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Effective harm reduction strategies, evidence-based guidelines and interventions are urgently needed to protect users from counterfeit products found on the black market, and to support the development of effective services. Substandard and counterfeit products found in our systematic review were most likely produced by manufacturers not in line with good manufacturing practices (GMP’s) . Some articles also included other classes of substances in their analysis, such as WADA classes S2, S3, S4, S5, dietary supplements, stimulants, and sexual performance enhancers. We searched PubMed/Medline, Embase and Google Scholar for studies published before March 29, 2022 that analyzed the quality and quantity of AAS to determine the proportions of substandard and counterfeit products found on the black market. D) All electrical e) All inhalation f) All burns with fracture or major tissue trauma g) All with poor risk secondary to age or illness FACTORS AFFECTING OUTCOME 1. 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Biogerontology (2020) 201) Bliziotis, Nikolaos G., et al. "A comparison of high-throughput plasma NMR protocols for comparative untargeted metabolomics." Metabolomics 16.5 (2020) Several in vitro studies have shown that chitosan binds dietary fats and bile acids. The data that is available, however, does not demonstrate significant weight loss. A double-blind, placebo-controlled parallel group study performed by Mattes and Bormann enrolled 89 mildly overweight females to evaluate HCA on weight loss and appetite suppression. In addition, the placebo group demonstrated a decrease in percent body fat mass of 2.16%, and the HCA group demonstrated a 1.44% decrease. Overall, it appears as though that CLA helps to reduce BFM and SAD in patients, but minimal effect on BMI or body weight. Overall, this study demonstrated that CLA use is safe over 24 months and may be beneficial in initial weight loss and may help with maintaining weight loss and reductions in BFM. Gaullier et al. decided to not only evaluate the effectiveness of CLA on weight loss, but to see if either CLA-triacylglycerol or CLA-FFA is more efficacious than the other. Along with other weight related endpoints, this study also evaluated the effects of CLA on sagittal abdominal diameter (SAD) as abdominal obesity has been linked with the metabolic syndrome. At the end of 12 weeks, the results demonstrated a decrease in body fat mass (BFM) of 1.73 kg in the group receiving CLA 3.4 grams (P ≤ .05) and a decrease of 1.3 kg in the group receiving 6.8 grams (P ≤ .05). In regards to weight loss, CLA is believed to work by promoting apoptosis in adipose tissue. Studies which included multiple products were not included due to inconclusive evidence of the effectiveness of individual products. Several mechanisms are proposed to differentiate how these products work. 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