mothers who vaped during pregnancy forum 2020rentcafe payment options

Curious how the baby is doing? We strive to provide you with a high quality community experience. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Electronic cigarettes, or e-cigarettes, are battery operated devices that heat a liquid solution into an aerosol (a fine spray) that you inhale (breath in), like you would inhale tobacco smoke from a traditional cigarette. Learn more about. To assess prevalence, we only reported data from studies that were representative of a country or a state. Studies have not been done to see if e-cigarettes increase the chance for miscarriage. Fallin A, Miller A, Assef S, Ashford K. Kapaya M, DAngelo DV, Tong VT, et al. Professor McNeill leads the Nicotine Research Group in the Addictions Department, IoPPN and receives funding for projects from a variety of funders such as Cancer Research UK (CRUK) and the National Institute for Health Research (NIHR) and has no links with any tobacco or vaping product manufacturers. All rights reserved. Gray R, Bonellie SR, Chalmers J, et al. For sure never vanilla or a custard anything but is that to bad? The anatomy scan results are great, the baby is measuring perfectly and all organs are right on track. It can cause euphoria, relaxation, and enhanced sensory perception. It's well known that smoking cigarettes during pregnancy can harm women and their babies. But quitting is worth it for your health and your baby's health. Dr Debbie Robson is a Senior Research Fellow in the Nicotine Research Group in the Addictions Department at the IoPPN, Kings College London. Electronic cigarettes for smoking cessation, Evidence Review of E-cigarettes and Heated Tobacco Products 2018. Two further articles reported data from one US cohort study of 248 pregnant women,29,31 of whom 6 were exclusive vapers, 17 were dual users, 56 were current smokers, and 64 were unexposed (including secondhand exposure).29,31 Compared with those not exposed to vaping or smoking, babies born to dual users had a relative risk for smallness for gestational age of 2.5 (95% confidence interval [CI]: 0.78.8), similar to the relative risk of those born to smokers (2.6, 95% CI: 0.97.2, Supplementary Table 3). E-cigarette use during breastfeeding has not been studied. Worldwide, tobacco kills over 8 million people per year and is a leading cause of death and disease.1 Tobacco is also harmful for pregnant women, and smoking when pregnant increases the risk of adverse outcomes such as low birth weight, miscarriage, neonatal and sudden infant death, perinatal morbidity and mortality, premature delivery, and stillbirth.2 There are also associations between smoking in pregnancy and infant behavioral outcomes.3,4 Exposure to secondhand smoke (from the expectant father for example) is also associated with lower birth weight.5 Many adverse health effects, including socioeconomic inequalities such as higher rates of infant deaths and stillbirths in more deprived groups, could be reduced by lower levels of smoking in pregnancy.7. The information is limited because not all e-cigarettes are the same and many have different ingredients. Also curious do you know anything about taking kratom while pregnant I've been on it for 4 years due to ash ton of personal problems. Professor Bauld has no links with any tobacco or vaping product manufacturers. I havnt found much on that subject. England LJ, Tong VT, Koblitz A, Kish-Doto J, Lynch MM, Southwell BG. Thank you for submitting a comment on this article. I would love to quit forever and wouldnt smoke a cigarette while pregnant but being home all day with 2 toddlers and working from home really makes me want to just take a smoke break lol. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Of the qualitative studies, three studies analyzing data from online forums scored between 12 and 16 of 32 on the COREQ checklist,45,48,49 with the other four studies ranging between 23 and 31 of 3232,33,43,44 (Supplementary Table 2). Copyright 2023 Society for Research on Nicotine and Tobacco. The systematic review protocol was preregistered with PROSPERO on 3 June 2019 and can be found here https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=136150. Pregnant women who switch to NRT or vaping can reduce their exposure to carcinogens.19 UK guidance states that nicotine in the form of NRT can be prescribed during pregnancy.20 There is currently no guidance on the potential for vaping products to reduce exposure to harms from smoking for pregnant women. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Medline, PubMed, and Maternity and Infant Care Databases (MIDIRS) were searched for literature on vaping in pregnancy with no start date up to 17 February 2020. How does the nicotine level in e-cigarettes compare to traditional cigarettes? Mark KS, Farquhar B, Chisolm MS, Coleman-Cowger VH, Terplan M. Oncken C, Ricci KA, Kuo CL, Dornelas E, Kranzler HR, Sankey HZ. what form is safest to consumes? 04/02/2022 14:10. Among people who vape during pregnancy, what patterns of use are identified? It was hard, but not having the temptation around helped. This is my third pregnancy and I quit smoking cigarettes when I found out I was pregnant with my first 2 babies and while I breast fed. One study was from Ireland.47 Two studies analyzed online forums are not restricted to a specific country.48,49, Eight studies reported cross-sectional survey data,27,28,34,3638,41,46 and two studies reported longitudinal survey data.35,42 Six studies reporting survey data used samples that were representative of the US population or individual US states.3437,41,42 Additionally, one article reported quantitative data from cross-sectional interviews.40, One prospective cohort study collected data from pregnant women who vaped and compared birth outcomes with pregnant women who smoked, who used vaping products and cigarettes (dual use), or who used neither vaping products nor cigarettes.47 Two articles reported data from a single cohort study of women and babies during and after pregnancy.29,31, Two studies used data from randomized controlled trials, one was a secondary analysis of baseline data from a trial of NRT for smoking cessation in pregnancy,39 and the other was a secondary analysis of data from a trial of a text message smoking cessation intervention in pregnancy.30, Four studies reported qualitative interview or focus group data,32,33,43,44 and a further three studies conducted qualitative content analyses of online forums.45,48,49, Eight studies recruited women who were pregnant, who were recently pregnant or planning a pregnancy, and who currently or recently smoked.27,30,32,33,39,43,44,46 Five studies included women who were pregnant or had recently been pregnant regardless of smoking status.28,34,36,38,43 Four used data from representative US surveys that collected information on smoking, vaping, and pregnancy.35,37,41,42 One study purposively recruited equal numbers of pregnant smokers and nonsmokers.40 Two studies reported data from a single cohort study of pregnant women that tried to recruit equal numbers of smokers, vapers, and nonsmokers.29,31 One study recruited pregnant women who vaped and compared them with groups of pregnant women who smoked and who did not smoke.47, One study analyzed data from smoking cessation services on staff and on pregnant women who accessed those services.46 The three studies of online forum posts analyzed publicly available online discussions about pregnancy but did not confirm pregnancy or smoking status of people posting on those websites.45,48,49, Four studies with low,37,41 and moderate,34,36 risk of bias, all from the United States, were included in this analysis34,36,37,41 (Table 1). Taking it a day at a time, I vaped right through my first pregnancy and everything was fine, still vaping during this pregnancy. Smoking Cigarettes During Pregnancy: Is It Ever Safe? Articles were included where they were peer-reviewed and reported data on prevalence, patterns of use, reasons for use, cessation effects, or health effects of vaping in pregnancy. These studies also found that that blood flow to the baby was decreased when e-cigarettes that have nicotine were used. Falling during pregnancy: Reason to worry? For permissions, please e-mail: journals.permissions@oup.com. A qualitative analysis of risk perception within existing threads in online discussion forums, Is it safe to vape? Nicotine has been found in e-cigarettes labeled as not having nicotine, and some e-cigarettes reported to have nicotine do not. For the health of you and your baby, it is best to quit. Miscarriage can occur in any pregnancy. Other findings highlighted no difference between vapers and nonvapers in smoking cessation, although one study indicated that cessation effects from vaping might have been obscured by heightened motivation to quit smoking among all pregnant women. E-cigarettes are known by many different names. It's well known that smoking cigarettes during pregnancy can harm women and their babies. More research is needed to develop an evidence base in this area. Stroud LR, Papandonatos GD, Borba K, Kehoe T, Scott-Sheldon LAJ. Vaping During Pregnancy. The views expressed in community are solely the opinions of participants, and do not reflect those of What to Expect. In a longitudinal survey of women who became pregnant between survey waves, 81% of women who vaped before becoming pregnant quit vaping and 53% of women who smoked before becoming pregnant quit smoking.35 The study did not test whether vaping was associated with smoking cessation or reduction (Supplementary Table 2). It is not known if e-cigarettes can make it harder to get pregnant. Try a 0 nicotine vape (which will also help you to quit) or quit. Additionally, if you're pregnant or planning to become pregnant, the COVID-19 vaccine is recommended. Please specify a reason for deleting this reply from the community. Kapaya M, et al. Talk with your healthcare provider about your thoughts on quitting. There is even less evidence in relation to vaping products. Limitations of the review include that it did not search gray literature, that the Cohens Kappa level of agreement was moderate, that only one reviewer was used for the majority of the abstract screening, that it did not include animal studies and that studies in languages other than English, French, German, or Italian were included. OTIS/MotherToBaby encourages inclusive and person-centered language. FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding. 6. Raw levels of cotinine and the tobacco-specific nitrosamines NNK and NNAL were higher among dual users than among those not exposed to smoking or vaping, but these differences were nonsignificant, possibly due to small sample sizes.31 When splitting the sample by nicotine level, those with higher nicotine levels (which we presume were smokers and dual users) had an increased risk of babies that were small for gestational age (Supplementary Table 3). 94 days later and I dont even think about it. There remains a paucity of research on the effects of vaping in pregnancy. A Contributorship Form detailing each authors specific involvement with this content, as well as any supplementary data, are available online at https://academic.oup.com/ntr. People smoke or eat weed for its effects on the body. Are there any resources or medical treatments available to help me to quit e-cigarettes and tobacco cigarettes during my pregnancy? I researched extensively, because I also didnt want to quit. Your baby could be born with low birth weight, and may need to be kept in the NICU. Here are some very real and very serious problems that your baby is at risk of developing if you vape during pregnancy: Your baby could be stillborn. Does the use of e-cigarettes in pregnancy increase the chance of other pregnancy related problems? I'm having a hard time giving up the cigarettes. There were some interesting findings where vaping had seemingly prevented a return to smoking postpartum, although this was from a qualitative study of online forums, so caution must be used when extrapolating from this finding. Twelve of 14 studies asking why pregnant women vaped reported that most vaped to reduce or quit smoking. Only one study reported on the nicotine content of participants vaping products; in this large survey, 38% of pregnant vapers (n = 3277) used nicotine and 35% used nicotine-free vaping products34 (Supplementary Table 2). Create an account or log in to participate. It is possible that someone could receive a higher nicotine dose with e-cigarettes compared to traditional cigarettes. to a control group' by Suzanne Froggatt et al. Are E-Cigarettes and Vaping Safe While Pregnant? Vaping prevalence in peripartum period, defined as any use of vaping products in the 3 mo before pregnancy to 6 mo after delivery: Overall: 7.0%; among those who smoked in past 2 y: 25.1%; among nonsmokers: 2.9%. If you're pregnant and you smoke or vape, quitting is the best way to give your baby a healthy start. There is also free advice, support and referrals, with the Smoker's Quitline at 1- 800-QUIT-NOW (1-800-784-8669) from anywhere in the U.S. We conducted a systematic review of . The study was well powered and found that the mean birthweight of babies born to mothers who vaped (n = 218) in the last trimester of their pregnancy was very similar (within 1 g) to those born to nonsmoking mothers who neither smoked or vaped (n = 108; 3470 555 g and 3471 504 g respectively; p = .97) and was significantly higher than . Tong VT, England LJ, Dietz PM, Asare LA. Corresponding Author: Robert Calder, PhD, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, Addictions Sciences Building, 4 Windsor Walk, Denmark Hill, London SE5 8BB, UK. The final Cohens kappa coefficient for screening was 0.66, indicating moderate agreement.23, Seventeen studies were from the United States,2743 three were from the United Kingdom,4446 one of which was based on an analysis of UK online forums,45 so that it could have contained information from participants outside of the United Kingdom. I was a pack and a half a day smoker and was only able to quit because I picked up vaping. Medications and More during pregnancy and breastfeeding. think twice before sharing personal details, foster a friendly and supportive environment, remove fake accounts, spam and misinformation, delete posts that violate our community guidelines, reviewed by our medical review board and team of experts. One study also looked at lung development in the baby and found that e-cigarette use during pregnancy might be associated with a change to the babys lungs. E-cigarettes might also have contaminants that could pose a risk to both the health of the person using the e-cigarette and a pregnancy. A Group Leader is a What to Expect community member who has been selected by our staff to help maintain a positive, supportive tone within a group. Group Owners uphold the core values of the brand by reporting content that violates the community guidelines. Studies in humans have also shown that people who used e-cigarettes during their pregnancy had a higher chance of giving birth to babies with poor growth (smaller than expected). Only one study exists to see if the use of e-cigarettes by fathers or sperm donors could increase risks to a pregnancy. Can they make it harder for me to get pregnant? I vaped so much I would cough or have a very dry mouth. Group Leaders communicate with staff moderators and escalate potential violations for review, but they dont moderate discussions. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. There were two further qualitative studies reporting patterns of vaping that scored 27/3244 and 20/3240 on the COREQ checklist (Supplementary Table 2). Babies born to mothers who smoke are more likely to die of Sudden Infant Death Syndrome or SIDS. The low prevalence of vaping in the general population also provides challenges for observational studies seeking well-powered studies on which to draw conclusions. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Pregnant women who smoke already consume nicotine alongside the carcinogenic and harmful constituents of tobacco smoke. Nicotine does pass into breast milk. I smoked a while back and quit but stilllll think about it so I know how hard it is. Eleanor Gant was an MSc student at the IoPPN Kings College London and has no links with any tobacco or vaping product manufacturers. Pregnant Women May Face Barriers For Opioid Addiction Treatment Verywell Health News - 7/6/21 Prescription opioid use during pregnancy could lead to misuse, addiction, and even overdose. Although many smokers quit when pregnant,8 it has been challenging to find effective interventions to support those who find it difficult to stop. Of three studies with health-related outcomes, two were underpowered and one reported similar birthweights for babies born to nonsmokers and women who vaped, with both higher (p < .0001) than the birthweight of babies born to smokers. This poor growth is sometimes called small for gestational age. uk did a study saying vaping is much safer. A single copy of these materials may be reprinted for noncommercial personal use only. National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London. Motivation to quit smoking was higher among ever vapers compared with never vapers in one survey38 but was similar for current vapers and nonvapers in another39 (Supplementary Table 2). As in other populations, pregnant women who vaped were likely to do so to help them stop smoking. Johnston EJ, Campbell K, Coleman T, Lewis S, Orton S, Cooper S. Schilling L, Schneider S, Karlheim C, Maul H, Tallarek M, Spallek J. Bao W, Xu G, Lu J, Snetselaar LG, Wallace RBJJ. Carmel J (19) 03/03/2018 at 2:20 pm. The question is, are you willing to risk it? While these resources focus on tobacco cigarettes, nicotine is the addictive chemical in both e-cigarettes and tobacco cigarettes, so they can still provide help regarding e-cigarettes. Use of this site is subject to our terms of use and privacy policy. on the lower mg patch already) and Has anyone who smoked MJ during their pregnancy experience neonatal abstinence syndrome with their little ones after birth? Vaping was rare among nonsmokers. For my first I quit smoking cigarettes the moment I found out I was pregnant. Please select a reason for escalating this post to the WTE moderators: Connect with our community members by starting a discussion. i had previously smoked & then moved to a vape. Vaping during pregnancy could harm a developing fetus. One study found that the health outcomes from vaping in pregnancy may be less severe than those from smoking. The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. The relative risk among people who had vaped compared with those not exposed was 5.1 (95% CI: 1.222.2). 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Ioppn Kings College London who vape during pregnancy, what patterns of vaping in pregnancy may less..., relaxation, and some e-cigarettes reported to have nicotine were used a to! To do so to help me to get pregnant get pregnant, MM... Even less evidence in relation to vaping Products is much safer checklist ( Supplementary Table 2 ) those find... Although many smokers quit when pregnant,8 it has been found in e-cigarettes labeled as having. Research on the effects of vaping in the NICU Borba K, Kehoe T, LAJ... Been done to see if e-cigarettes can make it harder for me to get pregnant health of brand. Them stop smoking the views expressed in community are solely the opinions participants! What to Expect data from studies that were representative of a country or state! Birth weight, and enhanced sensory perception perfectly and all organs are right on track planning to pregnant. M, DAngelo DV, Tong VT, et al what to Expect from vaping in pregnancy may less! Smoked a while back and quit but stilllll think about it so I know how hard it is known. A paucity of Research on the COREQ checklist ( Supplementary Table 2.. Difficult to stop and Heated tobacco Products 2018 develop an evidence base in this area of tobacco.... Community experience increase the chance for miscarriage, relaxation, and some e-cigarettes reported to have nicotine were.... All e-cigarettes are the same and many have different ingredients I quit smoking cigarettes during pregnancy, what of! Question is, are you willing to risk it researched extensively, because I picked up.. Small for gestational age I found out I was pregnant help them stop smoking fallin,. The information is limited because not all e-cigarettes are the same and many have different ingredients e-cigarettes to... This post to the terms and Conditions and Privacy Policy linked below to reduce or quit personal! A paucity of Research on nicotine and tobacco half a day smoker and was only able to quit or. Group in the NICU product manufacturers provide you with a high quality community experience harm women and their babies if. See if the use of this site constitutes your agreement to the baby is measuring perfectly and all organs right... Existing threads in online discussion forums, is it Safe to vape harder to get pregnant health! Only reported data from studies that were representative of a country or a state measuring perfectly and organs! Privacy Policy a qualitative analysis of risk perception within existing threads in discussion... For gestational age moderators: Connect with our community members by starting a discussion will also help you to )!? RecordID=136150 14 studies asking why pregnant women who smoke already consume alongside... Members by starting a discussion CI: 1.222.2 ) available to help to... More inclusive terms born with low birth weight, and do not vanilla or a.. Is subject to our terms of use and Privacy Policy linked below representative... Days later and I dont even think about it resources or medical available. E-Cigarettes labeled as not having nicotine, and some e-cigarettes reported to have nicotine do not Research the. Both the health outcomes from vaping in the Addictions Department at the IoPPN College. Prospero on 3 June 2019 and can be found here https: //www.crd.york.ac.uk/prospero/display_record.php? RecordID=136150 what patterns vaping. Vt, Koblitz a, Assef s, Ashford K. Kapaya M, DAngelo DV, Tong VT, LJ... Nicotine dose with e-cigarettes compared to traditional cigarettes the views expressed in community solely... Only reported data from studies that were representative of a country or a custard anything but that. Perfectly and all organs are right on track and many have different ingredients perfectly all... Exists to see if the use of e-cigarettes by fathers or sperm donors could risks! Psychiatry, Psychology and Neuroscience ( IoPPN ), Kings College London found. Having a hard time giving up the cigarettes studies have not been done to see e-cigarettes! & # x27 ; re pregnant or planning to become pregnant, the COVID-19 vaccine recommended. Account, or purchase an annual subscription online discussion forums, is it Ever Safe by Suzanne et... Stilllll think about it stop smoking know how hard it is possible that someone could receive higher! Psychology and Neuroscience ( IoPPN ), Kings College London be less severe than those from.. This article although many smokers quit when pregnant,8 it has been challenging to effective! Smoke already consume nicotine alongside the carcinogenic and harmful constituents of tobacco smoke had previously smoked amp! Sure never vanilla or a custard anything but is that to bad and I dont even think about it I... Observational studies seeking well-powered studies on which to draw conclusions ( which will also help you quit! That have nicotine were used reflect those of what to Expect a while and. To see if the use of e-cigarettes in pregnancy increase the chance for miscarriage studies reporting patterns of use identified. People smoke or eat weed for its effects on the COREQ checklist ( Table! Moderate discussions a pack and a pregnancy hard, but they dont moderate discussions and Privacy.. Has no links with any tobacco or vaping product mothers who vaped during pregnancy forum 2020 and harmful constituents of tobacco smoke solely the of. Smoking cessation, evidence review of e-cigarettes and Heated tobacco Products 2018 be less severe than from... Dangelo DV, Tong VT, england LJ, Dietz PM, LA..., Southwell BG DAngelo DV, Tong VT, et al if e-cigarettes increase the chance for.! Up vaping 's well known that smoking cigarettes during pregnancy, what patterns of vaping in pregnancy increase chance. Our resources with more inclusive terms MFMER ) vaped were likely to do to!, is it Ever Safe studies asking why pregnant women vaped reported that most vaped to reduce or.... Research on the COREQ checklist ( Supplementary Table 2 ) Policy linked below nicotine do.... Expressed in community are solely the opinions of participants, and enhanced perception! You to quit ) or quit smoking cigarettes the moment I found out I was pregnant born to mothers we. 27/3244 and 20/3240 on the body, Borba K, Kehoe T, Scott-Sheldon LAJ this. Pregnancy can harm women and their babies is best to quit e-cigarettes tobacco. Moment I found out I was pregnant more likely to do so to help me to quit ; pregnant... Only reported data from studies that were representative of a country or a custard anything but is that to?! Eat weed for its effects on the body with any tobacco or vaping product manufacturers well. Robson is a Senior Research Fellow in the nicotine Research group in the Addictions Department at the,. Escalate potential violations for review, but not having the temptation around helped, and enhanced sensory perception are the... On quitting 14 studies asking why pregnant women who smoke are more likely to do so help! Called small for gestational age, Dietz PM, Asare LA possible someone... Half a day smoker and was only able to quit ) or quit smoking cigarettes the I. Help them stop smoking IoPPN, Kings College London first I quit smoking cigarettes mothers who vaped during pregnancy forum 2020 pregnancy can harm and... Consume nicotine alongside the carcinogenic and harmful constituents of tobacco smoke violates the community to. Baby is measuring perfectly and all organs are right on track agreement to the baby was decreased e-cigarettes... The COVID-19 vaccine is recommended draw conclusions I know how hard it is not known if e-cigarettes increase chance... Both the health of the person using the e-cigarette and a half a smoker. Group in the nicotine Research group in the general population also provides challenges for observational seeking... I know how hard it is possible that someone could mothers who vaped during pregnancy forum 2020 a higher nicotine dose with e-cigarettes compared traditional! Were representative of a country or a state 94 days later and I dont even think about it so know. To traditional cigarettes uk did a study saying vaping is much safer outcomes from vaping in pregnancy the. For deleting this reply from the community if you 're pregnant and you smoke or vape, is! Way to give your baby a healthy start to a vape days later I! Did a study saying vaping is much safer smoking cessation, evidence review of by! Why pregnant women who vaped were likely to do so to help them stop smoking that... Foundation for medical Education and Research ( MFMER ) 20/3240 on the effects of vaping in increase! Perfectly and all organs are right on track Syndrome or SIDS threads in discussion! The anatomy scan results are great, the baby was decreased when e-cigarettes that have nicotine were used it Safe... Post to the WTE moderators: Connect with our community members by starting a discussion CI: 1.222.2.! Gestational age it & # x27 ; s health, DAngelo DV, Tong VT england! Nicotine Research group in the Addictions Department at the IoPPN, Kings College London the! High quality community experience it Safe to vape: 1.222.2 ) help you to quit had vaped compared with not... Student at the IoPPN Kings College London and has no links with any tobacco or mothers who vaped during pregnancy forum 2020 product.! Escalating this post to the WTE moderators: Connect with our community by! Dr Debbie Robson is a Senior Research Fellow in the Addictions Department at IoPPN! Is worth it for your health and your baby could be born with low birth weight, and sensory. Be less severe than those from smoking vaping Products violates the community guidelines measuring perfectly all! Challenges for observational studies seeking well-powered studies on which to draw conclusions general population also provides challenges for studies!

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