Measurement Tools Research Articles

Development of the Reasoning Ways Scale: Validity and Reliability Study

The aim of this study was to develop a valid and reliable measurement tool to determine the reasoning ways of university students. The study was carried out in two separate stages consisting of the pilot and main application in the 2020-2021 academic year. In the main application, the analysis was made on the data obtained from 378 university students. Exploratory and Confirmatory Factor Analysis was performed for the construct validity of the scale; Average Explained Variance [Average Variance Extracted (AVE)], square root of AVE, Composite Reliability [CR], Maximum Shared Variance [Maximum Squared Variance (MSV)], Average Squared Shared Variance [(Average Shared Square Variance (ASV)] and inter-construct correlations were calculated for convergent and divergent validities. The Cronbach’s alpha internal consistency and CR coefficients were calculated to examine the reliability. The Exploratory and Confirmatory Factor Analysis results showed that the scale had a seven-factor structure (deductive, inductive, analogical, heuristic, algebraic, historical, and verbal) and consisted of 21 items. Convergent and divergent validity of the scale was proved by examining AVE, square root of AVE, CR, MSV, ASV values, and inter-construct correlation coefficients. Cronbach’s alpha and composite reliability coefficients which were calculated for the whole scale and each sub-dimension indicated that the scale was reliable. The results reveal that the Reasoning Ways Scale is a valid and reliable measurement tool.

Reliability of ultrasound measurements of muscle thickness and echointensity in older adults with type 2 diabetes

Ultrasound is an emerging tool for muscle-based measurements. However, the analysis of hyperechoic images (high muscle fat infiltration, as in type 2 diabetes [T2D]) can be challenging. ObjectiveTo evaluate the reliability of ultrasound image analysis of muscle thickness and echointensity in older adults with T2D and non-diabetic controls by experienced and novice analysts. We hypothesized that reliability would be high for the experienced analysts, and lower, but acceptable, for a novice analyst. MethodsWe recruited three groups: 1) adults >60 years with T2D; 2) age- and sex-matched normoglycemic controls; and 3) healthy adults 18–35 years. All participants underwent ultrasound imaging of the abdomen and anterior thigh. Ultrasound images were de-identified, randomized, and separately analyzed by two expert analysts (>3 years experience each). A subset of images was also analyzed by a novice analyst with no prior experience. Inter- and intra-rater reliability was assessed using coefficients of variation (CVs), intraclass correlation coefficients (ICCs), and Bland-Altman analysis. ResultsFor the expert analysts, ICCs were >0.90 and CVs were <10 % for all measurements, regardless of participant group. For the novice analyst, all ICCs were >0.90, except for rectus abdominus thickness measurements in the T2D group (ICC: 0.659 [95%CI: -0.134, 0.911]). CVs were <10 % for all measurements, except for rectus abdominus thickness in the T2D group (CV: 12.7 %). Ultrasound image analysis of muscle thickness and echointensity by experienced analysts was highly reliable. ConclusionNovice and expert analysts produced comparable measurements, except for rectus abdominus thickness in images obtained from older adults with T2D.

#2464 Association of vascular access flow and volume status on fistula arm by bio-impedance analysis

Abstract Background and Aims Multi-frequency bio-impedance is a tool of body composition measure and can monitor changes in extracellular volume during dialysis. Arterio-venous fistulae (AVF) could potentially affect fluid retention in the arm. We investigated whether multi-frequency bio-impedance could defect AVF stenosis or association of AVF with fluid retention in the AVF arm. Method We measured the extracellular water (ECF) and total body water (TBW) in AVF arm following hemodialysis by multi-frequency bio-impedance (Inbody S10®) using an eight-electrode contact technique. We measured AVF or AVG flow by transonic ultrasonography using an ultrasound dilution technology (HD 03®) in hemodialysis. Results Total 82 patients (male 38 patients : female 44 patients) were enrolled. The causes of ESRD were DM : non-DM = 38 : 44. The mean age of patients was 54.89 ± 13.21 years. The ECW/TBW ration of fistula arm was a significantly higher than the ECW/TBW ration of non-fistula arm (0.389 ± 0.010 vs. 0.382 ± 0.001; p&amp;lt;0.05). The ECW/TBW ration of fistula arm was a significantly negative correlation with access flow level (mL/min) on fistula (p&amp;lt;0.05). The 5kHz reactance of fistula arm was a significantly positive correlation with access flow level (mL/min) on fistula (p&amp;lt;0.05). The 5kHz Phase Angle of fistula arm was a significantly positive correlation with access flow level (mL/min) on fistula (p&amp;lt;0.05). Conclusion Absolute and also relative extracellular fluid volumes are increased in the fistula arm of hemodialysis. We thought that extracellular fluid volumes in the fistula arm were associated with access flow level (mL/min) and/or relative fistula stenosis. We suggest that multi-frequency bio-impedance can be a useful assistant tool of vascular access flow measure.

Translation and Adaptation of the Reinjury Anxiety Inventory, the Sport Injury Rehabilitation Adherence Scale, and the Athletic Injury Self-Efficacy Questionnaire Into Turkish.

Psychological difficulties can adversely affect rehabilitation outcomes and make return to sport more difficult. Identifying psychological difficulties is possible with valid and reliable measurement tools. The purpose of this study is to translate and culturally adapt the Reinjury Anxiety Inventory (RIAI), the Sport Injury Rehabilitation Adherence Scale (SIRAS), and the Athletic Injury Self-Efficacy Questionnaire (AISEQ) into Turkish and evaluate the psychometric properties of the Turkish versions. Cross-sectional study. The instruments were forward- and back-translated, culturally adapted, and validated on 248 athletes and 34 physical therapists. The physical therapists of the athletes completed the SIRAS to evaluate the athletes. Statistical analysis included reliability tests (Cronbach alpha and test-retest), exploratory factor analysis, confirmatory factor analysis, and correlational analysis. Floor and ceiling effects (<15%) were also assessed. Confirmatory factor analyses revealed a satisfactory model fit for the RIAI and the AISEQ, and exploratory factor analysis revealed the 1-factor structure for the SIRAS as in the original. All 3 instruments displayed adequate internal consistency (Cronbach alpha coefficients ranged from .84 to .88) and test-retest reliability (coefficients ranged from .81 to .93). Convergent validity of the instruments was supported by significant correlations between the AISEQ and both the RIAI and the SIRAS. Our results suggest that the Turkish versions of the instruments were valid, consistent, and reliable in athletes who have serious injuries. Scores on these instruments could be useful for evaluating the contributions of psychological factors to return to sport following serious injuries. Clinicians are encouraged to use RIAI-Turkish (RIAI-TR), SIRAS-Turkish (SIRAS-TR), and AISEQ-Turkish (AISEQ-TR) together to make decisions about the treatment and rehabilitation plans of injured athletes.

Scale of material development literacy perception for teachers

The aim of this study is to develop a measurement tool designed for evaluating teachers' perceptions of their proficiency in material development literacy. This tool aims to provide a structured and effective means of evaluating educators' competencies and understanding in the domain of creating educational materials. The development of such a measurement tool is crucial for obtaining accurate insights into teachers' perceptions, facilitating research on material development literacy, and guiding future interventions or training programs in the educational context. In the research, despite the participation of 1157 teachers, forms with missing data were excluded from the study. The data of 406 teachers were utilized for Explanatory Factor Analysis, and the data of 360 teachers were employed for Confirmatory Factor Analysis. The analyses resulted in a 23-item Likert-type measurement tool comprising four factors: Self-Adequacy, Desire, Material Use, and Process Skill. Additionally, three open-ended questions were included to gather qualitative data, independent of the scale. The measurement tool, explaining 66.18% of the total variance, demonstrates a high level of internal consistency with a Cronbach's Alpha Coefficient of .91. In conclusion, based on the obtained values, it is affirmed that this measurement tool can be effectively utilized to assess the material literacy perception levels of teachers.

Development and Implementation of a Decision-making Support Tool for Measures against Clubroot of Broccoli

Development and Implementation of a Decision-making Support Tool for Measures against Clubroot of Broccoli

Electrocardiogram signal processing algorithm on microcontroller using wavelet transform method

The electrocardiogram (ECG) is an important parameter for analyzing the cardiac system. It serves as the primary diagnostic tool for patients with suspected heart disease, guiding appropriate cardiac investigations according to the disease or condition suspected. However, ECG measurements may generate noise, leading to false diagnoses. The wavelet transform is an effective and widely-used technique for eliminating noise. Typically, analysis and generation algorithms are developed on computer and using software built in. This paper presents a noise elimination algorithm based on the wavelet transform method, designed to operate on resource-limited Node microcontroller unit (MCU). An efficiency study was conducted to determine the optimum mother wavelet implementation of the algorithm, and the results showed that, when considering synthetic ECG signals, db4 was the most suitable for eliminating interference by achieving the highest signal to noise ratio (SNR) and correlation coefficient. In addition, this algorithm prototype can analyze ECG signals using the wavelet transform method processed in a microcontroller and is accurate compared to reliable programs. It has the potential to be further developed into a low-cost portable ECG signal measurement tool for use in remote medicine, healthcare facilities in resource-limited areas, education and training, as well as home monitoring for chronic patients.

Measurement Invariance of Achievement Motives Model: PISA 2018 Turkey Sample

This study aims to find out whether the achievement motives model, constructed by attitudes towards competition, motivation to master tasks, and fear of failure scales, has measurement invariance in the PISA 2018 student questionnaire concerning gender and school type in Turkey sample, containing 6442 students. According to the results, the model's fit levels with the data were within acceptable levels across gender groups and school-type groups. Then, the measurement invariance across gender and school type was tested by multigroup confirmatory factor analysis including a sequence of tests of four nested hierarchical models which are configural, metric, scalar, and strict invariance. The fit indices of models and the differences of indice values between models were examined to decide whether measurement invariance is established. It is found that the full measurement invariance is met according to gender and school type since the values of the indices for each invariance step are acceptable values. It means that it will be appropriate and meaningful to compare the students based on the scores obtained from the measurement tool within the framework of the achievement motives model.

Pro-Social Behavior Scale (PSBS) Development Study

In this study, it was aimed to develop a measurement tool to measure the prosocial behaviors of adolescents. The research was carried out on 540 students studying at secondary and high school levels in Istanbul and Küçükçekmece districts. After the exploratory factor analysis, it was observed that the scale consisted of 4 sub-dimensions: empathy, altruism, sympathy and self-worth. The theoretical structure of these four dimensions of the scale was supported by confirmatory factor analysis. The variance explained by all items of the scale was measured as 66.75. In order to support the validity level of the scale, it was observed that the correlations between the item discrimination values of the items calculated with the t-test and the subscale scores were significant. The external validity of the scale was compared with the previously developed prosocial behavior scale and significant relationships were found between them. Cronbach Alpha values were calculated for the reliability study of the scale, and it was observed that the reliability values of the scale, including the total scale scores, ranged between .74 and .91. In the light of the psychometric data obtained as a result, a measurement tool with high reliability and validity values was developed for adolescents.

Impact of power consumption in containerized clouds: A comprehensive analysis of open-source power measurement tools

Recently, container-based solutions have become de facto compute units of modern cloud-native applications. However, the exponential growth in data traffic and the power consumption of these technologies to handle high data traffic alarm the strong need for energy evaluation approaches in containerized clouds. Furthermore, the proliferation of highly distributed edge clouds raises additional concerns regarding the power consumption of future cloud architectures. This article presents a detailed overview of methods and techniques for monitoring power consumption within popular cloud platforms. The study offers an in-depth evaluation of these approaches, demonstrating variations in measured power consumption based on the chosen technique. A well-known container orchestration platform named Kubernetes (K8s) has been applied in our extensive measurements. This work argues that energy-efficient container clouds will play a vital role in building a more sustainable and eco-friendly digital infrastructure by optimizing power consumption and reducing carbon footprint, paving the way for a greener future. The paper also discusses open challenges and future research directions on energy sustainability, leading to the conclusion, offering lessons learned and prospects on potential solutions to foster sustainable practices within the container ecosystem.

Improving model performance of shortest‐path‐based centrality measures in network models through scale space

SummaryThe quality of the solution in resolving a complex network depends on either the speed or accuracy of the results. While some health studies prioritize high performance, fast algorithms are favored in scenarios requiring rapid decision‐making. A comprehensive understanding of the problem necessitates a detailed analysis of the network and its individual components. Betweenness Centrality (BC) and Closeness Centrality (CC) are commonly employed measures in network studies. This study introduces a new strategy to compute BC and CC that assesses their sensitivity in the scale space while measuring the shortest path. The scale space is generated by incorporating a scale parameter that is shown to achieve up to 60% performance improvements for various datasets. The study provides in‐depth insights into the importance of the scale space analysis. Finally, a flexible measurement tool is provided that is suitable for various types of problems. To demonstrate the flexibility and applicability, we experimented with two methods for 10 different graphs using the proposed approach.

Measurement invairance and construct validity of the Turkish version of the learner autonomy scale in a sample of high and secondary school students

The goal of this research is to adapt the 24-item "Learner Autonomy Scale" developed by Sereti and Giossos (2018) in higher education samples into Turkish by examining the psychometric properties of high school and secondary school samples, and to determine whether these groups are equivalent in terms of measurement invariance. The scale was applied in high school (n = 475) and secondary school (n = 395) samples consisting of 870 students. Different from the original four-factor scale form, EFA applied to both groups revealed a two-factor (factor load range: .308-.775) and 21-item. Correlation values (r = .209-.392, p˂.001) indicate that the factors are not strongly related. The factors produced adequate internal consistency coefficients (α = .706-.866; ω = .708-.871) and were validated by meeting the fit indices accepted in the literature for CFA. Measurement invariance tests revealed strong invariance for the structural and metric tests and partial invariance for the scalar test in high school and secondary school samples. More research is needed to determine why the intersections of items 19, 20, and 21 are not invariant. The main contribution to "learner autonomy" in this study is the adaptation and justification of a valid and reliable measurement tool for determining autonomy in the adolescent age group. The use of the adapted scale in different educational environments and in the examination of "autonomy" by adapting it specific to the field (science, mathematics, etc.) will provide important implications for further theoretical studies.

Relationships between sodium, fats and carbohydrates on blood pressure, cholesterol and HbA1c: an umbrella review of systematic reviews

BackgroundThe relationship between nutrition and health is complex and the evidence to describe it broad and diffuse. This review brings together evidence for the effect of nutrients on cardiometabolic risk factors.MethodsAn umbrella review identified systematic reviews of randomised controlled trials and meta-analyses estimating the effects of fats, carbohydrates and sodium on blood pressure, cholesterol and haemoglobin A1c (HbA1c). Medline, Embase, Cochrane Library and Science Citation Index were search through 26 May 2020, with supplementary searches of grey literature and websites. English language systematic reviews and meta-analyses were included that assessed the effect of sodium, carbohydrates or fat on blood pressure, cholesterol and HbA1c. Reviews were purposively selected using a sampling framework matrix. The quality of evidence was assessed with A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR2) checklist, evidence synthesised in a narrative review and causal pathways diagram.ResultsForty-three systematic reviews were included. Blood pressure was significantly associated with sodium, fibre and fat. Sodium, fats and carbohydrates were significantly associated with cholesterol. Monounsaturated fat, fibre and sugars were associated with HbA1c.ConclusionMultiple relationships between nutrients and cardiometabolic risk factors were identified and summarised in an accessible way for public health researchers. The review identifies associations, inconsistencies and gaps in evidence linking nutrition to cardiometabolic health.

Development of Electronic Portfolio Attitude Scale

The aim of this study is to develop an electronic portfolio attitude scale (EPAS) for prospective teachers. The scale, which was prepared during the scale development phase, was applied to 524 prospective teachers studying in the third and fourth grade. Exploratory factor analysis results (EFA) showed that 40 items in the scale were gathered under three factors. These are: "benefit for the student", "denial (negation)" and "effectiveness in terms of the instructional process". The three-factor structure obtained by confirmatory factor analysis was confirmed. When these factors are evaluated together, their contribution value to the total variance is 39.37%. Factor loadings were found to vary between .33 and .71. However, according to the results obtained in the item analysis, it was determined that all the items in the scale were distinctive. In addition, it is seen that the CR value is greater than .70, and the dimensions of the scale fulfill the composite reliability requirement. In addition, as a result of ANOVA, it was revealed that the attitudes of prospective teachers towards e-portfolio differ significantly according to their knowledge about e-portfolio and their competence in using technology. The McDonald’s ω coefficient (known as congeneric reliability) of the three factors in the scale were .97, .91 and .88, respectively, and the McDonald’s ω coefficient for all items of the scale was .96. As a result of the reliability and validity analysis, it was concluded that the electronic portfolio attitude scale is a reliable and valid measurement tool for prospective teachers.

Motor imagery for paediatric neurorehabilitation: how much do we know? Perspectives from a systematic review.

Motor Imagery (MI) is a cognitive process consisting in mental simulation of body movements without executing physical actions: its clinical use has been investigated prevalently in adults with neurological disorders. Review of the best-available evidence on the use and efficacy of MI interventions for neurorehabilitation purposes in common and rare childhood neurological disorders. systematic literature search conducted according to PRISMA by using the Scopus, PsycArticles, Cinahl, PUBMED, Web of Science (Clarivate), EMBASE, PsychINFO, and COCHRANE databases, with levels of evidence scored by OCEBM and PEDro Scales. Twenty-two original studies were retrieved and included for the analysis; MI was the unique or complementary rehabilitative treatment in 476 individuals (aged 5 to 18 years) with 10 different neurological conditions including, cerebral palsies, stroke, coordination disorders, intellectual disabilities, brain and/or spinal cord injuries, autism, pain syndromes, and hyperactivity. The sample size ranged from single case reports to cohorts and control groups. Treatment lasted 2 days to 6 months with 1 to 24 sessions. MI tasks were conventional, graded or ad-hoc. MI measurement tools included movement assessment batteries, mental chronometry tests, scales, and questionnaires, EEG, and EMG. Overall, the use of MI was stated as effective in 19/22, and uncertain in the remnant studies. MI could be a reliable supportive/add-on (home-based) rehabilitative tool for pediatric neurorehabilitation; its clinical use, in children, is highly dependent on the complexity of MI mechanisms, which are related to the underlying neurodevelopmental disorder.

Interprofessional Collaboration on Drug Administration to Clients with Diabetes Mellitus at Bali Hospital: A Case Study

Background: Errors in health services in Indonesia are caused by poor communication in implementing interprofessional collaboration with a percentage of 70-80%. This causes medical errors, namely with the percentage distribution of 11% drug administration errors, 46% inappropriate drug use and 54% drug prescribing errors. The purpose of this scientific work is to analyze interprofessional collaboration on drug administration to clients with diabetes mellitus. Method: The method used in this study is observation and measurement tools to evaluate interprofessional collaboration using a checklist Self-rating score for Interprofessional Collaboration in Clinical Practice. Results: The results obtained are that the application of interprofessional collaboration has not been carried out optimally due to a lack of communication clinical pathway as a guide in carrying out clinical actions, and no health workers have attended IPC (Inter-Professional Collaboration) implementation training.Good communication during the interprofessional collaboration process can solve health problems and improve patient safety. In addition to optimizing the implementation of interprofessional collaboration by holding integrated training to enhance good cooperative relations between professions. Conclusion: Therefore, there is a need for evaluation by services in hospitals regarding interprofessional collaboration as an effort to reduce the risk of errors in administering drugs to patients and improve the quality of health services in hospitals.

Many Patients Will Experience Stool and Bowel Movement-Related Symptoms After Treatment for Colorectal and Anal Cancer-A Descriptive Study

Purpose: Stool-related late complications have a major impact on patients’ quality of life. The objective of this study was to investigate stool and bowel movements as late complications to colorectal and anal cancer treatment. Methods: We performed a prospective cohort study from a single center using patient reported outcome measurements. We included patients who had surgery for colorectal and anal cancer from October 2019 to January 2022. This was supplemented by a subgroup of patients with late complications after chemo-radiation therapy for anal cancer. The study population comprised 293 patients. The main outcome included descriptive data on stool and bowel movement related complications. We used the Low Anterior Resection Symptom score (LARS), St Mark´s incontinence score, Bristol stool form scale, Patient Assessment of Constipation Symptoms Score (PAC-SYM), colostomy impact factor and self-rated health on a visual analog scale as measurement tools. Results: The low anterior resection symptom score was median 36 (range 24-41) in patients with rectum cancer, for patients with anal cancer it was 39 (4-41), for patients with a right or left sided hemicolectomy it was 26 (4-41) and 25 (0-41), respectively. Conclusion: Patients who had surgery for rectum cancer had in 90% of the cases major Low Anterior Resection Syndrome (LARS). Patients who underwent surgery for colon cancer would in about one third of the cases experience stool or bowel movement impairments. Patients with anal cancer who had chemo-radiation therapy experienced a very high degree of stool and bowel movement impairment.

TEACHER INTERACTION FROM THE PERSPECTIVE OF HIGH SCHOOL STUDENTS

Based on Leary’s interpersonal model (Interpersonal Circumplex), Wubbels elaborated the scheme of interpersonal behavior that was completed by questionnaires (Questionnaire on Teacher Interaction (QTI)). Our research involved 110 high school students. The aim of our present research was to determine the teacher's interaction style from the high school students' perspective using the QTI measurement tool. The purpose of the research was to assess how students see the teacher's classroom activities and how the teachers see themselves, and also to see whether there is a difference between the teacher's point of view and that of the students'. The questionnaire contains 48 items. The QTI measurement tool can serve as a valuable source of information for teachers in comparing their self-assessment with the student's view, which can obviously enhance their professional development.

Development and clinical empirical validation of the chronic critical illness prognosis prediction model.

The evolution of critical care medicine and nursing has aided and enabled the rescue of a large number of patients from numerous life-threatening diseases. However, in many cases, patient health may not be quickly restored, and the long-term prognosis may not be optimistic. In this study, we aimed to develop and validate a prediction model for accurate, precise, and objective identification of the severity of chronic critical illness (CCI) in patients. We used a retrospective case-control and prospective cohort study with no interventions. Patients diagnosed with CCI admitted to the ICU of a large metropolitan public hospital were selected. In the case-control study, 344 patients (case: 172; control:172) were enrolled to develop the prognosis prediction model of chronic critical illness (PPCCI Model); 88 patients (case:44; control: 44) in a prospective cohort study, served as the validation cohort. The discrimination of the model was measured using the area under the curve (AUC) of the receiver operating characteristic curve (ROC). Age, prolonged mechanical ventilation (PMV), sepsis or other severe infections, Glasgow Coma Scale (GCS), mean artery pressure (MAP), heart rate (HR), respiratory rate (RR), oxygenation index (OI), and active bleeding were the nine predictors included in the model. In both cohorts, the PPCCI model outperformed the Acute Physiology And Chronic Health Evaluation II (APACHE II), Modified Early Warning Score (MEWS), and Sequential Organ Failure Assessment (SOFA) in identifying deceased patients with CCI (development cohort: AUC, 0.934; 95%CI, 0.908-0.960; validation cohort: AUC, 0.965; 95% CI, 0.931-0.999). The PPCCI model can provide ICU medical staff with a standardized measurement tool for assessing the condition of patients with CCI, enabling them to allocate ward monitoring resources rationally and communicate with family members.

The effectiveness of transcranial magnetic stimulation for dysphagia in stroke patients: an umbrella review of systematic reviews and meta-analyses.

Numerous studies have explored the use of repetitive Transcranial Magnetic Stimulation (rTMS) intervention in post-stroke dysphagia. The primary aim of this umbrella review was to appraise the methodological quality of systematic reviews (SRs), with and without meta-analyses (MAs), that synthesized the findings of randomized controlled trials (RCTs) exploring the effectiveness of rTMS in the management of dysphagia post-stroke. A secondary aim of was to evaluate the consistency and reliability of translational implications of rTMS for swallowing recovery after stroke across these SRs and MAs. We searched several databases from inception to the 14th of May 2023, to identify SRs and MAs that examined the effectiveness of rTMS in the management of dysphagia post-stroke. The methodological quality of the included studies was evaluated utilizing the AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) instrument. To investigate the extent of literature overlap among the primary studies included in the SRs, the Graphical Overview of Evidence (GROOVE) was utilized. Of the 19 SRs that were identified, two studies received low quality ratings, while the rest (17) were rated with critically low quality based on the AMSTAR 2 rating. A high literature overlap across the SRs was observed. In all SRs and MAs reviewed, there was a consistent presence of at least some significant evidence supporting the effectiveness of rTMS in enhancing swallowing outcomes for individuals with dysphagia post-stroke, that is, all MAs reported at least a moderate overall effect in favor of rTMS (SMD range = [0.59, 6.23]). While rTMS shows promise for improving dysphagia post-stroke, the current evidence remains limited and inconclusive due to the methodological flaws observed in the published SRs and their respective MAs on the topic so far. Concerning the limitations of our study, language restrictions and methodological shortcomings may affect the generalizability of our findings.