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Lamma W, Miyake Y, Tanaka K, Karim AA, Arakawa M. Breastfeeding and behavioral problems in five-year-old Japanese children: The Kyushu Okinawa Maternal and Child Health Study. Ann Epidemiol 2024; 96:53-57. [PMID: 38914248 DOI: 10.1016/j.annepidem.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE This prebirth cohort study examined the relationship between breastfeeding duration and behavioral problems in five-year-old Japanese children. METHODS Study subjects were 1198 mother-child pairs. Data were collected using a self-administered questionnaire. Emotional, conduct, hyperactivity, and peer problems and low prosocial behavior were assessed using the Strengths and Difficulties Questionnaire (SDQ). RESULTS Neither exclusive breastfeeding duration nor breastfeeding duration regardless of exclusivity was significantly associated with childhood emotional, conduct, hyperactivity, or peer problems or low prosocial behavior. In children with older siblings only, ≥ 4 months of exclusive breastfeeding was significantly inversely associated with hyperactivity problems (adjusted odds ratio [OR] = 0.57, 95 % confidence interval [CI]: 0.31-0.99). In children without older siblings, ≥ 4 months of exclusive breastfeeding was inversely significantly associated with low prosocial behavior (adjusted OR = 0.54, 95 % CI: 0.30-0.93). No interactions were observed between exclusive breastfeeding duration and the presence of older siblings regarding the two outcomes. CONCLUSIONS No associations were found between breastfeeding duration and any of the outcomes based on the SDQ. Exclusive breastfeeding for ≥ 4 months may be inversely associated with hyperactivity problems in children with older siblings and with low prosocial behavior in children without older siblings.
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Affiliation(s)
- Wahyuni Lamma
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Yoshihiro Miyake
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Ehime, Japan; Integrated Medical and Agricultural School of Public Health, Ehime University, Ehime, Japan; Research Promotion Unit, Translation Research Center, Ehime University Hospital, Ehime, Japan; Center for Data Science, Ehime University, Ehime, Japan; Department of Healthcare Data Science, Ehime University Graduate School of Medicine, Ehime, Japan.
| | - Keiko Tanaka
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Ehime, Japan; Integrated Medical and Agricultural School of Public Health, Ehime University, Ehime, Japan; Research Promotion Unit, Translation Research Center, Ehime University Hospital, Ehime, Japan; Center for Data Science, Ehime University, Ehime, Japan
| | - Alifa Abdul Karim
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Masashi Arakawa
- Wellness Research Fields, Faculty of Global and Regional Studies, University of the Ryukyus, Okinawa 903-0213, Japan; The Department of Cross Cultural Studies, Osaka University of Tourism, Okinawa 905-0025, Japan
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Nguyen MQ, Miyake Y, Tanaka K, Hasuo S, Nakamura Y, Okubo H, Sasaki S, Arakawa M. Nut consumption during pregnancy is associated with decreased risk of peer problems in 5-year-old Japanese children. J Pediatr Gastroenterol Nutr 2024; 78:927-935. [PMID: 38451048 DOI: 10.1002/jpn3.12177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Nuts are nutrient-dense foods rich in unsaturated fatty acids, protein, dietary fiber, vitamins, and minerals. The present prebirth cohort study examined the association between maternal nut intake during pregnancy and the risk of childhood behavioral problems in 5-year-old Japanese children. METHODS Study subjects were 1199 mother-child pairs. Dietary intake was assessed using a diet history questionnaire. Emotional problems, conduct problems, hyperactivity problems, peer problems, and low prosocial behavior were assessed using the parent-reported version of the Strengths and Difficulties Questionnaire. Adjustments were made for a priori-selected nondietary confounders and potentially related dietary factors. RESULTS Compared with mothers who had not eaten nuts during pregnancy, mothers who had eaten nuts had a significantly reduced risk of peer problems in children; the adjusted odds ratio was 0.64 (95% confidence interval: 0.42-0.97). There were no measurable associations between maternal consumption of nuts during pregnancy and the risk of childhood emotional problems, conduct problems, hyperactivity problems, and low prosocial behavior. CONCLUSIONS Maternal consumption of nuts during pregnancy may be associated with a decreased risk of peer problems in 5-year-old children.
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Affiliation(s)
- Mai Quynh Nguyen
- Food Microbiology and Function Research Laboratories, R&D Division, Meiji Co., Ltd., Tokyo, Japan
| | - Yoshihiro Miyake
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Ehime, Japan
- Integrated Medical and Agricultural School of Public Health, Ehime University, Ehime, Japan
- Research Promotion Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
- Center for Data Science, Ehime University, Ehime, Japan
| | - Keiko Tanaka
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Ehime, Japan
- Integrated Medical and Agricultural School of Public Health, Ehime University, Ehime, Japan
- Research Promotion Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
- Center for Data Science, Ehime University, Ehime, Japan
| | - Shizuka Hasuo
- Food Microbiology and Function Research Laboratories, R&D Division, Meiji Co., Ltd., Tokyo, Japan
| | - Yoshitaka Nakamura
- Food Microbiology and Function Research Laboratories, R&D Division, Meiji Co., Ltd., Tokyo, Japan
| | - Hitomi Okubo
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Ehime, Japan
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Ibaraki, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masashi Arakawa
- Wellness Research Fields, Faculty of Global and Regional Studies, University of the Ryukyus, Okinawa, Japan
- The Department of Cross Cultural Studies, Osaka University of Tourism, Okinawa, Japan
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Gumma SD, Elotla SF, Ibrahim OY, Rizkalla NH. Nutrients patterns and attention deficit hyperactivity disorder among Egyptian children: a sibling and community matched case-control study. Eur J Clin Nutr 2024; 78:64-71. [PMID: 37752197 PMCID: PMC10774123 DOI: 10.1038/s41430-023-01345-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Attention Deficit Hyperactive Disorder (ADHD) diagnosis has been growing among children, with great public health concern. The relationship between nutrient intake pattern and ADHD remains unclear. AIM To identify the nutrient intake patterns and its association with ADHD in children. SUBJECTS AND METHODS The study involved 146 children with ADHD, 141 control sibling, and 146 community controls. ADHD diagnosis was confirmed using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) criteria following the assessment by the long-form Conner's Scale. Dietary intakes were assessed using a semi-quantitative food frequency questionnaire. Nutrients patterns were identified using the principal component analysis (PCA). RESULTS ADHD children have significantly higher mean total energy intake than community controls and siblings (8867.9, 4481.9 and 7308.2 KJ, respectively, p < 0.001). Four nutrient patterns extracted by the PCA explained 75.9% of the total variance. Lower tertiles of "predominantly calcium-phosphorus; pattern 1" and "predominantly-vitamins; pattern 3" were significantly associated with increasing odds of ADHD, compared to community controls (p for trend: 0.002 and 0.005, respectively), while the same associations were noted in "predominantly-vitamins" and "predominantly Zinc-Iron; pattern 2" when compared to siblings (p for trend: <0.001 and <0.001, respectively). However, Higher tertiles of macronutrients; pattern 4" were associated with increased ADHD odds, compared to either community controls or siblings (p for trend: 0.017 and <0.001, respectively). CONCLUSION Lower intakes of nutrients patterns of minerals and vitamins, and higher intakes of macronutrients were associated with increased likelihood of ADHD in children.
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Affiliation(s)
- Samia Dahshan Gumma
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Sally Fawzy Elotla
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Omneya Youssef Ibrahim
- Department of Neuropsychiatry, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nadia Hosny Rizkalla
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Ding Y, Li G, Zhang M, Shao Y, Wu J, Wang Z. Development and validation of a novel food exchange system for Chinese pregnant women. Nutr J 2023; 22:65. [PMID: 38037031 PMCID: PMC10690967 DOI: 10.1186/s12937-023-00902-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 11/28/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND The dietary nutritional status of pregnant women is critical for maintaining the health of both mothers and infants. Food exchange systems have been employed in the nutritional guidance of patients in China, although their application in the dietary guidance of healthy pregnant women is quite limited. This study aimed to develop a novel food exchange system for Chinese pregnant women (NFES-CPW) and evaluate the relative validation of its application. METHODS NFES-CPW covers approximately 500 types of food from ten categories and has more elaborate food portion sizes. It established a recommendation index for guiding food selection and used energy, water content, and protein as the exchange basis to balance the supply of energy and important nutrients throughout pregnancy. Furthermore, dietitians used the NFES-CPW and traditional food exchange system to generate new recipes based on the sample recipe. There were 40 derived recipes for each of the two food exchange methods. The food consumption, energy, and key nutrients of each recipe were calculated, and the differences between the two food exchange systems were compared using the Wilcoxon rank sum test or the Chi-square test. RESULTS The results revealed that compared to those derived from traditional food exchange system, the NFES-CPW derived recipes had a better dietary structure, as evidenced by the intakes of whole-grain cereals, beans excluding soybeans, potatoes, fruits, fish, shrimp and shellfish, as well as eggs (P < 0.05), which were more conducive to reaching the recommended range of balanced dietary pagoda. After calculating energy and nutrients, although these two food exchange systems have similar effects on the dietary energy and macronutrient intake of pregnant women, the intake of micronutrients in NFES-CPW derived recipes was significantly higher than that from the traditional food exchange system, which was more conducive to meeting the dietary requirements of pregnant women. The outstanding improvement are primarily vitamin A, vitamin B2, folic acid, vitamin B12, vitamin C, calcium, iron, and iodine (P < 0.05). Moreover, when compared to recipes obtained from the traditional food exchange system, the error ranges of energy and most nutrients were significantly reduced after employing the NFES-CPW. CONCLUSIONS Therefore, NFES-CPW is an appropriate tool that adheres to Chinese dietary characteristics and can provide suitable dietary guidance to pregnant women.
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Affiliation(s)
- Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Genyuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Man Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Yingying Shao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jieshu Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China.
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Maternal Consumption of Dairy Products during Pregnancy Is Associated with Decreased Risk of Emotional Problems in 5-Year-Olds: The Kyushu Okinawa Maternal and Child Health Study. Nutrients 2022; 14:nu14224713. [PMID: 36432404 PMCID: PMC9697969 DOI: 10.3390/nu14224713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Milk is a good source of fats, minerals, and vitamins. The present prebirth cohort study examined the association between maternal dairy product intake during pregnancy and the risk of childhood behavioral problems in 5-year-old Japanese children. Study subjects were 1199 mother-child pairs. Dietary intake was assessed using a diet history questionnaire. Emotional problems, conduct problems, hyperactivity problems, peer problems, and low prosocial behavior were assessed using the parent-reported version of the Strengths and Difficulties Questionnaire. Adjustments were made for a priori selected non-dietary confounders and potentially related dietary factors. A significant inverse exposure-response association was observed between maternal total dairy intake during pregnancy and the risk of childhood emotional problems (adjusted odds ratio [OR] between extreme quartiles, 0.62; 95% confidence interval [CI]: 0.36-1.03, p for trend, 0.04). The greater maternal consumption of cow's milk, but not yogurt or cheese, during pregnancy was independently related to a reduced risk of emotional problems in children (adjusted OR between extreme quartiles, 0.41; 95% CI: 0.23-0.70, p for trend, 0.003). Higher maternal consumption levels of total dairy products, especially cow's milk, during pregnancy may be associated with a decreased risk of emotional problems in 5-year-old children.
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Miyake Y, Tanaka K, Okubo H, Sasaki S, Tokinobu A, Arakawa M. Maternal consumption of soy and isoflavones during pregnancy and risk of childhood behavioural problems: the Kyushu Okinawa Maternal and Child Health Study. Int J Food Sci Nutr 2021; 72:1118-1127. [PMID: 33792472 DOI: 10.1080/09637486.2021.1904844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
It is uncertain whether the effects of prenatal exposure to isoflavones on childhood behaviour are beneficial or detrimental. This prebirth cohort study investigated the associations between maternal consumption of soy products and isoflavones during pregnancy and behavioural problems in Japanese children aged 5 years. Subjects were 1199 mother-child pairs. Emotional problems, conduct problems, hyperactivity problems, peer problems and low prosocial behaviour were assessed using the Strengths and Difficulties Questionnaire. Maternal total soy product consumption during pregnancy was independently inversely associated with childhood hyperactivity and peer problems. Maternal fermented soybean consumption during pregnancy was independently inversely associated with childhood hyperactivity problems. Maternal isoflavone consumption during pregnancy was independently inversely related to childhood hyperactivity problems. Maternal consumption of total soy products, fermented soybean and isoflavones during pregnancy may be protective against hyperactivity problems in Japanese children. Also, maternal total soy product consumption during pregnancy may be preventive against childhood peer problems.
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Affiliation(s)
- Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.,Research Promotion Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.,Center for Data Science, Ehime University, Ehime, Japan
| | - Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.,Research Promotion Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.,Center for Data Science, Ehime University, Ehime, Japan
| | - Hitomi Okubo
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.,Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Akiko Tokinobu
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.,Center for Data Science, Ehime University, Ehime, Japan
| | - Masashi Arakawa
- Faculty of Global and Regional Studies, Wellness Research Fields, University of the Ryukyus, Okinawa, Japan.,The Department of Cross Cultural Studies, Osaka University of Tourism, Okinawa, Japan
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Miyake Y, Tanaka K, Okubo H, Sasaki S, Tokinobu A, Arakawa M. Maternal metal intake during pregnancy and childhood behavioral problems in Japan: the Kyushu Okinawa Maternal and Child Health Study. Nutr Neurosci 2021; 25:1641-1649. [PMID: 33568010 DOI: 10.1080/1028415x.2021.1885241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Lower maternal metal intake during pregnancy might affect childhood development. The current prebirth cohort study investigated the relationship between maternal intake of zinc, magnesium, iron, copper, and manganese during pregnancy and behavioral problems in Japanese children aged five years. METHODS Subjects were 1199 mother-child pairs. Dietary intake during the preceding month was assessed using a diet history questionnaire. Emotional, conduct, hyperactivity, and peer problems and low prosocial behavior were assessed using the Strengths and Difficulties Questionnaire. Maternal age, gestation at baseline, region of residence, number of children, maternal and paternal education, household income, maternal depressive symptoms during pregnancy, maternal alcohol intake during pregnancy, maternal smoking during pregnancy, child's birth weight, child's sex, breastfeeding duration, smoking in the household during the first year of life, and some dietary confounders that were associated with outcomes under study in this population were adjusted for. RESULTS Compared with maternal magnesium intake during pregnancy in the first quartile, magnesium intake in the second, third, and fourth quartiles was independently inversely related to childhood hyperactivity problems, but not to emotional, conduct, or peer problems or low prosocial behavior: the adjusted odds ratio between extreme quartiles was 0.48 (95% confidence interval: 0.23-0.99, P for trend = 0.04). No evident associations were observed between maternal intake of zinc, iron, copper, or manganese during pregnancy and childhood emotional, conduct, hyperactivity, or peer problems or low prosocial behavior. CONCLUSIONS The present study suggests that higher maternal magnesium intake during pregnancy is inversely associated with hyperactivity problems in Japanese children.
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Affiliation(s)
- Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.,Research Promotion Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.,Center for Data Science, Ehime University, Ehime, Japan
| | - Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.,Research Promotion Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.,Center for Data Science, Ehime University, Ehime, Japan
| | - Hitomi Okubo
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.,Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Akiko Tokinobu
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.,Center for Data Science, Ehime University, Ehime, Japan
| | - Masashi Arakawa
- Wellness Research Fields, Faculty of Global and Regional Studies, University of the Ryukyus, Okinawa, Japan.,The Department of Cross Cultural Studies, Osaka University of Tourism, Okinawa, Japan
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Farias PM, Marcelino G, Santana LF, de Almeida EB, Guimarães RDCA, Pott A, Hiane PA, Freitas KDC. Minerals in Pregnancy and Their Impact on Child Growth and Development. Molecules 2020; 25:molecules25235630. [PMID: 33265961 PMCID: PMC7730771 DOI: 10.3390/molecules25235630] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022] Open
Abstract
During pregnancy, women undergo metabolic and physiological changes, and their needs are higher, to maintain growth and development of the fetus. If the nutritional status of the expectant mother is not satisfactory, some maternal and neonatal complications can occur. In the second and third trimester of pregnancy, there is a reserve of nutrients in the fetus that can be utilized after birth; thereby, children present an accelerated growth in the first years of life, which is a proven response to the available nutrition pattern. However, if such a pattern is insufficient, there will be deficits during development, including brain function. Therefore, despite many recent published works about gestational nutrition, uncertainties still remain on the mechanisms of absorption, distribution, and excretion of micronutrients. Further elucidation is needed to better understand the impacts caused either by deficiency or excess of some micronutrients. Thus, to illustrate the contributions of minerals during prenatal development and in children, iodine, selenium, iron, zinc, calcium, and magnesium were selected. Our study sought to review the consequences related to gestational deficiency of the referred minerals and their impact on growth and development in children born from mothers with such deficiencies
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Affiliation(s)
- Patricia Miranda Farias
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Gabriela Marcelino
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Lidiani Figueiredo Santana
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Eliane Borges de Almeida
- Biologist, Hematology Laboratory, State Secretariat of Health of Mato Grosso do Sul, Campo Grande 79084-180, Mato Grosso do Sul, Brazil;
| | - Rita de Cássia Avellaneda Guimarães
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Arnildo Pott
- Graduate Program in Biotechnology and Biodiversity in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil;
| | - Priscila Aiko Hiane
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Karine de Cássia Freitas
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
- Correspondence: ; Tel.: +55-67-3345-7416
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