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Al-Beltagi M. Nutritional management and autism spectrum disorder: A systematic review. World J Clin Pediatr 2024; 13:99649. [PMID: 39654662 PMCID: PMC11572612 DOI: 10.5409/wjcp.v13.i4.99649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 09/21/2024] [Accepted: 10/15/2024] [Indexed: 10/30/2024] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) presents unique challenges related to feeding and nutritional management. Children with ASD often experience feeding difficulties, including food selectivity, refusal, and gastrointestinal issues. Various interventions have been explored to address these challenges, including dietary modifications, vitamin supplementation, feeding therapy, and behavioral interventions. AIM To provide a comprehensive overview of the current evidence on nutritional management in ASD. We examine the effectiveness of dietary interventions, vitamin supplements, feeding therapy, behavioral interventions, and mealtime practices in addressing the feeding challenges and nutritional needs of children with ASD. METHODS We systematically searched relevant literature up to June 2024, using databases such as PubMed, PsycINFO, and Scopus. Studies were included if they investigated dietary interventions, nutritional supplements, or behavioral strategies to improve feeding behaviors in children with ASD. We assessed the quality of the studies and synthesized findings on the impact of various interventions on feeding difficulties and nutritional outcomes. Data extraction focused on intervention types, study designs, participant characteristics, outcomes measured, and intervention effectiveness. RESULTS The review identified 316 studies that met the inclusion criteria. The evidence indicates that while dietary interventions and nutritional supplements may offer benefits in managing specific symptoms or deficiencies, the effectiveness of these approaches varies. Feeding therapy and behavioral interventions, including gradual exposure and positive reinforcement, promise to improve food acceptance and mealtime behaviors. The findings also highlight the importance of creating supportive mealtime environments tailored to the sensory and behavioral needs of children with ASD. CONCLUSION Nutritional management for children with ASD requires a multifaceted approach that includes dietary modifications, supplementation, feeding therapy, and behavioral strategies. The review underscores the need for personalized interventions and further research to refine treatment protocols and improve outcomes. Collaborative efforts among healthcare providers, educators, and families are essential to optimize this population's nutritional health and feeding practices. Enhancing our understanding of intervention sustainability and long-term outcomes is essential for optimizing care and improving the quality of life for children with ASD and their families.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
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Kandeel M, Morsy MA, Al Khodair KM, Alhojaily S. Meta-analysis of the efficacy of camel milk consumption for improving autism symptoms in children in randomized clinical trials. Open Vet J 2024; 14:2441-2452. [PMID: 39553772 PMCID: PMC11563599 DOI: 10.5455/ovj.2024.v14.i9.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 08/06/2024] [Indexed: 11/19/2024] Open
Abstract
Background Camel milk has emerged as a potential complementary therapy for autism spectrum disorder (ASD). Aim This study aimed to gather evidence from randomized controlled trials (RCTs) on the effectiveness of camel milk consumption in improving symptoms and associated measures in children with ASD. Methods Comprehensive searches of multiple databases were conducted up to March 14, 2024, for RCTs that evaluated whether camel milk consumption by children with ASD was more beneficial than the consumption of a control substance. Quality and bias analyses and meta-anlaysis data were synthesized and analyzed. Results Of 136 records identified, 5 RCTs (n = 299 children) were selected. The mean difference in scores on the childhood autism rating scale (CARS) for the group given camel milk and the control groups was a mean deviation (MD) ‒0.75, 95% CI‒1.97 to 0.47, p = 0.23. The mean difference in CARS scores in the subgroup analyses for raw camel milk was MD‒0.95, 95% CI‒2.33 to 0.44, p = 0.18 and boiled camel milk MD ‒0.50, 95% CI‒1.93 to 0.93, p = 0.49. A qualitative synthesis found that raw camel milk intake led to improvements in various social behaviors in children with ASD. Camel milk consumption resulted in increased levels of anti-inflammatory, antioxidant, and immunomodulatory biomarkers, with some differences observed between patients given raw camel milk and boiled camel milk. Conclusion Camel milk shows promise in improving social behaviors and certain biochemical markers in children with ASD, although the current meta-analysis did not document a significant statistical difference in CARS scores for the children studied. Future studies should focus on rigorous RCTs and larger sample sizes to substantiate these preliminary findings.
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Affiliation(s)
- Mahmoud Kandeel
- Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Mohamed A. Morsy
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Pharmacology, Faculty of Medicine, Minia University, El-Minia, Egypt
| | - Khalid M. Al Khodair
- Department of Anatomy, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Sameer Alhojaily
- Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
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Arain MA, Khaskheli GB, Shah AH, Marghazani IB, Barham GS, Shah QA, Khand FM, Buzdar JA, Soomro F, Fazlani SA. Nutritional significance and promising therapeutic/medicinal application of camel milk as a functional food in human and animals: a comprehensive review. Anim Biotechnol 2023; 34:1988-2005. [PMID: 35389299 DOI: 10.1080/10495398.2022.2059490] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Camel milk (CM) is the key component of human diet specially for the population belongs to the arid and semi-arid regions of the world. CM possess unique composition as compare to the cow milk with abundant amount of medium chain fatty acids in fat low lactose and higher concentration of whey protein and vitamin C. Besides the nutritional significance of CM, it also contains higher concentration of bioactive compounds including bioactive peptides, lactic acid bacteria (LAB), lactoferrin (LF), lactoperoxidase, lysozyme casein and immunoglobulin. Recently, CM and their bioactive compounds gaining more attention toward scientific community owing to their multiple health benefits, especially in the current era of emerging drug resistance and untold side effects of synthetic medicines. Consumption of fresh or fermented CM and its products presumed exceptional nutraceutical and medicinal properties, including antimicrobial, anti-inflammatory, antioxidant, anti-diabetic, hepatoprotective, nephroprotective, anticancer and immunomodulatory activities. Moreover, CM isolated LAB exhibit antioxidant and probiotic effects leading to enhance the innate and adaptive immune response against both gram-negative and gram-positive pathogenic bacteria. The main objective of this review is to highlight the nutritional significance, pharmaceutical potential, medicinal value and salient beneficial health aspect of CM for human and animals.
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Affiliation(s)
- Muhammad Asif Arain
- Faculty of Veterinary and Animal Sciences, Lasbela University of Agriculture, Water and Marine Sciences, Uthal, Pakistan
- Faculty of Animal Husbandry and Veterinary Science, Sindh Agriculture University Tandojam, Tandojam, Pakistan
| | - Gul Bahar Khaskheli
- Faculty of Animal Husbandry and Veterinary Science, Sindh Agriculture University Tandojam, Tandojam, Pakistan
| | - Atta Hussain Shah
- Faculty of Animal Husbandry and Veterinary Science, Sindh Agriculture University Tandojam, Tandojam, Pakistan
| | - Illahi Bakhash Marghazani
- Faculty of Veterinary and Animal Sciences, Lasbela University of Agriculture, Water and Marine Sciences, Uthal, Pakistan
| | - Ghulam Shabir Barham
- Faculty of Animal Husbandry and Veterinary Science, Sindh Agriculture University Tandojam, Tandojam, Pakistan
| | - Qurban Ali Shah
- Faculty of Veterinary and Animal Sciences, Lasbela University of Agriculture, Water and Marine Sciences, Uthal, Pakistan
| | - Faiz Muhammad Khand
- Department of Veterinary Surgery, Shaheed Benazir Bhutto University of Veterinary and Animal Sciences, Sakrand, Pakistan
| | - Jameel Ahmed Buzdar
- Faculty of Veterinary and Animal Sciences, Lasbela University of Agriculture, Water and Marine Sciences, Uthal, Pakistan
| | - Feroza Soomro
- Faculty of Animal Husbandry and Veterinary Science, Sindh Agriculture University Tandojam, Tandojam, Pakistan
| | - Sarfraz Ali Fazlani
- Faculty of Veterinary and Animal Sciences, Lasbela University of Agriculture, Water and Marine Sciences, Uthal, Pakistan
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Kandeel M, El-Deeb W. The Application of Natural Camel Milk Products to Treat Autism-Spectrum Disorders: Risk Assessment and Meta-Analysis of Randomized Clinical Trials. Bioinorg Chem Appl 2022; 2022:6422208. [PMID: 35669459 PMCID: PMC9166988 DOI: 10.1155/2022/6422208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/28/2022] [Accepted: 05/09/2022] [Indexed: 01/08/2023] Open
Abstract
Camel milk is better tolerated than the milk of other ruminants, potentially expanding its consumer appeal. It also contains essential vitamins, minerals, and immunoglobulins, providing the milk with antioxidant, antibacterial, and antiviral properties. These properties may reduce oxidative stress in camel milk consumers, ameliorating many conditions, including those of the CNS, such as autism spectrum disorders (ASDs). We performed a meta-analysis of randomized controlled trials (RCTs) in which camel milk administration (boiled or raw) was examined as an ASD treatment intervention. The primary endpoint was participants' total autism scores, determined using the Childhood Autistic Responsiveness Scale (CARS). A comparison of the responsiveness in these ASD intervention groups yielded a mean difference (MD) of 1.99 (0.89, 3.08) in those consuming boiled camel milk, MD = 2.77 (1.92, 3.61) in raw camel milk consumers, and MD = -1.02 (-0.10, 2.13) in cow milk consumers. Heterogeneity was notably low among the examined studies. Treatment of ASD with raw and boiled camel milk resulted in significantly lower CARS scores than the placebo. Our findings support the development of larger, more populated RCTs to establish camel milk's overall potential as a therapeutic intervention for CNS disorders.
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Affiliation(s)
- Mahmoud Kandeel
- Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Hofuf 31982, Al-Ahsa, Saudi Arabia
- Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelshikh University, Kafr El-Shikh 33516, Egypt
| | - Wael El-Deeb
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al Hofuf, Al-Ahsa, Saudi Arabia
- Department of Internal Medicine,Infectious Diseases and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Manosura, Egypt
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Muthukumaran MS, Mudgil P, Baba WN, Ayoub MA, Maqsood S. A comprehensive review on health benefits, nutritional composition and processed products of camel milk. FOOD REVIEWS INTERNATIONAL 2022. [DOI: 10.1080/87559129.2021.2008953] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- M. Selva Muthukumaran
- Department of Food Technology, Hindustan Institute of Technology and Science, Chennai, India
| | - Priti Mudgil
- Department of Food Science, College of Agriculture and Veterinary Medicine United Arab Emirates University, UAE
| | - Waqas N Baba
- Department of Food Science, College of Agriculture and Veterinary Medicine United Arab Emirates University, UAE
| | - Mohammed Akli Ayoub
- Department of Biology, College of Science, United Arab Emirates University, UAE
- Zayed Center for Health Sciences, The United Arab Emirates University, UAE
| | - Sajid Maqsood
- Department of Food Science, College of Agriculture and Veterinary Medicine United Arab Emirates University, UAE
- Zayed Center for Health Sciences, The United Arab Emirates University, UAE
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Nutritional and therapeutic perspectives of camel milk and its protein hydrolysates: A review on versatile biofunctional properties. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.103441] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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AL-Ayadhi L, Halepoto DM. Camel Milk as a Potential Nutritional Therapy in Autism. NUTRIENTS IN DAIRY AND THEIR IMPLICATIONS ON HEALTH AND DISEASE 2017:389-405. [DOI: 10.1016/b978-0-12-809762-5.00030-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Mihic T, Rainkie D, Wilby KJ, Pawluk SA. The Therapeutic Effects of Camel Milk: A Systematic Review of Animal and Human Trials. J Evid Based Complementary Altern Med 2016; 21:NP110-26. [PMID: 27432772 DOI: 10.1177/2156587216658846] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The clinical effectiveness and value of camel milk as a therapeutic agent is currently unclear. MEDLINE (1946 to March 2016), EMBASE (1974 to March 2016), and Google Scholar were searched using the following terms: milk, bodily secretions, camels, camelus, camelini, camelidae, dromedary, bactrian camel, body fluid, and bodily secretions. Articles identified were reviewed if the study was investigating the use of camel milk for the potential treatment of diseases affecting humans. Of 430 studies, 24 were included after assessment. Identified studies highlighted treatment with camel milk of diseases, including diabetes, autism, cancer, various infections, heavy metal toxicity, colitis, and alcohol-induced toxicity. Although most studies using both the human and animal model do show a clinical benefit with an intervention and camel milk, limitations of these studies must be taken into consideration before widespread use. Based on the evidence, camel milk should not replace standard therapies for any indication in humans.
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Affiliation(s)
- Tamara Mihic
- The University of British Columbia, Vancouver, British Columbia, Canada
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The unique medicinal properties of camel products: A review of the scientific evidence. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2015.12.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Zibaee S, Hosseini SMAR, Yousefi M, Taghipour A, Kiani MA, Noras MR. Nutritional and Therapeutic Characteristics of Camel Milk in Children: A Systematic Review. Electron Physician 2015; 7:1523-8. [PMID: 26767108 PMCID: PMC4700900 DOI: 10.19082/1523] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/21/2015] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Camel milk is the closest to a human mother's milk. Camel milk is different from other milks, however, having low sugar and cholesterol, high minerals (sodium, potassium, iron, copper, zinc and magnesium, and vitamin C). The milk is considered have medicinal characteristics as well. This systematic review is aimed at determining and reporting nutritional values and medicinal characteristics of camel milk in children. METHODS The search strategy of the current review is "(camel AND milk) AND (autism OR food allergy OR milk allergy OR children OR diarrhea." The search was conducted via PubMed, Scopus, and Google scholar. Also two Persian scientific databases (SID and Iranmedex) and international congresses were investigated. Full-text papers and abstracts on the topic of camel milk, evaluating nutritional value and medicinal properties, were included in this systematic review. RESULTS Out of the 472 records found in the resources, 35 related studies were included in the final analysis. The result showed that camel milk is highly nutritious and is safe for consumption by children. CONCLUSION It seems that many researchers did not follow a specific guideline for reporting and confirming the therapeutic properties of camel milk in children, but there is evidence denoting the importance, trials, and investigations of its usability and benefits. Camel milk as a supplemental treatment seems less invasive and costly than specialist care, medications, alternative treatments, and behavioral interventions. Based on our findings, camel milk is safer for children, effective in the treatment of autism, improves general well-being, promotes body natural defenses, is a good nutritional source, and can helps the daily nutritional needs of humans.
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Affiliation(s)
- Said Zibaee
- Ph.D. of Microbiology, Assistant Professor, Razi Vaccine and Serum Research Institute of Mashhad, Iran
| | - Syed Musa Al-Reza Hosseini
- M.D., Assistant Professor, Department of Gastroenterology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Yousefi
- Ph.D. of Iranian Traditional Medicine, Assistant Professor, School of Iranian Traditional Medicine and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Taghipour
- Ph.D. of Epidemiology, Assistant Professor, school of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ali Kiani
- M.D., Assistant Professor, Department of Pediatrics Gastroenterology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Noras
- Ph.D. Candidate, School of Iranian Traditional Medicine and Complementary Medicine, Mashhad University Medical of Sciences, Mashhad, Iran
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Frye RE, Slattery J, MacFabe DF, Allen-Vercoe E, Parker W, Rodakis J, Adams JB, Krajmalnik-Brown R, Bolte E, Kahler S, Jennings J, James J, Cerniglia CE, Midtvedt T. Approaches to studying and manipulating the enteric microbiome to improve autism symptoms. MICROBIAL ECOLOGY IN HEALTH AND DISEASE 2015; 26:26878. [PMID: 25956237 PMCID: PMC4425814 DOI: 10.3402/mehd.v26.26878] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 04/05/2015] [Accepted: 04/06/2015] [Indexed: 02/07/2023]
Abstract
There is a growing body of scientific evidence that the health of the microbiome (the trillions of microbes that inhabit the human host) plays an important role in maintaining the health of the host and that disruptions in the microbiome may play a role in certain disease processes. An increasing number of research studies have provided evidence that the composition of the gut (enteric) microbiome (GM) in at least a subset of individuals with autism spectrum disorder (ASD) deviates from what is usually observed in typically developing individuals. There are several lines of research that suggest that specific changes in the GM could be causative or highly associated with driving core and associated ASD symptoms, pathology, and comorbidities which include gastrointestinal symptoms, although it is also a possibility that these changes, in whole or in part, could be a consequence of underlying pathophysiological features associated with ASD. However, if the GM truly plays a causative role in ASD, then the manipulation of the GM could potentially be leveraged as a therapeutic approach to improve ASD symptoms and/or comorbidities, including gastrointestinal symptoms. One approach to investigating this possibility in greater detail includes a highly controlled clinical trial in which the GM is systematically manipulated to determine its significance in individuals with ASD. To outline the important issues that would be required to design such a study, a group of clinicians, research scientists, and parents of children with ASD participated in an interdisciplinary daylong workshop as an extension of the 1st International Symposium on the Microbiome in Health and Disease with a Special Focus on Autism (www.microbiome-autism.com). The group considered several aspects of designing clinical studies, including clinical trial design, treatments that could potentially be used in a clinical trial, appropriate ASD participants for the clinical trial, behavioral and cognitive assessments, important biomarkers, safety concerns, and ethical considerations. Overall, the group not only felt that this was a promising area of research for the ASD population and a promising avenue for potential treatment but also felt that further basic and translational research was needed to clarify the clinical utility of such treatments and to elucidate possible mechanisms responsible for a clinical response, so that new treatments and approaches may be discovered and/or fostered in the future.
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Affiliation(s)
- Richard E Frye
- Division of Neurology, Arkansas Children's Hospital Research Institute, Little Rock, AR, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA;
| | - John Slattery
- Division of Neurology, Arkansas Children's Hospital Research Institute, Little Rock, AR, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Derrick F MacFabe
- Department of Psychology and Psychiatry, Western University, London, ON, Canada
| | - Emma Allen-Vercoe
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | | | - John Rodakis
- N of One: Autism Research Foundation, Dallas, TX, USA
| | - James B Adams
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
| | - Rosa Krajmalnik-Brown
- Swette Center for Environmental Biotechnology, Biodesign Institute, Arizona State University, Tempe, AZ, USA
| | - Ellen Bolte
- N of One: Autism Research Foundation, Dallas, TX, USA
| | - Stephen Kahler
- Division of Neurology, Arkansas Children's Hospital Research Institute, Little Rock, AR, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Jill James
- Department of Developmental Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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