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For the aim of this study, the inclusion criteria for children were diagnosis of trisomy 21 and no zinc supplement, antibiotic or oral cortisone therapy at blood draw (local cortisone therapy was allowed)

She is the first former Miss Teen USA delegate to win the Miss USA crown outright (her predecessor Shanna Moakler, previously Miss Rhode Island Teen USA, Miss New York USA and first runner-up to Miss USA Chelsi Smith, only inherited the title after Smith became Miss Universe)

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