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Trial registered on ANZCTR
Registration number
ACTRN12621001572853
Ethics application status
Approved
Date submitted
11/10/2021
Date registered
18/11/2021
Date last updated
3/11/2022
Date data sharing statement initially provided
18/11/2021
Date results provided
3/11/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Needle-free Blood Glucose Sensing
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Scientific title
Needle-free Jet Injection with suction to Measure Glucose Concentration in Capillary Blood for Diabetes
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Secondary ID [1]
305403
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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:
Diabetes
323834
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Condition category
Condition code
Metabolic and Endocrine
321340
321340
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Each participant will be subjected to four capillary blood sampling interventions. These interventions will be performed on the side of the fingertip of the middle (3rd finger) and ring finger (4th finger) of either hand.
Two of the four interventions will use a lancet to prick the finger to release the capillary blood sample. This is the current gold standard recommended by the WHO. Suction will be applied to the fingertip following one of the finger pricks.
The other two interventions will use a needle-free jet injection device in place of the lancet to break the skin. This injection device will use a thin stream of fluid (<0.05 mL) to break the skin, targeting the same penetration depth as a lancet (2.3 mm). The fluid used by the injector will be isotonic saline solution marked with a very low concentration (10 mg/L) of Indocyanine Green (ICG). ICG is an FDA approved fluorescent marker typically used in the body at a concentration of 5 g/L. Suction will be applied to the fingertip following one of the finger pricks.
The study is divided into three arms that differ only in the magnitude of the suction pressure applied following two of the four interventions. All participants will receive the same 2 lancet pricks and 2 jet injections, one jet injection and one lancet prick will then be followed by the application of suction. Participants will be randomly assigned to one of the arms as follow:
Arm 1: -20 kPa pressure applied following 2/4 interventions
Arm 2: -40 kPa pressure applied following 2/4 interventions
Arm 3: -60 kPa pressure applied following 2/4 interventions
All participants will receive all four interventions, however, the order and location (which fingertip) of each intervention will be randomised. The time between each intervention will be approximately 5 minutes. The interventions will be performed by a study researcher with a nurse present. A checklist will be prepared in advance of the study that includes the randomised sequence of interventions to ensure adherence to protocol.
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Intervention code [1]
321883
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Treatment: Devices
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Comparator / control treatment
Each participant will be subjected to a lancet prick based method of capillary blood sampling. This is the current best practice recommended by the WHO. As such each participant will serve as their own control.
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Control group
Active
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Outcomes
Primary outcome [1]
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Blood Volume. Measured by area of blood in a picture taken of blood within a capillary with known internal dimensions
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Assessment method [1]
329153
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Timepoint [1]
329153
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A single measurement will be made on each of the blood samples within 2 hrs following the interventions.
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Primary outcome [2]
329154
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Dilution of blood sample.
Measured using a custom fluorimeter which indicates the concentration of indocyanine green (ICG)in the sample. As a small, known volume of ICG is present in the fluid used to break the skin this provides a measure of the amount of this fluid present in the blood sample.
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Assessment method [2]
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Timepoint [2]
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A single measurement will be made on each of the blood samples within 2 hrs following the interventions.
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Secondary outcome [1]
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Perceived pain, using visual analog scale.
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Assessment method [1]
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Timepoint [1]
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Measured immediately after each intervention.
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Secondary outcome [2]
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Blood glucose concentration. Measured using point of care glucometer (CareSens N).
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Assessment method [2]
401663
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Timepoint [2]
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A single measurement will be made on each of the blood samples within 2 hrs following the interventions.
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Secondary outcome [3]
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Perceived ongoing pain.
Measured using study specific questionnaire.
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Assessment method [3]
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Timepoint [3]
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Questionnaire will be completed 24hrs after the interventions
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Eligibility
Key inclusion criteria
Aged between 20 and 60 years old.
Able to communicate in English
Able to give full informed consent (i.e. no neurological impairment)
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Minimum age
20
Years
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Maximum age
59
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
Insulin-dependent diabetes
Haemophilia (or other bleeding/clotting disorders)
Carrier of blood-borne infectious agent (e.g. HIV, HBV)
Reduced peripheral circulation (eg. from Raynaud’s disease or beta blocker use)
Amputation affecting a number of fingertips
Allergy to iodides and/or indocyanine green
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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)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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Intervention assignment
Crossover
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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
statistical power calculations were made for group sizes of 5 participants to enable the establishment of significant differences in the mean volume released as low as 1.4 µL (s_BloodVolume= 0.7 µL, a= 0.05, ß= 0.1). Differences in mean blood dilution as low as 6 % between groups (s_fluorimeter= 3 % , a= 0.05, ß= 0.1). Differences between groups whose mean glucose concentration differs by as little as 10 % (s_glucometer= 0.28 mmol/L, a= 0.05, ß= 0.1).
Comparisons of results will be conducted using t-tests and related methods to assess differences in measured values across interventions
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/12/2021
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Actual
20/06/2022
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Date of last participant enrolment
Anticipated
21/01/2022
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Actual
23/09/2022
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Date of last data collection
Anticipated
21/01/2022
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Actual
23/09/2022
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Sample size
Target
15
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Accrual to date
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Final
16
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Recruitment outside Australia
Country [1]
24170
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New Zealand
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State/province [1]
24170
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Auckland
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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New Zealand Ministry of Business, Innovation and Employment
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Address [1]
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15 Stout Street, Wellington 6011
PO Box 1473, Wellington 6140
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Professor Andrew Taberner
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Address
Level 6,
Auckland Bioengineering House, University of Auckland
70 Symonds Street,
Auckland, 1010
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Country
New Zealand
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Secondary sponsor category [1]
310794
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University
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Name [1]
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University of Auckland
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Address [1]
310794
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Private Bag 92019
Auckland 1142
New Zealand
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Country [1]
310794
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New Zealand
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Secondary sponsor category [2]
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Individual
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Name [2]
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James Mckeage
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Address [2]
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Level 6,
Auckland Bioengineering House, University of Auckland
70 Symonds Street,
Auckland, 1010
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Country [2]
310877
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern B Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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21/10/2021
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Approval date [1]
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14/12/2021
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Ethics approval number [1]
309523
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2021 FULL 11035
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Summary
Brief summary
Type 1 and insulin dependent type 2 diabetics require injections of insulin multiple times per day to manage the glucose concentration in their blood. The appropriate dose of insulin is determined using a measurement of blood glucose concentration that typically requires the fingertip be pricked with a lancet. The drop(s) of blood resulting from this prick are used to perform the glucose measurement. In an effort to make this process easier for diabetics, we are investigating whether glucose testing can be integrated into a needle-free jet injection device, thus totally avoiding the need for a lancet to prick the skin. Performing this process without a needle/lancet will avoid the associated issues of sharps waste, accidental needle stick, and needle-phobia. Towards this goal, we recently completed a study investigating the relationship between the shape of a jet injection and the volume of blood released. This study demonstrated that enough blood was released by jet injection for a glucose test, although the jet injection released less blood than a lancet. We believe that by applying a small suction cup after jet injection, we can significantly increase the volume of blood released. By enhancing the volume of blood released in this way, we want to collect a sample with the least discomfort to the participant possible. We now wish to perform a pilot study aiming to assess the feasibility of using a jet injector assisted by suction to retrieve a capillary blood sample. Each participant in the study will receive four interventions: a lancet prick, a lancet prick with suction applied, a jet injection, and a jet injection with suction applied. Participants will be aware they are receiving one of each intervention, but will be blinded to the order and which intervention is occurring at which site.
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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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Prof Andrew Taberner
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Address
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Level 6,
Auckland Bioengineering House, University of Auckland
70 Symonds Street,
Auckland, 1010
New Zealand
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Country
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New Zealand
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Phone
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+64 9 923 5024
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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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Andrew Taberner
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Address
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Level 6,
Auckland Bioengineering House, University of Auckland
70 Symonds Street,
Auckland, 1010
New Zealand
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Country
114451
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New Zealand
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Phone
114451
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+64 9 923 5024
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Fax
114451
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Email
114451
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[email protected]
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Contact person for scientific queries
Name
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Andrew Taberner
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Address
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Level 6,
Auckland Bioengineering House, University of Auckland
70 Symonds Street,
Auckland, 1010
New Zealand
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Country
114452
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New Zealand
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Phone
114452
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+64 9 923 5024
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Fax
114452
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Email
114452
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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
Given the extent of device specific and laboratory specific measurement involved in this trial it is best only to publicly release the analysed data.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
13461
Study protocol
382848-(Uploaded-07-10-2021-11-51-24)-Study-related document.docx
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