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Trial registered on ANZCTR
Registration number
ACTRN12624000134527
Ethics application status
Approved
Date submitted
13/01/2024
Date registered
14/02/2024
Date last updated
4/08/2024
Date data sharing statement initially provided
14/02/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Eating nuts while breastfeeding – the Nuts For Babies Study.
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Scientific title
Developing infant tolerance to nuts via breastmilk: a randomised controlled trial.
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Secondary ID [1]
311318
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Nil known
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Universal Trial Number (UTN)
U1111-1302-6343
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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:
IgE-mediated peanut allergy
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IgE-mediated cashew nut allergy
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Condition category
Condition code
Inflammatory and Immune System
329267
329267
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0
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Allergies
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Maternal consumption of at least 60 peanuts and 40 cashew nuts per week from birth until 6 months post-natal. Participants will purchase their own peanuts and cashew nuts. Every 2 weeks during the intervention period, the women will be sent a mobile phone text with a link to complete a quick survey about how much peanut and cashew nut they have eaten over the past week, and whether they would like any further advice and support regarding their allocated nut diet. This will also include one question on their breastfeeding status.
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Intervention code [1]
327764
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Prevention
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Comparator / control treatment
Maternal consumption of no more than 20 peanuts and 12 cashew nuts per week from birth until 6 months post-natal. Participants will purchase their own peanuts and cashew nuts. Every 2 weeks during the intervention period, the women will be sent a mobile phone text with a link to complete a quick survey about how much peanut and cashew nut they have eaten over the past week, and whether they would like any further advice and support regarding their allocated nut diet. This will also include one question on their breastfeeding status.
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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The proportion of infants with IgE-mediated peanut and/or cashew nut allergy - this is a composite primary outcome.
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Assessment method [1]
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Positive peanut/cashew nut allergen skin prick test and positive peanut/cashew nut oral food challenge.
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Timepoint [1]
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At 12 months of age
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Secondary outcome [1]
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The proportion of infants with IgE-mediated peanut allergy
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Assessment method [1]
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Positive peanut allergen skin prick test and positive peanut oral food challenge
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Timepoint [1]
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At 12 months of age
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Secondary outcome [2]
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The proportion of infants with IgE-mediated cashew nut allergy
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Assessment method [2]
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Positive cashew nut allergen skin prick test and positive cashew nut oral food challenge
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Timepoint [2]
430638
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At 12 months of age
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Secondary outcome [3]
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The proportion of infants with allergic sensitisation to peanut
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Assessment method [3]
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Positive peanut allergen skin prick test
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Timepoint [3]
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At 12 months of age
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Secondary outcome [4]
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The proportion of infants with allergic sensitisation to cashew nut
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Assessment method [4]
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Positive cashew nut allergen skin prick test
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Timepoint [4]
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At 12 months of age
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Secondary outcome [5]
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The proportion of infants with allergic sensitisation to almond
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Assessment method [5]
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Positive almond allergen skin prick test
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Timepoint [5]
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At 12 months of age
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Secondary outcome [6]
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The proportion of infants with allergic sensitisation to hazelnut
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Assessment method [6]
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Positive hazelnut allergen skin prick test
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Timepoint [6]
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At 12 months of age
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Secondary outcome [7]
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The proportion of infants with a medical diagnosis of eczema
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Assessment method [7]
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Parent report that a medical practitioner has diagnosed infant eczema.
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Timepoint [7]
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At 3, 6, 9 and 12 months of age
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Eligibility
Key inclusion criteria
Women with a singleton pregnancy, who are planning to breastfeed, and where the infant has a high-risk of developing nut allergies due to a family history of eczema/atopic dermatitis, IgE-mediated food allergy and/or hay fever (allergic rhinitis) in at least one of the infant’s biological parents (mother and/or father) or full-sibling (child with the same biological mother and father).
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Minimum age
18
Years
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Maximum age
50
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Women with a peanut and/or cashew nut allergy, as they would be unable to safely follow the intervention without an allergic reaction. Women who have already participated in the Nuts For Babies Study with a previous child.
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Study design
Purpose of the study
Prevention
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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 using a secure web-based randomisation service. The randomisation service will allocate a unique uninformative participant trial identification number and a group assignment according to a computer-generated randomisation schedule produced by a statistician not otherwise involved in the trial.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be stratified by any parental/sibling history of eczema/atopic dermatitis or IgE-mediated food allergy, using randomly permuted blocks of varying sizes.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
8/04/2024
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Actual
22/07/2024
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Date of last participant enrolment
Anticipated
30/06/2028
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Actual
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Date of last data collection
Anticipated
30/11/2029
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Actual
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Sample size
Target
742
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Accrual to date
3
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
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Other
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Name [1]
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Telethon Kids Institute
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Address [1]
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15 Hospital Ave Nedlands Western Australia 6009
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Country [1]
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Australia
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Primary sponsor type
Other
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Name
Telethon Kids Institute
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Address
15 Hospital Ave Nedlands Western Australia 6009
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
317661
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Address [1]
317661
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Country [1]
317661
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Child and Adolescent Health Service, Western Australia
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Ethics committee address [1]
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15 Hospital Ave Nedlands Western Australia 6009
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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19/01/2024
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Approval date [1]
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22/02/2024
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Ethics approval number [1]
314468
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Summary
Brief summary
Australia has the highest prevalence of food allergy in the world, with at least one in every 32 (3.1%) infants developing peanut allergy and one in every 66 (1.5%) infants developing a cashew nut allergy, which are usually lifelong. Nut allergies place individuals and their families under enormous stress and have been shown to decrease quality of life. This trial aims to determine if the risk of developing peanut and cashew nut allergy during infancy can be reduced by a maternal diet rich in peanuts and cashew nuts during breastfeeding. A finding from our recent Western Australian pilot randomised controlled trial (ACTRN12617001465347) with 109 mother-infant pairs discovered that a maternal high-peanut diet, compared to a low-peanut diet, during the first six months of lactation may reduce the risk that her infant will develop a peanut allergy. We now propose a definitive efficacy randomised controlled trial, in order to provide high-quality evidence to inform maternal diet guidelines for peanut and cashew nut allergy prevention. If the hypothesis is correct, this will be a simple strategy to reduce nut allergies. If incorrect, this information will be paramount for informing breastfeeding women about food choices. Participating mothers will be randomly allocated into either a high-nut (minimum of 60 peanuts and 40 cashew nuts per week), or a low-nut (maximum of 20 peanuts and 12 cashew nuts per week) group, for 6 months from the birth of their baby. From six months of age after commencement of solid foods, both groups will be encouraged to include smooth peanut butter and cashew nut spread in their baby’s diet as per our current Australian infant feeding and allergy prevention guidelines. Infant peanut and cashew nut allergy outcomes will be assessed at 12 months of age. This trial has been co-designed with consumers who will continue to be involved in all stages.
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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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A/Prof Debra Palmer
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Address
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Telethon Kids Institute, 15 Hospital Ave, Nedlands WA 6009
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Country
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Australia
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Phone
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+61 410851607
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Debra Palmer
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Address
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Telethon Kids Institute, 15 Hospital Ave, Nedlands WA 6009
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Country
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Australia
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Phone
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+61 410851607
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Debra Palmer
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Address
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Telethon Kids Institute, 15 Hospital Ave, Nedlands WA 6009
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Country
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Australia
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Phone
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+61 410851607
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Fax
131688
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Email
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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?
Individual (de-identified) participant data underlying published results only.
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When will data be available (start and end dates)?
Beginning 6 months and ending 3 years following main results publication.
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Available to whom?
Case-by-case basis at the discretion of the Chief Investigator Team and Primary Sponsor.
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Available for what types of analyses?
For individual participant data meta-analyses.
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How or where can data be obtained?
Access subject to approvals from Principal Investigator Debra Palmer
(email:
[email protected]
)
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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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