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ObjectiveThe aim of this study is to systematically review the published literature on the awareness, previous and current use, and harm perceptions of electronic cigarettes (e-cigarettes) among adults.MethodsA search of the most current literature using the PubMed and Scopus database to identify articles published since 2003 yielded a total of 28 relevant articles.ResultsThe pooled prevalence of awareness, previous use, current use of e-cigarettes and perceived healthier of e-cigarettes than regular cigarettes (healthier perception) among adults were 61.2% (95% confidence interval (CI): 51.5–70.8%), 16.8% (95% CI: 14.0–19.6%), 11.1% (95% CI: 9.2–13.1%), and 52.6% (95% CI: 42.5–62.6%), respectively, using a random effects model. The subgroup analysis showed that pooled estimates were highest in the group of current smokers of regular cigarettes, except that the highest pooled rate of current use was seen in the group of former smokers of regular cigarettes (the corresponding rates were 71.9% (95% CI: 57.5–86.3%), 27.2% (95% CI: 18.8–35.6%), 16.8% (95% CI: 7.2–26.3%), and 63.1% (95% CI: 52.1–74.1%)), and the lowest pooled rates were in the group of non-smokers, except for the rate of healthier perception in the users of e-cigarettes (and the corresponding rates were 46.8% (95% CI: 26.8–66.8%), 2.5% (95% CI: 1.1–5.6%), 1.2% (95% CI: 0.4–2.1%), and 37.9% (95% CI: -0.5–76.3%)). The cumulative meta-analysis found that awareness increased over time, while the prevalence of previous use, current use, and healthier perception first experienced an increase followed by a decrease and remained stable thereafter.ConclusionsE-cigarette awareness has been increasing, and e-cigarette use and perceived health risks are nearly invariable between 2009 and 2014. Given the substantial heterogeneity in the prevalence rate estimates, there is a need for more accurate and comparable prevalence estimates for e-cigarettes across the world.

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BackgroundThere is an increasing prevalence of women who tend to delay childbirth until a very advanced age. However, there is sparse data regarding very advanced maternal age (vAMA) and the interplay between vAMA and assisted reproductive technology (ART) on adverse perinatal outcomes. The study aimed to assess the risk of adverse maternal and neonatal outcomes of vAMA women (≥43 years), and to investigate the effect of maternal age on adverse maternal and neonatal outcomes in ART pregnancies.MethodsData was obtained from a population-based retrospective cohort of women who delivered in Ontario, Canada, between April 1st, 2012 and March 31st, 2015. The adjusted relative risks (ARR) and 95% confidence intervals (CI) for adverse maternal and neonatal outcomes were estimated by using multivariate log-binomial regression models among age groups. All models were stratified by the utilization of ART (ART and spontaneous conceptions).ResultsWomen at vAMA had a higher risk of composite outcome comprised of preeclampsia, intrauterine growth retardation, stillbirth, and placental abruption than the younger counterparts (ARR = 1.38, 95% CI: 1.23–1.55 compared to mothers aged 20–34; ARR = 1.26, 95% CI: 1.12–1.42 compared to mothers aged 35–42). Increased risk of the primary outcome in ART compared to spontaneous conception was only observed in women aged 20–34 years (ARR = 1.24, 95% CI: 1.14–1.35). For women conceived with ART, the risk for the primary outcome significantly increased in women at vAMA (ARR = 1.29, 95% CI: 1.01–1.65 compared to mothers aged 20–34; ARR = 1.36, 95% CI: 1.06–1.74 compared to mothers aged 35–42).ConclusionWomen at vAMA have higher risks of adverse maternal and neonatal outcomes. Although the utilization of ART may carry an independent role for adverse perinatal outcomes, it does not further enhance the adverse effect of vAMA.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2147-9) contains supplementary material, which is available to authorized users.

This prospective cohort study designed to assess the effect of folic acid supplementation in pregnancy on the risk of preeclampsia (PE) took place in Ottawa, ON and Kingston, ON, Canada, from September 1, 2002 to August 31, 2008. Pregnant women, less than 20 weeks gestational age were recruited and delivered in the Ottawa region and the Kingston General Hospital. Demographic characteristics of the study participants and the patterns of supplementation of folic acid were described and occurrence of PE between women with folic acid supplementation during pregnancy and women without were compared. Multiple logistic regression was used in the estimation of the independent effect of supplementation of folic acid. Additional analyses assessing the effect of low RBC and serum folate and dose-response relationship were performed. Analyses were performed in all study participants, and then in high risk and low risk sub-groups, respectively. A total of 7,669 participants were included in the final analysis. Ninety five percent of the study participants were taking folic acid supplementation in early second trimester. The rate of PE was lower in the supplementation group than in the no supplementation group, and the difference was statistically significant in high risk women. Similar patterns of associations were observed in analysis by RBC and serum folate levels and in dose-response analysis. Folic acid supplementation in pregnancy may reduce PE risk in pregnant women, especially in those women with increased risk of developing PE.

Anurognathids are an elusive group of diminutive, potentially arboreal pterosaurs. Even though their monophyly has been well-supported, their intrarelationships have been obscure, and their phylogenetic placement even more. In the present work, we present a new genus and species from the Middle-Late Jurassic Tiaojishan Formation, the third nominal anurognathid species from the Jurassic of China. The new species provides new information concerning morphological diversity for the group. Furthermore, we provide a new phylogenetic analysis incorporating into a single data set characters from diverging phylogenetic proposals. Our results place them as the sister-group of Darwinoptera + Pterodactyloidea, as basal members of the Monofenestrata.

ObjectiveTo explore inadequate and excessive gestational weight gain (GWG) among pregnant women of different racial/ethnic backgrounds in Ontario, Canada.MethodsA population-based retrospective cohort study was conducted among women who had prenatal screening and had a singleton birth in an Ontario hospital between April 2016 and March 2017. We estimated adjusted risk ratios (aRR) of racial/ethnic differences for inadequate or excessive GWG using multinomial logistic regression models. Interaction effects were examined to determine whether racial/ethnic difference in GWG varied by pre-pregnancy body mass index (BMI).ResultsAmong 74,424 women, the prevalence of inadequate GWG in White, Asian, and Black women was 15.7%, 25.8%, and 25.0%, and excessive GWG was 62.8%, 45.5%, and 54.7%, respectively. There were significant interaction effects between race/ethnicity and pre-pregnancy BMI for inadequate GWG (Wald p < 0.01) and excessive GWG (Wald p < 0.01). Compared with White women, Asian women had higher risk of inadequate GWG and lower risk of excessive GWG in all weight classes, and Black women had higher risk of inadequate GWG and lower risk of excessive GWG if their BMI was normal, overweight, or obese.ConclusionVariations in unhealthy GWG by pre-pregnancy weight classes among Ontario White, Asian and Black women were observed. Individualized counseling regarding appropriate GWG is universally recommended. Additional consideration of racial/ethnic variations by maternal weight classes may help to promote healthy GWG in Canada.Electronic supplementary materialThe online version of this article (10.17269/s41997-019-00250-z) contains supplementary material, which is available to authorized users.