scholarly journals The effective interventions to improve long-term physiotherapy exercise adherence among patients with lower limb osteoarthritis. A systematic review

2021 ◽  
Author(s):  
Pathmanathan Cinthuja ◽  
Nidhya Krishnamoorthy ◽  
Gamalendira Shivapatham
Keyword(s):  
Systematic Review ◽  
Lower Limb ◽  
English Language ◽  
Data Extraction ◽  
Exercise Adherence ◽  
Case Control Studies ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Booster Sessions

Abstract Introduction: Osteoarthritis (OA) is a chronic condition that severely effects work life balance impacting psychosocial and socio-economic aspects. Physiotherapy exercise is one of the intervention methods for the management of OA. Adherence to the exercise by patients is essential for the effective management of OA. Objectives: To determine different methods used to enhance physiotherapy exercise adherence for more than 12 months among patients with osteoarthritis and to report the effective method to enhance exercise adherence among people with lower limb osteoarthritis. Design: Systematic review Methods: PubMed, Pedro, Web of Science, and EMBASE databases searched for randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies published in the English language from 2000 to 2020. The date of data extraction was 04 September 2020. Two independent researchers conducted literature search, assessed eligibility, extracted data, conducted methodology quality assessment using the PEDro scale, and conducted risk of bias assessment. A narrative synthesis of key outcomes is presented; preferred Reporting Items for Systematic review was used to report the review. The study protocol was registered in the Prospero (Prospero ID: CRD42020205653). Results: The primary search strategy identified 5839 potentially relevant articles, of which 5157 remained after discarding duplicates. After screening based on title and abstract, 40 papers were potentially eligible for inclusion. Five of these papers met all predefined eligibility criteria. Introducing methods to enhance exercise adherence has caused a significant increase in exercise adherence for the short term (less than six months or 12 months). There were no significant differences, long-term adherence with different methods, reported. The results indicate that booster sessions (89.69%) and telephone-linked communication (86%) had higher percentages for the exercise adherence. Secondary outcomes such as pain, stiffness, function, show positive outcomes with increasing exercise adherence. However, there were no significant differences reported. Conclusion: The booster sessions and telephone-linked communication appear to enhance exercise adherence for more than 12 months among patients with osteoarthritis. However, a number of high-quality studies are inadequate to confirm our findings. Therefore, more studies with higher methodological quality are needed to determine the best strategies to enhance long-term exercise adherence among people with osteoarthritis. Key terms: Osteoarthritis, Long term, Exercise adherence

scholarly journals Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

2021 ◽  
Vol 8 ◽  
Author(s):  
Francesca Salamanna ◽  
Francesca Veronesi ◽  
Lucia Martini ◽  
Maria Paola Landini ◽  
Milena Fini
Keyword(s):  
Systematic Review ◽  
Chronic Fatigue ◽  
Current Data ◽  
Assessment Tools ◽  
Current Evidence ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Persistent Symptoms ◽  
Collection Form

Whilst the entire world is battling the second wave of COVID-19, a substantial proportion of patients who have suffered from the condition in the past months are reporting symptoms that last for months after recovery, i. e., long-term COVID-19 symptoms. We aimed to assess the current evidence on the long-term symptoms in COVID-19 patients. We did a systematic review on PubMed, Web of Science, EMBASE, and Google Scholar from database inception to February 15, 2021, for studies on long-term COVID-19 symptoms. We included all type of papers that reported at least one long-term COVID-19 symptom. We screened studies using a standardized data collection form and pooled data from published studies. Cohort cross-sectional, case-report, cases-series, case-control studies, and review were graded using specific quality assessment tools. Of 11,361 publications found following our initial search we assessed 218 full-text articles, of which 145 met all selection criteria. We found that 20.70% of reports on long-term COVID-19 symptoms were on abnormal lung functions, 24.13% on neurologic complaints and olfactory dysfunctions, and 55.17% on specific widespread symptoms, mainly chronic fatigue, and pain. Despite the relatively high heterogeneity of the reviewed studies, our findings highlighted that a noteworthy proportion of patients who have suffered from SARS-CoV-2 infection present a “post-COVID syndrome.” The multifaceted understanding of all aspects of the COVID-19 pandemic, including these long-term symptoms, will allow us to respond to all the global health challenges, thus paving the way to a stronger public health.

scholarly journals Neighbourhood socioeconomic status and overweight/obesity: a systematic review and meta-analysis of epidemiological studies

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028238 ◽  
Author(s):  
Shimels Hussien Mohammed ◽  
Tesfa Dejenie Habtewold ◽  
Mulugeta Molla Birhanu ◽  
Tesfamichael Awoke Sissay ◽  
Balewgizie Sileshi Tegegne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Observational Studies ◽  
Data Extraction ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Neighbourhood Socioeconomic Status

ObjectiveLow neighbourhood socioeconomic status (NSES) has been linked to a higher risk of overweight/obesity, irrespective of the individual’s own socioeconomic status. No meta-analysis study has been done on the association. Thus, this study was done to synthesise the existing evidence on the association of NSES with overweight, obesity and body mass index (BMI).DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Scopus, Cochrane Library, Web of Sciences and Google Scholar databases were searched for articles published until 25 September 2019.Eligibility criteriaEpidemiological studies, both longitudinal and cross-sectional ones, which examined the link of NSES to overweight, obesity or BMI, were included.Data extraction and synthesisData extraction was done by two reviewers, working independently. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale for the observational studies. The summary estimates of the relationships of NSES with overweight, obesity and BMI statuses were calculated with random-effects meta-analysis models. Heterogeneity was assessed by Cochran’s Q and I2 statistics. Subgroup analyses were done by age categories, continents, study designs and NSES measures. Publication bias was assessed by visual inspection of funnel plots and Egger’s regression test.ResultA total of 21 observational studies, covering 1 244 438 individuals, were included in this meta-analysis. Low NSES, compared with high NSES, was found to be associated with a 31% higher odds of overweight (pooled OR 1.31, 95% CI 1.16 to 1.47, p<0.001), a 45% higher odds of obesity (pooled OR 1.45, 95% CI 1.21 to 1.74, p<0.001) and a 1.09 kg/m2 increase in mean BMI (pooled beta=1.09, 95% CI 0.67 to 1.50, p<0.001).ConclusionNSES disparity might be contributing to the burden of overweight/obesity. Further studies are warranted, including whether addressing NSES disparity could reduce the risk of overweight/obesity.PROSPERO registration numberCRD42017063889

scholarly journals PIWI proteins as prognostic markers in cancer: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Alexios-Fotios A. Mentis ◽  
Efthimios Dardiotis ◽  
Athanassios G. Papavassiliou
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cancer Site ◽  
Synthesis Methods ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Protein Levels ◽  
Low Expression

ABSTRACTBackgroundPIWI proteins, which interact with piRNAs, are implicated in stem cell and germ cell regulation, but have been detected in various cancers, as well.ObjectivesIn this systematic review, we explored, for the first time in the literature (to our knowledge), the association between prognosis in patients with cancer and intratumoral expression of PIWI proteins.Data sourcesPubMed, Embase and Web of Knowledge databases were searched for the relevant cohort studies.Study eligibility criteriaProspective or retrospective cohort studies investigating the association of intratumoral mRNA or protein expression of different types of PIWI proteins with survival, metastasis or recurrence of various types of cancers in the systematic review. Exclusion of cross-sectional studies, of studies on the prognostic value of genetic polymorphism of PIWI genes, of studies re-analyzed previously published databases, and of conference abstracts and non-English articles.ParticipantsTwenty-six studies with 4,299 participants were included in the systematic review.InterventionsPooled Hazard Ratios (HRs) and their 95% Confidence Intervals (CIs) were calculated for different PIWI proteins separately, by pooling of log of the calculated HRs using the random-effects model.Study appraisal and synthesis methodsData extraction was performed using a pre-designed form and quality of the studies was assessed using REMARK criteria. Heterogeneity assessed using the I2 index and the Cochran Q test. Publication bias assessed using funnel plots and Egger’s regression.ResultsThe pooled HR of mortality in high compared to low expression of HIWI, HILI and PIWIL4 was 1.87 (CI95%: 1.31-2.66, p < 0.05), 1.09 (CI95%: 0.58-2.07, p = 0.79) and 0.44 (CI95%: 0.25-0.76, p < 0.05), respectively. The pooled HR of recurrence in in high compared to low expression of HIWI and HILI was 1.72 (CI95%: 1.20-2.49, p < 0.05) and 1.98 (CI95%: 0.65-5.98, p = 0.23), respectively.LimitationsExclusion of studies not in English; Discrepancy between mRNA and protein levels, and the respective analytical methods; Only one cancer site – PIWI protein pair investigated in three or more studies.Conclusions and Implications of Key FindingsThe prognosis of cancer patients is worse with higher HIWI and lower PIWIL4 expression, although the results are highly variable for different cancers. The expression of these proteins can be used for personalized prognostication and treatment of individual patients.Systematic review registration numberNot registered.

scholarly journals Predicting future self-harm or suicide in adolescents: a systematic review of risk assessment scales/tools

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029311 ◽  
Author(s):  
Isobel Marion Harris ◽  
Sophie Beese ◽  
David Moore
Keyword(s):  
Systematic Review ◽  
Risk Assessment ◽  
Data Extraction ◽  
Meta Analysis ◽  
Predictive Ability ◽  
Risk Of Bias ◽  
Assessment Tools ◽  
Case Control Studies ◽  
Eligibility Criteria ◽  
Self Harm

ObjectiveThis systematic review aimed to evaluate the ability of risk tools to predict the future episodes of suicide/self-harm in adolescents.DesignSystematic review.Data sourcesMEDLINE, EMBASE, CINAHL and PsycINFO were searched from inception to 3 March 2018.Eligibility criteria for selecting studiesCohort studies, case–control studies and randomised controlled trials of adolescents aged 10–25 who had undergone risk assessment in a clinical setting following an episode of self-harm were included.Data extraction and synthesisTwo independent reviewers extracted data and assessed risk of bias. Data were grouped by tool and narrative synthesis undertaken, with studies appraised using a checklist combining the QUIPS (Quality In Prognosis Studies) and QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tools.ResultsOf the 17 137 articles initially identified, 11 studies evaluating 10 separate tools were included. The studies varied in setting, population and outcome measure. The majority of the studies were rated as having an unclear risk of bias, and meta-analysis was not possible due to high variability between studies.The ability of the tools to correctly identify those adolescents going on to make a self-harm/suicide attempt ranged from 27% (95% CI 10.7% to 50.2%) to 95.8% (95% CI 78.9% to 99.9%). A variety of metrics were provided for 1–10 points increases in various tools, for example, odds and HRs.ConclusionsThis systematic review is the first to explore the use of assessment tools in adolescents. The predictive ability of these tools varies greatly. No single tool is suitable for predicting a higher risk of suicide or self-harm in adolescent populations.PROSPERO registration numberCRD42017058686

Incidence of HIV and HCV in Injecting Drug Users: Systematic and Meta-analysis Review protocol

2020 ◽  
Author(s):  
Asaad Sharhani ◽  
Azam Rahmani ◽  
Bahram Armoon ◽  
Zahra Jorjoran Shushtari ◽  
Mehdi Noroozi ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Systematic Review ◽  
People Who Inject Drugs ◽  
Data Extraction ◽  
Meta Analysis ◽  
Health Concern ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Quality Test ◽  
Cross Sectional

Abstract introduction: HIV and HCV is a health concern in the word. Therefore, this systematic review and meta-analysis protocol study is aimed to estimate the incidence of HIV and HCV among People who inject drugs (PWID) by applying mathematical modeling. The primary purpose of this systematic review is to identify and review existing studies of HIV and HCV incidence in people who inject drugs, that use mathematical modeling. Methods and analysis: Studies including cohort, cross-sectional, case–control studies which were conducted to estimate incidence of HIV and HCV based on mathematical or evaluated effectiveness of mathematical models will be considered to enroll the review; a comprehensive search with Cochrane approach would be applied to identify relevant studies in electronic databases in the period of 2000 to 2019. This protocol was prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and we will search PubMed, EMBASE, Opengrey, WOS, SCOPUS, and Cochrane Library with no restriction of language. Study selection and data extraction will be performed by two independent reviewers. Assessment of risk of bias will be implemented using three quality test tools including Newcastle Ottawa Scale and ROBIS scale for cross-sectional studies and quantitative studies quality test tool for observational and interventional studies for other study Publication bias will be assessed by funnel plots, Begg’s and Egger’s tests. Heterogeneity will be evaluated using the I2 statistic and the χ2 test. In addition, subgroup analyses will be conducted for population and the secondary outcomes.

scholarly journals Maltreatment in childhood substantially increases the risk of adult depression and anxiety in prospective cohort studies: systematic review, meta-analysis, and proportional attributable fractions

2015 ◽  
Vol 46 (4) ◽  
pp. 717-730 ◽  
Author(s):  
M. Li ◽  
C. D'Arcy ◽  
X. Meng
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Childhood Maltreatment ◽  
English Language ◽  
Meta Analysis ◽  
Grey Literature ◽  
Depression And Anxiety ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Attributable Fractions

BackgroundLiterature supports a strong relationship between childhood maltreatment and mental illness but most studies reviewed are cross-sectional and/or use recall to assess maltreatment and are thus prone to temporality and recall bias. Research on the potential prospective impact of maltreatment reduction on the incidence of psychiatric disorders is scarce.MethodElectronic databases and grey literature from 1990 to 2014 were searched for English-language cohort studies with criteria for depression and/or anxiety and non-recall measurement of childhood maltreatment. Systematic review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. Initial screening of titles and abstracts resulted in 199 papers being reviewed. Eight high-quality articles met eligibility criteria. Population attributable fractions (PAFs) estimated potential preventive impact.ResultsThe pooled odds ratio (OR) between any type of maltreatment and depression was 2.03 [95% confidence interval (CI) 1.37–3.01] and 2.70 (95% CI 2.10–3.47) for anxiety. For specific types of maltreatment and depression or anxiety disorders, the ORs were: physical abuse (OR 2.00, 95% CI 1.25–3.19), sexual abuse (OR 2.66, 95% CI 1.88–3.75), and neglect (OR 1.74, 95% CI 1.35–2.23). PAFs suggest that over one-half of global depression and anxiety cases are potentially attributable to self-reported childhood maltreatment. A 10–25% reduction in maltreatment could potentially prevent 31.4–80.3 million depression and anxiety cases worldwide.ConclusionThis review provides robust evidence of childhood maltreatment increasing the risk for depression and anxiety, and reinforces the need for effective programs and policies to reduce its occurrence.

scholarly journals  Prevalence Of Vitamin B Complex Deficiencies In Women In Reproductive Age, Pregnant Or Lactating Woman In Brazil: A Systematic Review And Meta-Analysis Protocol

2021 ◽  
Author(s):  
Michel Carlos Mocellin ◽  
Cintia Chaves Curioni ◽  
Alessandra da Silva Pereira ◽  
Simone Augusta Ribas ◽  
Michelle Teixeira Teixeira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Population Based ◽  
B Vitamins ◽  
Reproductive Age ◽  
Vitamin B ◽  
Prevalence Rates ◽  
Eligibility Criteria ◽  
Cross Sectional

Abstract Background: Complex B vitamin deficiency are involved with several outcomes in fertility and pregnancy. In Brazil, the national prevalence rates of these micronutrients deficiencies in women at reproductive age was not known. Therefore, this study aims to systematically identify, select, evaluate, analyze and report the prevalence rates of complex B vitamins deficiencies in women at reproductive age in Brazil, and identify variables that may modify the outcome rates.Methods: A systematic review will be conducted guided by the following question: “What is the prevalence of vitamin B complex deficiencies in women at reproductive age in Brazil?”. The studies will be identified and selected from a literature search using electronic databases, consultation to researchers/specialists, as well as reference lists of eligible studies and reviews on the topic. Major eligibility criteria include observational cross-sectional and cohort studies performed in women with 10-49 years old from Brazil; pregnant and lactating mothers; and which that investigated the deficiency of complex B vitamins by laboratorial test. Two reviewers independently will perform the screening and selection of studies, to subsequently perform data extraction and risk assessment of bias. For data report, a narrative approach will be used to summarize the characteristics of the included studies and the individual prevalence found for each micronutrient tested, and if the studies are sufficiently homogeneous, a quantitative synthesis (meta-analysis) will be performed.Discussion: Identify the national and regional prevalence rates of complex B vitamins deficiencies allow the policy makers discuss, plan and implement public policy to prevent and/or reduces the rates, if they are larger, or at least highlight discussions about a program of screening the vitamins deficiencies in this specific population for to know the epidemiologic scenario among the years, serving as an indirect indicator of the socioeconomic and dietary patterns of this population. Also, specifically for folates, this study allows to compare the prevalence rates of deficiency of this vitamin before and after the mandatory fortification of wheat and corn flours implemented since 2004. Nevertheless, the evidence gathered may highlight the need for population-based studies to investigate the deficiency of these vitamins.Systematic review registration: PROSPERO registration number: CRD42020188474

scholarly journals Correlation of Dermatoglyphics in the Early Diagnosis of Dental Caries in Children in India

2020 ◽  
Author(s):  
Kritika Jain ◽  
Vibhor Dudhraj ◽  
Debraj Mukhopadhyay ◽  
Jasdeep Boparai ◽  
Sandhya Tathireddy
Keyword(s):  
Systematic Review ◽  
Dental Caries ◽  
Individual Identification ◽  
Congenital Defects ◽  
Case Control Studies ◽  
Exclusion Criteria ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Bias Assessment ◽  
The Relationship

Abstract Background: Dermatoglyphics defined as the study of the complex skin dermal structures covering hand and foot palmar and plantar surfaces. Upon the whole development of the structures, they are unaffected by the environment. That’s why they are considered ideal for individual identification, and to detect congenital defects. Nevertheless, the co-relation of dental caries to dermatoglyphics is still at infancy. Hence, the present research proposal will review the work conducted by various authors on application of dermatoglyphics in dentistry along with the advantages and patterns of dermatoglyphics. This systematic review aimed to synthesize the evidence of the relationship between the dermatoglyphics and dental caries. Methods: A systematic search of the literature will be done in the ProQuest, SCIENCE DIRECT, Google Scholar, PubMed. All papers published from 1 st January 2010 to 31 st December 2019 on this topic will be searched. PRISMA guidelines will be followed. Eligibility criteria will be informed using the PICOS guidelines. Inclusion and exclusion criteria will be used for search and analyzed for heterogeneity. Risk of bias assessment will be performed using Newcastle-Ottawa adapted for cross-sectional studies and case control studies. Systematic Review Registration: This study was registered with PROSPERO (CRD42020191996). Conclusion: Dermatoglyphics is a future aspect of medicine and forensic. The link between fingerprints and dental caries is still in its infancy, but in the upcoming time dermatoglyphic can be considered as the predictor of congenital abnormalities. Dermatoglyphics has shifted from darkness to diagnostic device acceptance. This can be important resource in the future that can forecast person’s oral health. Keywords: Dermatoglyphics, Dental Caries, India, Children

scholarly journals Studies on the prevalence of blindness in Ethiopia: a protocol for the systematic review and meta-analysis

2021 ◽  
Vol 6 (1) ◽  
pp. e000881
Author(s):  
Merkineh Markos ◽  
Biruktawit Kefyalew ◽  
Hana Belay Tesfaye
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Assessment Tool ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Design Strategies ◽  
Cross Sectional ◽  
Standard Data ◽  
Potential Sources

IntroductionBlindness refers to a lack of vision and/or defined as presenting visual acuity worse than 3/60 in the better eye. Its highest proportion has been conforming to the developing countries such as Ethiopia. So, timely information is crucial to design strategies. However, the study on the magnitude of blindness in Ethiopia was outdated, that means it was conducted in 2005–2006. Therefore, this protocol has been proposed to estimate the pooled prevalence of blindness in Ethiopia to provide up-to-date, comprehensive evidence on this theme.Methods and analysisThe following databases will be used to search articles: PubMed, Cochrane Library, Google Scholar and retrieving references. Standard data extraction approach will be employed and presented using Preferred Reporting Items for Systematic Review and Meta-Analysis. The Newcastle–Ottawa Scale quality assessment tool will be used to evaluate the quality of studies. Analysis will be held using STATA V.11. Funnel plot and Egger’s regression test will be applied to check for the potential sources of bias. Heterogeneity among the studies will be tested using Higgins method in which I² statistics will be calculated and compared with the standard. Meta-regression and subgroup analysis will be done to identify the potential sources of heterogeneity. Cross-sectional and survey studies conducted in Ethiopia and published in English language will be included.Ethics and disseminationEthics approval and consent are not required. On completion, the result will be submitted to a reputable peer-reviewed journal.Trial registration numberCRD42021268448.

scholarly journals Hypertensive disorders of pregnancy and risk of asthma in offspring: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e035145 ◽  
Author(s):  
Ping Li ◽  
Tao Xiong ◽  
Yong Hu
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Data Extraction ◽  
Meta Analysis ◽  
Published Data ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Hypertensive Disorders ◽  
Increased Risk

IntroductionHypertensive disorders of pregnancy (HDP), one of the most common obstetrical complications, has been reported to have a controversial relationship with the increased risk of asthma in offspring. No systematic review of this topic has been performed. The aim of this systematic review will be to summarise the available evidence examining the association between HDP and the risk of asthma in offspring.Methods and analysisWe will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines. A systematic search of the PubMed, Embase, Cochrane and Web of Science databases will be performed using a detailed search strategy from database inception through 31 December 2019. Cohort, case-control and cross-sectional studies that report a diagnosis of maternal HDP and asthma in offspring will be included. Studies will be limited to the English language and include only human participants. Two independent reviewers will conduct the study selection, data extraction and risk of bias assessments using a standardised data extraction form. A meta-analysis will be performed to calculate overall pooled estimates using the generic inverse variance method. The data will be synthesised by either fixed-effect or random effects models according to heterogeneity tests. All analyses will be performed in Stata 14 and RevMan 5.3. High-quality evidence of the relationship between HDP and the risk of asthma in exposed offspring will be identified through the synthesis of current studies. In addition, the results of subgroup analyses and related secondary outcomes will be reported. The following will be concluded: (i) whether HDP increases the risk of asthma in offspring, (ii) whether HDP affects the severity of asthma in exposed offspring and (iii) whether possible differences in the risk of asthma among different HDP subgroups exist.Ethics and disseminationThere is no requirement for ethics approval because the meta-analysis and systematic review will be based on published data. It is anticipated that the dissemination of results will take place at conferences and through publication in a peer-reviewed journal.

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