Tuberculosis

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  Subject Areas on Research

  • "The very pulse of the machine": the tuberculous granuloma in motion. 
  • 1 alpha,25 Dihydroxyvitamin D3 and mononuclear phagocytes: enhancement of mouse macrophage and human monocyte hydrogen peroxide production without alteration of tumor cytolysis. 
  • A clinical decision support system for integrating tuberculosis and HIV care in Kenya: a human-centered design approach. 
  • A critical role for CD8 T cells in a nonhuman primate model of tuberculosis. 
  • A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy. 
  • A new trial design to accelerate tuberculosis drug development: the Phase IIC Selection Trial with Extended Post-treatment follow-up (STEP). 
  • A prospective, randomized, double-blind study of the tolerability of rifapentine 600, 900, and 1,200 mg plus isoniazid in the continuation phase of tuberculosis treatment. 
  • A randomized controlled trial of standard versus intensified tuberculosis diagnostics on treatment decisions by physicians in Northern Tanzania. 
  • A short history of dapsone, or an alternative model of drug development. 
  • Access to and affordability of healthcare for TB patients in China: issues and challenges. 
  • Advances in basic and translational tuberculosis research: Proceedings of the first meeting of RePORT international. 
  • Adventures within the speckled band: heterogeneity, angiogenesis, and balanced inflammation in the tuberculous granuloma. 
  • Alcohol use and clinical manifestations of tuberculosis. 
  • An enzyme that inactivates the inflammatory mediator leukotriene b4 restricts mycobacterial infection. 
  • An explant technique for high-resolution imaging and manipulation of mycobacterial granulomas. 
  • Annual rates of decline in child, maternal, HIV, and tuberculosis mortality across 109 countries of low and middle income from 1990 to 2013: an assessment of the feasibility of post-2015 goals. 
  • Application of lipoarabinomannan antigen in tuberculosis diagnostics: current evidence. 
  • Are free anti-tuberculosis drugs enough? An empirical study from three cities in China. 
  • Are tuberculosis patients adherent to prescribed treatments in China? Results of a prospective cohort study. 
  • Association Between Staff Experience and Effective Tuberculosis Contact Tracing in North Carolina, 2008-2009. 
  • Association of SLC11A1 with tuberculosis and interactions with NOS2A and TLR2 in African-Americans and Caucasians. 
  • Attenuated host resistance against Mycobacterium bovis BCG infection in mice lacking osteopontin. 
  • Bacteremic disseminated tuberculosis in sub-saharan Africa: a prospective cohort study. 
  • Bacterial infection remodels the DNA methylation landscape of human dendritic cells. 
  • Barriers to initiating tuberculosis treatment in sub-Saharan Africa: a systematic review focused on children and youth. 
  • Brain and spine imaging findings in AIDS patients. 
  • Building capacity for advances in tuberculosis research; proceedings of the third RePORT international meeting. 
  • CLARITY and PACT-based imaging of adult zebrafish and mouse for whole-animal analysis of infections. 
  • Chemotaxis of mononuclear leukocytes. 
  • Clinical features and outcomes of tuberculosis in transplant recipients as compared with the general population: a retrospective matched cohort study. 
  • Clinical features associated with HIV-1 infection in adult patients diagnosed with tuberculosis in Djibouti, Horn of Africa. 
  • Clinical pathologic conference on atypical case of tuberculous meningitis with moniliasis, cerebral arteriosclerosis and terminal bronchopneumonia. 
  • Clinical presentation and outcome of tuberculosis in kidney, liver, and heart transplant recipients in Spain. Spanish Transplantation Infection Study Group, GESITRA. 
  • Clinical research and development of tuberculosis diagnostics: moving from silos to synergy. 
  • Clinical usefulness of detecting growth of Mycobacterium tuberculosis in positive Bactec phials using PCR. 
  • Comparison between peer-led and teacher-led education in tuberculosis prevention in rural middle schools in Chongqing, China. 
  • Comparison of altitude effect on Mycobacterium tuberculosis infection between rural and urban communities in Peru. 
  • Comparison of methods based on different molecular epidemiological markers for typing of Mycobacterium tuberculosis complex strains: interlaboratory study of discriminatory power and reproducibility. 
  • Complex transmission dynamics of clonally related virulent Mycobacterium tuberculosis associated with barhopping by predominantly human immunodeficiency virus-positive gay men. 
  • Complications of enzymatic debridement in pulmonary tuberculosis with bronchopleural fistula. 
  • Conditions that may affect the results of susceptibility testing of Mycobacterium tuberculosis to pyrazinamide. 
  • Control of biologic hazards. 
  • Controlled comparison of BacT/Alert MB system, manual Myco/F lytic procedure, and isolator 10 system for diagnosis of Mycobacterium tuberculosis Bacteremia. 
  • Costs and cost-effectiveness of four treatment regimens for latent tuberculosis infection. 
  • Cryopreserved mitral homograft in the tricuspid position for infective endocarditis: a valve that can be repaired in the long-term (13 years). 
  • Current issues in global tuberculosis control. 
  • Cutaneous complications of BCG vaccination in infants with immune disorders: two cases and a review of the literature. 
  • Deficiency of double-strand DNA break repair does not impair Mycobacterium tuberculosis virulence in multiple animal models of infection. 
  • Design, synthesis, and study of a mycobactin-artemisinin conjugate that has selective and potent activity against tuberculosis and malaria. 
  • Detection of bloodstream pathogens in a bacille Calmette-Guérin (BCG)-vaccinated pediatric population in Malawi: a pilot study. 
  • Developing a Framework for Evaluating Ethical Outcomes of Good Participatory Practices in TB Clinical Drug Trials. 
  • Development of tuberculosis in human immunodeficiency virus infected patients receiving antiretroviral therapy. 
  • Diagnosis and treatment of latent tuberculosis infection in liver transplant recipients in an endemic area. 
  • Did the 'Great Recession' produce a depression in tuberculosis incidence? 
  • Discriminating between latent and active tuberculosis with multiple biomarker responses. 
  • Disparity in reimbursement for tuberculosis care among different health insurance schemes: evidence from three counties in central China. 
  • Disseminated bacille Calmette-Guérin disease after vaccination. 
  • Do clinical decision-support reminders for medical providers improve isoniazid preventative therapy prescription rates among HIV-positive adults? Study protocol for a randomized controlled trial. 
  • Early versus delayed fixed dose combination abacavir/lamivudine/zidovudine in patients with HIV and tuberculosis in Tanzania. 
  • Effect of dihydrostreptomycin on tissue lipids of tuberculous guinea-pigs. 
  • Efficacy and safety of live attenuated persistent and rapidly cleared Mycobacterium tuberculosis vaccine candidates in non-human primates. 
  • Enhanced priming of adaptive immunity by a proapoptotic mutant of Mycobacterium tuberculosis. 
  • Epidemiology of human immunodeficiency virus testing among patients with tuberculosis in North Carolina. 
  • Epidemiology of tuberculosis in North Carolina, 1966 to 1986: analysis of demographic features, geographic variation, AIDS, migrant workers, and site of infection. 
  • Esophageal tuberculosis: findings on barium swallow and computed tomography. 
  • Evaluation of the Vitek MS v3.0 Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry System for Identification of Mycobacterium and Nocardia Species. 
  • Excretion of viable tubercle bacilli by Blatta orientalis (the oriental cockroach) following ingestion of heat-fixed sputum smears: a laboratory investigation. 
  • Exogenous reinfection of tuberculosis in a low-burden area. 
  • Extensively drug-resistant tuberculosis: are we learning from history or repeating it? 
  • Extrapulmonary tuberculosis, human immunodeficiency virus, and foreign birth in North Carolina, 1993 - 2006. 
  • Extrapulmonary tuberculosis: a potential source of laboratory-acquired infection. 
  • Factors Influencing Hospitalization Rates and Inpatient Cost of Patients with Tuberculosis in Jiangsu Province, China: An Uncontrolled before and after Study. 
  • Factors that associated with TB patient admission rate and TB inpatient service cost: a cross-sectional study in China. 
  • Factors that determine catastrophic expenditure for tuberculosis care: a patient survey in China. 
  • Fatal Mycobacterium tuberculosis bloodstream infections in febrile hospitalized adults in Dar es Salaam, Tanzania. 
  • Feasibility and willingness-to-pay for integrated community-based tuberculosis testing. 
  • Fit for consumption: zebrafish as a model for tuberculosis. 
  • Functionally Overlapping Variants Control Tuberculosis Susceptibility in Collaborative Cross Mice. 
  • Genomic sequencing is required for identification of tuberculosis transmission in Hawaii. 
  • Genotypic and Spatial Analysis of Mycobacterium tuberculosis Transmission in a High-Incidence Urban Setting. 
  • Geographic information system-based screening for TB, HIV, and syphilis (GIS-THIS): a cross-sectional study. 
  • Global tuberculosis control report. 
  • Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. 
  • HIV risk factors among patients with tuberculosis--Botswana 1999. 
  • HIV-1 infection in injection drug users. 
  • High-throughput identification and dendritic cell-based functional validation of MHC class I-restricted Mycobacterium tuberculosis epitopes. 
  • Histoplasmosis among hospitalized febrile patients in northern Tanzania. 
  • History of antibiotics. From salvarsan to cephalosporins. 
  • Host-Directed Therapies for Tuberculosis. 
  • How affordable are tuberculosis diagnosis and treatment in rural China? An analysis from community and tuberculosis patient perspectives. 
  • IL-17 Production of Neutrophils Enhances Antibacteria Ability but Promotes Arthritis Development During Mycobacterium tuberculosis Infection. 
  • Identification of a W variant outbreak of Mycobacterium tuberculosis via population-based molecular epidemiology. 
  • Immune control of tuberculosis by IFN-gamma-inducible LRG-47. 
  • Impact of Community-Based DOT on Tuberculosis Treatment Outcomes: A Systematic Review and Meta-Analysis. 
  • Impact of an innovative financing and payment model on tuberculosis patients' financial burden: is tuberculosis care more affordable for the poor? 
  • Impact of an innovative tuberculosis financing and payment model on health service utilization by tuberculosis patients in China: do the poor fare better than the rich? 
  • Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries. 
  • Implementing a "free" tuberculosis (TB) care policy under the integrated model in Jiangsu, China: practices and costs in the real world. 
  • Incidence and risk factors for tuberculosis in HIV-positive subjects by HAART status. 
  • Incidence of tuberculosis in HIV-infected patients receiving HAART: interaction between TST and CD4 count. 
  • Increased prevalence of advanced tuberculosis in rural low tuberculosis caseload counties in North Carolina. 
  • Infection with Mycobacterium bovis BCG diverts traffic of myelin oligodendroglial glycoprotein autoantigen-specific T cells away from the central nervous system and ameliorates experimental autoimmune encephalomyelitis. 
  • Infection-Induced Vascular Permeability Aids Mycobacterial Growth. 
  • Infectious complications of treatment with biologic agents. 
  • Inhibition of apoptosis by Rv2456c through Nuclear factor-κB extends the survival of Mycobacterium tuberculosis. 
  • Interception of host angiogenic signalling limits mycobacterial growth. 
  • Intermittent tuberculosis treatment for patients with isoniazid intolerance or drug resistance. 
  • Internal migration and transmission dynamics of tuberculosis in Shanghai, China: an epidemiological, spatial, genomic analysis. 
  • Iproniazid in pulmonary tuberculosis. 
  • Is liver transplantation advisable for isoniazid fulminant hepatitis in active extrapulmonary tuberculosis? 
  • Isoniazid in pulmonary tuberculosis, with special reference to X-ray findings after four and six months' treatment. 
  • Knowledge, attitudes and beliefs regarding tuberculosis preventive therapy for HIV-infected persons, Botswana, 1999. 
  • Knowledge, attitudes, and beliefs about directly-administered antiretroviral therapy among tuberculosis patients, Botswana 2002. 
  • Lung, heart, kidney and spleen lipids in experimental tuberculosis in chicken. 
  • Lysosomal Disorders Drive Susceptibility to Tuberculosis by Compromising Macrophage Migration. 
  • Macrophage form, function, and phenotype in mycobacterial infection: lessons from tuberculosis and other diseases. 
  • Matrix metalloproteinase inhibitors enhance the efficacy of frontline drugs against Mycobacterium tuberculosis. 
  • Medicine. A portfolio model of drug development for tuberculosis. 
  • Medium matters: modeling the impact of solid medium performance on tuberculosis trial sample size requirements. 
  • Mice deficient in LRG-47 display increased susceptibility to mycobacterial infection associated with the induction of lymphopenia. 
  • Mice that overexpress CC chemokine ligand 2 in their lungs show increased protective immunity to infection with Mycobacterium bovis bacille Calmette-Guérin. 
  • Missed opportunities for diagnosis of tuberculosis and human immunodeficiency virus co-infection in Moshi, Tanzania. 
  • Modeling Diversity: Do Homogeneous Laboratory Strains Limit Discovery? 
  • Molecular Diagnostics for Mycobacterium tuberculosis Infection. 
  • Molecular epidemiology and tuberculosis control. 
  • Molecular identification of streptomycin monoresistant Mycobacterium tuberculosis related to multidrug-resistant W strain. 
  • Monitored isoniazid prophylaxis for low-risk tuberculin reactors older than 35 years of age: a risk-benefit and cost-effectiveness analysis. 
  • Monitored isoniazid prophylaxis for low-risk tuberculin reactors. 
  • Multiple perspectives on diagnosis delay for tuberculosis from key stakeholders in poor rural China: case study in four provinces. 
  • Mycobacterial Mutagenesis and Drug Resistance Are Controlled by Phosphorylation- and Cardiolipin-Mediated Inhibition of the RecA Coprotease. 
  • Mycobacterial interspersed repetitive-unit-variable-number tandem-repeat analysis and Beijing/W family of Mycobacterium tuberculosis. 
  • Mycobacterium bovis bacille Calmette-Guérin infection in the CNS suppresses experimental autoimmune encephalomyelitis and Th17 responses in an IFN-gamma-independent manner. 
  • Mycobacterium tuberculosis presenting as an infected pulmonary bulla. 
  • NLRC3 negatively regulates CD4+ T cells and impacts protective immunity during Mycobacterium tuberculosis infection. 
  • Natural ventilation for the prevention of airborne contagion. 
  • Neonatal tuberculosis: neonatal intensive care unit considerations in the United States. 
  • Nitric oxide prevents a pathogen-permissive granulocytic inflammation during tuberculosis. 
  • Non-medical financial burden in tuberculosis care: a cross-sectional survey in rural China. 
  • Notes from the Field: Contact Investigation for an Infant with Congenital Tuberculosis Infection - North Carolina, 2016. 
  • Occupational Risk Factors for Tuberculosis Among Healthcare Workers in KwaZulu-Natal, South Africa. 
  • One Month of Rifapentine plus Isoniazid to Prevent HIV-Related Tuberculosis. Reply. 
  • Osteoarticular manifestations of Mycobacterium tuberculosis infection. 
  • Paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome in children. 
  • Patient and provider perspectives on implementation models of HIV counseling and testing for patients with TB. 
  • Patient medical costs for tuberculosis treatment and impact on adherence in China: a systematic review. 
  • Perceptions of tuberculosis and health seeking behaviour in rural Inner Mongolia, China. 
  • Performance of Homologous and Heterologous Prime-Boost Immunization Regimens of Recombinant Adenovirus and Modified Vaccinia Virus Ankara Expressing an Ag85B-TB10.4 Fusion Protein against Mycobacterium tuberculosis. 
  • Performance of Interferon-gamma Release Assays for Tuberculosis Screening in Pediatric Inflammatory Bowel Disease. 
  • Performance of nucleic acid amplification following extraction of 5 milliliters of whole blood for diagnosis of Mycobacterium tuberculosis bacteremia. 
  • Pharmacokinetics of rifampicin. 
  • Predicting tuberculosis: does the IGRA tell the tale? 
  • Prevalence of mycobacteremia among HIV-infected infants and children in northern Tanzania. 
  • Protection against Mycobacterium avium by DNA vaccines expressing mycobacterial antigens as fusion proteins with green fluorescent protein. 
  • Public health costs for tuberculosis suspects in Wake County, North Carolina, United States. 
  • Public-private mix for tuberculosis care and control: a systematic review. 
  • Pulmonary immune-compartment-specific interferon gamma responses in HIV-infected individuals with active tuberculosis (TB) in an area of high TB prevalence. 
  • Purine nucleoside phosphorylase deficiency with fatal course in two sisters. 
  • Racial and ethnic disparities in pediatric tuberculosis in North Carolina. 
  • Rapid identification of laboratory contamination with Mycobacterium tuberculosis using variable number tandem repeat analysis. 
  • Rapid molecular detection of tuberculosis and rifampin resistance. 
  • RePORT International: Advancing Tuberculosis Biomarker Research Through Global Collaboration. 
  • Rifampin Pharmacokinetics and Safety in Preterm and Term Infants. 
  • Risk factors for development of systemic lupus erythematosus: allergies, infections, and family history. 
  • SARS-CoV-2 Receptor ACE2 Is an Interferon-Stimulated Gene in Human Airway Epithelial Cells and Is Detected in Specific Cell Subsets across Tissues. 
  • Safety of 2 months of rifampin and pyrazinamide for treatment of latent tuberculosis. 
  • Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement. 
  • Severe tuberculosis induces unbalanced up-regulation of gene networks and overexpression of IL-22, MIP-1alpha, CCL27, IP-10, CCR4, CCR5, CXCR3, PD1, PDL2, IL-3, IFN-beta, TIM1, and TLR2 but low antigen-specific cellular responses. 
  • Shorter drug regimens for tuberculosis: the multiple applications of decision models. 
  • Study of total red cell volume and erythrocyte survival using radioactive chromium in patients with advanced pulmonary tuberculosis. 
  • Successful treatment of disseminated BCG in a patient with severe combined immunodeficiency. 
  • Suppression of the NF-κB pathway by diesel exhaust particles impairs human antimycobacterial immunity. 
  • Synergistic pandemics: confronting the global HIV and tuberculosis epidemics. 
  • TB: the Yin and Yang of lipid mediators. 
  • Tackling the unknowns of short-course rifapentine-based treatment for active tuberculosis: a decision analysis. 
  • Technologies for global health. 
  • The Effect of an Innovative Financing and Payment Model for Tuberculosis Patients on Health Service Utilization in China: Evidence from Hubei Province of China. 
  • The bioavailability of isoniazid, rifampin, and pyrazinamide in two commercially available combined formulations designed for use in the short-course treatment of tuberculosis. 
  • The challenges of an HIV vaccine enterprise. 
  • The cost of 'free' tuberculosis care. 
  • The effect of NCMS on catastrophic health expenditure and impoverishment from tuberculosis care in China. 
  • The global health and diagnostic (flow) cytometry--breakthroughs in HIV and tuberculosis. 
  • The hidden hypothesis: A disseminated tuberculosis case. 
  • The human antibody response to the surface of Mycobacterium tuberculosis. 
  • The impact of increased reimbursement rates under the new cooperative medical scheme on the financial burden of tuberculosis patients. 
  • The impact of the new cooperative medical scheme on financial burden of tuberculosis patients: evidence from six counties in China. 
  • The infectiousness of tuberculosis patients coinfected with HIV. 
  • The lta4h locus modulates susceptibility to mycobacterial infection in zebrafish and humans. 
  • The p47 GTPase Lrg-47 (Irgm1) links host defense and hematopoietic stem cell proliferation. 
  • The race to eliminate tuberculosis. 
  • The risks and benefits of childhood bacille Calmette-Guérin immunization among adults with AIDS. International MAC study groups. 
  • The role of the granuloma in expansion and dissemination of early tuberculous infection. 
  • Therapeutic drug monitoring of antimycobacterial drugs in patients with both tuberculosis and advanced human immunodeficiency virus infection. 
  • Three months of rifapentine and isoniazid for latent tuberculosis infection. 
  • Thrombocyte Inhibition Restores Protective Immunity to Mycobacterial Infection in Zebrafish. 
  • Tissue plasminogen activator (tPA) signal sequence enhances immunogenicity of MVA-based vaccine against tuberculosis. 
  • Translating tuberculosis research into practice: collaboration between academic researchers and public health departments in North Carolina. 
  • Treatment of tuberculosis in patients with advanced human immunodeficiency virus infection. 
  • Trends in tuberculosis/human immunodeficiency virus comorbidity, United States, 1993-2004. 
  • Tuberculin reactivity in bacille Calmette-Guérin vaccinated populations: a compilation of international data. 
  • Tuberculosis Immune Reconstitution Inflammatory Syndrome in children initiating Antiretroviral Therapy for HIV infection: A systematic literature review. 
  • Tuberculosis Susceptibility and Vaccine Protection Are Independently Controlled by Host Genotype. 
  • Tuberculosis after solid-organ transplant: incidence, risk factors, and clinical characteristics in the RESITRA (Spanish Network of Infection in Transplantation) cohort. 
  • Tuberculosis among health care workers in KwaZulu-Natal, South Africa: a retrospective cohort analysis. 
  • Tuberculosis complicating hepatitis C treatment in HIV-infected patients. 
  • Tuberculosis genes expressed during persistence and reactivation in the resistant rabbit model. 
  • Tuberculosis in hospital personnel. 
  • Tuberculosis in patients receiving antiretroviral treatment: incidence, risk factors, and prevention strategies. 
  • Tuberculosis in solid organ transplant recipients at a tertiary hospital in the last 20 years in Barcelona, Spain. 
  • Tuberculosis knowledge and attitudes among physicians who treat young children in North Carolina, USA. 
  • Tuberculosis knowledge, attitudes, and beliefs among North Carolinians at increased risk of infection. 
  • Tuberculosis management continues to utilize a large amount of hospital resources in the United States. 
  • Tuberculosis of the abdomen. 
  • Tuberculosis patient expenditure on drugs and tests in subsidised, public services in China: a descriptive study. 
  • Tuberculosis treatment and risk of stavudine substitution in first-line antiretroviral therapy. 
  • Tuberculous granuloma induction via interaction of a bacterial secreted protein with host epithelium. 
  • Tuberculous psoas muscle abscess following chemoprophylaxis with isoniazid in a patient with human immunodeficiency virus infection. 
  • Tumor necrosis factor-alpha antagonists for the treatment of rheumatic diseases. 
  • Two decades of disseminated tuberculosis at a university medical center: the expanding role of mycobacterial blood culture. 
  • Ultra-low dose of Mycobacterium tuberculosis aerosol creates partial infection in mice. 
  • Under-reporting of TB cases and associated factors: a case study in China. 
  • Unrecognised Mycobacterium tuberculosis bacteraemia among hospital inpatients in less developed countries. 
  • Unrecognised Mycobacterium tuberculosis. 
  • Utilization and expenses of outpatient services among tuberculosis patients in three Chinese counties: an observational comparison study. 
  • Validation of the surveillance system for tuberculosis in Botswana. 
  • Vitamin B1 Helps to Limit Mycobacterium tuberculosis Growth via Regulating Innate Immunity in a Peroxisome Proliferator-Activated Receptor-γ-Dependent Manner. 
  • Vitamin B5 Reduces Bacterial Growth via Regulating Innate Immunity and Adaptive Immunity in Mice Infected with Mycobacterium tuberculosis. 
  • What lessons can be drawn from tuberculosis (TB) control in China in the 1990s? An analysis from a health system perspective. 
  • Whole genome sequencing identifies circulating Beijing-lineage Mycobacterium tuberculosis strains in Guatemala and an associated urban outbreak. 
  • [Effect of an antitoxin, administered for a month, on the course of cavitary pulmonary tuberculosis presently refractory to antibacterial drugs. Contribution to the use of oxynhyles (stimulative substances)]. 
  • [HIV infection in immigrants in Spain: Epidemiological characteristics and clinical presentation in the CoRIS Cohort (2004-2006)]. 
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  Keywords of People

  • Ferrari, Guido, Associate Professor of Surgery, Molecular Genetics and Microbiology
  • Le, Thuy, Associate Professor of Medicine, Molecular Genetics and Microbiology
  • Stout, Jason Eric, Professor of Medicine, Medicine, Infectious Diseases
  • Taylor, Gregory Alan, Professor in Medicine, Immunology
  • Tobin, David M., Associate Professor of Molecular Genetics and Microbiology, Immunology