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Moreover, fourteen articles had an unclear risk of selection bias for random sequence generation and allocation concealment [11, 15, 19, 24, 26, 27, 30, 32, 39,40,41,42, 46, 47], thirteen articles presented unclear risk of bias for blinding [15, 19, 24, 28, 31, 32, 36,37,38, 41, 44, 46, 47], while three articles showed an unclear risk for attrition bias, reporting bias and other sources of bias [23, 27, 31]

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