Medicine and Health Sciences Commons^™

A Representative Clinical Course Of Progression, With Molecular Insights, Of Hormone Receptor-Positive, Her2-Negative Bone Metastatic Breast Cancer, Elizabeth Magno, Karen M. Bussard

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Despite treatment advances, breast cancer remains a leading cause of death of women in the United States, mostly due to metastatic disease. Bone is a preferential site for breast cancer metastasis, and most metastatic breast cancer patients experience bone involvement at the time of death. The majority of patients with bone metastatic breast cancer are first diagnosed with and treated for early-stage disease, and from development of early-stage breast cancer to the recurrence of cancer in the bones, up to 30 years may elapse. Throughout this timeframe, a typical patient undergoes many treatments that have effects on the bone microenvironment. …

Raccoons (Procyon Lotor) Show Higher Trypanosoma Cruzi Detection Rates Than Virginia Opossums (Didelphis Virginiana) In South Carolina, Usa, David A. Bernasconi, Madison L. Miller, Jacob E. Hill, Pooja Gupta, Richard Chipman, Amy Gilbert, Olin E. Rhodes Jr., Guha Dharmarajan

USDA Wildlife Services: Staff Publications

Chagas disease, a significant public health concern in the Americas, is caused by a protozoan parasite, Trypanosoma cruzi. The life cycle of T. cruzi involves kissing bugs (Triatoma spp.) functioning as vectors and mammalian species serving as hosts. Raccoons (Procyon lotor) and opossums (Didelphis virginiana) have been identified as important reservoir species in the life cycle of T. cruzi, but prevalence in both species in the southeastern United States is currently understudied. We quantified T. cruzi prevalence in these two key reservoir species across our study area in South Carolina, USA, and …

Combining Genomic And Epidemiological Data To Compare The Transmissibility Of Sars-Cov-2 Variants Alpha And Iota., Mary E Petrone, Jessica E Rothman, Mallery I Breban, Isabel M Ott, Alexis Russell, Erica Lasek-Nesselquist, Hamada Badr, Kevin Kelly, Gregory Omerza, Nicholas Renzette, Anne E Watkins, Chaney C Kalinich, Tara Alpert, Anderson F Brito, Rebecca Earnest, Irina R Tikhonova, Christopher Castaldi, John P Kelly, Matthew Shudt, Jonathan Plitnick, Erasmus Schneider, Steven Murphy, Caleb Neal, Eva Laszlo, Ahmad Altajar, Claire Pearson, Anthony Muyombwe, Randy Downing, Jafar Razeq, Linda Niccolai, Madeline S Wilson, Margaret L Anderson, Jianhui Wang, Chen Liu, Pei Hui, Shrikant Mane, Bradford P Taylor, William P Hanage, Marie L Landry, David R Peaper, Kaya Bilguvar, Joseph R Fauver, Chantal B F Vogels, Lauren M Gardner, Virginia E Pitzer, Kirsten St George, Mark D Adams, Nathan D Grubaugh

Faculty Research 2022

SARS-CoV-2 variants shaped the second year of the COVID-19 pandemic and the discourse around effective control measures. Evaluating the threat posed by a new variant is essential for adapting response efforts when community transmission is detected. In this study, we compare the dynamics of two variants, Alpha and Iota, by integrating genomic surveillance data to estimate the effective reproduction number (R_t) of the variants. We use Connecticut, United States, in which Alpha and Iota co-circulated in 2021. We find that the R_t of these variants were up to 50% larger than that of other variants. We then …

Central Nervous System Immune Interactome Is A Function Of Cancer Lineage, Tumor Microenvironment, And Stat3 Expression., Hinda Najem, Martina Ott, Cynthia Kassab, Arvind Rao, Ganesh Rao, Anantha Marisetty, Adam M Sonabend, Craig Horbinski, Roel G W Verhaak, Anand Shankar, Santhoshi N Krishnan, Frederick S Varn, Víctor A Arrieta, Pravesh Gupta, Sherise D Ferguson, Jason T Huse, Gregory N Fuller, James P Long, Daniel E Winkowski, Ben A Freiberg, Charles David James, Leonidas C Platanias, Maciej S Lesniak, Jared K Burks, Amy B Heimberger

Faculty Research 2022

BACKGROUNDImmune cell profiling of primary and metastatic CNS tumors has been focused on the tumor, not the tumor microenvironment (TME), or has been analyzed via biopsies.METHODSEn bloc resections of gliomas (n = 10) and lung metastases (n = 10) were analyzed via tissue segmentation and high-dimension Opal 7-color multiplex imaging. Single-cell RNA analyses were used to infer immune cell functionality.RESULTSWithin gliomas, T cells were localized in the infiltrating edge and perivascular space of tumors, while residing mostly in the stroma of metastatic tumors. CD163+ macrophages were evident throughout the TME of metastatic tumors, whereas in gliomas, CD68+, CD11c+CD68+, and CD11c+CD68+CD163+ …

The Age Presents Introduction To Geroscience Video Lecture Series., Alessandro Bitto, Mitchell B Lee, Cristal M Hill, Ron Korstanje, Matt Kaeberlein

Faculty Research 2021

The AGE Presents Introduction to Geroscience video lecture series is a collection of high-quality didactic video lectures and associated teaching materials focused on foundational topics in aging biology. The videos are made freely available on YouTube and are targeted toward an audience familiar with concepts learned in the first year of a college undergraduate biology/biomedical major. Members of the American Aging Association also receive the original lecture slides and lecture notes, with additional course materials to be developed in the future. We expect that these lectures will enhance understanding of geroscience among the general public while also providing tools that …

The National Covid Cohort Collaborative (N3c): Rationale, Design, Infrastructure, And Deployment., Melissa A Haendel, Christopher G Chute, Tellen D Bennett, David A Eichmann, Justin Guinney, Warren A Kibbe, Philip R O Payne, Emily R Pfaff, Peter N Robinson, Joel H Saltz, Heidi Spratt, Christine Suver, John Wilbanks, Adam B Wilcox, Andrew E Williams, Chunlei Wu, Clair Blacketer, Robert L Bradford, James J Cimino, Marshall Clark, Evan W Colmenares, Patricia A Francis, Davera Gabriel, Alexis Graves, Raju Hemadri, Stephanie S Hong, George Hripscak, Dazhi Jiao, Jeffrey G Klann, Kristin Kostka, Adam M Lee, Harold P Lehmann, Lora Lingrey, Robert T Miller, Michele Morris, Shawn N Murphy, Karthik Natarajan, Matvey B Palchuk, Usman Sheikh, Harold Solbrig, Shyam Visweswaran, Anita Walden, Kellie M Walters, Griffin M Weber, Xiaohan Tanner Zhang, Richard L Zhu, Benjamin Amor, Andrew T Girvin, Amin Manna, Nabeel Qureshi, Michael G Kurilla, Sam G Michael, Lili M Portilla, Joni L Rutter, Christopher P Austin, Ken R Gersing

Faculty Research 2021

OBJECTIVE: Coronavirus disease 2019 (COVID-19) poses societal challenges that require expeditious data and knowledge sharing. Though organizational clinical data are abundant, these are largely inaccessible to outside researchers. Statistical, machine learning, and causal analyses are most successful with large-scale data beyond what is available in any given organization. Here, we introduce the National COVID Cohort Collaborative (N3C), an open science community focused on analyzing patient-level data from many centers.

MATERIALS AND METHODS: The Clinical and Translational Science Award Program and scientific community created N3C to overcome technical, regulatory, policy, and governance barriers to sharing and harmonizing individual-level clinical data. We …

Disparities In Sars-Cov-2 Positivity Rates: Associations With Race And Ethnicity, Harvey W Kaufman, Justin K Niles, David B. Nash

College of Population Health Faculty Papers

Numerous reports indicate that African Americans and Latinos are being affected disproportionately by coronavirus disease 2019 (COVID-19). Positivity rates have not been analyzed on scale because only 4 states report race/ethnicity as part of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. Previous studies also have had little ability to control for many known risk factors to better identify the effects of COVID-19 on racial and ethnic communities. Using test results from a large national reference laboratory database that included patients from all 50 states and the District of Columbia, this study compared positivity rates for SARS-CoV-2 nucleic acid amplification …

Vampire Bats: Preparing For Range Expansion Into The U.S., Michael J. Bodenchuk, David L. Bergman

USDA Wildlife Services: Staff Publications

The common vampire bat apparently is expanding its range northwards in Mexico and seems poised to enter the southern United States. Climate models predict suitable habitat in the U.S. in south Texas and parts of southern Arizona. While vampire bats’ northward range expansion is not unexpected, the fact that this species brings a strain of rabies that impacts livestock and people warrants a strategic response. Annual economic damages from bats are estimated between $7M and $9M, largely associated with deaths of livestock from rabies. To prepare for the emerging rabies issue, USDA Wildlife Services programs in Texas and Arizona have …

Bone Marrow Concentrate (Bmc) Therapy In Musculoskeletal Disorders: Evidence-Based Policy Position Statement Of American Society Of Interventional Pain Physicians (Asipp), Laxmaiah Manchikanti, Christopher J. Centeno, Sairam Atluri, Sheri L. Albers, Shane Shapiro, Gerard A. Malanga, Alaa Abd-Elsayed, Mairin Jerome, Joshua A. Hirsch, Alan David Kaye, Steve M. Aydin, Douglas Beall, Don Buford, Joanne Borg-Stein, Ricardo M. Buenaventura, Joseph A. Cabaret, Aaron K. Calodney, Kenneth D. Candido, Cameron Cartier, Richard Latchaw, Sudhir Diwan, Ehren Dodson, Zachary Fausel, Michael Fredericson, Christopher G. Gharibo, Mayank Gupta, Adam M. Kaye, Nebojsa Nick Knezevic, Radomir Kosanovic, Matthew Lucas, Maanasa V. Manchikanti, R. Amadeus Mason, Kenneth Mautner, Samuel Murala, Annu Navani, Vidyasagar Pampati, Sarah Pastoriza, Ramarao Pasupuleti, Cyril Philip, Mahendra R Sanapati, Theodore Sand, Rinoo V Shah, Amol Soin, Ian Stemper, Bradley W Wargo, Philippe Hernigou

School of Pharmacy Faculty Articles

BACKGROUND: The use of bone marrow concentrate (BMC) for treatment of musculoskeletal disorders has become increasingly popular over the last several years, as technology has improved along with the need for better solutions for these pathologies. The use of cellular tissue raises a number of issues regarding the US Food and Drug Administration's (FDA) regulation in classifying these treatments as a drug versus just autologous tissue transplantation. In the case of BMC in musculoskeletal and spine care, this determination will likely hinge on whether BMC is homologous to the musculoskeletal system and spine.

OBJECTIVES: The aim of this review is …

Thoroughbred Racehorse Welfare Through The Lens Of ‘Social License To Operate—With An Emphasis On A U.S. Perspective, Camie Heleski, C. Jill Stowe, Julie Fiedler, Michael L. Peterson, Colleen Brady, Carissa Wickens, James N. Macleod

Agricultural Economics Faculty Publications

This review addresses the question of whether Thoroughbred horse racing is sustainable in the context of current social values. A recently acknowledged framework, known as ‘Social License to Operate’ (SLO), provides us with a lens through which to view and assess racehorse welfare. In multiple surveys of the general public, the horse owning public, and university students, the primary topics of concern regarding Thoroughbred racing show considerable concordance: concern about catastrophic injuries—particularly as related to track surfaces, concern over the racing of two-year-olds, whip use by jockeys, drug/medication policies, and aftercare opportunities for retired Thoroughbred racehorses. Legitimacy of an industry, …

Black Vulture Conflict And Management In The United States: Damage Trends, Management Overview, And Research Needs, Bryan M. Kluever, Morgan Pfeiffer, Scott C. Barras, Brett Dunlap, Lee A. Humberg

USDA Wildlife Services: Staff Publications

Contrary to rapid declines of many vulture (Accipitridae, Cathartidea) species worldwide, black vulture (Coragyps atratus) populations are increasing and expanding their range in North America. Vultures exhibit complex behaviors and can adapt to any human-dominated landscape or land use. These traits, combined with population growth and range expansion, have contributed to increased human–vulture conflicts. Our goal was to summarize the current status and trends in human–black vulture conflicts (hereafter human– vulture conflicts), review available management strategies, identify knowledge gaps, and provide recommendations to enhance management and understanding of this species and the associated conflicts. We found human–vulture conflicts …

Animal Agriculture And American Health: The Search For Sustainable Protein, Britta Brinkmann

Biology: Student Scholarship & Creative Works

This study examines the impact large-scale animal agriculture has on the environment. It links the environment and health. The goal is to find protein sources that are sustainable and nutritious in order to replace typical meat and dairy products. A study is proposed to measure the impact of the typical American diet, a vegan diet, an insect-supplemented diet and a diet heavy in seafood.

Obesity, Noah Rhodes

Global Issues in Public Health

Obesity is a worldwide issue that can be defined as a non-communicable condition which means that it is non-infectious and non-transmissible and it is defined as having a BMI over 30 even though BMI doesn’t account for the person’s muscle mass which causes some athletes to be considered obese just because they weigh a lot for their height. Diagnosing obesity can be a long process which includes a health history being taken, a general physical exam, calculation of BMI, and measuring waist circumference. Diagnosis of obesity also involves checking for problems such as high blood pressure, variation of cholesterol levels …

Food Insecurity: United States, Courtney Handzel

Global Issues in Public Health

Food insecurity is a global issue and has caused struggles to millions of people, specifically in the United States. This environmental issue involves not having the resources to obtain adequate food supply. The economic and social influences that affect food insecurity leave vulnerable populations, such as low-income families and minority races, at a greater disadvantage. This issue causes serious health complications to arise too, the most common being diabetes. The increased risk of diabetes due to food insecurity has been studied on several occasions and the results all show the correlation, lack of food security increases the risk of diabetes. …

Cetuximab Plus Carboplatin And Paclitaxel With Or Without Bevacizumab Versus Carboplatin And Paclitaxel With Or Without Bevacizumab In Advanced Nsclc (Swog S0819): A Randomised, Phase 3 Study, Roy S. Herbst, Mary W. Redman, Edward S. Kim, Thomas J. Semrad, Lyudmila Bazhenova, Gregory Masters, Kurt Oettel, Perry Guaglianone, Christopher Reynolds, Anand Karnad, Susanne M. Arnold, Marileila Varella-Garcia, James Moon, Philip C. Mack, Charles D. Blanke, Fred R. Hirsch, Karen Kelly, David R. Gandara

Markey Cancer Center Faculty Publications

Background

EGFR antibodies have shown promise in patients with advanced non-small-cell lung cancer (NSCLC), particularly with squamous cell histology. We hypothesised that EGFR copy number by fluorescence in-situ hybridisation (FISH) can identify patients most likely to benefit from these drugs combined with chemotherapy and we aimed to explore the activity of cetuximab with chemotherapy in patients with advanced NSCLC who are EGFR FISH-positive.

Methods

We did this open-label, phase 3 study (SWOG S0819) at 277 sites in the USA and Mexico. We randomly assigned (1:1) eligible patients with treatment-naive stage IV NSCLC to receive paclitaxel (200 mg/m ²; every …

Shopping Pattern And Food Purchase Differences Among Supplemental Nutrition Assistance Program (Snap) Households And Non-Supplemental Nutrition Assistance Program Households In The United States, Alison A. Gustafson

Dietetics and Human Nutrition Faculty Publications

No abstract provided.

Challenges And Considerations Related To Studying Dementia In Blacks/African Americans, Eseosa T. Ighodaro, Peter T. Nelson, Walter A. Kukull, Frederick A. Schmitt, Erin L. Abner, Allison M. Caban-Holt, Shoshana H. Bardach, Derrick C. Hord, Crystal M. Glover, Gregory A. Jicha, Linda J. Van Eldik, Alexander X. Byrd, Anita Fernander

Neuroscience Faculty Publications

Blacks/African Americans have been reported to be ~2–4 times more likely to develop clinical Alzheimer’s disease (AD) compared to Whites. Unfortunately, study design challenges (e.g., recruitment bias), racism, mistrust of healthcare providers and biomedical researchers, confounders related to socioeconomic status, and other sources of bias are often ignored when interpreting differences in human subjects categorized by race. Failure to account for these factors can lead to misinterpretation of results, reification of race as biology, discrimination, and missed or delayed diagnoses. Here we provide a selected historical background, discuss challenges, present opportunities, and suggest considerations for studying health outcomes among racial/ethnic …

Hla-B*57:01 Allele Prevalence In Hiv-Infected North American Subjects And The Impact Of Allele Testing On The Incidence Of Abacavir-Associated Hypersensitivity Reaction In Hla-B*57:01-Negative Subjects, Catherine Small, D Margolis, M Shaefer, L Ross

NYMC Faculty Publications

BACKGROUND: The presence of the HLA-B*57:01 allele in HIV-infected subjects is associated with a higher risk of abacavir-associated hypersensitivity reaction (ABC HSR). HLA-B*57:01 allele prevalence varies in different populations, but HLA-B*57:01 testing with immunological confirmation has had a negative predictive value for ABC HSR between 97 and 100%. METHODS: In the ASSURE study (EPZ113734), the HLA-B*57:01 prevalence in virologically suppressed, antiretroviral treatment-experienced, HIV-infected subjects from the United States, including Puerto Rico, was assessed. RESULTS: Three hundred eighty-five subjects were screened; 13 were HLA-B*57:01 positive and 372 were negative. Only HLA-B*57:01-negative, abacavir-naive subjects were eligible to enroll into the ASSURE trial. …

Cpt1a Methylation Is Associated With Plasma Adiponectin, S. Aslibekyan, A. N. Do, H. Xu, S. Li, M. R. Irvin, D Zhi, H. K. Tiwari, D. M. Absher, A. R. Shuldiner, T. Zhang, W. Chen, K. Tanner, C. Hong, B. D. Mitchell, G. Berenson, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background and Aims—Adiponectin, an adipose-secreted protein that has been linked to insulin sensitivity, plasma lipids, and inflammatory patterns, is an established biomarker for metabolic health. Despite clinical relevance and high heritability, the determinants of plasma adiponectin levels remain poorly understood.

Methods and Results—We conducted the first epigenome-wide cross-sectional study of adiponectin levels using methylation data on 368,051 cytosine-phosphate-guanine (CpG) sites in CD4+ T-cells from the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN, n= 991). We fit linear mixed models, adjusting for age, sex, study site, T-cell purity, and family. We have identified a positive association (regression …

Physical Activity And Sedentary Behaviors In Urban Chinese Children: Grade Level Prevalence And Academic Burden Associations, Xihe Zhu, Justin A. Haegele, Yan Tang, Xueping Wu

Human Movement Sciences Faculty Publications

The objectives of this study were (a) to report grade level prevalence in physical activity and sedentary behaviors and (b) to examine academic burden associations with these behaviors. School-aged children (n = 48,118) reported their physical activity, perception of physical activity sufficiency, factors for activity insufficiency, homework hours, and screen time in a typical week. Data were analyzed using general linear models and logistic regression models of Complex Samples. Prevalence results showed that children had lower physical activity and lower screen viewing time, but higher homework time during transition grades (6th, 9th, and 12th) and high school years. Academic burden …

A One Health Message About Bats Increases Intentions To Follow Public Health Guidance On Bat Rabies, Hang Lu, Katherine A. Mccomas, Danielle E. Buttke, Sungjong Roh, Margaret A. Wild

Research Collection Lee Kong Chian School Of Business

Since 1960, bat rabies variants have become the greatest source of human rabies deaths in the United States. Improving rabies awareness and preventing human exposure to rabid bats remains a national public health priority today. Concurrently, conservation of bats and the ecosystem benefits they provide is of increasing importance due to declining populations of many bat species. This study used a visitor-intercept experiment (N = 521) in two U.S. national parks where human and bat interactions occur on an occasional basis to examine the relative persuasiveness of four messages differing in the provision of benefit and uncertainty information on intentions …

The Genomic Cds Sandbox: An Assessment Among Domain Experts., Ayesha Aziz, Kensaku Kawamoto, Karen Eilbeck, Marc S Williams, Robert R Freimuth, Mark A Hoffman, Luke V Rasmussen, Casey L Overby, Brian H Shirts, James M Hoffman, Brandon M Welch

Manuscripts, Articles, Book Chapters and Other Papers

Genomics is a promising tool that is becoming more widely available to improve the care and treatment of individuals. While there is much assertion, genomics will most certainly require the use of clinical decision support (CDS) to be fully realized in the routine clinical setting. The National Human Genome Research Institute (NHGRI) of the National Institutes of Health recently convened an in-person, multi-day meeting on this topic. It was widely recognized that there is a need to promote the innovation and development of resources for genomic CDS such as a CDS sandbox. The purpose of this study was to evaluate …

Molecular Evolution And Intraclade Recombination Of Enterovirus D68 During The 2014 Outbreak In The United States., Yi Tan, Ferdaus Hassan, Jennifer E. Schuster, Ari Simenauer, Rangaraj Selvarangan, Rebecca A. Halpin, Xudong Lin, Nadia Fedorova, Timothy B. Stockwell, Tommy Tsan-Yuk Lam, James D. Chappell, Tina V. Hartert, Edward C. Holmes, Suman R. Das

Manuscripts, Articles, Book Chapters and Other Papers

In August 2014, an outbreak of enterovirus D68 (EV-D68) occurred in North America, causing severe respiratory disease in children. Due to a lack of complete genome sequence data, there is only a limited understanding of the molecular evolution and epidemiology of EV-D68 during this outbreak, and it is uncertain whether the differing clinical manifestations of EV-D68 infection are associated with specific viral lineages. We developed a high-throughput complete genome sequencing pipeline for EV-D68 that produced a total of 59 complete genomes from respiratory samples with a 95% success rate, including 57 genomes from Kansas City, MO, collected during the 2014 …

Two Boundaries Separate Borrelia Burgdorferi Populations In North America, Gabriele Margos, Jean I. Tsao, Santiago Castillo-Ramirez, Yvette A. Girard, Anne G. Hoen

Dartmouth Scholarship

Understanding the spread of infectious diseases is crucial for implementing effective control measures. For this, it is important to obtain information on the contemporary population structure of a disease agent and to infer the evolutionary processes that may have shaped it. Here, we investigate on a continental scale the population structure of Borrelia burgdorferi, the causative agent of Lyme borreliosis (LB), a tick-borne disease, in North America. We test the hypothesis that the observed d population structure is congruent with recent population expansions and that these were preceded by bottlenecks mostly likely caused by the near extirpation in the 1900s …

A Systematic Review Of Physical Activity Interventions In Hispanic Adults, Melinda J. Ickes, Manoj Sharma

Kinesiology and Health Promotion Faculty Publications

Healthy People 2020 aims to achieve health equity, eliminate disparities, and improve the health of all groups. Regular physical activity (PA) improves overall health and fitness and has the capability to reduce risk for chronic diseases. Identifying barriers which relate to the Hispanic population is important when designing PA interventions. Therefore, the purpose was to review existing PA interventions targeting Hispanic adults published between 1988 and 2011. This paper was limited to interventions which included more than 35% Hispanic adults (n = 20). Most of the interventions were community based (n = 16), although clinical, family-based, and faith-based …

A Brief History Of Phssr: The National Coordinating Center. Lessons From History, F. Douglas Scutchfield Md

Preventive Medicine and Environmental Health Presentations

No abstract provided.

Ixodes Affinis (Acari: Ixodidae) In Southeastern Virginia And Implications For The Spread Of Borrelia Burgdorferi, The Agent Of Lyme Disease, Robyn M. Nadolny, Chelsea L. Wright, Wayne L. Hynes, Daniel E. Sonenshine, Holly Gaff

Biological Sciences Faculty Publications

Ixodes affinis Neumann is a hard-bodied (ixodid) tick known to be a competent vector for Borrelia burgdorferi, the agent of Lyme disease, and agents of other human diseases (Keirans et al. 1999). Ixodes affinis has been reported in Florida, Georgia, and South Carolina and throughout coastal North Carolina (Clark et al. 1998, Harrison et al. 2010). Harrison et al. (2010) indicated that I. affinis was established throughout the coastal plain of North Carolina up to the Virginia border and suggested that I. affinis might occur in Virginia.

The Us Preventive Service Taskforce And The Guide To Clinical Preventive Services., F. Douglas Scutchfield Md

Preventive Medicine and Environmental Health Presentations

No abstract provided.

Public Health Services And Systems Research: Data For Research, F. Douglas Scutchfield Md

Preventive Medicine and Environmental Health Presentations

No abstract provided.

50 Years For The Uk College Of Medicine, F. Douglas Scutchfield Md

Preventive Medicine and Environmental Health Presentations

No abstract provided.