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Trial registered on ANZCTR
Registration number
ACTRN12619001773123
Ethics application status
Approved
Date submitted
7/09/2019
Date registered
13/12/2019
Date last updated
13/12/2019
Date data sharing statement initially provided
13/12/2019
Date results provided
13/12/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Energy-Enhanced Parenteral Nutrition in preterm newborns
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Scientific title
Long term effects of Energy-Enhanced Parenteral Nutrition in preterm newborns
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Secondary ID [1]
299210
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None
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Universal Trial Number (UTN)
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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:
preterm newborns
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Parenteral Nutrition
314328
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Condition category
Condition code
Diet and Nutrition
312676
312676
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0
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Other diet and nutrition disorders
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Reproductive Health and Childbirth
313897
313897
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0
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Childbirth and postnatal care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intravenous administration of parenteral nutrition given by neonatal specialist, starting from the first day of life. Adherence to the intervention was monitored by clinical observation. For newborns with a birth weight less than 1000 g in the Cohort B: Energy starting dose 45 kcal/kg/day and target dose 105 kcal/kg/day at 7 days of life; Proteins starting dose 2.0 g/kg/day and target dose 4.0 g/kg/day at 7 days of life; Dextrose starting dose 7.0 g/kg/day and target dose 14.0 at 7 days of life; Lipids starting dose 1.0 g/kg/day and target dose 3.5 at 7 days of life. For newborns with a birth weight greater than or equal to 1000 g in the Cohort B: Energy starting dose 45 kcal/kg/day and target dose 100 kcal/kg/day at 7 days of life; Proteins starting dose 2.0 g/kg/day and target dose 3.5 g/kg/day at 7 days of life; Dextrose starting dose 7.0 g/kg/day and target dose 14.5 at 7 days of life; Lipids starting dose 1.0 g/kg/day and target dose 3.0 at 7 days of life.
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Intervention code [1]
315511
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Treatment: Other
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Comparator / control treatment
Intravenous administration of parenteral nutrition given by neonatal specialist, starting from the first day of life. Adherence to the intervention was monitored by clinical observation. Data of Cohort A was collected from Policlinico Umberto I records from 1st January 2015 to 31 January 2016. For newborns with a birth weight less than 1000 g in the Cohort A: Energy starting dose 55 kcal/kg/day and target dose 120 kcal/kg/day at 7 days of life; Proteins starting dose 2.0 g/kg/day and target dose 4.0 g/kg/day at 7 days of life; Dextrose starting dose 7.0 g/kg/day and target dose 16.0 at 7 days of life; Lipids starting dose 2.0 g/kg/day and target dose 4.0 at 7 days of life. For newborns with a birth weight greater than or equal to 1000 g in the Cohort A: Energy starting dose 60 kcal/kg/day and target dose 110 kcal/kg/day at 7 days of life; Proteins starting dose 2.0 g/kg/day and target dose 3.5 g/kg/day at 7 days of life; Dextrose starting dose 8.5 g/kg/day and target dose 15 at 7 days of life; Lipids starting dose 2.0 g/kg/day and target dose 3.5 at 7 days of life.
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Control group
Historical
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Outcomes
Primary outcome [1]
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Body weight measured by digital scale
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Assessment method [1]
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Timepoint [1]
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At 24 months of life.
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Primary outcome [2]
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Head circumference measured by tape measurement
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Assessment method [2]
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Timepoint [2]
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At 24 months of life.
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Primary outcome [3]
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Length measured from the top of the head to the sole of the feet, using a neonatal stadiometer,
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Assessment method [3]
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Timepoint [3]
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At 24 months of life.
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Secondary outcome [1]
374679
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The rate of patients with Extrauterine growth retardation (EUGR), defined as a reduction in percentiles >2.0 SD in body weight (measured by digital scale). between birth and 36 weeks of postmestrual age (PMA), according with INeS charts (http://inescharts.com).
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Assessment method [1]
374679
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Timepoint [1]
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At 36 weeks of PMA
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Eligibility
Key inclusion criteria
Newborns with gestational age <32 weeks or with birth weight <1500 g,
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Minimum age
0
Days
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Maximum age
2
Years
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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
Infants with major congenital malformations, inborn errors of metabolism, congenital infections, hospital discharge or death within 72 hours of life.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
This study compared two Cohorts of newborns, consecutively observed during two different periods in NICU of Policlinico Umberto I, receiving different energy intakes through PN in the first weeks of life. Cohort A included newborns observed from the 1st of January 2015 to 31 January 2016 (historical control), and Cohort B included newborns observed from the 1st of February 2016 to 31 March 2017 (intervention). We provided a clinical follow-up to evaluate growth until 24 months of adjusted age for both Cohorts of the study.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Statistical analysis performed using Statistical Package for Social Science software for Microsoft Windows (SPSS Inc, Chicago, IL), version 22.0. Check for normality using Shapiro-Wilk test. The mean and standard deviation or median and interquartile range summarised continuous variables. Cohorts compared using chi-square test for categorical variable and t-test or Mann-Whitney for paired and unpaired variables. Multivariate analysis using binary logistic regression analysis to evaluate whether GA, sex, pH of cord blood at birth or PN protocol, influenced growth at 36 weeks PMA and at 24 months of life. The level of significance for all statistical tests: 2-sides (p<0.05).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/01/2015
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Date of last participant enrolment
Anticipated
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Actual
31/03/2017
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Date of last data collection
Anticipated
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Actual
3/06/2019
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Sample size
Target
120
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Accrual to date
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Final
130
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Recruitment outside Australia
Country [1]
21844
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Italy
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State/province [1]
21844
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Rome
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Department of Maternal and Child Health Policlinico Umberto I, University La Sapienza, Rome, Italy
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Address [1]
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Viale del Policlinico, 155 , 00161 Roma RM
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Country [1]
303755
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Italy
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Primary sponsor type
University
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Name
Department of Maternal and Child Health Policlinico Umberto I, University La Sapienza, Rome, Italy
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Address
Viale del Policlinico, 155 , 00161 Roma RM
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Country
Italy
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Secondary sponsor category [1]
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None
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Name [1]
303873
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none
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Address [1]
303873
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Country [1]
303873
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
304276
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Policlinico Umberto I
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Ethics committee address [1]
304276
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Viale del Policlinico, 155, 00161 Roma RM
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Ethics committee country [1]
304276
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Italy
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Date submitted for ethics approval [1]
304276
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01/09/2018
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Approval date [1]
304276
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13/09/2018
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Ethics approval number [1]
304276
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5089
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Summary
Brief summary
To assess the best energy intake for very low birth weight newborns, considering both possible benefits for growth and risk of metabolic complications, we designed a prospective study, comparing Cohort of newborns, which received Energy-Enhanced (Cohort A) vs. Standard (Cohort B) Parenteral Nutrition. The main outcome measure was the growth until 24 months of life. Extra-uterine growth retardation, complications associated with PN, survival, length of the hospital stay and morbidity at time point of 36 weeks of Post Menstrual Age were also measured.
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Trial website
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Trial related presentations / publications
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Public notes
Since the 1st of January 2015, we prospectively collected, in a specific database, data regarding metabolic complications, nutritional intakes, morbidity, survival during hospitalization and growth until 24 months of life of all VLBW newborns consecutively observed in the NICU of Policlinico Umberto I. According with our policy, we collected and recorded only data of newborns for which parents gave informed signed consent. From the 1st of January 2015 to 31 January 2016, we used an aggressive PN protocol. Starting from the 1st of February 2016, we adopted a new PN protocol, consisting in a reduced energy intake. To verify the effects of the change of nutritional policy on the children growth at 24 months of life, we designed a study protocol that was submitted to Ethical Committee. We obtained ethics approval in 13/09/2018. Thus, in the first Cohort of the study we included newborns observed in the NICU from the 1st of January 2015 to 31 January 2016, and followed in paediatric office of NICU of Policlinico Umberto I for growth assessment until 31 January 2018 (i.e. historical Cohort). In the second Cohort of the study, we included newborns admitted in the NICU from the 1st of February 2016 to 31 March 2017. On the 3rd June of 2019 we completed the follow-up of the last infant enrolled in the second Cohort of the study (namely “interventional Cohort”). Finally, we concluded the study and we analysed data prospectively collected in our database.
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Contacts
Principal investigator
Name
96366
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Prof Gianluca Terrin
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Address
96366
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Department of Maternal and Child Health Policlinico Umberto I, University La Sapienza, Rome, Italy, Viale del Policlinico 155, 00161 Roma RM
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Country
96366
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Italy
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Phone
96366
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+39 0649972536
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Fax
96366
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Email
96366
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[email protected]
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Contact person for public queries
Name
96367
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Gianluca Terrin
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Address
96367
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Department of Maternal and Child Health Policlinico Umberto I, University La Sapienza, Rome, Italy, Viale del Policlinico 155, 00161 Roma RM
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Country
96367
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Italy
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Phone
96367
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+39 0649972536
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Fax
96367
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Email
96367
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[email protected]
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Contact person for scientific queries
Name
96368
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Gianluca Terrin
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Address
96368
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Department of Maternal and Child Health Policlinico Umberto I, University La Sapienza, Rome, Italy, Viale del Policlinico 155, 00161 Roma RM
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Country
96368
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Italy
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Phone
96368
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+39 0649972536
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Fax
96368
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Email
96368
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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)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
4626
Study protocol
[email protected]
378327-(Uploaded-07-09-2019-21-40-04)-Study-related document.pdf
4627
Informed consent form
[email protected]
378327-(Uploaded-07-09-2019-21-38-30)-Study-related document.pdf
4628
Statistical analysis plan
[email protected]
378327-(Uploaded-07-09-2019-21-52-45)-Study-related document.pdf
4633
Ethical approval
[email protected]
378327-(Uploaded-07-09-2019-21-36-30)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Long-term effects on growth of an energy-enhanced parenteral nutrition in preterm newborn: A quasi-experimental study.
2020
https://dx.doi.org/10.1371/journal.pone.0235540
N.B. These documents automatically identified may not have been verified by the study sponsor.
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