Posted on Authorea 17 Mar 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161598597.73269137/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. rgatpol’ esetvso anbsuedrn rgac:Asseai eiwand review McDonald, systematic A Vanstone, : Meredith during synthesis use research mixed-methods on integrative perspectives A people’s research. mitigation. Pregnant of risk order for results in strategies cannabis and use and design to benefit choose the of might influences perceptions person substances pregnant about using a other dialogue for why foster with reasons understanding or to of grouped benefits importance is perceived the grouped perceptions emphasizes addressed cannabis or analysis seldom and way comparative alone substance priorities The other studied decision-making with Conclusions: was participant people’s cannabis of combining cannabis pregnant cannabis. 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Search and pregnancy in use cannabis about Objectives: Background: pregnancy words) in (242/250 use Abstract cannabis of Perspectives references) title: or Running tables including (not words 3528 x22113 905-525-9140 [email protected] 1H6 L8S Canada Ontario, Hamilton, W St Main 100 5001F, Medicine Family of Department Professor Associate PhD Vanstone, Meredith author: Corresponding [email protected] [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], author: each for addresses E-mail MMse iwfr eerhCnr,MMse nvriy 20Mi tW,Hmlo,Ontario, Hamilton, W., St Main 1280 Western University, Dentistry, McMaster and Centre, Medicine Research of Midwifery School McMaster Schulich Innovation, 7. and Research Education for Center 6. aaaLS4L8 L8S 5C1 Canada N6A Canada, Ontario, London, St, Richmond 1151 University, osnhsz xsigkoldeo h esetvso rgatpol n hi partners their and people pregnant of perspectives the on knowledge existing synthesize To anbsuedrn h eiaa eidi rising. is period perinatal the during use Cannabis h a anbsi rue ihohrsbtne nune h einadrslsof results and design the influences substances other with grouped is cannabis way The eietfid2 tde eciigteveso 44penn epead63postpartum 613 and people pregnant 9474 of views the describing studies 23 identified We esace ELN,AAPyIF,Cmltv ne oNrigadAle Health Allied and Nursing to Index Cumulative PsycINFO, APA MEDLINE, searched We lgbesuiswr hs faymtoooywihicue h esetvsand perspectives the included which methodology any of those were studies Eligible eepoe ovretitgaieapoc oteaayi ffindings of analysis the to approach integrative convergent a employed We 2 Posted on Authorea 17 Mar 2021 — The copyright holder is the author/funder. 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We how during and about pregnancy knowledge in lactating existing use and synthesize METHODS: cannabis pregnant to about by beliefs review faced and use systematic attitudes, cannabis a experiences, about conducted challenges we decisional the people, understand clinicians help To tde aeaaye h am fcnai xouetruhlcain hr scnitn vdneabout evidence conflicting is development there motor lactation; through in exposure delays cannabis for of potential harms the the analyzed have studies a loaetlne emnuoeeomna ucmsicuigatnin yeatvt,ipliiyin impulsivity hyperactivity, attention, admission including unit delivery outcomes neurodevelopmental childhood care preterm term intensive early for longer neonatal risk affect for the also or risk may increases contra- stillbirth increased use been weight, an cannabis have use birth whether poses There cannabis on about with effects inconsistencies clear. weight has also yet birth pregnancy in not during effects decrease is cannabis neonatal a and of pregnancy users birth use during non-pregnant preterm the use than , whether cannabis anemia on for of findings risk harms dictory greater fetal at are about users Evidence challenges cannabis addiction pregnant and pregnancy; health that of mental outside evidence as and well is within as same There disorders the cardiovascular remain and effects respiratory health include negative harms person, lactating opioids) or aid pregnant (e.g. an Pregnancy the harmful For as During more or Use be needs, Cannabis or to health of mental judged seizures, Outcomes or substances control Health physical other to unmet of of sleep, use impact the , negative discontinue pain, perceived to the as decrease which such to treatment pregnancy conditions reduction, hair pre-existed treat and fatigue which to skin and reasons for including pain for , reasons, , use of as period cannabis variety such perinatal a conditions the pregnancy-related to for unknown related alleviate cannabis similarly are is and use lactation pre-exist that people both during suggesting use lactating studies cannabis and existing of Pregnant prevalence with The pregnancy, methodology. during and use cannabis use, cannabis use of of people pregnant rate of precise time 2-36% a over establish increasing to been difficult has population lactation general during the and in pregnancy in use Cannabis Introduction: CRD42020180038 number: registration Prospero words: Key Funding: aainIsiue fHat Research Health of Institutes Canadian anbs rgac,lcain ytmtcrve,mxdmtos nertv review integrative mixed-methods, review, systematic lactation, pregnancy, cannabis, 4 35 34, mtoa n eaiu problems behaviour and emotional , 4-6 ,8 1 15-18 11, 8, 7, n h ieiodo eua sr ocniu ouei pregnancy in use to continue to users regular of likelihood the and -,7 9-12 7, 1-3, o oepenn epecnai s a eamto fharm of method a be may use cannabis people pregnant some For . htaeteeprecs eif,adoiin fpenn people pregnant of opinions and beliefs, experiences, the are What 8 1 32 31, 28, 27-30 0 41 40, ihvrac eae otepplto tde,definition studied, population the to related variance with 7 37-39 27, eaaaye aerpre htsm tde show studies some that reported have Meta-analyses . 3 ,8 1 15-19 11, 8, 7, hl tesrpr oassociation no report others while , o hsrve,w ogtpiay miia studies empirical primary, sought we review, this For 35 . n uimsetu disorder spectrum autism and , rgatpol eotuigcnai to cannabis using report people Pregnant . 8 9 33 29, 28, ti eitrda RSEOreview PROSPERO as registered is It rntlepsr ocannabis to exposure Prenatal . 1-3 rvnb nraiguse increasing by driven , 6 7 20 17, 16, 21 . 8 9 32-34 29, 28, tescontinue Others . 7 29 27, 36 hr are There . 3 14 13, eyfew Very . ,8 7, ri it if or , . tis It . 28 22-27 . . 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Posted on Authorea 17 Mar 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161598597.73269137/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. eotdadbohmclytse aiun s mn rgatfmlsi aionafo 2009-2016. from self- California in Trends in al. females et pregnant C, among Weisner use A, Conway MA, 2017;318(24):2490-1. tested Armstrong Jama. biochemically S, During Alexeeff and Dependence L-Y, reported Tucker Gynaecology or and KC, Young-Wolff Abuse Obstetrics of Cannabis 3. Journal HA. Births. Million Abenhaim 12 J, 2019;41(5):623-30. on Balayla Study Canada. among Cohort N, use Population-Based marijuana A Czuzoj-Shulman in Pregnancy: A, Trends DS. Petrangelo 2017;317(2):207-9. Hasin Jama. MM, 2. Wall 2002-2014. SS, women, Martins reproductive-aged D, nonpregnant Shmulewitz and AL, pregnant Sarvet QL, Brown 1. research. 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ST, SM, collected AP, JP, ST DG, AP, SM, JP, MV, from study. tions the designed ED BMD, Authorship: to Contribution Interests of Disclosure decisions appraisal. informed critical encourage with to sisted children. and necessary future ways is their evidence. the and period Acknowledgments: on existing people perinatal research of pregnant reflect the additional to may design during legalization, risk gap study people following cannabis reduce This the jurisdictions that that use use. on many people reasons this use in that to of specific cannabis rise benefits reasons use about rates are perceived the use assumptions there of about cannabis researcher’s host that perspectives As the a acknowledge or of and not pregnancy, partners, influence during do their the pregnancy, cannabis of in studies use use perspectives Many cannabis to the on choose include people lactation. pregnant yet of during not perspectives cannabis does the about literature evidence this of but body growing with a studies is There included study only pregnant. 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All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161598597.73269137/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 0 abs-ekrC udl ,SihC,Bok ,OrM atti .DiyCnai s During Use Cannabis Daily M. Medicine. Gartstein Addiction M, of Journal Orr Cannabis. O, Recreational 31;31:31. Legalized Brooks Jan With State 2020 CL, Health. a cannabis Smith in Public Postpartum about E, and of Perceptions Pregnancy Burduli Journal C. C, Canadian Barbosa-Leiker Ringham synthesis. 20. KA, qualitative Hayden best-framework JM, rapid Smith a CS, 2020:1-11. pregnancy: Ginn use during KS, cannabis Bright use about 10.1111/jmwh.13205). Decisions SJ, 2021(DOI: substitution: Weisbeck Health. Women’s or 19. Nausea & self-treatment, Severe Midwifery Desistance, of 2014;73(9):283. B. of Journal Health. C Experiences pregnancy. Public L, during Maternal & Roosevelt and Medicine D, of Use Greyson Journal 18. Marijuana Hawai’i EL. ‘i. Hawai Hurwitz in WK, Pregnancy Patrick During of EK, Association Roberson al. et 17. 2018;178(10):1423- medicine. MA, internal Armstrong JAMA use. A, marijuana Conway prenatal LA, with 4. pregnancy Avalos in L-Y, vomiting Tucker 2018. and V, nausea during medicine. Sarovar Preventive use KC, review. cannabis Young-Wolff integrative about 16. An perspectives Women’s period: P. postpartum Janssen the S, Lisonkova and 2018;197:90-6. M, maternal pregnancy pediatrics. between Zahradnik peri- of association the H, Journal The during Bayrampour The marijuana: use 15. outcomes. year. neonatal and LM. and recreational Borgelt one legalized patterns, E, at with Wymore breastfeeding development state KE, characteristics, a Hall infant in A, and Brooks-Russell period AL, natal lactation Juhl during TL, Crume use 14. marijuana Maternal 1990;12(2):161-8. Clinical teratology. RE. Alcoholism: and Little children. Neurotoxicology to SJ, drug risk and Astley the smoking, 13. and Alcohol, pregnancy SW. during Jacobson 2011;35(6):1081-91. age JL, Research. childbearing Jacobson Experimental use O, of and marijuana Boucher women J, Inuit of Gagnon among patterns D, use Laflamme and G, Prevalence Muckle gynecology. WM. 12. and obstetrics Callaghan of AA, journal American e10. Creanga age. e1-. reproductive Health. VT, 2015;213(2):201. of women Tong 2002–2011. Public nonpregnant pregnancy: Alaska, SL, and in of pregnant in Farr Births among Live Journal use JY, Delivering Women cannabis Ko Canadian among of 11. Use 2017. Marijuana correlates L. to and Castrodale 2012 J, Trends McLaughlin from M. 10. Walker of Canada DB, Journal Ontario, Fell harm. in D, potential 2019;110(1):76-84. Weiss study of H, population-based knowledge intended Hsu a and and DJ, current legalization Corsi women’s toward 9. Pregnant views M. their Terplan RP, 2017;11(3):211-6. to Schwartz medicine. relation E, addiction in Axenfeld 2012;3(4). therapy. use J, & tobacco Gryczynski cannabis research versus K, addiction marijuana of of Mark costs Journal 8. financial women. perceived pregnant and low-income Prevalence urban Ottawa, SJ. among 2017. Ondersma use DS, for Svikis results JR, of Beatty Summary 7. Survey: 2017. Drugs Canada; and of Alcohol Government Tobacco, 2019. ON: Canadian Canada; Canada. Statistics ON: Statistics Ottawa, 6. Survey. the investigating Cannabis states: National Canada. 50 Drug Statistics in dependence. 5. laws and marijuana abuse use, Medical 2012;120(1-3):22-7. marijuana D. dependence. and marijuana Hasin alcohol medical and S, of Galea legalization state KM, between Keyes relationship M, Wall Cerd´a M, 4. 9 Posted on Authorea 17 Mar 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161598597.73269137/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 9 ensK vtbeN lcadC olsC asu ,Hle ,e l aiun:peaa and prenatal Marijuana: al. et L, Holmes B, 1985;59:48-60. Hassoun Monogr. C, Res Boyles NIDA human. C, the Blackard in N, Recommendations. exposure Avitable Clinical postnatal and K, year. Review Tennes one 25;25:25. Literature 39. at Jan Lactation: 2020 During development Can. Use infant Gynaecol Cannabis and Obstet G. J lactation Kim A, during Ordean use 38. marijuana pregnancy Maternal Mar-Apr;12(2):161-8. in RE. 1990 use Teratol. cannabis Little Neurotoxicol Maternal SJ, al. 2020/08/10. Astley et El-Chaˆar 2020 D, H, 37. Medicine. Hsu Nature S, Hawken outcomes. neurodevelopmental E, Sucha child J, and multi-informant Donelle a offspring; DJ, the 2019;48(1):287-96. Corsi and Epidemiology. in 36. Preconception problems of al. emotional Journal et and BB, International behavioural study. Lahey of MH, longitudinal risk Hillegers prospective the VWV, and Jaddoe use IHA, cannabis Franken prenatal K, Bolhuis Gynecology. HE, & Marroun Obstetrics 35. Lactation. and Pregnancy During Use Marijuana Gynecology. 2017;130(4):e205-e9. 722: & No. Obstetrics Opinion Breastfeeding. Committee While 34. and Pregnancy preg- in during Use and Marijuana 11;132(5):1198-210. LM. women 2018 Borgelt among TD, use 2014;13(2):93-100. Metz cannabis 33. 2014 of Treatment. two management Their from the & results on Exploring Disorders outcomes: Addictive N. Impact birth nancy. el-Guebaly on Its 05;05:05. FF, use Mar and Alharbi marijuana 2020 32. pregnancy Use Perinatology. of of Marijuana Impact Journal D. at cohorts. Shah population-based Look DL, matched Wood Updated BA, An Bailey Gynecological 03;62(1):185-90. 31. Pregnancy: & 2019 Gynecology. in Obstetrical & Review. Use Obstetrics A Clinical Marijuana Pregnancy. Pregnancy: E. in Apr Stickrath Use 2016 30. Marijuana Open. J. BMJ Lo cannabis Jul;74(7):415-28. K, meta-analysis. to 2019 DeJong Survey. and exposure R, Prenatal review al. Thompson systematic et 29. C, a Christ outcomes: SJ, health Gibson A, child Physician. 05;6(4):e009986. Nunez Family and KE, Canadian Center maternal CB, postpartum. and Rosales and JK, pregnancy Gunn during 28. use Cannabis of and Jul-Sep;6(3):E339-E46. G. effects effects Feb;66(2):98-103. 2018 health Smith 2020 open. health adverse S, CMAJ adverse The review. Badowski F. overview the 27. Clement an about T, use: Noseworthy revealed marijuana E, to decades Spackman related LE, two harms Dowsett past KA, Memedovich the on 26. over Jan;110(1):19-35. 2015 research Addiction. and has use? Cannabis cannabis What of recreational W. Effects Negative Hall J and 25. Engl 2019;105(5):1139-47. Positive N Therapeutics. A. & use. Weinstein Pharmacology marijuana A, Clinical of Weizman Health. effects K, health Cohen Adverse effects 24. SRB. long-term Weiss and WM, Acute Compton al. 2014;370(23):2219-27. RD, et Med. HJ, Baler 2014;20(25):4112-8. Aubin ND, Des. Volkow M, Pharm Reynaud 23. Curr parenthood. A, review. Benyamina early morality a B, use: and dominant Rolland cannabis P, pregnancy the of Roux during Complicating L, S. use Karila 2015;14(1):72. 22. Charbonneau substance health. in L, of equity Marcellus constructions for R, journal fathers’ International Phillips and S, mothers Magnus discourse: C, Benoit 21. 10 Posted on Authorea 17 Mar 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161598597.73269137/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 6 rhrM.Po n rgat eiaa aj s nrrlJmia d loo us Abuse. Subst Alcohol Adv Jamaica. rural in use Cannabis perinatal of Journal pregnant: eat? and to Poor not MC. 1989;8(1):45-54. or Dreher eat and to 56. Beliefs cannabis: clinical al. and et gravidarum 2002;2(3/4):63-83. Alcohol KL, Hyperemesis Therapeutics. Drug Rodriguez WL. use. GA, Curry report Richardson who 55. NM, women pregnant Genna 01;196:14-20. of 03 De Perspectives 2019 CL, use: Depend. Holland marijuana information JA, prenatal perceptions 2020 of Tarr regarding Canadians’ Canada. attitudes JC, impact Pregnant Gynaecology Chang the and al. Obstetrics and 54. et of breastfeeding T, Journal while Patel use. and S, of pregnancy discontinuation Sharma 2020/05/15/. on in N, providers Vu cannabis 12 healthcare N, of 2017 from Gervais transmission comparison K, Depend. the A Alcohol Kaarid about Drug K, pregnancy: Bartlett during women. pregnant use 53. unmarried Marijuana and DM. HIV-positive married DiNitto in among MG, motherhood 01;181:229-33. correlates Vaughn and on CP, Salas-Wright trends findings of S, qualitative Oh of 2003;26(2):153-70. metasynthesis 52. Health. a and Toward Nursing in BJ. Research M women. 2003;52(4):226- Sandelowski Research. Nursing 51. London: findings. qualitative analysis. of metasummaries qualitative Creating through 33. BJ. guide M practical Sandelowski a 50. in theory: findings grounded extracting 2006. Constructing for Publications; 2013;69(6):1428-37. Sage K. method Nursing. a Charmaz Advanced Text-in-context: of 49. JL. Journal Crandell studies. nursing. K, synthesis advanced research Knafl of mixed J, mixed-methods Journal Leeman methodology. M, Sandelowski updated 48. review: integrative The K. quality of Knafl 2005;52(5):546-53. compendium R, a Whittemore syntheses: 47. evidence 2018;28(13):2115-31. for research. research Publishing; health qualitative Qualitative Springer Appraising tools. York: Stud. M. appraisal Vanstone New Nurs U, research.: J Majid qualitative reviews: Int 46. synthesizing studies tool. for mixed appraisal Handbook Systematic methods BJ. P. 2006. mixed M Pluye the Sandelowski I, of Vedel 45. efficiency PL, and Bush reliability International QN, the 2015;52(1):500-1. review. Hong on studies V, results mixed Khanassov updating systematic RQ, for Souto (MMAT) 44. efficiency Tool and 2012;49(1):47-53. reliability Appraisal the studies. Testing al. nursing Methods et of J, Mixed journal Jagosh J, pilot Salsberg AC, the Macaulay G, of Ap- Bartlett P, Methods Pluye Mixed R, Information. Pace The for 43. al. Education Joanna et researchers. P, and The systematic Dagenais professionals information M, Manual: methods for Cargo 2018;34(4):285-91. Reviewer’s Mixed 2018 F, version al. Institute Boardman (MMAT) Tool G, et Briggs praisal Bartlett F`abregues S, Joanna S, QN, Salmond editors. Hong K, 42. Z, Rieger Munn C, E, 2019. Godfrey Institute; Aromataris J, Briggs In: Carrier C, . Stern reviews. reviews. L, Systematic for Lizarondo implications evidence. quantitative designs: 41. synthesis and sequential qualitative and of Convergent reviews M. 2017;6(1):61. systematic Wassef M, reporting Bujold and P, conducting Pluye QN, Hong 40. 11 Posted on Authorea 17 Mar 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161598597.73269137/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 4 oebu ,IwnK rgac,dus n amrdcin rgadcinrsac n h health the 1998:309-18. and Abuse. research Drug addiction Health Drug on Public Institute reduction. National harm nursing. MD: and drugs, Rockville, health Pregnancy, women public K. of Irwin and M, and Rosenbaum health, safety 74. public of principle, question precautionary the 2008;25(3):261-8. The and RV. Nursing. choices, women’s Chaudry 2004;10(1):30-6. pregnancy: midwifery. 73. in and nursing herbs pharmacotherapy. in anti-emetic therapies herbal of Complementary of Use efficacy. Journal RE. Westfall experiences. women’s 72. pregnancy: in healing to Herbal 11/17;34. 2003;3(4):17-39. Awaiting RE. 2016 barrier Addictions Westfall with Journal. a Women Work Pregnant 71. becomes of Social Behaviors Adolescent pregnancy and and Beliefs during P. Child Fisher use Initiation. J, Treatment drug Harrison A, how Scoyoc Van 2011;15(3):333-41. calculations: 70. J. Health Complex Child substance C. Matern care. for Pies care. prenatal SCM, Reasons in prenatal use Roberts drug 2019 and al. alcohol 69. et for Birth. May-Jun;20(3):193-200. screening S, 2010 on and perspectives Ito Issues. Women Women’s Health A. Z, Womens Nuru-Jeter study. Austin SC, qualitative Roberts T, A 68. Leibson M, pregnancy: during Motz Cali- discontinuation NCZ, 2019/02/01/;32(1):e57-e64. the and from Andrews continuation Findings KA, Jan-Mar;29(1):55-66. use women: 1997 Latuskie substance-using Drugs. pregnant Psychoactive of 67. of Perspectives Journal E. assessment. Zahnd needs D, perinatal Crim fornia D, Sep;22(3):425-32. Klein 1995 Nursing. 66. Advanced of parenting SUBSTANCE- PREGNANT Journal and OF TREATMENT. BEHAVIORS pregnant DRUG-TAKING IN C. among Wallerstedt ABUSERS DH, use Clough PG, substance Higgins 1998;8(1):69-95. about 65. . Beliefs on MR. Research Gillmore of Midwifery. MS, Journal Spencer Test). adolescents. pregnancy DM, Screening in Involvement Morrison study Substance investigation 64. and the Smoking from data Alcohol, qualitative (the of Mar;34:183-97. 3.0 Analysis 2016 Version versus JM. ASSIST White Marijuana the RL, 2012 of of Ali Therapy. Costs ED, & Hotham Financial Research 63. Perceived Addiction of and Journal Prevalence Women. SJ. Pregnant 30;3(4):30. 30;30:30. Ondersma Low-Income Sep Jan Urban DS, 2020 among Svikis (Larchmt). use Health Tobacco Perinatal JR, Womens About Beatty J Questions Women’s Responses. 62. JJ. Obstet Providers’ Prochaska J Care GW, Health Opinions. Rutledge and V, Maternal Use Sarovar of K, Cannabis Survey Gali Information A KC, Young-Wolff to Labour: 61. During Access 27;27:27. Marijuana Women’s Jan A. Pregnant Jul-Aug;26(4):452-9. 2020 Moore 2016 JC. Can. C, Issues. Gynaecol Chang Xu Health T, D, Womens Postonogova Farrell Study. 60. Qualitative CL, A Holland Use: JA, Marijuana Tarr Perinatal M, About mari- Jarlenski above ”Anything marijuana 09;99(9):1446-51. 59. perinatal al. 2016 regarding et strategies KL, Couns. counseling Rodriguez Educ and D, Intervention Patient attitudes Rubio Brief providers’ use. JA, Obstetric Tarr Electronic P, priority”: Providers. Morrison takes al. MA, and juana et Nkumsah Patients CL, J, of Holland Konkel Acceptability 58. 08;5(11):e172. Initial K, Nov Resnicow Pregnancy: 2017 KS, During Uhealth. Puder Use Mhealth Marijuana DS, JMIR for Svikis Messaging JR, Text Beatty and J, Gray 57. 12 Posted on Authorea 17 Mar 2021 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161598597.73269137/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. e;N=N;C a’ el ealddsrpin fec rtro r ulse lehr.(42) elsewhere. published are criterion page) each 1 of than descriptions longer Detailed Tell. 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All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.161598597.73269137/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 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