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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Unhealthy behaviors such as tobacco use&#44; poor diet&#44; physical inactivity&#44; and sedentary time are associated with morbidity and mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">1</span></a> Those behaviors are frequently established during childhood and adolescence&#44; and sustained through adulthood&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">1</span></a> The increasing availability of technology helps people spend more time seated&#44; and the amount of hours spent in this type of activity will probably continue to increase over the next years&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">2</span></a> In the last decade&#44; there was an increase in the number of studies reporting the health-related consequences of excessive sedentary time&#44;<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">3&#44;4</span></a> especially time in front of screens&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">5</span></a> Among adolescents&#44; higher levels of screen time have been associated with clustered cardiometabolic risk factors&#44; lower fitness&#44; unfavorable behavioral conduct&#44; lower self-esteem&#44; and poorer mental health status&#46;<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Currently&#44; sedentary behavior is characterized as activities with low levels of energy expenditure &#40;&#8804;1&#46;5 METs&#41; in a sitting or reclining position&#44; and it is a consensus that sedentary behavior is not merely a lack of physical activity&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">8</span></a> That definition includes activities such as sitting&#44; lying down and screen-based entertainment&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">9</span></a> Among adolescents&#44; TV viewing is the most studied sedentary behavior&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">10</span></a> Considering the implications cited above&#44; the American Academy of Pediatrics recommends that children and adolescents limit total entertainment screen time to no more than two hours per day&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Although it is not indicative of total sedentary daily time&#44; screen-based entertainment is considered the most prevalent form of sedentary behavior<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">12</span></a> and it is harmful for general health&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">13</span></a> In Brazil&#44; recent national estimates showed a prevalence of 51&#46;8&#37; in screen time among adolescents&#46;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a> Data from the Brazilian National School-Based Health Survey &#40;PeNSE&#41; showed that the prevalence of adolescents exposed to at least two hours a day of watching TV is high all over the country &#40;78&#46;0&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">15</span></a> However&#44; those studies used different definitions&#44; cutoff points and components of screen time to assess sedentary behavior&#44; all of which hampers comparisons and surveillance in this field&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Two systematic reviews about sedentary behavior among Brazilian adolescents were recently published&#46;<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">16&#44;17</span></a> One was focused on the methodological characteristics of the studies selected&#44; and it evaluated associated factors for sedentary time&#46;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">16</span></a> The other review aimed to summarize studies that reported the prevalence of screen-based sedentary time&#59; however&#44; only a qualitative synthesis was done&#46;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">17</span></a> Considering the importance of screen-based sedentary behavior among adolescents&#44; this study aims to investigate the prevalence of excessive screen time and TV viewing among Brazilian adolescents through systematic review and meta-analysis&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This study was registered on the International Prospective Register of Systematic Reviews Database &#40;PROSPERO-CRD 2017 CRD42017074432&#41; and reported in accordance with the Preferred Reporting Items for Systematic Reviews &#40;PRISMA&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">18</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Search strategy</span><p id="par0030" class="elsevierStylePara elsevierViewall">A comprehensive literature search was conducted to identify articles containing information on excessive screen-time prevalence in Brazilian adolescents&#46; Two reviewers independently searched in the electronic databases &#40;MEDLINE&#47;PubMed&#44; LILACS&#44; SciELO and ADOLEC&#41; looking for studies published between January 1980 and July 2017&#46; Search strategies included medical-subject heading terms for &#8220;Screen time&#8221;&#44; &#8220;Brazil&#8221; and its states&#44; and &#8220;Prevalence&#8221;&#46; The search strategies used in all databases are presented in <a class="elsevierStyleCrossRef" href="#sec0090">Supplementary File 1</a>&#46; In addition&#44; references from published studies were also searched manually&#46; Duplicate reports were deleted in the first step of selection of articles&#46; All potentially eligible studies were considered for review&#46; The software EndNote version X7 &#40;Thomson Reuters&#44; New York&#44; NY&#41; was used for the management of reference selection&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study selection</span><p id="par0035" class="elsevierStylePara elsevierViewall">We included observational &#40;cohort and cross-sectional&#41; studies &#8211; in which the sample consisted of adolescents aged between 10 and 19 years old &#8211; reporting the prevalence of screen-based sedentary behavior&#46; Two different patterns of screen-time evaluation were identified&#58; studies that have only investigated TV viewing and those that assessed time in front of multiple screens &#40;e&#46;g&#46; TV viewing<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>computer use<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>video game-playing&#41; following the cutoff point recommended by the American Academy of Pediatrics&#44;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">11</span></a> which suggests a limit for total entertainment screen time for youth of no more than two hours per day&#46; No language restrictions were applied&#59; however&#44; studies in which the included sample size was smaller than 300 adolescents were excluded&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Data extraction</span><p id="par0040" class="elsevierStylePara elsevierViewall">The titles and abstracts of all articles identified in the search strategy were evaluated in duplicate by independent investigators for potential future inclusion of studies for a full-text review&#46; All abstracts that did not provide sufficient information regarding the inclusion and exclusion criteria were selected for full-text evaluation&#46; In the second phase&#44; the same reviewers independently evaluated the full-text articles and made their selection in accordance with the eligibility criteria&#46; Any disagreement between reviewers was debated until a consensus was reached&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Data was independently extracted by two reviewers using a standardized spreadsheet based on the Strengthening in Epidemiology Statement &#40;STROBE&#41; checklist&#44;<a class="elsevierStyleCrossRefs" href="#bib0455"><span class="elsevierStyleSup">19&#44;20</span></a> comprising methodological characteristics&#44; description of studies&#44; and main research questions&#59; disagreements were resolved by consensus&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Assessment of study quality</span><p id="par0050" class="elsevierStylePara elsevierViewall">The risk for bias for each selected study was assessed using a 10-item tool specifically developed for prevalence studies&#46;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">21</span></a> The tool was structured in two sets&#58; an external validity domain containing four items and an internal validity domain containing six items&#46; A summary assessment deemed a study to be at low&#44; moderate or high risk of bias&#46; For this review&#44; a study was considered to be at a high risk of bias if the sample frame was not truly representative of the population and if non-random selection was used&#59; similarly&#44; a study was considered to be at a moderate risk if non-random selection was used or if the study had more than a minimal risk of non-response bias&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Data analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">The selected studies were analyzed according to the category of the screen-based sedentary time as follows&#58; screen time &#40;TV&#44; computer&#44; video games&#44; or combinations of them&#41; or TV viewing only&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Random-effect models were used to calculate all estimates and their 95&#37; confidence interval &#40;95&#37; CI&#41;&#44; as well as to estimate the prevalence of excessive screen time and TV viewing among Brazilian adolescents&#46; Sensitivity analyses were performed by sex&#44; age group&#44; region&#44; year of the study&#44; and cutoff points for screen time&#47;TV viewing used in each study&#46; Double arcsine transformation was used to handle distribution asymmetry related to different prevalence measures&#46;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">22</span></a> Continuity correction was used for adjustment when a discrete distribution was approximated by a continuous distribution&#46; Prevalence was weighted by the inverse variance of transformed values&#46; Pooled values were then converted to prevalence to make the results interpretable&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Statistical heterogeneity among the results of the studies on prevalence of excessive screen time and TV viewing was assessed by the Cochran Chi-squared test&#44; with a significance level of 0&#46;1&#44; and by the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test&#44; in which values above 50&#37; were considered as indicative of high heterogeneity&#46;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">23</span></a> Statistical analyses were performed using Stata version 14 &#40;StataCorp LP&#44; College Station&#44; TX&#41; and MetaXL &#40;EpiGear International&#44; Sunrise Beach&#44; Australia&#41;&#44; an Excel-based&#44; comprehensive program for meta-analysis&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Description of the studies</span><p id="par0070" class="elsevierStylePara elsevierViewall">The flowchart of study selection is presented in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46; Seven hundred and seventy-five studies were identified with the adopted search strategy&#44; of which 28 articles met all inclusion criteria&#46; One paper assessed screen time and TV viewing at two different moments &#40;2001 and 2011&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a> and thus was included twice in the analysis&#46; In total&#44; 21 studies<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">4&#44;14&#44;24&#8211;41</span></a> were included in the screen time analysis and 10 studies<a class="elsevierStyleCrossRefs" href="#bib0480"><span class="elsevierStyleSup">24&#44;42&#8211;49</span></a> were included in the TV-viewing analysis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The age of participants included in the selected studies ranged from 10 to 19 years old&#46; Thirty studies with a cross-sectional design and one cohort study were included&#44; accounting for a total of 307&#44;485 adolescents &#40;151&#44;767 girls and 143&#44;560 boys&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The characteristics of the studies are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Most of the studies were from Southern Brazil &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17&#41;&#44; followed by the Northeast and Southeast regions &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5 each&#41;&#59; one study was from the Midwest region&#46; Moreover&#44; three studies showed national estimates of excessive screen time or TV viewing&#46; Twenty studies reported the prevalence of screen time and eight studies reported the prevalence of TV viewing only&#46; All studies assessed screen time through questionnaires&#46; Five studies reported the distribution of screen time as a continuous variable&#44; and the observed median was 3&#46;6<span class="elsevierStyleHsp" style=""></span>hours per day&#46; Moreover&#44; prevalence of excessive screen time above 50&#37; was observed in 90&#37; and 67&#37; of studies that evaluated screen time and TV viewing&#44; respectively&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Risk of bias assessment</span><p id="par0085" class="elsevierStylePara elsevierViewall">The methodological quality of the studies is presented in <a class="elsevierStyleCrossRef" href="#sec0090">Supplementary File 2</a>&#46; Eight studies were classified as being at a moderate risk of bias &#40;25&#46;8&#37;&#41;&#44; and three studies were at a high risk of bias &#40;9&#46;7&#37;&#41;&#46; Twelve studies &#40;38&#46;7&#37;&#41; showed high risk to have a reliable and valid measurement of the parameter of interest&#59; seven studies &#40;22&#46;6&#37;&#41; had a minimal risk of non-response bias&#59; five studies &#40;16&#46;1&#37;&#41; did not report the used random selection&#59; three studies &#40;9&#46;7&#37;&#41; had a sample frame that was not truly representative of the target population&#59; and one study &#40;3&#46;2&#37;&#41; did not represent the national population&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Synthesis of data</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Screen-time results</span><p id="par0090" class="elsevierStylePara elsevierViewall">The meta-analysis of studies that reported excessive screen-time prevalence of excessive screen time &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41; is presented in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; The prevalence of screen time among Brazilian adolescents was high &#40;70&#46;9&#37;&#44; 95&#37; CI&#58; 65&#46;5&#8211;76&#46;1&#37;&#41;&#44; with no differences between boys and girls &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> &#8211; panel A&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the results of the meta-analyses for predefined subgroups&#46; The prevalence of excessive screen time tended to be higher among older adolescents &#40;15&#8211;19 years old&#41; in comparison to younger ones &#40;10&#8211;14 years old&#41;&#46; Regarding regions&#44; the lowest prevalence of excessive screen time was observed in the Northeast region&#59; however&#44; the heterogeneity was high in that analysis&#46; The meta-analysis of studies that used data from national estimates &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41; showed lower prevalence of excessive screen time than studies that used data from a city or a region individually&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">There was no difference in the prevalence of excessive screen time considering the year of data collection&#46; As expected&#44; studies that have adopted a cutoff point of &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day showed higher prevalence of excessive screen time than those studies that have used a cutoff point of &#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">TV-viewing results</span><p id="par0105" class="elsevierStylePara elsevierViewall">Ten studies only reported data related to excessive TV viewing&#44; and the meta-analysis showed a prevalence of 58&#46;8&#37; &#40;95&#37; CI&#58; 49&#46;4&#8211;68&#46;0&#37;&#41; among Brazilian adolescents &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; In the meta-analysis by sex&#44; the prevalence of excessive TV viewing among boys was slightly lower &#40;59&#46;2&#37;&#44; 95&#37; CI&#58; 52&#46;2&#8211;66&#46;1&#37;&#41; when compared to girls &#40;66&#46;3&#37;&#44; 95&#37; CI&#58; 58&#46;2&#8211;73&#46;9&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> &#8211; panel B&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the subgroup meta-analyses for excessive TV viewing&#46; For this outcome&#44; only data from the Northeast and South regions were available&#44; and no difference in the prevalence of excessive screen time was observed among the regions&#46; In addition&#44; a trend analysis comparing studies performed until 2007 or later showed a similar prevalence of excessive TV viewing&#46; Studies that have adopted a cutoff point of &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day instead of &#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day showed a higher prevalence of excessive TV viewing&#46; High statistical heterogeneity was identified in all analyses&#46;</p></span></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">The present systematic review with meta-analysis showed a wide range and a high prevalence of excessive screen time and TV viewing among Brazilian adolescents&#46; In the subgroup meta-analyses we investigated the prevalence of excessive screen time and TV viewing by sex&#44; region&#44; age&#44; and cutoff point&#59; however&#44; those were not sufficient to explain the heterogeneity observed&#46; Moreover&#44; the majority of the studies included showed a low risk of bias&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">In all analyses&#44; we observed a high prevalence of excessive screen time and TV viewing&#46; The majority of the Brazilian adolescents spent more than two hours a day in front of screens&#46; Similarly&#44; 59&#46;2&#37; of the Spanish adolescents<a class="elsevierStyleCrossRef" href="#bib0610"><span class="elsevierStyleSup">50</span></a> and 80&#46;6&#37; of the Canadian adolescents<a class="elsevierStyleCrossRef" href="#bib0615"><span class="elsevierStyleSup">51</span></a> spent more than two hours per day in front of screens&#46; Data from the United States showed a decrease in the prevalence of TV viewing from 1999 to 2013 &#40;43&#37; vs 32&#37;&#41;&#46; On the other hand&#44; the percentage of adolescents who spent more than two hours per day playing video games or using the computer in their leisure time increased from 2003 to 2013 &#40;22&#37; vs 41&#37;&#41; in the US&#46;<a class="elsevierStyleCrossRef" href="#bib0620"><span class="elsevierStyleSup">52</span></a> Similarly&#44; over ten years&#44; there was a decrease in TV viewing and an increase in computer and video game console use among Brazilian adolescents&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">The prevalence of excessive screen time among Brazilian adolescents ranged from 35&#37;<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">34</span></a> to 90&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a> Both studies assessed adolescents from cities in Southern Brazil&#44; although Rech et al&#46;<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">34</span></a> evaluated younger adolescents &#40;11&#8211;14 years old&#41;&#44; and the cutoff point was &#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#44; whereas Silva et al&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a> evaluated older adolescents &#40;15&#8211;19 years&#41; and the cutoff point was &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#46; Guidelines<a class="elsevierStyleCrossRefs" href="#bib0625"><span class="elsevierStyleSup">53&#44;54</span></a> recommend no more than two hours per day of recreational screen time among children and adolescents&#46; There is discussion about whether this cutoff point is too low&#44; as mainly nowadays&#44; due to the high availability of technology&#44; adolescents spend more time in front of screens whether for study or entertainment&#46; Two studies<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">4&#44;55</span></a> included in the present review were performed in the same city and with the same age-range sample&#44; showing an almost 25&#37; &#40;71&#46;7&#37; vs 89&#46;9&#37;&#41; difference in prevalence of excessive screen time due to differences in cutoff points between them&#46; This is a challenge for researchers&#44; which hinders the comparability between the studies&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Among adults the recommendation from the American Heart Association is &#8220;Sit less&#44; move more&#8221;&#44; because there is insufficient evidence regarding the appropriate limit of sedentary behavior required to maximize cardiovascular health benefits&#46;<a class="elsevierStyleCrossRef" href="#bib0640"><span class="elsevierStyleSup">56</span></a> Ekelund et al&#46; showed that one hour of moderate to intense physical activity per day could eliminate the detrimental effects of eight hours of sitting time in men and women&#46;<a class="elsevierStyleCrossRef" href="#bib0645"><span class="elsevierStyleSup">57</span></a> Would screen time be more harmful among children and adolescents than among adults&#63; Is it enough for children to be more physically active to offset potential health effects of sedentary behavior&#63; There are many questions that still need to be answered in order to work out the best recommendation regarding the amount of screen time that is harmful and dangerous in this population&#46; On the other hand&#44; technological advances provide access to information for more people&#44; improving health equity&#46;<a class="elsevierStyleCrossRef" href="#bib0650"><span class="elsevierStyleSup">58</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">No statistical difference by sex was observed in the prevalence of excessive screen time and TV viewing in the present review&#46; Guerra et al&#46;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">16</span></a> also did not find an association between sex and high levels of screen-based sedentary time among Brazilian adolescents&#46; This is in line with what is observed among US adolescents&#46;<a class="elsevierStyleCrossRef" href="#bib0655"><span class="elsevierStyleSup">59</span></a> However&#44; Mielgo-Ayuso et al&#46;<a class="elsevierStyleCrossRef" href="#bib0610"><span class="elsevierStyleSup">50</span></a> showed that Spanish boys spent more time playing console and computer games&#44; especially on the weekend&#44; compared to girls&#46; This information reinforces that the prevalence of sedentary behavior may vary according to the domain &#40;sitting time&#44; screen time&#44; TV viewing&#41; and week or weekend days&#46; Those aspects of sedentary behavior should be further investigated in future research&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">We did not find any difference in the prevalence of excessive screen time or TV viewing according to the age groups&#46; In contrast&#44; Gebremariam et al&#46;<a class="elsevierStyleCrossRef" href="#bib0660"><span class="elsevierStyleSup">60</span></a> evaluated Norwegian children in the transition between childhood and adolescence and they observed that the use of TV&#44; computer and electronic games increased with age over a two-year period&#46; Similarly&#44; older Spanish adolescents &#40;14&#8211;16 years old&#41; were more likely to use computer&#44; video game consoles and mobile phones than younger adolescents &#40;12&#8211;13 years old&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0665"><span class="elsevierStyleSup">61</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In the analysis by region&#44; the prevalence of excessive screen time in the South and Southeast regions is slightly higher than in the Northeast region&#44; but no difference in prevalence of excessive TV viewing was observed&#46; A recent study<a class="elsevierStyleCrossRef" href="#bib0670"><span class="elsevierStyleSup">62</span></a> has reported that 65&#37; and 60&#37; of Brazilian adolescents spent more than two hours a day in front of screens in the Southeast and South regions&#44; respectively&#44; compared to 44&#46;6&#37; in the North region&#46; In Brazil&#44; there is great socioeconomic inequality across regions&#59; the top five states that account for about 65&#37; of the national Gross Domestic Product &#40;GDP&#41; are located in the Southeast and South regions&#46;<a class="elsevierStyleCrossRef" href="#bib0675"><span class="elsevierStyleSup">63</span></a> Those inequalities could have an impact on household access to technology and consequently on the time spent in front of screens&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In this study&#44; the prevalence of excessive screen time was stable throughout the analyzed period&#59; however&#44; the time spent watching TV has decreased among Brazilian adolescents in the same period&#46; At the same time&#44; previous studies<a class="elsevierStyleCrossRefs" href="#bib0680"><span class="elsevierStyleSup">64&#44;65</span></a> also found a reduction or stabilization in excessive TV viewing in the last few years&#46; Nonetheless&#44; there are studies showing an increase in time spent in front of computers and&#47;or video game consoles among adolescents&#44; in Brazil and abroad&#46;<a class="elsevierStyleCrossRefs" href="#bib0480"><span class="elsevierStyleSup">24&#44;66&#44;67</span></a> These contradictory observations could be explained&#44; in part&#44; by the change in behavior &#40;TV viewing to computer&#47;video game use&#41; and by methodological strategies adopted by most studies included in this review&#44; which have evaluated the total screen time &#40;combinations&#41; and did not separately evaluate the specific domains&#46; Indeed&#44; when we combine TV&#44; computer and video game times&#44; the differences in patterns of use may be diluted&#46; Moreover&#44; the trend analysis could be affected because the studies involving sedentary behavior and screen time are very recent&#44; thus limiting the analysis&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">All studies in this systematic review used a questionnaire to evaluate the screen time and TV viewing&#46; The accuracy of self-reporting is influenced by the respondent&#39;s ability to correctly recall what is being asked&#46; Therefore&#44; indirect methods are subject to recall bias&#46;<a class="elsevierStyleCrossRef" href="#bib0700"><span class="elsevierStyleSup">68</span></a> A previous study<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">16</span></a> observed that one of four studies about sedentary behavior did not report information regarding the validity of the instrument used to evaluate sedentary time&#46; Moreover&#44; besides the improvement of the questionnaires&#44; combining self-reported methods with objective measures may provide a better measurement and control for memory bias&#46;<a class="elsevierStyleCrossRef" href="#bib0705"><span class="elsevierStyleSup">69</span></a> Additionally&#44; despite the wide use of questionnaires to evaluate the sedentary behavior involving children and adolescents&#44; Lubans et al&#46; in their systematic review showed few studies reporting the reliability and validity of the measures used&#44; thus recommending that researchers select previously reported instruments with acceptable reliability and validity&#46;<a class="elsevierStyleCrossRef" href="#bib0710"><span class="elsevierStyleSup">70</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">In the last few years&#44; there has been an increase in studies reporting strategies to reduce screen time exposure&#46; In their systematic review&#44; Buchanan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0715"><span class="elsevierStyleSup">71</span></a> showed strong evidence that interventions aimed to reduce recreational screen time and increase physical activity or adopt a healthy diet were effective in improving or maintaining weight status among children aged<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>13 years&#46; However&#44; Biddle et al&#46;<a class="elsevierStyleCrossRef" href="#bib0720"><span class="elsevierStyleSup">72</span></a> observed a small effect among interventions in which the objective was to reduce sedentary behavior&#44; and thus concluded that future studies should involve children and families in the strategy to reduce sedentary behavior&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Limitations</span><p id="par0165" class="elsevierStylePara elsevierViewall">The present study has some limitations&#46; Firstly&#44; the different domains of screen time evaluated through the studies and the high heterogeneity in the meta-analysis limit the interpretation of results&#44; especially for total screen time&#46; All studies evaluated TV viewing and screen time by questionnaire&#44; and almost 40&#37; did not report the validation of the used instrument&#46; Moreover&#44; there was a difference among studies in the interpretation of the recommendations of the American Academy of Pediatrics that highlight that youth should limit screen time to no more than two hours per day&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conclusion</span><p id="par0170" class="elsevierStylePara elsevierViewall">Despite the high heterogeneity&#44; this systematic review with meta-analysis showed a high prevalence of excessive screen time and TV viewing among Brazilian adolescents&#46; The present study reinforces the need to homogenize the measurement of screen time with standardized questionnaires to accurately monitor and identify risk groups&#46; Moreover&#44; intervention studies designed to prevent and reduce excessive screen time are needed&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflicts of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Purpose</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the prevalence of excessive screen-based behaviors among Brazilian adolescents through a systematic review with meta-analysis&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Data source</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Systematic review and meta-analysis were recorded in the International Prospective Register of Ongoing Systematic Reviews &#40;PROSPERO-CRD 2017 CRD42017074432&#41;&#46; This review included observational studies &#40;cohort or cross-sectional&#41; that evaluated the prevalence of excessive screen time &#40;i&#46;e&#46; combinations involving different screen-based behaviors&#41; or TV viewing &#40;&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day or &#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day in front of screen&#41; through indirect or direct methods in adolescents aged between 10 and 19 years&#46; The research strategy included the following databases&#58; MEDLINE&#44; LILACS&#44; SciELO and ADOLEC&#46; The search strategy included terms for &#8220;screen time&#8221;&#44; &#8220;Brazil&#8221;&#44; and &#8220;prevalence&#8221;&#46; Random effect models were used to estimate the prevalence of excessive screen time in different categories&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Data summary</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Twenty-eight out of 775 studies identified in the search met the inclusion criteria&#46; The prevalence of excessive screen time and TV viewing was 70&#46;9&#37; &#40;95&#37; CI&#58; 65&#46;5&#8211;76&#46;1&#41; and 58&#46;8&#37; &#40;95&#37; CI&#58; 49&#46;4&#8211;68&#46;0&#41;&#44; respectively&#46; There was no difference between sexes in both analyses&#46; The majority of studies included showed a low risk of bias&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The prevalence of excessive screen time and TV viewing was high among Brazilian adolescents&#46; Intervention are needed to reduce the excessive screen time among adolescents&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Avaliar a preval&#234;ncia de tempo excessivo de tela e de TV em adolescentes brasileiros atrav&#233;s de revis&#227;o sistem&#225;tica com meta-an&#225;lise&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Fontes de dados</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A revis&#227;o sistem&#225;tica e a meta-an&#225;lise foram registradas no o ingl&#234;s &#40;n&#227;o tem tradu&#231;&#227;o para portugu&#234;s&#41;&#58; International Prospective Register of Ongoing Systematic Reviews &#40;PROSPERO-CRD 2017 CRD42017074432&#41;&#46; Esta an&#225;lise incluiu estudos observacionais &#40;coorte ou transversais&#41; que avaliaram a preval&#234;ncia de tempo excessivo de tela &#40;ou seja&#44; combina&#231;&#245;es que envolvem diferentes comportamentos baseados em tempo de tela&#41; ou tempo em frente &#224; TV &#40;&#8805; 2 horas&#47;dia ou &#62; 2 horas&#47;dia em frente &#224; tela&#41; por avalia&#231;&#227;o direta ou indireta em adolescentes com idades entre 10 a 19 anos&#46; A estrat&#233;gia de pesquisa incluiu as seguintes bases de dados&#58; MEDLINE&#44; LILACS&#44; SciELO e ADOLEC&#46; A estrat&#233;gia de busca incluiu termos como &#8220;tempo de tela&#8221;&#44; &#8220;Brasil&#8221; e &#8220;preval&#234;ncia&#8221;&#46; Os modelos de efeito aleat&#243;rio foram utilizados para estimar a preval&#234;ncia de tempo excessivo de tela em diferentes categorias&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resumo de dados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">28 dos 775 estudos identificados na busca atenderam aos crit&#233;rios de inclus&#227;o&#46; A preval&#234;ncia de tempo excessivo de tela e tempo de TV foi 70&#44;9&#37; &#40;IC de 95&#37;&#58; 65&#44;5 a 76&#44;1&#41; e 58&#44;8&#37; &#40;IC de 95&#37;&#58; 49&#44;4 a 68&#44;0&#41;&#44; respectivamente&#46; N&#227;o houve nenhuma diferen&#231;a entre os sexos nas duas an&#225;lises&#46; A maior parte dos estudos inclu&#237;dos mostrou baixo risco de vi&#233;s&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A preval&#234;ncia de tempo excessivo de tela e tempo de TV foi alta entre os adolescentes brasileiros&#46; S&#227;o necess&#225;rias interven&#231;&#245;es para reduzir o tempo excessivo de tela entre os adolescentes&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Schaan CW&#44; Cureau FV&#44; Sbaraini M&#44; Sparrenberger K&#44; Kohl HW&#44; Schaan BD&#46; Prevalence of excessive screen time and TV viewing among Brazilian adolescents&#58; a systematic review and meta-analysis&#46; J Pediatr &#40;Rio J&#41;&#46; 2019&#59;95&#58;155&#8211;65&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">This manuscript was part of the PhD thesis of the first author in the Postgraduate Program in Endocrinology at Universidade Federal do Rio Grande do Sul&#44; Porto Alegre&#44; RS&#44; Brazil&#46;</p>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Panel A&#58; Meta-analyses of studies on excessive screen time in Brazilian adolescents by sex&#46; Panel B&#58; Meta-analyses of studies on excessive TV viewing in Brazilian adolescents by sex&#46;</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">NR&#44; not reported&#59; AL&#44; Alagoas&#59; PE&#44; Pernambuco&#59; SE&#44; Sergipe&#59; PB&#44; Para&#237;ba&#59; MT&#44; Mato Grosso&#59; SP&#44; S&#227;o Paulo&#59; MG&#44; Minas Gerais&#59; RS&#44; Rio Grande do Sul&#59; PR&#44; Paran&#225;&#59; SC&#44; Santa Catarina&#59; PeNSE&#44; National School Health Survey&#59; ERICA&#44; Study of Cardiovascular Risk in Adolescents&#59; TV&#44; television&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study by region&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Year of study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">City&#47;state&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Components of sedentary behavior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cutoff point &#40;hours per day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Northeast</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rivera et al&#46;&#44; 2010<a class="elsevierStyleCrossRef" href="#bib0595"><span class="elsevierStyleSup">47</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Macei&#243;&#44; AL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#8211;17<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ten&#243;rio et al&#46;&#44; 2010<a class="elsevierStyleCrossRef" href="#bib0605"><span class="elsevierStyleSup">49</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pernambuco &#40;PE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4210&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Silva et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0600"><span class="elsevierStyleSup">48</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aracaju&#44; SE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2174&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#8211;18<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>de Lucena et al&#46;&#44; 2015<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Jo&#227;o Pessoa&#44; PB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2879&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Silva et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">35</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sergipe &#40;SE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3992&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Midwest</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Wendpap et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0550"><span class="elsevierStyleSup">38</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2009&#47;2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cuiab&#225;&#44; MT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1326&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#8211;14<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Southeast</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ceschini et al&#46;&#44; 2009<a class="elsevierStyleCrossRef" href="#bib0585"><span class="elsevierStyleSup">45</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#227;o Paulo&#44; SP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#8211;16<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>de Vitta et al&#46;&#44; 2011<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">27</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bauru&#44; SP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#8211;14<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>de Vitta et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bauru&#44; SP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">524&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#8211;14<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>de Prado Junior et al&#46;&#44; 2015<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">29</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2010&#47;2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Vi&#231;osa&#44; MG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">676&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fernandes et al&#46;&#44; 2015<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">31</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ourinhos&#44; SP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1461&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#8211;14<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">South</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dutra et al&#46;&#44; 2006<a class="elsevierStyleCrossRef" href="#bib0590"><span class="elsevierStyleSup">46</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pelotas&#44; RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">810&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Silva et al&#46;&#44; 2008<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">37</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Santa Catarina &#40;SC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Campagnolo et al&#46;&#44; 2007<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">44</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2002&#47;2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#227;o Leopoldo&#44; RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">722&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dumith et al&#46;&#44; 2010<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">30</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2004&#47;2005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pelotas&#44; RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4431&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#8211;15<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Silva et al&#46;&#44; 2011<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">36</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caxias do Sul&#44; RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#8211;17<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Barbosa Filho et al&#46;&#44; 2012<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">42</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Curitiba&#44; PR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1628&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#8211;18<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rech et al&#46;&#44; 2013<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">34</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caxias do Sul&#44; RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1230&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#8211;14<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Silva et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2001&#47;2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Santa Catarina &#40;SC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Coledam et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0565"><span class="elsevierStyleSup">41</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Londrina&#44; PR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">738&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#8211;17<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Christofaro et al&#46;&#44; 2015<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">4</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Londrina&#44; PR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1231&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#8211;17<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Castro et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">25</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#227;o Jos&#233;&#44; SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">930&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gon&#231;alves et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">33</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#227;o Jos&#233;&#44; SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">879&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#8211;19<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bacil et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0555"><span class="elsevierStyleSup">39</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ponta Grossa&#44; PR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">945&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#8211;18<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ferreira et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">32</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pelotas&#44; RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8661&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#8211;16<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&#47;sitting activities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">National estimates</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Camelo et al&#46;&#44; 2012<a class="elsevierStyleCrossRef" href="#bib0575"><span class="elsevierStyleSup">43</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Capitals &#40;PeNSE&#44; 2009&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#44;809&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#8211;16<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>de Rezende et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0560"><span class="elsevierStyleSup">40</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Capitals &#40;PeNSE&#44; 2012&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">109&#44;104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#8211;16<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Oliveira et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2013&#47;2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Capitals and other cities &#40;ERICA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#44;589&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#8211;17<span class="elsevierStyleHsp" style=""></span>y&#46;o&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TV&#47;video game&#47;computer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Included four times in the analysis &#40;data from TV viewing and total screen time in 2001 and 2011&#41;&#46;</p> <p class="elsevierStyleNotepara" id="npar0010">All studies evaluated screen time by questionnaire&#46;</p>"
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">CI&#44; confidence interval&#59; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span>&#44; inconsistency test&#59; younger&#58; 10&#8211;14 years old&#59; older&#58; 15&#8211;19 years old&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prevalence &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleItalic">&#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleBold">Screen time</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Age group</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8220;Younger&#8221;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;9 &#40;62&#46;6&#8211;72&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8220;Older&#8221;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#46;6 &#40;64&#46;0&#8211;86&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Region</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>South&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&#46;1 &#40;67&#46;0&#8211;80&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Southeast&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#46;5 &#40;65&#46;9&#8211;74&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Northeast&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;0 &#40;28&#46;3&#8211;95&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>National estimates&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;9 &#40;46&#46;9&#8211;66&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Year of the study</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Until 2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#46;7 &#40;66&#46;9&#8211;80&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2008&#8211;2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#46;0 &#40;58&#46;3&#8211;81&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After 2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#46;9 &#40;65&#46;5&#8211;76&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Cutoff point</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;5 &#40;61&#46;6&#8211;71&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#46;9 &#40;72&#46;6&#8211;88&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleBold">TV time</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Region</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>South&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#46;0 &#40;46&#46;9&#8211;70&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Northeast&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;4 &#40;41&#46;2&#8211;75&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Year of the study</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Until 2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;0 &#40;41&#46;7&#8211;79&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2008&#8211;2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#46;7 &#40;44&#46;7&#8211;66&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Cutoff point</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#46;7 &#40;34&#46;5&#8211;66&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#46;5 &#40;61&#46;7&#8211;78&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                        0 => array:2 [
                          "etal" => true
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                            0 => "D&#46;K&#46; Eaton"
                            1 => "L&#46; Kann"
                            2 => "S&#46; Kinchen"
                            3 => "S&#46; Shanklin"
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                            5 => "J&#46; Hawkins"
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                            1 => "A&#46;S&#46; Singh"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                            0 => "S&#46;S&#46; Thosar"
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                      ]
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                      "Revista" => array:6 [
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                0 => array:2 [
                  "contribucion" => array:1 [
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                            2 => "J&#46;R&#46; Cardoso"
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                            4 => "J&#46;S&#46; Codogno"
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                      "doi" => "10.3109/08037051.2015.1070475"
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                          0 => array:2 [
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                    0 => array:2 [
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                        "fecha" => "2012"
                        "volumen" => "97"
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