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9 Across all NIH institutes and centers, mean representation of females in trials was 44.3 percent in 2013, 47.2 percent in 2014, 54.1 percent in 2016, 47.9 percent in 2017, and 52.4 percent in 2018 (on average 22.1 million participants were included in NIH-funded trials during each of these annual reporting periods)