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Trial registered on ANZCTR
Registration number
ACTRN12614000460606
Ethics application status
Approved
Date submitted
22/04/2014
Date registered
2/05/2014
Date last updated
11/11/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Green kiwifruit and Gut Health
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Scientific title
A randomised single blinded cross over trial to investigate the effect of Zespri green kiwifruit on digestive and gut health function in healthy participants and individuals with irritable bowel syndrome (constipation).
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Secondary ID [1]
284470
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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:
Constipation
291704
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Irritable bowel syndrome with constipation
291705
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Condition category
Condition code
Oral and Gastrointestinal
292082
292082
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0
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Inflammatory bowel disease
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Diet and Nutrition
292083
292083
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0
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Other diet and nutrition disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The study duration is a total of 16 weeks; 2- week lead in, 4-week intervention, 4 week washout, 4-week intervention, and final 2-week follow-up. The cross-over design will be completed using the kiwifruit intervention (2 green kiwifruit per day (Actinidia deliciosa var. Hayward), compared to a positive control intervention of psyllium (11g of psyllium per day providing 6g fibre). Compliance to the consumption of the kiwifruit will be monitored by measuring plasma vitaman C levels over the course of the study.
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Intervention code [1]
289226
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Treatment: Other
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Intervention code [2]
289227
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Lifestyle
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Comparator / control treatment
Participants will be asked to consume 11g of Psyllium daily (mucillage) as the control for this study. This treamtent phase will be four 4 weeks. The psyllium will be supplied to participants as a powder which they can either sprinkle onto food or consume with liquid.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary measurement of the trial is Complete Spontaneous Bowel Motion frequency (CSBM /week) as a measure of overall bowel function in constipation.
The number, or occurrence, of CSBM is recorded by all participants in a daily diary recording bowel habits.
A spontaneous bowel movement (SBM) is defined as a stool not induced by rescue medication, whereas a CSBM was defined as an SBM associated with a sensation of complete evacuation
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Assessment method [1]
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Timepoint [1]
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CBSM will be measured daily across the 16 week study
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Secondary outcome [1]
307920
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A range of additional measures will be made via the daily diary questionnaires. There will be a series of questions related to bowel habit and function:
1. frequency of BM
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Assessment method [1]
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Timepoint [1]
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Measured daily for the entire 16 weeks of the study.
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Secondary outcome [2]
307921
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2. ease of defaecation
Will be measured by a question in the daily diary. e.g Did you have to use any strain in order to defecate at any of the times you had a bowel movement?
This will be asked daily for the entire 16 weeks of the study
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Assessment method [2]
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Timepoint [2]
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Measured daily through daily diary over the entire 16 weeks of the study
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Secondary outcome [3]
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3. stool form (Bristol Stool Scale)
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Assessment method [3]
307922
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Timepoint [3]
307922
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measured daily through Bristol Stool Scale included in the daily diary over the entire 16 weeks of the study
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Secondary outcome [4]
307923
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4.stool volume (rated scale)
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Assessment method [4]
307923
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Timepoint [4]
307923
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Measured subjectively through daily diary over the entire 16 weeks of the study
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Secondary outcome [5]
307924
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Bowel transit time. Meaured in a sub group of main cohorts. 10 participants from each group of healthy, functionally constipated and IBS-C participants. Measured using SmartPill technology.
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Assessment method [5]
307924
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Timepoint [5]
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Measured during week two of each intervention phase (kiwifruit and pysllium treatment). Each participant measures it twice
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Eligibility
Key inclusion criteria
Healthy group: Adult (18-65 years); BMI 18-35; Generally healthy; Normal bowel habits
Functionally constipated group: 1.Adult (18-65 years); Females will be required to declare stage of menstrual cycle during the different trial phases; BMI between 18-35; Presence of functional constipation according to ROME III diagnostic criteria for functional constipation.
IBS-C group: 1.Adult (18-65 years); Females will be required to declare stage of menstrual cycle during the different trial phases; BMI between 18-35; Presence of functional constipation according to ROME III diagnostic criteria for IBSC.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Individuals with alarm features associated with bowel habit (recent changes in bowel habit (<3 months), rectal bleeding, weight loss, occult blood in stools, anaemia) , anal fissures, bleeding haemorrhoids, and family history of GI cancer or IBD.
Chronic disease (cardiovascular, cancer, renal failure, previous gastrointestinal surgery (not including appendectomy or cholecystectomy), neurological conditions (e.g. multiple sclerosis, spinal chord injury, stroke).
All patients will be screened at recruitment for fasting blood glucose. Those with results greater than 7.2 mmol/l will not be accepted into the trial.
Participants with diagnosed and stable conditions requiring the use of SSRI’s (selective serotonin reuptake inhibitors), tricyclates, opiates or anti-inflammatories will be permitted into the trial on condition the medication has been in use continually and the condition has been stable for > 3 months. Similarly those with stable and controlled diabetes (> 3 months) will be permitted to participate.
Women who are pregnant, breastfeeding or planning a pregnancy in the 3 months post selection (trial period) will be excluded.
Potential participants with known kiwifruit or latex allergy will be excluded.
Potential participants using laxatives who are not prepared to stop using the laxatives for the 2 week lead-in period will be excluded.
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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)
Subjects will be enrolled by investigators folllowing a face to face interview and given a unique identifying number for labelling all further trial data. This ID number will be provided to an independent biostatisician who will randomise the participants to the treatment schedule
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
simple randomisation by using a randomization table created by a computer software (i.e. computerised sequence generation
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Masking / blinding
Open (masking not 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
Crossover
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Other design features
N/a
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
An initial calculation has been completed using available data. Based on a previous studies the standard deviation for the primary outcome (number of CSBM per week) is 1.41. In order to detect an increase in CSBM of 1.5 per week in the treatment group compared to the control group, with 90% power and 5% significance, 16 subjects are required to complete the trial. In order to account for an expected 25% dropout, 20 subjects will be recruited for each of three subject populations, or a total of 60 subjects. Further statistical analysis will be done by an independent statisitican. Statistical analysis will describe the relationship between the consumption of kiwifruit and the parameters of bowel habit and digestive comfort measured. In addition the analysis will compare the effects of the 2 treatments (kiwifruit and psyllium), and determine the effects of these treatments in all groups (healthy, FBC and IBS-C).
P values =0.05 will be considered significant.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/05/2014
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Actual
5/05/2015
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Date of last participant enrolment
Anticipated
17/09/2015
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Actual
11/09/2015
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Date of last data collection
Anticipated
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Actual
6/01/2016
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Sample size
Target
60
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Accrual to date
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Final
58
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Recruitment outside Australia
Country [1]
6018
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New Zealand
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State/province [1]
6018
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Canterbury
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Country [2]
6024
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New Zealand
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State/province [2]
6024
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Manawatu
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Funding & Sponsors
Funding source category [1]
289119
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Commercial sector/Industry
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Name [1]
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Zespri International Ltd
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Address [1]
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40 Maunganui Road
Mt Maunganui
New Zealand 3116
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Country [1]
289119
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New Zealand
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Primary sponsor type
Commercial sector/Industry
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Name
Zespri International
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Address
40 Maunganui Road
Mt Maunganui
New Zealand 3116
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
287781
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None
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Address [1]
287781
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Country [1]
287781
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Other collaborator category [1]
277923
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Government body
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Name [1]
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New Zealand Institute for Plant & Food Research Ltd
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Address [1]
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Canterbury Agricultural and Science Centre
Gerald Street
Lincoln
Christchurch 8140
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Country [1]
277923
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290899
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Health and Disability Council
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Ethics committee address [1]
290899
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Ministry of Health No 1 The Terrace PO Box 5013 Wellington 6145
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Ethics committee country [1]
290899
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New Zealand
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Date submitted for ethics approval [1]
290899
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28/04/2014
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Approval date [1]
290899
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17/04/2015
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Ethics approval number [1]
290899
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14/CEN66
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Summary
Brief summary
Constipation is a common problem affecting up to 20% of the World’s population. Laxative treatment for this condition is not without side effects and currently, there is a need for natural and safe alternatives. The consumption of Kiwifruit is frequently used to treat constipation and digestive discomfort in New Zealand. Clinical trials in this area are limited but some have shown significant improvements in digestive health (stool frequency, reduced constipation and well being) in both healthy and constipated individuals as well as those suffering from irritable bowel syndrome. This study aims to examine the effect of daily consumption of two green kiwifruit in healthy individuals and in individuals with functional constipation and IBS as part of their everyday lifestyle to determine if the product is effective at improving bowel regularity, digestive discomfort, digestive health and function and gut health. It will compare the efficacy of kiwifruit with psyllium (mucilage), a bowel bulking agent that has been shown to be an effective treatment for constipation. The trial will be a randomized, single blinded cross over study where participants will consume either two green kiwifruit daily for four weeks or 11g psyllium powder for four weeks. There will be a four week washout period in between and then the participants will swap over treatments for a further four weeks. The trial will start and finish with a two week washout period. Participants will be asked to complete a daily study diary (either online or by hand) to record daily bowel movement and general wellbeing during the study. Faecal and blood samples will be collected at the beginning of the trial and at the end of each treatment period. Participants will also be asked to complete a questionnaire relating to bowel health at these time points.
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Trial website
N/a
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Trial related presentations / publications
N/a
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Public notes
N/a
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Contacts
Principal investigator
Name
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A/Prof Richard Gearry
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Address
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Gastroentetrology and Endoscopy Specialists
Level 1, 40 Stewart Street
Christchurch 8011
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Country
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New Zealand
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Phone
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64 3 378 6236
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Fax
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64 3 378 6299
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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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Sarah Eady
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Address
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Plant & Food Research
PO Box 4704
Christchurch 8140
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Country
47879
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New Zealand
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Phone
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64 3 3259671
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Fax
47879
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64 3 325 2074
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Email
47879
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[email protected]
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Contact person for scientific queries
Name
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Sarah Eady
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Address
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Plant & Food Research
PO Box 4704
Christchurch 8140
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Country
47880
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New Zealand
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Phone
47880
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64 3 3259671
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Fax
47880
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64 3 325 2074
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Email
47880
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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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