- Systematic Review
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The inaccurate citation of the “Universal Declaration of Animal Rights” (UDAR) in the scientific literature: a scoping review
BMC Veterinary Research volume 21, Article number: 59 (2025)
Abstract
Background
The Universal Declaration of Animal Rights (UDAR), adopted in 1977 by an international NGO inspired by the Universal Declaration of Human Rights and made public the following year, aimed to establish a universal code for human conduct toward animals. The declaration was revised twice, in 1989 and 2018, but it failed to be internationally recognised or adopted. While its global influence remained limited, misinterpretations of its scope and context have proliferated in legal and veterinary documents. To gauge its impact on scientific literature, a scoping review across three databases (Scopus, Web of Science Core Collection, and Google Scholar) was conducted for publications citing the UDAR from 1979 to 2022.
Results
In terms of research field, the UDAR is mostly cited in the fields of law (27%), philosophy, ethics, and religion (17%), clinical medicine (17%), and basic medicine (11%). The 1978 UDAR version was most often cited. Among 305 screened publications, 47.9% contained erroneous or misleading claims about the UDAR. Common errors included linking the UDAR to UNESCO (34.8%) and conferring it universal endorsement or legally binding value (10.2%). More than half (57%, 59/103) of the mentions in the ethics section contained errors, namely confusing UDAR with other animal protection texts. Regarding the type of animal use, most misleading claims were found in scientific publications focusing on the use of animals in research.
Conclusions
The misappropriation of the UDAR risks providing a false sense of legitimacy and moral compass to editors, reviewers, and readers regarding animal use and highlights that the authors are unaware of ethical or regulatory frameworks governing the proper use of animals in science. This is particularly relevant because the 1978 version, which is antithetical to animal use in science, was most often cited, raising concerns about the governance of animal research in some institutions and the efficacy of the peer review process in detecting these errors. Finally, UDAR mentions grew more than the estimated growth of scientific publications worldwide, thus suggesting an increase in its influence.
Background
The Universal Declaration of Animal Rights (henceforth referred to as UDAR or ‘the declaration’) was adopted in 1977 by the “Ligue Française des Droits de l’Animal” (LFDA)—an international non-governmental organization (NGO) advocating for animal rights—and its affiliated national leagues [1]. Seeking to establish a universal code to shape the conduct of humans toward animals inspired by the Universal Declaration of Human Rights [2], the proponents proclaimed the UDAR at (but not by [3]) the United Nations Educational, Scientific and Cultural Organization (UNESCO) headquarters in 1978 [1]. However, despite a substantial revision in 1989 [4], followed by a more recent revision in 2018, the UDAR has failed to be adopted or proclaimed by the UNESCO and has yet to be endorsed by any individual country, in the context of the United Nations (UN) or otherwise. A crucial difference between the adherence to the UDAR and the Universal Declaration of Human Rights might reside in the democratic legitimacy of the proposing institution. While the UN is an international organization of representatives of governments, the proponents of the UDAR are an NGO whose democratic legitimacy to represent the interests of animals or people can be theoretically questioned. Declarations and principles endorsed by the United Nations are non-binding soft law instruments that establish aspirational norms for countries and international organizations to follow. While not legally enforceable, these instruments are precursors for international treaties and shape international law. A prominent example is the Universal Declaration of Human Rights, which has profoundly influenced international law and governance, laying the groundwork for binding treaties such as the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights [5]. It has also shaped customary international law by guiding states' practices and serving as a reference point in court rulings [6]. By lacking endorsement from any state or the United Nations, the Universal Declaration of Animal Rights falls short of even soft law status. As a result, while the principles of the Universal Declaration of Human Rights have incorporated several international treaties [7], the principles of the UDAR have failed to achieve practical or legal significance [2].
Against this background, recent work has shown how the UDAR has influenced law-making and veterinary practice in at least some countries. A case study reviewing mentions of the UDAR in the official legal gazette in Portugal identified 36 mentions of the declaration in municipal ordinances, regulations establishing animal protection NGOs, and court rulings [8]. The review also found instances where the UDAR was cited in the international comparative law section of technical reports from the Portuguese Parliament. The same work showed how the UDAR has become mainstreamed in companion animal veterinary practice, strikingly illustrated by the printing of the declaration on the government-issued pet health book that accompanies every cat or dog throughout their lives. Most mentions of the UDAR in law and in veterinary practice pertained to companion animals, which probably reflects an animal rights zeitgeist that might not extend to other animals. Moreover, previous research has found that up to 91% of UDAR mentions in Portuguese legal documents contained false or misleading information, mainly its endorsement by UNESCO or the UN, or its binding value [8]. Similar concerns had been previously noted by others [9], and raise the question of whether the erroneous use of the UDAR is due to ignorance, misleading information, or driven by changes in human attitudes toward companion animals.
Reviews in 1989 and 2018 [1] attempted to align the declaration with current ethical standards in the use of animal for research purposes. However, the original 1978 [2] version, which is more explicit in condemning the use of animals in research, is consistently cited in legal documents [8]. This research aims to investigate the influence of the UDAR in science. We hypothesize that similar false claims regarding UDAR can also be found in the scientific literature. For that purpose, we conducted a systematic scoping review of scientific literature looking for mentions of the UDAR. We assessed their focus in terms of animal group and research topic, the section where the declaration is mentioned, whether the mentions contained misleading claims, and which version of the declaration was used.
Methods
We performed a scoping review based on searches for publications including the exact term “Universal Declaration of Animal Rights” in two databases considered suitable for systematic reviews [10], Scopus and Web of Science Core Collection, and a third search using Google Scholar, thought to be the most comprehensive interface [11]. The research objectives lend themselves to a scoping review approach because they aim to examine the extent, range, and nature of the citations of the UDAR, across a heterogeneous body of scientific literature, spanning several disciplines [12]. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist was followed [12].
Searches were performed by the first author (AA) in May 2022, without restrictions in terms of date or type of publication. Search results were exported to.csv files and inclusion criteria included the following: i) full text available; ii) written in English, French, Spanish, or Portuguese; iii) publication is a journal article, book, or book chapter; iv) the UDAR is mentioned in any section. Publications not fulfilling any of these criteria were excluded. The flow diagram with the screening process is illustrated in Fig. 1. From each selected publication, one author (AA) extracted the sentence(s) containing the search term, the journal or book name, year of publication and countries of the authors’ affiliations. Next, text excerpts with mentions or citations of the UDAR were assessed for misleading claims. To validate the process, another author (MMS) blindly reviewed a 5% subset of publications from the initial dataset (29 out of 577 records in Google Scholar), randomly selected using an online research randomizer (www.randomizer.org). The subset of publications was blindly screened for inclusion/exclusion, extraction and classification of the relevant text.
Flow diagram of the selection of publications for inclusion. Search and selection process was performed in parallel for the three interfaces, and the data were consolidated into a single dataset of 305 publications (searches in Scopus and Web of Science contributed to two and zero articles not identified in the Google Scholar search)
Statistical analysis
The interrater reliability score, calculated using NVIVO (QSR International), yielded a Cohen’s K of 0.801, indicating a strong agreement [13]. As part of the validation process, consensus between all authors was established regarding the grouping and levels of data categories, covering a) the type or context of animal use, b) the topic of the publication, c) the animal subject or taxon and d) the type of misleading claim. We classified mentions of the UDAR as misleading only when the text explicitly claimed a legal binding value. Similarly, although claiming the submission of the UDAR to UNESCO is likely misleading, it is difficult to ascertain exactly what the authors meant (formal submission vs. informal presentation), which prevented us from classifying these instances as misleading claims to avoid overestimating (type I) errors. Levels or categories for each variable extracted from the publications can be found in Table S1 of the supplementary materials. Detailed information extracted from publications including the excerpts where the UDAR is mentioned is available upon request to the authors. Finally, the data were analysed for distribution of mentions and misleading claims according to the sections in which UDAR mentions appear (main text vs. ethics sections), the publication topic, country of authors’ affiliation, year of publication, the context of animal use and animal subject or taxon. Observed annual growth rates [(MentionsYear n – MentionsYear n-1)/MentionsYear n] and average annual growth rates for the period between 1979 and 2022 were computed for the number of mentions of the UDAR and the number of misleading claims.
Results
The initial search identified 614 potentially relevant publications. After screening, our review identified N = 305 publications that mentioned or cited the UDAR, ranging from 1979 to 2022 (Fig. 1).
Misleading claims regarding the UDAR
Nearly half of the publications (n = 146, 47.9%) contained inaccurate (i.e. erroneous or misleading) claims regarding the UDAR (Fig. 2).
The most common error was the attribution of the conception, authorship, promotion, or endorsement of the UDAR to UNESCO (n = 106, 34.8%), followed by the attribution of universal endorsement or legally binding value to the UDAR (n = 31, 10.2%), confounding the UDAR with other legally binding animal protection documents (n = 19, 6.2%) and the citation of content that is not in the UDAR (n = 2) (Table 1). Four publications mentioning the submission of the UDAR to UNESCO were noted, but this claim was not considered misleading for the purpose of this review. In addition, 155 (52.1%) publications contained no misleading claims regarding the UDAR.
Claims that the UDAR was conceived, authored, endorsed, or promoted by the UNESCO were the most frequent errors in both ethics sections and main texts of publications. For example, in a historical review of the European legislation on the welfare and protection of companion animals, the authors state that “The United Nations Educational, Scientific, and Cultural Organization promoted an important step toward animal protection with the Universal Declaration of Animal Rights of October 15,1978” [14]. Additional examples can be found in an article focusing on animal welfare in poultry production [15] that claims that “In 1978, UNESCO issued Universal Declaration of Animal Rights, which text starts asserting that all animals have rights” and an article reflecting on the ethical debate of meat consumption stating that “in 1978, UNESCO adopted the Universal Declaration of Animal Rights, to be understood in this context as passive rights, or obligations of Man towards animals” [16]. The second most common error was the attribution of universal endorsement or legally binding value to the UDAR. An article discussing the welfare of small ruminants during electro-ejaculation states that “currently, there are palliative protocols for animal management that induce minimal pain and stress that are consistent with animal welfare international legislation standards (UNESCO – Universal Declaration of Animal Rights 17–10–1978)” [17]. Another example is an article exploring group theory to estimate chemical toxicity as an alternative to animal models that claims that “According to the eighth article of the Universal Declaration of Animal Rights, which was promulgated in Paris on 15 October 1978, conducting experiments causing physical or psychological suffering on animals are violation(s) of animal rights. This shall apply for any and all medical, scientific, commercial and etc. experiments. After 11 March 2013, the sale of any cosmetic and personal care products tested on animals was prohibited in the European Union. This also applies to products imported from the non-member countries (Universal Declaration of Animal Rights, 2016).” [18]. Confusion of the UDAR with other national or international animal protection texts was the third most common error. For example, the ethics sections of biomedical research articles stated that the research was performed “in compliance with the provisions of the Strasbourg Universal Declaration of Animal Rights of 1986” [19], “according to the Helsinki Universal Declaration of Animal Rights” [20], or “taking into account the Universal declaration of animal rights from the International League of Animal Rights (Law 84 of 1989, Geneva, Switzerland)” [21, 22]. Two publications cited content that is absent from the UDAR, e.g., stating that “According to the Universal Declaration of Animal Rights, experimental animals that can be used in research are mice and rats. We chose rats, because they are relatively close to human” [23]. Finally, although not considered an error in our analyses, four publications mentioned the submission of the UDAR to UNESCO, for example, questioning “Why do we not respect the principals established in the Universal Declaration of Animal Rights, proclaimed by the International League for Animal Rights in 1978 and submitted to UNESCO and the UN?” [24, 25].
Spatiotemporal distribution of UDAR mentions
Although proclaimed in 1978, mentions to the Declaration in the scientific literature are scarce until the year 2003. From 2003 to 2021 these mentions grew to over twenty mentions per year (Fig. 2). From 2013 onwards, the number of mentions has increased by more than 100% and shows an increasing trend. The distribution of mentions of the UDAR and its errors (in sections related to research ethics, main text, and total number of publications) can be found in Fig. 2. The observed average annual growth rate in the number of mentions of the UDAR in our data set was 14.7% for the total period (1979–2022), with a period of slower growth in the number of mentions from 1979 to 2002 (with an average annual growth rate of 11.3%) and a period of faster growth from 2003 to 2022 (average annual growth rate of 18.1%). The average annual growth in the number of errors is also distinct between the two periods, with a slow growth between 1979 and 2002 (average 4.0%) and a rapid growth between 2002 and 2022 (average 24.1%). Annual growth rates can be found in the supplementary materials (Table S2).
The UDAR was mentioned by authors from 50 different countries (Fig. 3). Brazil and Turkey had the highest representation, accounting for 39% of mentions, with over half containing misleading claims (47/77 for Brazil and 26/48 for Turkey) and accounting for 48% of all errors. Authors from France and the United States of America followed in terms of mentions, but with fewer errors (3/24 and 1/20, respectively). All mentions by authors from Portugal (3/3) and Bosnia and Herzegovina (6/6) contained misleading claims, as did most of the mentions from Poland (10/17), the United Kingdom (9/13), Romania (8/13), Colombia (8/11) and Italy (5/8). Australian authors were represented in 5 publications, none of which contained misleading information.
Distribution of mentions of the UDAR by animal use and animal subjects
Most publications in this review focused on animals in general, with no specific use identified in the text (n = 153), and on research animals (n = 116). Attributing UNESCO with the authorship, conception, promotion or endorsement of the UDAR was the most common error in publications focusing on animals in general (40/153) and research animals (51/116), followed by the attribution of universal endorsement or legally binding value to the UDAR (15/153 and 12/116 for animals in general and used in research, respectively). Animals used for production (n = 22), companionship (n = 7), and entertainment (n = 6) were less represented. Publications focusing on animals used in research and for companionship had the highest proportion of misleading claims (61.2% and 85.7%, respectively), while publications on animals in general had the lowest proportion of misleading claims (37.9%). The majority of mentions of the UDAR (Fig. 3) were found in publications focusing on several groups of animals (n = 173), followed by publications focusing on rodents (n = 82), livestock (n = 18), wildlife (n = 8), rabbits (n = 8), dogs (n = 6), primates (n = 3), fish or marine animals (n = 3), equids (n = 2) and invertebrates (n = 2).
Distribution of mentions of the UDAR by publication topic
Most of the publications mentioning the UDAR focused on law (n = 82), philosophy, ethics, and religion (n = 53), clinical medicine (n = 53) and basic medicine (n = 34). Other topics of publications mentioning the UDAR were veterinary science, animal and dairy science (n = 24), psychology and sociology (n = 18), biological and environmental sciences (n = 14), health sciences (n = 10), political science (n = 5), arts, language and literature (n = 5), educational sciences (n = 3) and economics and business (n = 3) (Fig. 3).
The UDAR was most often mentioned in ethics sections of clinical (n = 53) and basic (n = 29) medicine articles. Over half (57%, 59/103) of the ethics statements included misleading claims (Table 2), mainly confusing the UDAR with other animal protection texts or wrongly attributing its conception, endorsement or approval to UNESCO. Mentions of the UDAR in the main text were most common in publications on law (n = 83), philosophy, ethics, and religion (n = 53), psychology and sociology (n = 18) and veterinary, animal and dairy science (n = 17). Misleading claims were less frequent in publications mentioning the UDAR in the main text (43%, 87/202). The most frequent errors (Table 1) were attributing the UDAR’s conception, endorsement, or approval to UNESCO (65/202) and claiming is has universal or legally binding value (25/202).
Discussion
This review found a total of 305 scientific publications mentioning the UDAR from 1979 to 2022. About half contained inaccuracies, such as misattributing authorship, endorsement, or approval by UNESCO or claiming it has universal or legally binding value, suggesting a need for increased rigor and scrutiny when citing the document. Most mentions occurred in law publications (Fig. 3), where accurate citation is paramount. Significantly, over half of those mentions included misleading claims, which raises concerns about the inadequate dissemination of legal and ethical concepts, and suggests overreliance on secondary sources. These inaccuracies risk distorting legal scholarship, misinforming policy debates, and eroding public trust. A case study of Portuguese legislation found similar results, with errors in most of the local ordinances (21/23) and court rulings (3/5) citing the declaration in the country’s official gazette, as well as imprecise citations in technical reports from parliamentary commissions [8].
Furthermore, most publications found citing the 1989 UDAR version explored the evolution of the declaration (with three exceptions mentioning the 1989 version in the ethics statement [21, 22, 26]) while only one author mentioned the latest (2018) version [27, 28]. The remaining publications cite the 1978 version or do not specify one, highlighting the need for more careful and accurate citations. Citing the original, outdated, and arguably more controversial, 1978 version is particularly problematic when it is wrongly attributed to UNESCO or described as universally or legally binding. Recent estimates indicate that, as of 2022, over 5.14 million academic articles are published per year [29]. Given the total number of scientific publications, the influence of the UDAR could be considered small, which would lessen any concerns regarding the potential impact of this declaration of debatable legitimacy in science. However, the annual growth in the number of UDAR mentions (14.7%) and errors (13.5%) far exceeds estimates of the overall growth rate of scientific publications (4.10%) [30], suggesting increasing use—and misuse—of the declaration. Finally, most of the misleading claims were found in scientific publications focusing on the use of animals in research where the 1978 version, which is antithetical to animal use in science, was most often cited. This raises concerns about the governance of animal research and the effectiveness of peer review in detecting these errors.
The increasing frequency of mentions of the UDAR aligns with the emergence of new social norms regarding animal treatment in some countries. Norms are defined as ‘collective expectations about proper behavior for a given identity’ [31]. Over time, new norms emerge in societies and compete with the existing ones [32, 33]. While research focusing on norm emergence regarding social expectations for animal treatment is lacking, human attitudes towards animals have evolved rapidly in the last decades [34, 35]. These changes are reflected in how humans refer to themselves as “tutors” and “guardians” instead of “pet owners” [36]. Additionally, changes in animal protection laws over the past decades result from both scientific advances and evolving social norms [37]. In the European Union for example, citizens' initiatives such as the “End the Cage Age” have been successful in driving regulatory changes [37]. While the UDAR is not a democratically validated universal code, it does represent the view of a segment of the global population: those affiliated to NGOs that endorse the declaration, and even those that, albeit unaffiliated, agree with it. By modeling the declaration after the ubiquitously endorsed Universal Declaration for Human Rights, the LFDA framed animal rights in a way that resonates with the public. Despite having failed to garner the support from state actors or international organizations necessary to gather critical mass, the fact that the UDAR was proclaimed at the UNESCO headquarters seems to have emulated that support and facilitated its institutionalization through mentions in regulations and science, at least in some countries and contexts [8].
The findings of this study, along with previous research [8, 9], show that the UDAR is often cited without the necessary rigor to allow correct interpretation by readers. Its proclamation at the UNESCO headquarters appears to perpetuate the misconception that the declaration was authored, endorsed, or promoted by the UNESCO or the UN, therefore conferring an argument from authority. This misperception often results in its erroneous attribution as universally binding, whether legally or morally. It has been argued that this type of error stems from the strong emotional involvement of those working in animal protection [9], reflecting a form of bias motivated by prior beliefs akin to motivated reasoning [38]. Peer review systems in science and law are expected to filter emotion from evidence and avoid dissemination and validation of errors as reliable information. It is impossible to determine how many erroneous citations have been corrected in the peer-review process, but it is clear that errors have been missed and repeated. The UDAR is a moral code toward human treatment of animals proposed by the LFDA that legitimately represents the views of the associates of the NGO, its affiliated associations, and those that have formally endorsed the declaration. The UDAR is not validated by any institution that democratically represents the people of a state. It proposes a code that, irrespective of its value, is antithetical to a current global paradigm of livelihoods reliant on responsible animal use, particularly in research.
The research ethics sections within publications are meant to assure editors, reviewers, and readers that the animal use undergoes proper ethical oversight and governance [39]. Widely adopted frameworks such as PREPARE [40] and ARRIVE [39, 41] guidelines promote consistency, detail, and transparency of ethical standard reporting in animal research. However, citing the 1978 UDAR as authoritative, particularly with claims of UNESCO support, misleads readers, reviewers and editors by implying adherence to binding legal standards, despite the UDAR’s lack of legal authority. Furthermore, the UDAR reflects a complex and polarizing ethical debate with far-reaching implications that affect the global economic and social paradigm. Notwithstanding its alignment with the zeitgeist of the ethical treatment of animals such as pets, to our knowledge the UDAR is not endorsed by the UN, UNESCO, or any country in the world, and should therefore not be cited as such, nor as universally or legally binding. Contemporary science faces significant challenges including the reproducibility crisis [42,43,44], misinformation [45,46,47], mis-citations [48], misquotations [49], and discredit [50, 51] in what has been named ‘the post-truth era’ where deceptive information spreads widely, namely through social media. Imprecise or false claims in scientific publications have been shown to influence public attitudes and policies on critical issues like vaccination and climate change [50]. Similar risks exist for legislation, when basing laws on false evidence. In this context, both scientists and legislators must maintain the highest possible standards of rigor, truth, and transparency to uphold the credibility and effectiveness of both systems and counter the impact of misinformation.
Limitations
For this review, we used all resources available through the University of Lisbon’s library system, including access provided by b-on (Biblioteca do Conhecimento Online, www.b-on.pt) and the university’s collective catalogue of 59 libraries, granting access to a wide range of international academic journals, books and databases across various disciplines. However, 49 papers were not available due to paywalls, lack of digital versions or other restrictions beyond the scope of these systems and were therefore excluded from the review. While this ensured methodological consistency, it may have resulted in the omission of potentially relevant documents. Grey literature was not assessed, which limits the assessment of the influence of norm emergence. Substantial differences were found in the number of records retrieved from each search platform: Web of Science Core Collection returned only four records, Scopus 33 and Google Scholar 577 (Fig. 1). After applying the inclusion criteria, the four records returned by Web of Science were included, 31 of 33 Scopus records, and 303 of 577 of the Google Scholar records. The results align with existing literature in terms of the characteristics of the different databases [11] and reinforce the importance of using several databases for the systematic review of new or underexplored topics. While the inclusion of Google Scholar increases the range and scope of the review, it also increases the heterogenicity of the screened publications. Methods to gauge the quality of scientific publications are debatable and were beyond the scope of this review.
Conclusion
Approximately half of the citations of the Universal Declaration of Animal Rights in the reviewed scientific publications contained inaccuracies and errors, namely attribution of authorship or endorsement by UNESCO and citation of content not present in the declaration. These provide a false sense of legitimacy and moral compass to readers, reviewers, and editors, especially when it is mentioned in ethical statements for animal research. Finally, the fact that these errors are not being filtered through the peer-review process highlights the need for increased scrutiny and awareness. Targeted remediating actions could include awareness campaigns for researchers on legal frameworks applicable to animal research, revision of editorial and peer-review standards, guidelines or checklists and educational outreach to peer-review communities. On a broader scale, further research on citation practices, particularly related to sections concerning research ethics and animal protection, is warranted. Finally, maintaining the credibility of scientific work in times of rapid change requires an ongoing critical and transparent self-assessment of research and peer-review practices.
Data availability
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Abbreviations
- LFDA:
-
Ligue Française des Droits de l’Animal
- NGO:
-
Non-governmental organization
- UDAR:
-
Universal Declaration of Animal Rights
- UN:
-
United Nations
- UNESCO:
-
United Nations Educational, Scientific and Cultural Organization
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Manuel Magalhães-Sant’Ana was supported by the research project EVIEDVET, funded by FCT—Fundação para a Ciência e a Tecnologia, I.P., Portugal, with grant number PTDC/CED-EDG/ 0187/2020. Article processing charges were funded by FCT—Fundação para a Ciência e a Tecnologia, I.P., Portugal, under projects UIDB/00276/2020 (CIISA) and LA/P/0059/2020 (AL4AnimalS). The funding body played no role in the design, analysis, and reporting of the study.
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A.A., M.W. and M.M.S. conceived and designed the study, A.A. collected the data, A.A. and M.M.S. analysed and interpreted the data; A.A. drafted the initial manuscript, A.A., M.W. and M.M.S. substantially revised and edited the manuscript. All authors read and approved the submitted version of the manuscript.
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Additional file 1: Table S1. Data variables. List of variables extracted from the data and variable level and sub-level coding. Table S2. Observed average annual growth in UDAR mentions. Observed average annual growth of the mentions of the UDAR and errors therein, in the data set of publications included in this review
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Azevedo, A., Whiting, M. & Magalhães-Sant’Ana, M. The inaccurate citation of the “Universal Declaration of Animal Rights” (UDAR) in the scientific literature: a scoping review. BMC Vet Res 21, 59 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12917-025-04470-z
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DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12917-025-04470-z