2025
The inflammatory and genetic mechanisms underlying the cumulative effect of co-occurring pain conditions on depression
Jiang R, Geha P, Rosenblatt M, Wang Y, Fu Z, Foster M, Dai W, Calhoun V, Sui J, Spann M, Scheinost D. The inflammatory and genetic mechanisms underlying the cumulative effect of co-occurring pain conditions on depression. Science Advances 2025, 11: eadt1083. PMID: 40173244, PMCID: PMC11964001, DOI: 10.1126/sciadv.adt1083.Peer-Reviewed Original ResearchConceptsDepression riskChronic pain conditionsPain conditionsPrevalence of comorbid depressionPain scoresUK Biobank participantsPain-free individualsComposite pain scoresHigh-risk individualsPain screeningMendelian randomizationBiobank participantsPain sitesDepression incidenceComorbid depressionIncreased riskBody sitesDepressionC-reactive proteinPainCausal inferenceFollow-upScoresRiskInflammatory markers
2024
Nasal, dermal, oral and indoor dust microbe and their interrelationship in children with allergic rhinitis
Tang H, Du S, Niu Z, Zhang D, Tang Z, Chen H, Chen Z, Zhang M, Xu Y, Sun Y, Fu X, Norback D, Shao J, Zhao Z. Nasal, dermal, oral and indoor dust microbe and their interrelationship in children with allergic rhinitis. BMC Microbiology 2024, 24: 505. PMID: 39614169, PMCID: PMC11606197, DOI: 10.1186/s12866-024-03668-9.Peer-Reviewed Original ResearchConceptsSpecies levelBacterial speciesAR childrenNasal cavityMethodsIn this case–control studyBody sitesControl groupBacterial diversityCase-control studyB-diversityOral swab samplesS. epidermidisStaphylococcus epidermidisStaphylococcus aureusBacterial characterizationMicrobesAllergic rhinitisSpeciesHealthy subjectsBackgroundAllergic rhinitisSwab samplesHealthy onesConclusionsOur studyMicroorganismsRhinitisLongitudinal profiling of the microbiome at four body sites reveals core stability and individualized dynamics during health and disease
Zhou X, Shen X, Johnson J, Spakowicz D, Agnello M, Zhou W, Avina M, Honkala A, Chleilat F, Chen S, Cha K, Leopold S, Zhu C, Chen L, Lyu L, Hornburg D, Wu S, Zhang X, Jiang C, Jiang L, Jiang L, Jian R, Brooks A, Wang M, Contrepois K, Gao P, Rose S, Tran T, Nguyen H, Celli A, Hong B, Bautista E, Dorsett Y, Kavathas P, Zhou Y, Sodergren E, Weinstock G, Snyder M. Longitudinal profiling of the microbiome at four body sites reveals core stability and individualized dynamics during health and disease. Cell Host & Microbe 2024, 32: 506-526.e9. PMID: 38479397, PMCID: PMC11022754, DOI: 10.1016/j.chom.2024.02.012.Peer-Reviewed Original ResearchHost healthMicrobiome dynamicsBacterial taxaBody sitesMicrobiome stabilityIndividual taxaHuman microbiomeMicrobial compositionMicrobial dynamicsMulti-OmicsNasal microbiomeMicrobiomeDisrupt interactionsMolecular markersBody-sitesTaxaHostMetabolic diseasesOral microbiomeInsulin-resistant individualsIndividual-specificTemporal dynamicsClinical featuresComprehensive viewClinical markers
2023
Biospecimen Repositories in Low- and Middle-Income Countries: Insights From an American University of Beirut and Memorial Sloan Kettering Collaboration
Faraj W, Robson M, Tawil A, Reuter V, Mahfouz R, Cambria R, Saheb N, Ferrer C, Vemuri S, Yaghi M, Kanso M, Abdullah A, Nounou G, Jabbour M, Muenkel K, Kaufman K, Wakim J, Badson S, Wilson R, Houston C, Drobnjak M, Hoballah J, Ziyadeh F, Zaatari G, Brennan M, O'Reilly E, Abu-Alfa A, Abou-Alfa G. Biospecimen Repositories in Low- and Middle-Income Countries: Insights From an American University of Beirut and Memorial Sloan Kettering Collaboration. JCO Global Oncology 2023, 9: e2300140. PMID: 37883726, PMCID: PMC10846789, DOI: 10.1200/go.23.00140.Peer-Reviewed Original ResearchConceptsMemorial Sloan-Kettering Cancer CenterMiddle-income countriesPatients age 18 yearsBiospecimen repositoryPatient participation ratesAge 18 yearsPotential participantsDocumentation of reasonsPrimary physicianCancer CenterJoint tissuesTherapeutic interventionsBody sitesPatientsAbnormal tissueConsentFamily membersTissueResearch awarenessAUBParticipation ratesBiospecimensParticipantsCancer genomicsHighly multiplexed bioactivity screening reveals human and microbiota metabolome-GPCRome interactions
Chen H, Rosen C, González-Hernández J, Song D, Potempa J, Ring A, Palm N. Highly multiplexed bioactivity screening reveals human and microbiota metabolome-GPCRome interactions. Cell 2023, 186: 3095-3110.e19. PMID: 37321219, PMCID: PMC10330796, DOI: 10.1016/j.cell.2023.05.024.Peer-Reviewed Original ResearchDevelopment of an amplicon-based sequencing approach in response to the global emergence of mpox
Chen N, Chaguza C, Gagne L, Doucette M, Smole S, Buzby E, Hall J, Ash S, Harrington R, Cofsky S, Clancy S, Kapsak C, Sevinsky J, Libuit K, Park D, Hemarajata P, Garrigues J, Green N, Sierra-Patev S, Carpenter-Azevedo K, Huard R, Pearson C, Incekara K, Nishimura C, Huang J, Gagnon E, Reever E, Razeq J, Muyombwe A, Borges V, Ferreira R, Sobral D, Duarte S, Santos D, Vieira L, Gomes J, Aquino C, Savino I, Felton K, Bajwa M, Hayward N, Miller H, Naumann A, Allman R, Greer N, Fall A, Mostafa H, McHugh M, Maloney D, Dewar R, Kenicer J, Parker A, Mathers K, Wild J, Cotton S, Templeton K, Churchwell G, Lee P, Pedrosa M, McGruder B, Schmedes S, Plumb M, Wang X, Barcellos R, Godinho F, Salvato R, Ceniseros A, Breban M, Grubaugh N, Gallagher G, Vogels C. Development of an amplicon-based sequencing approach in response to the global emergence of mpox. PLOS Biology 2023, 21: e3002151. PMID: 37310918, PMCID: PMC10263305, DOI: 10.1371/journal.pbio.3002151.Peer-Reviewed Original ResearchConceptsPublic health laboratoriesHealth laboratoriesSevere acute respiratory syndrome coronavirus 2Acute respiratory syndrome coronavirus 2Monkeypox virusRespiratory syndrome coronavirus 2Ongoing coronavirus disease 2019 (COVID-19) pandemicAnatomical body sitesAtypical clinical presentationCoronavirus disease 2019 (COVID-19) pandemicSyndrome coronavirus 2Course of infectionDisease 2019 pandemicRapid outbreak responseWhole-genome sequencingHuman monkeypox virusCT valuesClinical presentationViral loadCoronavirus 2Viral DNA concentrationsPathogen whole-genome sequencingZika virusClinical specimensBody sites
2022
Antimicrobial resistance trends among canine Escherichia coli isolated at a New York veterinary diagnostic laboratory between 2007 and 2020
Osman M, Albarracin B, Altier C, Gröhn Y, Cazer C. Antimicrobial resistance trends among canine Escherichia coli isolated at a New York veterinary diagnostic laboratory between 2007 and 2020. Preventive Veterinary Medicine 2022, 208: 105767. PMID: 36181749, PMCID: PMC9703301, DOI: 10.1016/j.prevetmed.2022.105767.Peer-Reviewed Original ResearchMeSH KeywordsAnimalsAnti-Bacterial AgentsAnti-Infective AgentsCephalosporinsDog DiseasesDogsDrug Resistance, BacterialEnrofloxacinEscherichia coliEscherichia coli InfectionsFluoroquinolonesGentamicinsMicrobial Sensitivity TestsNew YorkRetrospective StudiesTrimethoprim, Sulfamethoxazole Drug CombinationConceptsTrimethoprim-sulfamethoxazole resistanceBody sitesGood first-line choiceCanine urinary tract infectionsResistant isolatesResistance trendsLaboratory Standards Institute breakpointsMultivariable logistic regression modelAntimicrobial resistance surveillance studyUrinary tract infectionDrug-resistant Escherichia coliFirst-line choiceAvailable clinical dataDrug-resistant E. coliAntimicrobial susceptibility patternsRetrospective study designUse of fluoroquinolonesE. coli infectionAntimicrobial resistance trendsResistance surveillance studiesClinical E. coliLogistic regression modelsEnrofloxacin-resistant isolatesSurvival analysis dataMIC trendsDevelopment and Initial Validation of a Novel System to Assess Ichthyosis Severity
Sun Q, Asch S, Bayart C, Bayliss SJ, Benjamin L, Bruckner A, DiGiovanna JJ, Fleckman P, Funk T, Lucky A, Nelson CA, Newell B, Polcari I, Teng J, Williams ML, Gan G, Deng Y, Paller AS, Choate KA. Development and Initial Validation of a Novel System to Assess Ichthyosis Severity. JAMA Dermatology 2022, 158: 359-365. PMID: 35171201, PMCID: PMC8851366, DOI: 10.1001/jamadermatol.2021.5917.Peer-Reviewed Original ResearchConceptsIchthyosis severityIntraclass correlation coefficientIntrarater reliabilityCare of patientsQuantifying treatment outcomesPatient advocacy groupsMost body sitesGood interrater reliabilityReferral centerDisease burdenClinical trialsTreatment outcomesErythema scoreMAIN OUTCOMEQualitative studyScoring systemBody sitesSeverityInterrater reliabilityUser-friendly instrumentErythemaPhotographs of participantsCohortDermatologistsEntire body
2021
Naturalization of the microbiota developmental trajectory of Cesarean-born neonates after vaginal seeding
Song SJ, Wang J, Martino C, Jiang L, Thompson WK, Shenhav L, McDonald D, Marotz C, Harris PR, Hernandez CD, Henderson N, Ackley E, Nardella D, Gillihan C, Montacuti V, Schweizer W, Jay M, Combellick J, Sun H, Garcia-Mantrana I, Gil Raga F, Collado MC, Rivera-Viñas JI, Campos-Rivera M, Ruiz-Calderon JF, Knight R, Dominguez-Bello MG. Naturalization of the microbiota developmental trajectory of Cesarean-born neonates after vaginal seeding. Med 2021, 2: 951-964.e5. PMID: 35590169, PMCID: PMC9123283, DOI: 10.1016/j.medj.2021.05.003.Peer-Reviewed Original ResearchConceptsMaternal vaginal fluidsCS birthBody sitesMaternal vaginal microbiomeVaginal fluidNon-pregnant womenDay of birthMultiple body sitesCesarean sectionImmunological underpinningsMicrobiota perturbationsClinical trialsVaginal seedingMicrobial exposureVaginal microbiomeMicrobiota developmentBabiesDisease riskBirthNational InstituteLongitudinal studyMaternal sitesPluripotential naturePublic healthFirst yearRole of microbes in the pathogenesis of neuropsychiatric disorders
Goswami A, Wendt FR, Pathak GA, Tylee DS, De Angelis F, De Lillo A, Polimanti R. Role of microbes in the pathogenesis of neuropsychiatric disorders. Frontiers In Neuroendocrinology 2021, 62: 100917. PMID: 33957173, PMCID: PMC8364482, DOI: 10.1016/j.yfrne.2021.100917.Peer-Reviewed Original ResearchConceptsNeuropsychiatric disordersDifferent anatomical sitesOral cavityAnatomical sitesHuman studiesBody sitesTranslational potentialPotential involvementPathogenesisGutMicrobial metabolitesDisordersBidirectional communicationStrong evidenceDiseaseNeurotransmittersBrainMicrobiome researchMicrobiome variation
2020
864. Whole Genome Sequencing is Unable to Track Candida auris Transmission
Roberts S, Ozer E, Zembower T, Qi C. 864. Whole Genome Sequencing is Unable to Track Candida auris Transmission. Open Forum Infectious Diseases 2020, 7: s470-s471. PMCID: PMC7776755, DOI: 10.1093/ofid/ofaa439.1053.Peer-Reviewed Original ResearchNorthwestern Memorial HospitalWhole-genome sequencingC. aurisSingle nucleotide variantsDifferent body sitesMethods Whole-genome sequencingMemorial HospitalResults TwentyPatient isolatesSame patientTransmission clustersPatientsBody sitesPairwise SNP differencesOutbreak investigationHealthcare settingsCandida aurisHospital systemReference labIdentical isolatesAurisFluconazole sensitivityACLEnvironmental specimensCDC
2018
Meta-analysis of the lung microbiota in pulmonary tuberculosis
Hong B, Paulson J, Stine O, Weinstock G, Cervantes J. Meta-analysis of the lung microbiota in pulmonary tuberculosis. Tuberculosis 2018, 109: 102-108. PMID: 29559113, DOI: 10.1016/j.tube.2018.02.006.Peer-Reviewed Original ResearchConceptsSpecies signatureNext generation sequencing dataLung microbiotaGeneration sequencing dataClustering of microbiotaMycobacterium tuberculosisCaulobacter henriciiLung microbiota compositionSequence dataBody nichesR. mucilaginosaMicrobiota compositionSputum microbiotaActinomyces graevenitziiBioinformatics analysisMicrobiotaRothia mucilaginosaTB patientsHealthy controlsTB casesAssociated with pulmonary TBHaemophilus parahaemolyticusMeta-analysisLower respiratory tractBody sites
2017
Establishing and Validating an Ichthyosis Severity Index
Marukian NV, Deng Y, Gan G, Ren I, Thermidor W, Craiglow BG, Milstone LM, Choate KA. Establishing and Validating an Ichthyosis Severity Index. Journal Of Investigative Dermatology 2017, 137: 1834-1841. PMID: 28596001, DOI: 10.1016/j.jid.2017.04.037.Peer-Reviewed Original ResearchConceptsIchthyosis severityDisorders of keratinizationIntrarater intraclass correlation coefficientsIntraclass correlation coefficientTherapeutic responseClinical trialsClinical phenotypingLevels of severityBody sitesErythemaSeverity IndexSeverityInterrater reliabilityPerson evaluationDermatologistsVisual indexSubjectsIndexVisual standardsSettingKeratinizationTrialsDifferent settings
2015
Risk stratification in extramammary Paget disease
Cohen JM, Granter SR, Werchniak AE. Risk stratification in extramammary Paget disease. Clinical And Experimental Dermatology 2015, 40: 473-478. PMID: 26011765, DOI: 10.1111/ced.12690.Peer-Reviewed Original ResearchConceptsExtramammary Paget's diseaseRisk stratificationPaget's diseaseUncommon intraepithelial adenocarcinomaImportant prognostic informationDepth of invasionIntraepithelial adenocarcinomaPatient ageExtracutaneous sitesLymph nodesPrognostic factorsPoor prognosisMucin 5ACPrognostic informationKi-67Perianal regionHigh riskLesion siteClinical practiceApocrine glandsBody sitesTumor geneticsReticular dermisCyclin D1Treatment planning
2012
The Human Microbiome Project strategy for comprehensive sampling of the human microbiome and why it matters
Aagaard K, Petrosino J, Keitel W, Watson M, Katancik J, Garcia N, Patel S, Cutting M, Madden T, Hamilton H, Harris E, Gevers D, Simone G, McInnes P, Versalovic J. The Human Microbiome Project strategy for comprehensive sampling of the human microbiome and why it matters. The FASEB Journal 2012, 27: 1012-1022. PMID: 23165986, PMCID: PMC3574278, DOI: 10.1096/fj.12-220806.Peer-Reviewed Original ResearchConceptsBody mass indexGood Clinical Practice standardsSubsequent physical examinationClinical practice standardsOral healthMass indexCutaneous lesionsSystemic diseasePhysical examinationReference cohortGastrointestinal tractExclusion criteriaOral cavityHealth historyPotential immunomodulatorClinical designBody sitesLongitudinal changesPrimary specimensPotential participantsHuman Microbiome ProjectPractice standardsIndividual microbiomesHuman microbiomeRecent useA framework for human microbiome research
Methé B, Nelson K, Pop M, Creasy H, Giglio M, Huttenhower C, Gevers D, Petrosino J, Abubucker S, Badger J, Chinwalla A, Earl A, FitzGerald M, Fulton R, Hallsworth-Pepin K, Lobos E, Madupu R, Magrini V, Martin J, Mitreva M, Muzny D, Sodergren E, Versalovic J, Wollam A, Worley K, Wortman J, Young S, Zeng Q, Aagaard K, Abolude O, Allen-Vercoe E, Alm E, Alvarado L, Andersen G, Anderson S, Appelbaum E, Arachchi H, Armitage G, Arze C, Ayvaz T, Baker C, Begg L, Belachew T, Bhonagiri V, Bihan M, Blaser M, Bloom T, Bonazzi V, Brooks P, Buck G, Buhay C, Busam D, Campbell J, Canon S, Cantarel B, Chain P, Chen I, Chen L, Chhibba S, Chu K, Ciulla D, Clemente J, Clifton S, Conlan S, Crabtree J, Cutting M, Davidovics N, Davis C, DeSantis T, Deal C, Delehaunty K, Dewhirst F, Deych E, Ding Y, Dooling D, Dugan S, Dunne W, Durkin A, Edgar R, Erlich R, Farmer C, Farrell R, Faust K, Feldgarden M, Felix V, Fisher S, Fodor A, Forney L, Foster L, Di Francesco V, Friedman J, Friedrich D, Fronick C, Fulton L, Gao H, Garcia N, Giannoukos G, Giblin C, Giovanni M, Goldberg J, Goll J, Gonzalez A, Griggs A, Gujja S, Haas B, Hamilton H, Harris E, Hepburn T, Herter B, Hoffmann D, Holder M, Howarth C, Huang K, Huse S, Izard J, Jansson J, Jiang H, Jordan C, Joshi V, Katancik J, Keitel W, Kelley S, Kells C, Kinder-Haake S, King N, Knight R, Knights D, Kong H, Koren O, Koren S, Kota K, Kovar C, Kyrpides N, La Rosa P, Lee S, Lemon K, Lennon N, Lewis C, Lewis L, Ley R, Li K, Liolios K, Liu B, Liu Y, Lo C, Lozupone C, Lunsford R, Madden T, Mahurkar A, Mannon P, Mardis E, Markowitz V, Mavrommatis K, McCorrison J, McDonald D, McEwen J, McGuire A, McInnes P, Mehta T, Mihindukulasuriya K, Miller J, Minx P, Newsham I, Nusbaum C, O’Laughlin M, Orvis J, Pagani I, Palaniappan K, Patel S, Pearson M, Peterson J, Podar M, Pohl C, Pollard K, Priest M, Proctor L, Qin X, Raes J, Ravel J, Reid J, Rho M, Rhodes R, Riehle K, Rivera M, Rodriguez-Mueller B, Rogers Y, Ross M, Russ C, Sanka R, Sankar P, Sathirapongsasuti J, Schloss J, Schloss P, Schmidt T, Scholz M, Schriml L, Schubert A, Segata N, Segre J, Shannon W, Sharp R, Sharpton T, Shenoy N, Sheth N, Simone G, Singh I, Smillie C, Sobel J, Sommer D, Spicer P, Sutton G, Sykes S, Tabbaa D, Thiagarajan M, Tomlinson C, Torralba M, Treangen T, Truty R, Vishnivetskaya T, Walker J, Wang L, Wang Z, Ward D, Warren W, Watson M, Wellington C, Wetterstrand K, White J, Wilczek-Boney K, Wu Y, Wylie K, Wylie T, Yandava C, Ye L, Ye Y, Yooseph S, Youmans B, Zhang L, Zhou Y, Zhu Y, Zoloth L, Zucker J, Birren B, Gibbs R, Highlander S, Weinstock G, Wilson R, White O. A framework for human microbiome research. Nature 2012, 486: 215-221. PMID: 22699610, PMCID: PMC3377744, DOI: 10.1038/nature11209.Peer-Reviewed Original ResearchConceptsHigh-throughput metagenomic dataRibosomal RNA genesMicrobial taxonomic profilesHuman microbiome researchMetagenomic dataRNA genesTaxonomic profilesMetagenomic sequencingMetagenomics protocolHuman microbiomeMicrobiome researchMicrobial communitiesMicrobiomeGenesDistinct typesBody sitesSequenceHuman healthProject consortiumAbundanceStrain
2011
Changing Disparities in Invasive Pneumococcal Disease by Socioeconomic Status and Race/Ethnicity in Connecticut, 1998–2008
Soto K, Petit S, Hadler JL. Changing Disparities in Invasive Pneumococcal Disease by Socioeconomic Status and Race/Ethnicity in Connecticut, 1998–2008. Public Health Reports 2011, 126: 81-88. PMID: 21836741, PMCID: PMC3150133, DOI: 10.1177/00333549111260s313.Peer-Reviewed Original ResearchConceptsRace/ethnicityNon-PCV7 serotypesSocioeconomic statusIncidence differenceCensus tract socioeconomic statusInvasive pneumococcal disease incidenceNeighborhood poverty levelInvasive pneumococcal diseasePneumococcal conjugate vaccinePneumococcal disease incidenceSterile body sitesRates of IPDHigh-poverty census tractsAbsence of vaccinesHigh rateIPD incidencePneumococcal diseaseConjugate vaccinePneumococcal isolatesTarget preventionLaboratory surveillancePoverty levelPercentage of peopleWhite peopleBody sites
2010
Serotype specific invasive capacity and persistent reduction in invasive pneumococcal disease
Yildirim I, Hanage WP, Lipsitch M, Shea KM, Stevenson A, Finkelstein J, Huang SS, Lee GM, Kleinman K, Pelton SI. Serotype specific invasive capacity and persistent reduction in invasive pneumococcal disease. Vaccine 2010, 29: 283-288. PMID: 21029807, PMCID: PMC3139683, DOI: 10.1016/j.vaccine.2010.10.032.Peer-Reviewed Original ResearchConceptsInvasive pneumococcal diseaseInvasive capacityPneumococcal diseaseIncidence of IPDNew pneumococcal conjugate vaccinesPneumococcal conjugate vaccineSterile body sitesStreptococcus pneumoniae serotypesCarriage serotypesNasopharyngeal acquisitionNP carriagePCV eraReplacement serotypesIPD incidenceRespiratory seasonsConjugate vaccineMassachusetts childrenCarriage prevalenceCommon serotypesPneumoniae serotypesOngoing surveillanceEnhanced surveillanceBody sitesPersistent reductionSerotype X
2009
Anaplastic oligoastrocytoma in Turcot syndrome
Baehring J, Hui P, Piepmeier J, Bannykh SI. Anaplastic oligoastrocytoma in Turcot syndrome. Journal Of Neuro-Oncology 2009, 95: 293-298. PMID: 19495563, DOI: 10.1007/s11060-009-9928-y.Peer-Reviewed Original ResearchMeSH KeywordsAdaptor Proteins, Signal TransducingAdenosine TriphosphatasesAgedAstrocytomaColorectal Neoplasms, Hereditary NonpolyposisDNA Repair EnzymesDNA, NeoplasmDNA-Binding ProteinsFemaleHumansImmunoenzyme TechniquesMagnetic Resonance ImagingMismatch Repair Endonuclease PMS2MutL Protein Homolog 1MutS Homolog 2 ProteinNuclear ProteinsPedigreePolymerase Chain ReactionConceptsHereditary non-polyposis colorectal cancerTurcot syndromeAnaplastic oligoastrocytomaNon-polyposis colorectal cancerYear old womanHandful of casesColorectal cancerLarge bowelDNA mismatch repair systemOlder womenBrain tumorsTumor DNABody sitesFamilial clusteringGermline mutationsRare variantsSyndromeOligoastrocytomasCancerMismatch repair systemChance occurrenceDetailed molecular dataBowelPathogenesisTumors
2006
Reinfection and relapse in early Lyme disease.
KRAUSE PJ, FOLEY DT, BURKE GS, Christianson D, Closter L, Spielman A, _ _. Reinfection and relapse in early Lyme disease. American Journal Of Tropical Medicine And Hygiene 2006, 75: 1090-4. PMID: 17172372, DOI: 10.4269/ajtmh.2006.75.1090.Peer-Reviewed Original ResearchConceptsEarly Lyme diseaseRecurrent episodesLyme diseaseErythema migransStandard antibiotic therapyInitial rashPrompt administrationAntibiotic therapyClinical manifestationsPrevent relapsePersistent infectionBody sitesDiseaseSequential episodesSpecific antibodiesEndemic sitesEpisodesReinfectionRelapseDetectable levelsFrequent contactVector ticksYearsRashSerology
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