly understood. Observations such as that the presence of Staphylococcus aureus in the sinuses at the time of surgery is associated with worse outcomes have continued to promote hypotheses regarding pathophysiology that incorporate bacteria. In patients with CRS, medical treatment with saline lavage and topical and systemic corticosteroids is typically recommended. In those individuals who do not respond well to these treatments, Endoscopic Sinus Surgery (ESS) is commonly offered. ESS is now one of the most commonly performed elective surgical procedures in the Western world. The evidence to support the use of antibiotics both in the treatment of CRS and after ESS for CRS remains limited. A 2018 review of evidence-based peri-operative antibiotic use in Ear Nose and Throat Surgery documented a paucity of data in this area but concluded that "current evidence does not support the routine use of prophylactic antibiotics for endoscopic sinus surgery." The overwhelming majority of Ear Nose and Throat Surgeons when surveyed however reported that they routinely prescribe antibiotics after ESS. Antibiotic resistance has been described by the World Health Organisation (WHO) as “one of the biggest threats to global health” and is accelerated by misuse of antibiotics. Data to rationalise or discourage the use of antibiotics are therefore urgently required.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Andrew James Wood
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Address
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Department of Surgery
Waikato Clinical School
Waikato Hospital
Pembroke Street
Hamilton 3204
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Country
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New Zealand
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Phone
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+64 7 8398750
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Fax
91754
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Email
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[email protected]
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Contact person for public queries
Name
91755
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Andrew James Wood
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Address
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Department of Surgery
Waikato Clinical School
Waikato Hospital
Pembroke Street
Hamilton 3204
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Country
91755
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New Zealand
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Phone
91755
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+64 7 8398750
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Fax
91755
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Email
91755
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[email protected]
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Contact person for scientific queries
Name
91756
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Andrew James Wood
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Address
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Department of Surgery
Waikato Clinical School
Waikato Hospital
Pembroke Street
Hamilton 3204
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Country
91756
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New Zealand
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Phone
91756
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+64 7 8398750
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Fax
91756
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Email
91756
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
De-identified demographics, pre-operative clinical parameters, outcome measures and adverse events
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When will data be available (start and end dates)?
After completion of the study the intention is to publish the data in the International Scientific literature and present our findings at International Scientific meetings
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Available to whom?
Anyone that accesses the published manuscript
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Available for what types of analyses?
Any
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How or where can data be obtained?
Publication in Scientific literature
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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