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efficacy of masks against COVID comes from observational studies. Due to the paucity of evidence from RCTs, some systematic reviews have included the observational studies along with the RCTs. As of August 2023, RCTs played a relatively small role in the evaluation of non-pharmaceutical interventions during the pandemic
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I think it's worded fine as it is. I'm good with the changes that were not reverted, and the status quo for the rest. If you want to propose more changes, up to you. I'm not clear on which review "made clear it wasn't rigorous"; it seems pretty unlikely that a review would negate itself like that. If
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Overall effectiveness of these interventions was affected by clinical heterogeneity and methodological limitations, such as confounding and measurement bias. It was not possible to evaluate the impact of type of face maks (eg, surgical, fabric, N95 respirators) and compliance and frequency of wearing
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However, within hospitals, severe restrictions due to SARS resulted in delays in treatments for cancer and surgeries, and the continuous, universal use of N95 respirators and other forms of personal protection was stressful for health care workers. Our experience suggests that the spread of SARS-CoV
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to exclude reviews that focus more on RCT evidence on the basis of being sympathetic to other reviews that argue that focusing on RCTs is flawed for whatever reason. As a more general comment, I don't see why compliance is necessarily fatal to RCTs. Whether people comply or not is a very important
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much discussion on a single source, doesn't that indicate it might be a little problematic to include? IMO, better to focus on one source, and mine it to make sure it stands up to scrutiny. Picking poison apples being less likely if you only pick one, even if potentially more of the apple could be
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A 2023 systematic review from the
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differing views, which is not what we are supposed to do. I'm not sure what specific changes you have in mind this time, but to be clear, consensus so far is clearly against removing the
Cochrane source or mention of RCTs, so it should not be attempted again. We can see if anyone else weighs in.
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There are two types of evidence for the efficacy of masks: observational studies, and randomised controlled trials (RCTs). While RCTs are more robust, they are too impractical for many public health interventions, yielding insufficient statistical power and validity. Most of the evidence for the
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template is not necessary and I will likely remove it soon. This isn't really a mathematics topic except in the sense that every science topic involves math to some extent. As Bon courage stated, preprints are useless (this one is over a year old but apparently never published). If the 2024 ASM
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HCWs were excluded if they (1) were unable or refused to consent; (2) had beards, long moustaches, or long facial hair stubble; (3) had a current respiratory illness, rhinitis, and/or allergy; or (4) worked part-time or did not work in the aforementioned wards or
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Cochrane review was criticized for combining studies about influenza and about COVID, which could "yield invalid conclusions". Another 2023 systematic review, by the Royal
Society, found the evidence from RCTs was that masks reduced risk by 12% to 18%.
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As for the other reviews, "judgement on methodology not changing the article"... is cutting it a little close IMO, given that prose is a concern and mining a source is a policy. We have to make judgements all the time-- that's the difficulty of
1803:, a more productive alternative, given the presence of updated information and citations. In my opinion, reversions can only lead to a worse article, and more prose than necessary. So refining is more of a priority, rather than reverting.——
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by means of respiratory droplets can be controlled in many settings with less restrictive measures (e.g., the use of surgical masks in quarantine). Studies examining the costs and effectiveness of various control measures are under way.
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Actually, I caught a mistake in the lead citation, made by me, that was not said during the discussion. Specificity next time would have reduced the temperature, and got me to realize my mistakes in a shorter period of time. With that
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Participants were randomized by ward to three arms: (1) medical masks at all times on shift; (2) N95 respirators at all times on shift; and (3) targeted (intermittent) use of N95 respirators only while doing high-risk procedures or
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As for that discussion you linked, I think one has to loop back around to the top to see a noted omission in the discussions: compliance. As I said, you can have discussions all day without realizing the work already done (NIOSH TB
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Of course I bloody read it; what kind of question is that? BMJ is also reputable, but that doesn't mean you get to remove a
Cochrane review with a misleading edit summary. There was already much discussion about how to include this
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Various case-control and population-based studies have also shown that increased levels of masking in a community reduces the spread of SARS-CoV-2, though there is a paucity of evidence from randomized controlled trials
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Unless the RCT study emphasizes worker training (required under 29 CFR 1910.134), it should probably be removed. Currently, I'm in the process of removing these RCT studies, but getting it right might take a
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Masks are not of equal efficacy. While N95 masks outperform surgical masks in filtration, healthcare worker population studies have not shown a significant difference between the two, as of June 2021.
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had a lot more to say on the
Cochrane Review than I anticipated. I'm going to try to think up another bold edit, keeping in mind that this is the only paper AFAIK challenging this at the moment.——
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So, I'm not receiving much substantive feedback concerning this diff. I mean, it could be worded better, maybe certain phrases could be refined, additional citations and words could be added (see
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This was removed for prose, and in light of the 2024 review, (again), I have to agree with myself again; not only does it add to the prose, it adds undue weight, especially after the phrasing
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paragraphs dedicated to
Efficacy - Overall, and one large paragraph (the second one) just talking about RCTs. Understandable if one isn't aware of the Tuberculosis studies in the 1990s...
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I'll wait until the end of the day if you (or anyone else) want to indicate your views, maybe even keeping the paragraph in the "overall" section. Otherwise, I'll commit to my changes.——
1838:. The material you are removing (and the article as whole) is about "masks", not further defined, as an intervention for the general public, whereas what is emphasized here seems to be
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On a second read, yeah sure, I guess you could include it for now. I'm still not happy with the size of the article, but if size is not a concern, I can see why it should be included.
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The rate of CRI was highest in the medical mask arm (98 of 572; 17%); followed by the targeted N95 arm (61 of 516; 11.8%); and lowest in the N95 arm (42 of 581; 7.2%) (P < 0.05).
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the consensus process. Also, you keep emphasizing NPOV-- it's a bit (presumptuous(?)) to keep citing NPOV when we're all fallible people. I rely on you all to maintain NPOV, since
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part of whether an intervention to promote masking can be effective. The subject is about more than mere physics of aerosols and suchlike, it's about realistic human behavior too.
1300:. However your edits removed not these, but reviews and systematic reviews. You also introduced irrelevant material into the lede (which should mirror the body). Hence, reverted.
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in this article also pointing out the "confounding factor" problem, buried in point-counterpoints with RCT findings. I think this quote from the review sums it up best:
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after that discussion. The BMJ source pre-dates the
Cochrane one, so it doesn't rebut it. The text of the article needs to reflect the diversity of expert opinion with
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the 'not rigorous' bit is a
Knowledge editor's judgment of its methodology, that's not relevant at all and should not be used as a basis for changing the article.
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policies that state you must provide "verifiable, reliable sources" for contentious claims in articles. In the context of medical claims, an even stricter policy,
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80:: It's not a matter of opinion; I read the source material, and all the so-called evidence for masks is obvious nonsense that any rational person can see through.
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that does not allow users to make edits based on their own conclusions drawn from their own interpretation of source material. Please find some evidence from
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impact the N95 RCT result (and because they're following the protocol through fit testing and not allowing people with beards to participate in the trial.)
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Participants using N95 respirators underwent a fit testing procedure using a 3M FT-30 Bitrex Fit Test Kit according to the manufacturer’s instructions (3M).
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Also the addition of new information and due and undue weight on older information... did you notice the new 2024 review that was added in my edits? ——
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Our data show that SARS spreads when it is not recognized. Once it was recognized, the infection-control measures that were instituted worked well.
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Hey, edit summaries may be mistyped and they might not be everything. That's why there's a talk page, and that's why I put more context in there.
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When it gets published, we should obviously revisit this situation. But does anybody think we should return to this sooner? (See notes below).——
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rather than keep of that review in particular. Removal... may seem a bit radical, but it's not outside the realm of possibility, based on this
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A later study performed in 2024, however, criticized the methodology of such studies due to substantial healthcare worker compliance problems.
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is going to read this, and this doesn't give any impression that updates to the scientific consensus have occurred (see the 2024 review,
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While the other changes seem okay to me at least and I left them in, I did revert (as did another editor previously) the removal of
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Another note to the point-counterpoint problem: avoid mentioning RCTs, even if it's a rebuttal. The mere mention may give RCTs more
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This is completely unnecessary, and adds to prose and undue weight. (The cited paper is still included in the following sentence.)
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49:: I read a blog page / Twitter / Facebook post and it says masks don't work and the research is bogus. Why can't I say it here?
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I... don't know why you felt the need to restore these, given that one, it adds to the prose, and two, the fact that another,
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masks with HEPA/Dust-fume-mist-radionuclides-asbestos filters, but still, reduction of expense was one of the goals stated in
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Even though the matter above is settled (for now), I'd like to draw attention to the chart and this quote from the the NEJM
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an issue noted by NIOSH, hence the creation of the
Hierachy of Controls and the emphasis on fit tests under 29 CFR 1910.134.
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Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
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Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
1711:. My main problem, initially, was the fact that mentioning this in the lead kinda gives undue weight to RCTs? I mean, the
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I pointed out one of the reviews made clear it wasn't rigorous. So I think at least that can be omitted, just on prose. ——
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I agree with Bon courage. I'll add that while sources seem to be divided on how ideal RCTs are for this topic, it isn't
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Cloth masks are insufficient for healthcare workers and not recommended, according to two randomized controlled trials.
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Part of the reason why an excessive amount of material might have been removed is the prose is 200K, hard to verify.
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2272:. All of these engineered objects are PPE too, that can be misused, and might need to be fitted to certain people!
1842:. These are not the same thing. And lastly, inclusion of the Cochrane study (and how) already reached a consensus
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can maintain NPOV on their own. Though as I said above, I would also... appreciate refinement over reversion.——
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1830:. We cannot reframe the entire topic due to a single review, when it is clear that multiple near-simultaneous
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This is mostly just to solicit more papers though, because obviously we can't use these as an end by itself.
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Clinical studies had not evaluated the efficacy of cloth masks in COVID-19 transmission by the end of 2021.
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Textual citation? Did you read the review? I could just as easily claim that the BMJ is among the best.——
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may be blocked or restricted by an administrator. Editors are advised to familiarise themselves with the
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Okay, just make sure that the article is updated to account for these concerns before the removal. ——
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A Randomized Clinical Trial of Three Options for N95 Respirators and Medical Masks in Health Workers
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thinks about this preprint, given it says the methodology is flawed. I'm going to put up a notice.——
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crazy in thinking there was a problem with the Cochrane paper cited. Looks like somebody else had a
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Actually, calling it an N95 RCT might be a bit of a misnomer; here are some quotes from the paper:
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to me. COVID-19 is not SARS. RCTs on masks have been done, therefore it is possible and relevant.
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on Knowledge. If you would like to participate, please visit the project page, where you can join
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on Knowledge. If you would like to participate, please visit the project page, where you can join
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on Knowledge. If you would like to participate, please visit the project page, where you can join
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Preprints are useless for our purposes, and raising them could be seen as disruptive for this
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cannot. The question for the researchers and math experts who happen to read this talk page:
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Okay, I'll consider this matter settled for now, unless anyone else wants to add anything.——
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review is already included in the article, long before I was here. I'm of the opinion that
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Also adding pre-pandemic sources to this topic, which can never be relevant except through
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It's been such a pervasive problem, that, even before COVID, even before the 2000s, OSHA
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source, at least the lead needs to be changed. Am I missing or misinterpreting anything?
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There also appears to be a problem with point-counterpoint statements. I found another
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Could you highlight the diff or refs you think are most important or problematic?
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For the record, you don't need to remind me that I need to seek consensus. This
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It's kind of odd that they didn't cite 29 CFR 1910.134 considering how much it
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I don't see why you conclude that discussion makes it okay to remove. It was
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Named references that were broken were re-added by the last diff, so that's
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Hmm... perhaps it could be worded a bit better then. What are you proposing?
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requires fit testing for all respirator users, and pre-dates the passage of
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The section or sections that need attention may be noted in a message below.
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If anyone has any papers on this matter, please feel free to let us know.——
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that concludes all the changes that will occur following this discussion.
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Yeah, but it's cited by the 2024 paper. This is giving me a headache...——
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outperform surgical masks, while cloth masks provide marginal protection.
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support your claim. In the context of this article, that generally means
2268:. An RCT here would obviously be unethical here, along with every other
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For example removing a Cochrane systematic review and calling it a RCT.
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What I'm saying here is, to give the proper weight to the BMJ and the
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1146:) reiterates why this approach is a problem; namely, the issue of
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review has comments on the Cochrane review, it's okay to include
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This topic is in need of attention from an expert on the subject
909:. Please visit the project page for details or ask questions at
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1846:. Please do not remove it again without a consensus to do so.
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This could be replaced with the citation I added in the lead.
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procedure applies to this article. This article is related to
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This reminds me of drowning deaths due to people not wearing
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https://www.acpjournals.org/doi/10.7326/M22-1966#_comments
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Editors who repeatedly or seriously fail to adhere to the
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for masks. This has been a thing since the H1N1 outbreak.
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procedure applies to this page. This page is related to
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As far as I can tell, the consensus there is more of a
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In the past, many have put a great deal of emphasis on
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This... this is why adding multiple papers instead of
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Knowledge contentious topics with custom restrictions
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back during the 2003 SARS pandemic (emphasis mine):
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2160:material, but still only with NPOV and due weight.
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Named references were re-added to other sections.——
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2392:be conducted as a meaningful RCT. Respirators by
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903:Manual of Style for medicine-related articles
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1826:content. The 2024 review emphasized here is
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88:: Unfortunately, Knowledge also has a
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2388:Here's my hot take: 29 CFR 1910.134
1709:Source control (respiratory disease)
1116:The following discussion is closed.
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2446:WikiProject COVID-19 articles
1372:If you look on page 15-22 on
1274:Federal Register document.)⸺(
1026:Knowledge:WikiProject Viruses
1020:and see a list of open tasks.
924:Template:WikiProject Medicine
810:Knowledge:WikiProject Fashion
804:and see a list of open tasks.
699:and see a list of open tasks.
619:Template:WikiProject COVID-19
436:contentious topics procedures
379:contentious topics procedures
140:Put new text under old text.
2496:WikiProject Viruses articles
2245:of RCTs, if say, the danger
2241:What does this mean for the
1707:, based on contributions to
1644:this review released in 2024
1504:learned if more were picked.
1167:Hierarchy of hazard controls
1029:Template:WikiProject Viruses
813:Template:WikiProject Fashion
711:Disaster management articles
1735:was removed. This could be
148:New to Knowledge? Welcome!
90:no original research policy
2512:
1783:I'll go ahead and do that.
1748:While RCTs are more robust
1052:project's importance scale
947:project's importance scale
836:project's importance scale
731:project's importance scale
642:project's importance scale
41:Frequently asked questions
2471:C-Class medicine articles
2436:C-Class COVID-19 articles
1127:randomized control trials
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381:before editing this page.
178:Be welcoming to newcomers
2461:C-Class fashion articles
2196:Future improvement notes
1988:Please do not modify it.
1144:Respirator#Disadvantages
1118:Please do not modify it.
432:normal editorial process
375:normal editorial process
102:medical reliable sources
2046:Wikiproject mathematics
362:as a contentious topic.
2486:C-Class virus articles
2378:
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1468:Okay, calm down. That
1226:weight than necessary.
1202:
606:and to participate in
457:This article is rated
428:standards of behaviour
371:standards of behaviour
173:avoid personal attacks
1165:. Not to mention the
522:Guild of Copy Editors
519:, on 1 November 2022.
516:Guild of Copy Editors
488:Guild of Copy Editors
221:Find medical sources:
198:Neutral point of view
2345:I found a RCT named
2295:WP:Original research
2205:the section above.——
2044:Gosh, I wonder what
2017:we can't cite it yet
1238:...but now that the
898:WikiProject Medicine
595:WikiProject COVID-19
424:purpose of Knowledge
367:purpose of Knowledge
203:No original research
1642:), but in light of
1009:WikiProject Viruses
793:WikiProject Fashion
702:Disaster management
693:Disaster management
665:Disaster management
608:project discussions
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1674:going to be issue.
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2083:Bon courage
2069:Bon courage
2005:Bon courage
1760:Citations:
1632:Bon courage
1489:Bon courage
1466:Bon courage
1452:Bon courage
1430:Bon courage
1416:Bon courage
1370:Bon courage
1356:Bon courage
1318:Bon courage
1302:Bon courage
507:copy edited
129:not a forum
2420:Categories
2394:themselves
2372:Findings:
2312:Crossroads
2301:Crossroads
2175:Crossroads
2164:Crossroads
2132:Turns out
2001:Crossroads
1946:Crossroads
1939:synthesize
1898:BMJ review
1890:Crossroads
1861:Crossroads
1850:Crossroads
1799:encourage
1636:Crossroads
1583:consensus.
1577:Crossroads
1566:Crossroads
1541:Crossroads
1530:Crossroads
1472:helpful.——
1244:references
360:designated
69:, applies.
2406:tapler's
2327:tapler's
2282:tapler's
2239:Question:
2210:tapler's
2182:tapler's
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