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Trial registered on ANZCTR
Registration number
ACTRN12610001094066
Ethics application status
Approved
Date submitted
14/12/2010
Date registered
14/12/2010
Date last updated
14/12/2010
Type of registration
Retrospectively registered
Titles & IDs
Public title
Assessing the feasiblity of the use of ultrasound-guided spermatic cord block in patients undergoing vasectomy reversal in a prospective interventional study with a historical comparison group
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Scientific title
Assessing the feasibility of ultrasound-guided spermatic cord block in patients undergoing vasectomy reversal in a prospective interventional study with a historical comparison group.
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Secondary ID [1]
253291
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nil
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Universal Trial Number (UTN)
nil
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Trial acronym
nil
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Vasectomy reversal
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Anesthesia
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Condition category
Condition code
Surgery
258964
258964
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0
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Surgical techniques
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Anaesthesiology
258966
258966
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0
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Other anaesthesiology
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients scheduled for vasectomy reversal are prospectively included into the study. Vasectomy reversal is done in regional anesthesia with an ultrasound-guided spermatic cord block instead of general or neuraxial anesthesia. The ultrasound-guidance is done under sterile conditions 15 minutes before surgery on each side at the inguinoscrotal level by injection of 5ml short- and 5ml long-acting local anesthesia. Before, during and after the operation pain-level by visual-analogue-scale (VAS) and general anesthesiological values are monitored on a regular base. Postoperatively, monitoring of first request of an analgetic treatment, first alimentation, first mobilization and discharge is noted until discharge of the patient, which usually takes place within 24 hours. Analysis of complications until 7 days postoperatively. End of monitoring 7 days postoperatively.
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Intervention code [1]
257742
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Treatment: Surgery
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
A consecutive historical comparison group of the same number of patients having had vasectomy reversal in general or neuraxial anesthesia is analyzed and compared in terms of postoperative analgetic treatment, first alimentation and mobilization, discharge and complications.
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Control group
Historical
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Outcomes
Primary outcome [1]
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Success rate of the spermatic cord block, which was defined as surgery with no or light pains VAS <= 3 (0 no pain up to 10 worst imaginable pain) without any substitution of opioids, additional local anesthetics, or conversion to general or neuraxial anesthesia.
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Assessment method [1]
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Timepoint [1]
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Pains and eventual substitution of opioids, additional local anesthetics or conversion to general or neuraxial anesthesia are assessed before the injection of the block (15 min before surgery) for baseline, during the injection of the block (15 min before surgery), at the beginning of surgery, during surgery every 30 min, and at the end of surgery.
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Secondary outcome [1]
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Intraoperative microsurgical conditions evaluated by the surgeon according to a scale-system.
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Assessment method [1]
268626
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Timepoint [1]
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During the microsurgical part of surgery, which takes place 15 min after start of surgery. Reevaluation until the end of surgery, if conditions change.
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Secondary outcome [2]
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Pains assessed by the VAS.
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Assessment method [2]
268627
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Timepoint [2]
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5 minutes before block (baseline), during the injection of the block, 15 minutes after the begin of surgery, then every 30 minutes until the end of surgery.
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Secondary outcome [3]
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Number of inadvertent vascular punctures during ultrasound-guided spermatic cord block. This outcome is assessed visually by ultrasound during the ultrasound-guided spermatic cord block. Assessed are intracordal bleedings and hematomas.
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Assessment method [3]
268628
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Timepoint [3]
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During injection of the block.
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Secondary outcome [4]
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Number of intraoperative spermatic cord haematoma, assessed by visual control of the spermatic cord at the level of injection by the surgeon.
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Assessment method [4]
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Timepoint [4]
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Before the end of surgery on each side.
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Secondary outcome [5]
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Number of patients reporting postoperative nausea and vomiting (PONV) and urinary retentions. PONV is assessed using reports of the postoperative care unit. Urinary retention is assessed using questioning of patient by the surgeon and ultrasound of residual urine, if postoperative bladder voiding has not taken place until 6 hours postoperatively and a feeling of a full bladder exists.
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Assessment method [5]
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Timepoint [5]
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During the first 24 hours after surgery.
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Secondary outcome [6]
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Time between end of surgery and first mobilization (assessed by postoperative care unit, when patient calls for immediately postoperatively offered first mobilization), first alimentation (assessed by postoperative care unit, when patient calls for immediately postoperatively offered first alimentation), and demission (time noted in files).
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Assessment method [6]
268631
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Timepoint [6]
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Assessed regularely (on call) as soon as requested until discharge from hospital.
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Secondary outcome [7]
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Duration of the block, which was defined as time between injection of the block and first request of postoperative analgesic by the patient.
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Assessment method [7]
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Timepoint [7]
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Assessed regularely (on call) as soon as requested because of discomfort in the operated area until discharge from hospital.
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Secondary outcome [8]
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Overall patient satisfaction with the spermatic cord block as the method of anesthesia.
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Assessment method [8]
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Timepoint [8]
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Assessed by telephone interview 7 days after surgery, pointed out as follows: 1 = very satisfactory, 2 = satisfactory, 3 = indifferent, 4 = unsatisfactory, 5 = very unsatisfactory.
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Eligibility
Key inclusion criteria
Males after vasectomy scheduled for vasectomy reversal surgery.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
Refusal of regional anesthesia.
Adiposity with a body-mass-index over 40.
Known bleeding disorders.
Blood coagulation abnormalities as International Normalized Ratio (INR) >1.5 or platelet count <100`000/µl
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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)
Inclusion of a consecutive series into a prospective trial.
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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
Single group
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Other design features
Historical comparison group.
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/01/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
3087
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Switzerland
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State/province [1]
3087
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Funding & Sponsors
Funding source category [1]
258207
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Hospital
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Name [1]
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Department of Urology, Inselspital Bern
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Address [1]
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Anna Seiler-Haus
Inselspital
CH-3010 Bern
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Country [1]
258207
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Switzerland
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Funding source category [2]
258208
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Hospital
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Name [2]
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Department of Anaesthesia and Pain Therapy, Inselspital Bern
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Address [2]
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BHH F-230
Inselspital
CH-3010 Bern
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Country [2]
258208
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Switzerland
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Primary sponsor type
Hospital
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Name
Department of Urology, Inselspital Bern
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Address
Anna Seiler-Haus
Inselspital
CH-3010 Bern
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Country
Switzerland
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Secondary sponsor category [1]
257379
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None
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Name [1]
257379
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Address [1]
257379
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Country [1]
257379
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Kantonale Ethikkommission Bern (KEK)
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Ethics committee address [1]
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Postfach 56 CH-3010 Bern
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Ethics committee country [1]
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Switzerland
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Date submitted for ethics approval [1]
260191
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Approval date [1]
260191
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10/11/2008
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Ethics approval number [1]
260191
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Summary
Brief summary
Between 5 and 8% of men having had a vasectomy wish a vasectomy reversal. Vasectomy reversal, also called vaso-vasostomy or vaso-epididymostomy, depending on the technique, is used to be in general or neuraxial anesthesia. Performing ultrasound-guided spermatic cord block avoids the potential risks of first general and neuraxial anesthesia and second vascular damage by the injection of the block. Moreover, it provides long-lasting postoperative analgesia. The aim of this study was to evaluate the feasibility of the ultrasound-guided spermatic cord block in patients scheduled for vasectomy reversal and to compare the results with a corresponding retrospective series in general or neuraxial anesthesia.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Frederic Birkhaeuser
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Address
15260
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Department of Urology
Inselspital
Anna Seiler-Haus
CH-3010 Bern
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Country
15260
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Switzerland
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Phone
15260
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+41 31 632 36 41
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Fax
15260
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Email
15260
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[email protected]
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Contact person for scientific queries
Name
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Frederic Birkhaeuser
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Address
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Department of Urology
Inselspital
Anna Seiler-Haus
CH-3010 Bern
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Country
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Switzerland
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Phone
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+41 31 632 36 41
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
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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