Digital Commons Network^™

A Quantitative Analysis Of Barriers To College Students’ Seasonal Vaccination Intentions And Behaviors, Kelly S. Clemens, John Matkovic

Faculty Publications – Health Sciences

Objective
Vaccination is crucial to college student health, but quantitative analyses of barriers in this population are limited. The present study expands the work of Su and Chen to determine the relative influence of structural, psychological, and social vaccination barriers.

Participants
Participants were 650 students from a large, midwestern university during the 2024 vaccination season.

Methods
Participants were recruited from a college campus and randomized to respond to items assessing their barriers to, intentions to receive, and uptake of the COVID-19 or influenza vaccination.

Results
Structural, psychological, and social barriers were differentially important to vaccinations and to intentions vs. uptake …

Balancing Care And Chaos: A Phenomenological Study On The Emotional And Mental Health Challenges Of Emergency Department Nurses, Shantilee Green

Theses and Dissertations

The purpose of this qualitative, phenomenological study was to examine the experiences of emergency department nurses related to emotional and mental health challenges, coping with stress, and ways to provide them with better workplace support. Emergency department nurses are required to work 12-hour shifts in a high-stress environment with a significant patient load and an inadequate patient-to-nurse ratio. Emergency department nurses are exposed daily to patient events that can be traumatic and affect their mental and emotional health, and nurses may find it challenging to cope with the resultant stress.

The researcher created an interview protocol of 14 questions to …

Management Of Newborns Born To Mothers With Positive Syphilis Testing During Pregnancy: A Community Hospital Experience, Jeffrey Johnson Md, Phd, Jonathan T. Berback Mph, Cic, Tibisay Villalobos Md

Fellows and Residents

No abstract provided.

Redling And Soil Contamination In Los Angles County: Mapping The Influence Of Polutants And Regulatory Landscapes On Enviromental Justice Outcomes, Gillian G. Maynard

Scripps Senior Theses

This thesis examines soil contamination in Los Angeles as a pervasive yet underexamined environmental justice issue, rooted in the region’s history of industrialization, racialized land-use policy, and regulatory failure. It argues that soil operates as both a long-term repository and an active pathway of toxic exposure, embedding environmental risk directly within residential landscapes. Through an analysis of key contamination sources, including legacy lead pollution, urban oil extraction, wildfire-related toxins, and industrial sites such as the Santa Susana Field Laboratory and the Exide battery recycling facility, this study demonstrates how contaminants persist across generations, often long after their original sources have …

Development Of A Bidirectional Tmv-Based Plant Expression Vector For Dual Gene Co-Expression, Matisse Schutten-Burgess

Scripps Senior Theses

Monoclonal antibodies, or mAbs, have recently joined the growing array of biopharmaceuticals used to treat a variety of chronic, autoimmune, and infectious diseases. Antibody therapy is highly customizable, as mAbs can be genetically engineered to target specific disease markers. Traditional systems of producing monoclonal antibodies use mammalian cells, most prominently Chinese Hamster Ovary Cells. While these systems are widely used, they are time-intensive and costly. Because of this, plant-based antibody production systems have risen in prominence, as they provide a more cost-efficient and faster way to generate antibodies. One drawback that has surfaced is that the co-expression of antibody heavy …

Motivational Interviewing Impact On Provider Burnout, Julie Cook

Graduate Studies Theses and Dissertations 2026

The study of patient–provider communication rarely considers the impact of provider–patient dialogue on providers themselves. This dissertation explores why motivational interviewing (MI) has been shown to reduce burnout among health care providers who use it. Using the empathic communication model (ECM) as a lens, it examines possible explanations for how MI contributes to lower burnout in providers. A mixed‑methods approach was used, consisting of a survey‑based quantitative study and a qualitative study using semi‑structured interviews. The quantitative study surveyed physicians, nurse practitioners, and physician assistants. Participants were asked questions assessing their knowledge of MI, the types of empathy they experience …

A Comparison Of F/Taf And F/Tdf As Hiv Pre-Exposure Prophylaxis In A Predominantly Cisgender Women Population In East And South Africa: A Randomised, Factorial, Non-Inferiority Trial, Sheena Mccormack, David Dunn, Sylvia Kusemererwa, Patricia Munseri, Nishanta Singh, Wiston William, Gertrude Mutonyi, Henry Bern, Lauriane Goldwirt, Cherry Kingsley, Arne Kkroidl, Christian Holm Hansen, Song Ding, Rachel Kawuma, Mary Amondi, Ubaldo Bahemuka, Deus Buma, Daniel Clutterbuck, Zakir Gaffoor, Angus Jennings, Agricola Joachim, Ayoub Kakande, Berna Kalanzi, Abisai Kisinda, Mabela Matsoso, Thomas Miller, Neetha Mmedsci Morar, Jacqueline Musau, Jane Nabbuto, Ayanda Nzuza, Doreen Pamba, Simona Salomone, Thandiwe Sithole, Edith Tarimo, Kubashni Woeber, Kundai Chinyenze, Glenda Gray, Eligius Lyamuya, Muhammad Bakari, Said Aboud, Lucas Maganga, Gustavo Doncel, Janet Seeley, Jonathan Weber, Pontiano Kaleebu, Julie Fox, Eugene Ruzagira, On Behalf Of The Prepvacc Study Group

CONRAD Publications

Background:

F/TAF was shown to be non-inferior to F/TDF as pre-exposure prophylaxis (PrEP) in men, but approval was not extended to cisgender women. We report the results of PrEPVacc, in which a predominantly female population was randomly allocated to receive daily oral F/TDF or F/TAF for ∼6 months within a HIV-1 prophylactic vaccine trial.

Setting:

Five study sites in three African countries (Uganda, Tanzania, South Africa).

Methods:

The two regimens were compared by the averted infections ratio (AIR) - the proportion of infections averted by F/TAF relative to F/TDF. The counterfactual HIV incidence, an essential component of this metric, was …

Longitudinal Changes In Plasma Biomarkers Of Immune Activation, Neuronal Inflammation And Injury In Persons With Hiv Initiating Art, Merle Henderson, Peter Dutey-Magni, Carolina Herrera, Wolfgang Stöhr, Alejandro Arenas-Pinto, Owen Swann, Amanda Heslegrave, Henrik Zetterberg, John Tregoning, Sarah Fidler, François Raffi, Andrea Calcagno, Ab Babiker, Alan Winston

CONRAD Publications

Background

Data on changes in biomarkers of brain health, and their associations with cognitive function in adults commencing either dual- or triple-antiretroviral therapy (ART) are sparse.

Methods

Plasma biomarkers (neurofilament light [NfL], glial fibrillary acidic protein [GFAP], sCD14, CXCL10, neopterin and IL-6) were measured at baseline and after 96 weeks on ART in individuals randomized to darunavir/ritonavir and either tenofovir-DF/emtricitabine (triple-ART, n = 119) or raltegravir (dual-ART, n = 119) in NEAT-001/ANRS143. Regression models examined associations of baseline and week-96 biomarker concentrations with HIV clinical parameters, composite cognitive test scores (Standardized neuropsychological test [NPZ], 7-domains) and treatment arm.

Results

In …

Partial Post-Exposure Protection By Topical Inserts Containing Tenofovir Alafenamide Fumarate/Elvitegravir In A Macaque Model Of Rectal Simian Hiv (Shiv) Infection, Natalia Makarova, Tyana Singletary, M. Melissa Peet, Kristen Kelley, Ryan Johnson, Vivek Agrahari, Maria Mendoza, Yi Pan, Walid Heneine, Meredith R. Clark, J. Gerardo García Lerma, Gustavo F. Doncel, James W. Smith

CONRAD Publications

On-demand topical inserts for HIV prevention may be a good option for people who have a low frequency of sexual activity. We recently demonstrated in a preclinical macaque model that rectal application of inserts containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) conferred protection against SHIV infection (93% efficacy) when applied as pre-exposure prophylaxis 4 hours before SHIV exposure. Here, we show that the same inserts provide significant postexposure protection (82.9% efficacy) when applied 4 hours after SHIV exposure. Our findings further support the ongoing clinical development of TAF/EVG inserts for on-demand HIV prevention.

A Position Statement On Endovascular Models And Effectiveness Metrics For Mechanical Thrombectomy Navigation, On Behalf Of The Stakeholder Taskforce For Artificial Intelligence-Assisted Robotic Thrombectomy (Start), Harry Robertshaw, Anna Barnes, Phil Blakelock, Raphael Blanc, Robert Crossley, Rebecca Fahrig, Ameer E. Hassan, Benjamin Jackson, Lennart Karstensen

School of Medicine Publications

Although we are making progress in overcoming infectious diseases and cancer, one of the major medical challenges of the mid-21st century will be the increasing prevalence of stroke. Occlusions in large vessels are especially debilitating, yet effective treatment—needed within hours to achieve best outcomes—remains limited because of geographic accessibility. One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the widespread deployment of robotic surgical systems. Artificial intelligence assistance may enable the safe and effective upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating artificial …

Accuracy Of The Phenotypic 1g Test To Detect Mycobacterium Tuberculosis And Drug Resistance From Sputa In The Us-Mexico Border, Mia Aguirre, Doris Ayala, Juan Ignacio Garcia, Yoscelina Estrella Martinez-Lopez, Amberlee Hicks, Nadine M. Chacon, Ashley Gay-Cobb, Alyssa Schami, Selena Zavala-Perez, Blanca I. Restrepo

School of Medicine Publications

Background: With >10 million new tuberculosis (TB) cases/year, a limitation to TB control is the lack of simple and accurate tests for TB diagnosis and drug-susceptibility testing (DST) in endemic regions. We evaluated the accuracy of the first-generation, low-complexity phenotypic TB test (1G test), designed for simultaneous Mtb detection and resistance to isoniazid, rifampicin and moxifloxacin, suitable for resource-limited settings.

Methods: A cross-sectional study was conducted using sputa from 426 possible pulmonary TB subjects from two small Mexican cities bordering Texas. The 1G test was compared against phenotypic TB detection tests in the region [acid fast bacilli smear microscopy and …

Bovine Lactoferrin Maintains Antibacterial Effect Against Neonatal Escherichia Coli Septicaemia Isolates Despite The Presence Of Iron Acquisition Genes, Matthew Mayorga, Joshua L. Wheatley, Brianna N. Maldonado, Susana Chavez-Bueno

Student Publications

Introduction. Escherichia coli is a dominant cause of neonatal sepsis for which no prevention measures currently exist. Lactoferrin (LF) is an iron-sequestering antibacterial protein that has been noticed to decrease neonatal late-onset sepsis.

Hypothesis/Gap Statement. LF’s effect on in vitro growth of neonatal E. coli clinical isolates causing septicaemia is unknown. The prevalence of iron acquisition virulence genes which contribute to pathogenicity outcomes in these strains has also not been described in detail.

Aim. To evaluate bovine lactoferrin’s (bLF) effects on the in vitro growth of neonatal septicaemia E. coli isolates, and to determine the presence of iron acquisition …

The Challenges Of International Travel Insurance For Leisure Travellers With Pre-Existing Mental Health Conditions, Alison Mcintosh, Gregory Willson, Dhananjana Madushani Morayes Gajaweera Marthinna Moraslage

Research outputs 2022 to 2026

International leisure travel is deemed therapeutic for reducing stress and improving mental health and wellbeing, although unfamiliar environments can exacerbate pre-existing mental health conditions. Travel insurance plays a crucial role in mitigating risks for travellers. There is a lack of critical evaluation regarding how insurers assess risk, determine coverage eligibility and communicate exclusions. International travel insurance policies may contain restrictive clauses, ambiguous wording and outright exclusions that may disproportionately disadvantage travellers with pre-existing conditions, including mental health conditions. This paper evaluates whether New Zealand’s international travel insurance policies adequately accommodate travellers with pre-existing mental health conditions. Analysis of 23 international …

A Multi-Method Study Evaluating The Inference Of Compartmental Model Parameters From A Generative Agent-Based Model, Elizabeth Hunter, Jim Duggan

Research Outputs: 2025-Present

Calibrating process models such as compartmental SIR Models to real data can be performed using either optimization or Bayesian techniques. To accurately assess the performance of these methods, synthetic outbreak data can be used. All information about the data generative process is known for synthetic data, while when using real data there are many unknowns such as under-reporting of cases or real parameter values. We propose using an agent-based model to generate synthetic data. Calibrating to synthetic datasets created using different agent contact structures can provide us with information on how changes in contact structures impact SIR model parameters. We …

The Impact Of Criminal Justice System Contact On Adolescents In The U.S.: Prescription Drug Misuse, Marijuana Use, Health Outcomes, And Demographic Characteristics, Fadime Gokce Karaaslan

Graduate Studies Theses and Dissertations 2026

Criminal justice system (CJS) contact remains a pervasive feature of social life in the United States, with both direct and indirect consequences for adolescents and their families. Although previous research has explored the consequences of direct CJS contact, less is known about how indirect or vicarious contact affects adolescents’ well-being and substance use. Drawing on data from the Future of Families and Child Wellbeing Study (FFCWS), this study investigates the association between parental incarceration and vicarious police stops, defined as police stops involving parents, siblings, friends, neighbors, or other social ties, and adolescent well-being. Findings indicate that CJS contact is …

The Diversity Of Flavivirus Antibody Dependent Enhancement (Ade) Profiles From A Pediatric Cohort In Mexico, Maiesha Samiha Mahmood

Graduate Studies Theses and Dissertations 2026

The Aedes mosquito-borne flaviviruses Zika (ZIKV) and dengue (DENV-1-4) cause an estimated 400 million annual infections globally and pose an increasing threat to public health. Typically, individuals infected with ZIKV or a DENV serotype generate neutralizing serotype-specific antibodies and non-neutralizing, cross-reactive antibodies that bind multiple flaviviruses. Upon secondary heterotypic infection, pre-existing antibodies can either protect or exacerbate disease through antibody dependent enhancement (ADE). ADE occurs when non- or sub-neutralizing concentrations of cross-reactive antibodies facilitate viral uptake into FcγR-bearing myeloid cells, enabling infection of otherwise non-permissive cells and driving severe disease. To date, ADE has not been characterized at a population …

The Biosynthesis Of The Natural Product N-Nitroglycine, Gabriel Padilla

Graduate Studies Theses and Dissertations 2026

N-Nitroglycine (NNG) is a nitramine [R(R′)N–NO2; R′=H or alkyl] natural product (NP) produced by certain actinomycetes, such as Streptomyces noursei. At the beginning of this project, the biosynthesis of this NP was unknown. The goal was to determine how NNG and its nitramine moiety are enzymatically formed. This could lead to the discovery of novel nitramine NPs with diverse applications as well as alternative/green synthesis of nitramine explosives. This work begins by examining diverse biochemical N–N bond formation strategies. Nitrogen cycle enzymes, nitration of NPs, kutzneride biosynthesis, the aspartate/nitrosuccinate superfamily, hydrazinoacetic acid (HAA) biosynthesis, and streptozocin biosynthesis are among the …

Evaluation Of Multiple Generative Large Language Models On Neurology Board-Style Questions, Mohammad Almomani, Vijaya Valaparla, James Weatherhead, Xiang Fang, Alok Dabi, Chih Ying Li, Peter Mccaffrey, Dan Hier, Jorge Mario Rodríguez-Fernández

Electrical and Computer Engineering Faculty Research & Creative Works

Objective: To compare the performance of eight large language models (LLMs) with neurology residents on board-style multiple-choice questions across seven subspecialties and two cognitive levels. Methods: In a cross-sectional benchmarking study, we evaluated Bard, Claude, Gemini v1, Gemini 2.5, ChatGPT-3.5, ChatGPT-4, ChatGPT-4o, and ChatGPT-5 using 107 text-only items spanning movement disorders, vascular neurology, neuroanatomy, neuroimmunology, epilepsy, neuromuscular disease, and neuro-infectious disease. Items were labeled as lower- or higher-order per Bloom's taxonomy by two neurologists. Models answered each item in a fresh session and reported confidence and Bloom classification. Residents completed the same set under exam-like conditions. Outcomes included overall and …

Viral Dynamics Across Managed And Wild Pollinators: Integrating Immunity, Ecology, And Community Structure, Allison Malay

Graduate Studies Theses and Dissertations 2026

Managed honey bees (Apis mellifera) are critical agricultural pollinators, yet colonies continue to experience persistently high losses across North America and Europe. These declines are driven by interacting stressors, including parasites, pathogens, nutrition, and landscape context. Viral pathogens are key contributors to colony morbidity and mortality, but the processes governing variation in viral prevalence, load, and host response remain incompletely understood. This dissertation investigates how viral dynamics in honey bees emerge from interactions among host immunity, colony condition, environmental context, and pollinator community structure. By integrating measures of viral prevalence, viral load, and immune gene expression across multiple …

Tour Guide Research Revisited: A Thematic Synthesis And Future Directions, Zhicheng Yu, Songshan (Sam) Huang, Jiqing Deng, Wenling Zhou, Zhiyong Li

Research outputs 2022 to 2026

Purpose: Existing knowledge on tour guiding is fragmented, which limits the understanding of this important profession. This paper aims to critically examine the progress of tour guide research, identify key theoretical tensions and propose future research directions based on a systematic synthesis of existing knowledge. Design/methodology/approach: A thematic analysis was conducted on 267 papers retrieved from the Web of Science Core Collection, Scopus and Google Scholar databases. Papers were systematically coded, categorized into themes and integrated into a framework that represents relationships among key themes in tour guide research. Findings: The analysis generated an integrated framework consisting of nine interrelated …

Tuberculosis Presenting As Multiple Pulmonary Nodules Mimicking Malignancy, Abdel Martinez Borrego, Fatimah Bello, Brandon Cantazaro, Luisa Montoya, Frank Mediola

School of Medicine Publications

Multiple pulmonary nodules often raise concern for metastatic malignancy; however, the differential diagnosis is broad and includes infectious, inflammatory, granulomatous, vascular, and benign etiologies. Tuberculosis (TB), although uncommon, can present with multiple nodules that closely mimic metastatic disease on advanced imaging, requiring careful clinicoradiologic and microbiologic correlation. We describe a woman in her 50s who presented with dyspnea and new-onset heart failure, in whom imaging revealed mediastinal lymphadenopathy and bilateral pulmonary nodules concerning for malignancy. Evaluation was limited by concurrent COVID-19 infection, and CT-guided biopsy demonstrated necrotizing granulomas without evidence of malignancy or infection. She later re-presented with fever and …

A Scientometric Study On Research Trends And Characteristics Of Kimura Disease, Zhongjing Lv, Yiming Luo, Wei Liu, Jian Yuan

Journal of Dental Sciences

Background/purpose: Kimura disease (KD) is an idiopathic condition that presents as a chronic, benign inflammatory disorder, typically affecting the head and neck region. The purpose of this study was to analyze the scientometric characteristics and research trends of KD.

Materials and methods: All the papers on KD were comprehensively retrieved from the Scopus database. The years of publication were divided into before 2012 and after 2012 in the analysis of research trends.

Results: There were 925 papers on KD, with total citations of 10,821 and the h index of 47. Eosinophilia, lymphadenopathy, nephrotic syndrome, angiofollicular lymph node hyperplasia, …

Routine Dental Scaling And Reduced Risk Of Serious Infections In Individuals With Moderate-To-Severe Cerebral Palsy: A Nationwide Population-Based Cohort Study, Li-Wei Ou-Yang, Yu-Tung Huang, Ya-Ting Chang, Hsin-Mao Hsu, Shih-Hao Chang, Chia-Ling Wu, Tsung-Chieh Yao

Journal of Dental Sciences

Background/ purpose: Individuals with moderate-to-severe cerebral palsy (CP) are highly susceptible to serious infections. Oral biofilms may serve as reservoirs for pathogenic microorganisms, yet the impact of professional oral healthcare on systemic infection risk in this population remains unclear. This study investigated the association between routine dental scaling and the risk of serious infections and infection-related mortality among individuals with moderate-to-severe CP.

Materials and methods: This nationwide, population-based cohort study used data from Taiwan’s National Health Insurance Research Database and National Death Registry (2009–2019). Individuals with moderate-to-severe CP were categorized into a routine dental scaling group (≥1 scaling annually for …

Digital Dialectic: Why Every “Ai-Generated” Work Has A Human Author, Lea Bishop

FIU Law Review

Are ChatGPT and Midjourney tools or creators? Ownership of billions of AI-assisted creative outputs hangs in the balance. Copyright scholars have long debated whether an autonomous artificial intelligence could qualify as an author, but this remains a hypothetical question. Despite widespread application of the term “AI” to software products of the 2020s, autonomously creative artificial intelligence still does not exist. Today’s commercial AI products—such as ChatGPT, Midjourney, Dall-E, Copilot, Gemini, Claude, Suno, Perplexity, and Lumo—are simply the newest generation of computer software. They do not qualify as “artificial intelligence” in either the scientific or science fiction senses. They are mere …

Understanding Motivations And Health Outcomes Of College-Aged Triathletes During Covid-19: A Mixed-Methods Study, Patrick Wilson, Eddie Hill, Justin Haegele, Xihe Zhu

Human Movement Studies & Special Education Faculty Publications

A triathlon is a multi-sport event that consists of three simultaneous events: swimming, biking, and running. This sport has experienced significant growth in the past few decades, with colleges and universities now participating. This exploratory mixed-methods study examined the motivations and perceived health benefits of college triathletes during the COVID-19 pandemic, using the Means-Ends of Recreation Scale and the Perceived Health Outcomes of Recreation Scale (N = 29), as well as semi-structured interviews (N = 4). Results indicate no difference in motives or health outcomes between male and female survey respondents. The thematic analysis of open-ended interview questions highlighted lived …

A Systematic Review On Niosomes: Composition, Preparation, And Applications, Sanket Gawade Mr., Sunil Attimarad, Vishakha Desai Ms.

Manipal Journal of Medical Sciences

Conventional drug carrier systems are restricted owing to poor bioavailability, weak stability and non-specific localization, which causes systemic toxicities and reduced therapeutic efficacy. Niosomes, one of the nonionic surfactant vesicular systems, have been suggested that value to overcome these constraints. In this review, we give an account of recent progress in niosome research, highlighting their merits, composition, characterization, and applications.

Niosomes offer several advantages including increased drug bioavailability, targeted delivery and reduced toxicity. Bilayered niosomes can entrap both hydrophilic and lipophilic drugs, therefore allowing simultaneous delivery of actives components. We provide an overview of various techniques for niosome preparation including …

Human Oral Microbiota Dysbiosis May Be A Novel Non-Invasive Indicator Of Erectile Dysfunction, Yu Qiao, Fei Mao, Bing-Ru Jiang, Shu-Yan Lv, Heng-Bing Wang, Guang-Bo Fu

Journal of Dental Sciences

No abstract provided.

Activities Of Dental Hygienists Registered In The Disaster Relief System Of The Japan Dental Hygienists’ Association In The 2024 Noto Peninsula Earthquake, Hitomi Suzuki, Kumiko Sugimoto

Journal of Dental Sciences

No abstract provided.

Hollow Fiber Assay Microtube Array Membrane (Mtam-Hfa) For Personalized Anticancer Drug Screening In Selection Of Concurrent Chemoradiotherapy In Oral Squamous Cell Carcinoma, Shan-Ju Chou, Po-Chih Hsu, Chee Ho Chew, Wan-Ting Huang, Amanda Lin Chen, Chen-Yin Yong, Chia-Che Wu, Chia-Lun Chang, Chien-Chung Chen, Kuan-Chou Lin

Journal of Dental Sciences

Background/purpose: In Asia, oral squamous cell carcinoma (OSCC) are on the rise in part due to the consumption of betel nut in several regions. This clinical case study evaluated the application of the microtube array membrane-hollow fiber assay (MTAM-HFA) that was previously clinically demonstrated in the context of the selection of chemotheraputic agents as part of the treatment of concurrent chemoradiotherapy (CCRT) in OSCC.

Materials and methods: In this double-blind cohort study, surgical samples from OSCC patients were retrieved and sent for screening of tumor response against a panel of chemotherapeutic agents (5-fluorouracil (5-FU), cisplatin, carboplatin and docetaxel). …

Inflammation In Early Borrelia Burgdorferi Skin Infection, Ariana Nobles

Electronic Theses & Dissertations (2024 - present)

Borrelia burgdorferi (Bb) is the causative agent of approximately 476,000 cases of Lyme disease in the United States and rising. Bb is spread through infected saliva of the black-legged tick, Ixodes scapularis, to the host. Patients infected with Bb experience short-term symptoms, such as erythema migrans (EMs), fatigue, pain, and cognitive impairment. If left untreated, Bb infection will cause long-term health complications, like Lyme neuroborreliosis and Lyme arthritis. It is postulated that symptoms associated with Lyme disease are driven in part by inflammation.

My thesis focuses on the skin as it holds significant immunological importance in the …