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Trial registered on ANZCTR
Registration number
ACTRN12620000477921
Ethics application status
Approved
Date submitted
2/04/2020
Date registered
16/04/2020
Date last updated
8/09/2020
Date data sharing statement initially provided
16/04/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
The design of an updated iron lung ventilator which can be easily built and used by people with minimal training in situations such as COVID-19 where skilled doctors or normal ventilators are unavailable.
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Scientific title
The use of a simplified negative pressure cuirass style ventilator under COVID-19 pandemic conditions in support of critically overwhelmed healthcare systems
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Secondary ID [1]
300932
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Nil Known
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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:
Ventilation
316913
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COVID-19
316914
0
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Coronavirus
316915
0
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Acute Respiratory Distress Syndrome
316916
0
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Condition category
Condition code
Respiratory
315088
315088
0
0
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Other respiratory disorders / diseases
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Emergency medicine
315089
315089
0
0
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Resuscitation
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Anaesthesiology
315090
315090
0
0
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Other anaesthesiology
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Infection
315246
315246
0
0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study is an unblinded trial of a cuirass based negative pressure ventilator.
The device consists of a plastic casing (cuirass) placed over the thorax with negative pressure of -200cmH2O applied by a household vacuum cleaner.The negative pressure in the cuirass facilitates inspiration. The device cycles back to atmospheric pressure allowing expiration.
Following confirmation of fit by the research team, application of ANZCA standard monitoring (Australian and New Zealand College of Anaesthetists, 2017) and trial of the device in an awake volunteer, the study will use sedation to simulate an unwell patient.
Baseline data before intervention will include AVPU level of consciousness, HR, SpO2 and Vt on room air, then HR and SpO2 on 4L/min via Hudson mask.
The patient will be ventilated using the device with supplemental oxygen via Hudson face mask at 4L/min for one hour. Tidal volumes will be recorded every 15 minutes. The Hudson mask will be removed and a face mask connected to a GE Anaesthetic Machine running FiO2 at 30%, 4L/min will be used to record Vt for 3 consecutive breaths.
Sedation will be provided by an accredited Consultant Anaesthetist and targeted to maintain an AVPU score of ‘V’, that is, rousable to command. The level of sedation will be targeted to not require direct airway intervention. Sedation will be provided using propofol and Total Intravenous Anaesthesia (TIVA) using the Marsh algorithm. An initial bolus of Lignocaine will be included with the propofol to minimise patient discomfort as per accepted practice.
An anaesthetic record will be maintained as per ANZCA Guidelines (Australian and New Zealand College of Anaesthetists, 2019).
The trial will be conducted in an operating theatre environment with full resuscitation capabilities including trained assistance and support staff.
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Intervention code [1]
317248
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Treatment: Devices
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Comparator / control treatment
Comparison made to baseline observations in the same volunteer.
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Control group
Active
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Outcomes
Primary outcome [1]
323385
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Recorded tidal volumes whilst continuously using the pandemic cuirass ventilator for 60 minutes. Tidal volumes will be recorded using a face mask connected to an existing GE Anaesthetic Machine.
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Assessment method [1]
323385
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Timepoint [1]
323385
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Tidal volumes will be assessed every 15 minutes. Total sedation time will be 60 minutes.
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Secondary outcome [1]
381752
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Number of times device requires external intervention to maintain fit will be assessed by direct observation of the research team.
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Assessment method [1]
381752
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Timepoint [1]
381752
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The ventilator will be assessed from initial fit through to the end of the sedation period.
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Eligibility
Key inclusion criteria
1 healthy volunteer, of average age and size.
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Minimum age
35
Years
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Maximum age
45
Years
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Sex
Males
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Pre-exisiting medical illness. History of adverse reaction to anaesthetic agent.
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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
Comparison of tidal volumes during intervention will be compared to baseline measures.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Descriptive statistics will be reported comparing baseline to intervention data.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
20/04/2020
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Actual
23/04/2020
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Date of last participant enrolment
Anticipated
20/04/2020
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Actual
23/04/2020
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Date of last data collection
Anticipated
20/04/2020
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Actual
23/04/2020
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Sample size
Target
1
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Accrual to date
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Final
1
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
16341
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St John of God Hospital, Murdoch - Murdoch
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Recruitment postcode(s) [1]
29885
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6150 - Murdoch
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Funding & Sponsors
Funding source category [1]
305378
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Hospital
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Name [1]
305378
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Saint John of God Murdoch Hospital
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Address [1]
305378
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100 Murdoch Dr
Murdoch WA 6150
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Country [1]
305378
0
Australia
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Funding source category [2]
305410
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Self funded/Unfunded
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Name [2]
305410
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Dr Michael Soares
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Address [2]
305410
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Perth Anaesthetic Group
5/38 Meadowvale Ave
SOUTH PERTH WA 6151
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Country [2]
305410
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Australia
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Primary sponsor type
Individual
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Name
Dr Michael Soares
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Address
Perth Anaesthetic Group
5/38 Meadowvale Ave
SOUTH PERTH, WA
AUSTRALIA 6010
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Country
Australia
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Secondary sponsor category [1]
305756
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None
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Name [1]
305756
0
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Address [1]
305756
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Country [1]
305756
0
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Other collaborator category [1]
281262
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Individual
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Name [1]
281262
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Mr Benjamin Henry
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Address [1]
281262
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Perth Anaesthetic Group
5/38 Meadowvale Ave
SOUTH PERTH WA 6010
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Country [1]
281262
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Australia
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Other collaborator category [2]
281263
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Individual
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Name [2]
281263
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Mr Michael Pearson
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Address [2]
281263
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Perth Anaesthetic Group
5/38 Meadowvale Ave
SOUTH PERTH WA 6010
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Country [2]
281263
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Australia
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Other collaborator category [3]
281264
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Individual
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Name [3]
281264
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Mr Arthur Manowski
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Address [3]
281264
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Perth Anaesthetic Group
5/38 Meadowvale Ave
SOUTH PERTH WA 6010
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Country [3]
281264
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305709
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Saint John of God Healthcare
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Ethics committee address [1]
305709
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St John of God Health Care Human Research Ethics Committee C/o St John of God Subiaco Hospital 12 Salvado Road Subiaco Western Australia 6008
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Ethics committee country [1]
305709
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Australia
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Date submitted for ethics approval [1]
305709
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08/04/2020
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Approval date [1]
305709
0
20/04/2020
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Ethics approval number [1]
305709
0
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Summary
Brief summary
We herein propose a simple, achievable and safe method of assisting ventilation using a high throughput device, which can be operated without specific skills in ventilator management. The device is a modernised version of the Both Respirator created in 1939. A Modern commercial version has been FDA approved in the United States by Hayek Medical, but currently lacks Australian distribution. As advertised by Hayek Medical, a cuirass ventilator does not require skilled medical professionals. Our simplified device has also been designed to not require a skilled medical professional. Moreso, this device is specifically designed with simplified parts so it can be built quickly and easily in regional areas.
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Trial website
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Trial related presentations / publications
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Public notes
A lack of critical resources such as ICU beds and ventilators is thought to be a key determinant of mortality, and their allocation is requiring doctors to make decisions on patient survival based on perceived merit rather than medical grounds.in other parts of the world. Regional centres in Australia with populations > 10,000 with 2 operating theatres and at most 5 high dependency beds could potentially have close to 150 ventilation requiring patients per ventilator. This device of last resort is designed to be safely and easily built and used in areas of greatest need.
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Contacts
Principal investigator
Name
101306
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Dr Michael Soares
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Address
101306
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Perth Anaesthetic Group
5/38 Meadowvale Ave
SOUTH PERTH WA 6010
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Country
101306
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Australia
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Phone
101306
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+61893678311
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Fax
101306
0
+61893677197
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Email
101306
0
[email protected]
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Contact person for public queries
Name
101307
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Michael Soares
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Address
101307
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Perth Anaesthetic Group
5/38 Meadowvale Ave
SOUTH PERtH WA 6010
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Country
101307
0
Australia
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Phone
101307
0
+61893678311
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Fax
101307
0
+61893677197
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Email
101307
0
[email protected]
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Contact person for scientific queries
Name
101308
0
Michael Soares
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Address
101308
0
Perth Anaesthetic Group
5/38 Meadowvale Ave
SOUTH PERTH WA 6010
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Country
101308
0
Australia
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Phone
101308
0
+61893678311
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Fax
101308
0
+61893677197
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Email
101308
0
[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?
All data after de-identification
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When will data be available (start and end dates)?
Immediately following publication, no end date
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Available to whom?
Case by case basis at the discretion of the Primary Sponsor
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Available for what types of analyses?
Any purpose
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How or where can data be obtained?
Access subject to approvals by Principal Investigator,
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
7498
Ethical approval
[email protected]
7499
Informed consent form
[email protected]
7500
Study protocol
[email protected]
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.
Download to PDF