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Because this is the first study, to our knowledge, to investigate the effects of vitamin B 12 on vocal performance, the sample size was determined based on estimation alone, assuming the trial will result in a medium effect size (0.5) and for a 2-tailed α of 0.05 with a power of 0.9 (for detecting a MCID of 5 for the SVHI-10), while comparing 2 normally distributed paired groups ( t test)