Archive for the ‘research’ Category

Autism Guide

April is Autism Awareness Month

According to one Lyme literate doctor Lyme disease is present in over 65% of autism cases in her practice, and a case report showed substantial improvement in a child with autism after using treatment for vector-borne infections.

Another doctor has stated:

‘I Never Had a Single Unvaccinated Patient with Autism’ — Dr. Ben Tapper

Many are unaware that CDC scientist William Thompson admitted scientists purposely destroyed data that showed:

“The omitted data suggested that African-American males who received the MMR vaccine before age 36 months were at increased risk for autism.” ~ Dr. William Thompson
A study has confirmed that ‘vaccines’ are likely responsible for nearly 80% of autism in the U.S. and the government has misled the public on thimerosal link to autism for decades, falsely claiming it’s been removed from ‘vaccines.’

Clarke et al from UCLA as summarized that ‘profound autism’ (those who require 24-hour support and assistance) a severe childhood neuropsychiatric disorder is rising at alarming rates:

New prevalence estimates from the Centers for Disease Control (CDC) found that over a quarter, 26.7%, of children with autism in the United States meet criteria for profound autism (26), suggesting that in the United States, a substantial minority of children with autism may be at increased risk of experiencing stigma due to the nature and intensity of their autism symptoms. Additional work is needed to further understand the prevalence of profound autism, particularly in clinical and community-based samples, so we can better understand what proportion of autistic individuals and their families may experience stigma related to profound autism. Such information is also critical to improving service planning for this population, as most profoundly autistic individuals cannot speak for themselves and are likely to need intensive support services for much or all their lives.

Go here for a 13 minute film on ‘The Unseen Severe Autism.”

https://worldcouncilforhealth.substack.com/p/stop-press-wch-launches-new-autism?

Stop Press: WCH Launches New Autism Guide

This Autism Awareness Month, discover natural approaches to heal and thrive with autism – there is a Better Way!

Did you know that diagnosis of Autism Spectrum Disorder (ASD) in developed countries has risen from 1 in 10,000 children in the 1980s, to 1 in 33 today? It’s a staggering figure and inspires many questions. What is causing it? What are the implications? And, how can we support our ASD children’s health and wellbeing in the best way?

With this in mind, we are delighted to announce the release of an all-new Autism: New Horizons guide, exploring natural approaches to heal and thrive, authored by Anne Pemberton.

About the author

Anne began her career as a specialist cardiothoracic intensive care nurse. After her son was diagnosed with autism, she looked to natural therapies to support him, eventually retraining in psychology and then in functional medicine. More recently, she has specialised in trauma-informed energy medicine and runs a busy international clinic. She’s an author, tutor, international speaker, and she brings expertise, compassion and heart to this excellent guide.

View the checklist free!

To celebrate this incredible resource, we’re sharing an exclusive checklist pulled straight from the guide – so you can get a taste of what’s inside and discover how this guide can help you, or someone you care about, thrive.

Go here to get the guide for $10.60 in the U.S. or 7.95 GBP.

For more:

Japanese Researchers: COVID Shot Spike Protein Damages Blood Vessels for up to 17 Months & WHO States ‘Monkeypox’ is a ‘Side Effect’ of COVID Shot

https://www.sciencedirect.com/science/article/pii/S096758682500195X?

Expression of SARS-CoV-2 spike protein in cerebral Arteries: Implications for hemorrhagic stroke Post-mRNA vaccination

https://doi.org/10.1016/j.jocn.2025.111223Get rights and content
Under a Creative Commons license
Received 31 January 2025, Accepted 31 March 2025, Available online 3 April 2025, Version of Record 3 April 2025.
Open access

Highlights

  • Spike protein expression was detected in 43.8% of vaccinated patients.
  • SARS-CoV-2 spike protein persists in cerebral arteries up to 17 months post-vaccination.
  • Spike protein was expressed in the intima of the cerebral arteries.
  • In situ hybridization confirmed vaccine- and virus-derived spike protein mRNA.
  • Findings highlight concerns about mRNA vaccine biodistribution and long-term safety.

Abstract

Background

The rapid deployment of mRNA vaccines for SARS-CoV-2, such as BNT162b2 (BioNTech-Pfizer) and mRNA-1273 (Moderna), provided a critical tool in combating the COVID-19 pandemic. While their short-term safety and efficacy were demonstrated in clinical trials, rare adverse events, including hemorrhagic strokes, have been reported after widespread use. However, the long-term biodistribution and effects of mRNA vaccines remain underexplored.
This study aimed to investigate the long-term presence of SARS-CoV-2 spike protein in brain tissues of patients with hemorrhagic strokes, examining its potential association with mRNA vaccination.

Methods

A total of 19 cases of hemorrhagic stroke from 2023 to 2024 were retrospectively analyzed. Immunohistochemical staining for SARS-CoV-2 spike protein and nucleocapsid protein was performed on tissue samples. In situ hybridization was conducted in selected cases to confirm the origin of spike protein expression (vaccine or viral infection). Vaccination history and SARS-CoV-2 infection status were documented for all cases.

Results

Spike protein expression was detected in 43.8 % of vaccinated patients, predominantly localized to the intima of cerebral arteries, even up to 17 months post-vaccination. While no active inflammatory changes were identified, infiltration of CD4-, CD8- and CD68- positive cells was observed in the spike protein positive vessels. In situ hybridization confirmed the presence of both vaccine-derived mRNA and SARS-CoV-2 virus-derived mRNA, which encode the spike protein, in select cases. Notably, spike protein positivity was observed exclusively in female patients (P = 0.015). None of the cases showed nucleocapsid protein positivity, supporting the absence of active viral infection.

Conclusion

Although the possibility of spike protein expression due to asymptomatic SARS-CoV-2 infection cannot be entirely excluded, this study demonstrated prolonged presence of SARS-CoV-2 spike protein in the cerebral arteries following mRNA vaccination. Additionally, some inflammatory cell infiltration was observed in spike-positive vessels. These findings raise significant concerns regarding the biodistribution of lipid nanoparticle-based vaccines and their long-term safety. Global replication studies are urgently required to validate these findings and ensure comprehensive safety evaluations of mRNA vaccines.
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**Comment**
While the authors insist that the clot shots provided a critical tool in combating the COVID-19 pandemic, data, a systemic review and reality show otherwise.  In fact in November 2024, a peer-reviewed study called for immediate global moratorium on these experimental gene therapy injections due to unprecedented adverse reactions including death.
They weren’t even tested for reduction in hospitalization, death, or transmission, rather they were tested for reduction in severe symptoms – which is not the proper endpoint for “vaccine” efficacy. To make matters even worse, they dropped the 50% efficacy requirement for Emergency use Authorization (EUA).  Then, they authorized boosters without consulting its vax panel.  Rubberstamping these shots is their modus operandi.

https://slaynews.com/news/who-monkeypox-side-effect-covid-mrna-vaccines/

WHO: ‘Monkeypox’ Is a ‘Side Effect’ of Covid mRNA ‘Vaccines’

The World Health Organization (WHO) has admitted that so-called “monkeypox” is actually a side effect of Covid mRNA “vaccines.”

The United Nations “health” buried the admission on the WHO’s VigiAccess website.

The website contains a database that lists all known side effects of all drugs and vaccines that have been approved for public use.

Under “potential side effects” for the Pfizer BioNTech COVID-19 vaccine, the WHO lists “monkeypox,” “smallpox,” and “cow pox” among hundreds of other disorders.

They are listed under “infections and infestations” that emerge as “side effects” of the Pfizer mRNA vaccine.  (See link for article)

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**Comment**

A new study of WHO data shows that ‘COVID deaths’ skyrocketed among the ‘vaccinated,’ and a study of 9 million also reveals brain damage.

Similarly to COVID, a Monkeypox outbreak followed a ‘Germ-Game’ preparation. A renowned German doctor has already spoken out to warn the public that the monkeypox “outbreak” is a hoax and the “symptoms” are actually side effects of Covid clot shots.  Another doctor states monkeypox is psychological bioterrorism being pushed by ‘evil.’

Take home: these shots are worthless and dangerous.
For more:

Piperacillin Kills Lyme Bacteria in Mice, Leaves Gut Microbiome Alone

https://www.lymedisease.org/piperacillan-kills-lyme/

Piperacillin kills Lyme bacteria in mice, leaves gut microbiome alone

From Northwestern University:

Lyme disease, a disease transmitted when deer ticks feed on infected animals like deer and rodents, and then bite humans, impacts nearly half a million individuals in the U.S. annually.

Even in acute cases, Lyme can be devastating; but early treatment with antibiotics can prevent chronic symptoms like heart and neurological problems and arthritis from developing.

Scientists from Northwestern University have identified that piperacillin, an antibiotic in the same class as penicillin, effectively cured mice of Lyme disease at 100-times less than the effective dose of doxycycline, the current gold standard treatment.

At such a low dose, piperacillin also had the added benefit of “having virtually no impact on resident gut microbes,” according to the study, in the journal Science Translational Medicine.

Doxycycline and other generic antibiotics, on the other hand, wreak havoc on the microbiome, killing beneficial bacteria in the gut and causing troubling side effects even as it kills the Borrelia bacteria that causes Lyme.

In addition to its negative impact on the gut, doxycycline also fails to help between 10 and 20% of individuals who take it, and it is not approved for use in young children — who are at the highest risk of tick bites, and therefore, of developing Lyme.

More effective, or at least more specific, treatment options are needed as climate change extends tick seasons and Lyme becomes more prevalent.

The need for customized medicine

“Powerful, broad-spectrum antibiotics that kill extracellular bacteria are seen as the most effective medication because physicians want to just kill the bacterium and don’t care how,” said Brandon L. Jutras, who led the research.

“This is certainly a reasonable approach, but I think the future for Lyme disease patients is bright in that we are approaching an era of customized medicine, and we can potentially create a particular drug, or a combination to treat Lyme disease when other fail. The more we understand about the various strains and species of Lyme disease-causing Borrelia, the closer we get to a custom approach.”

Jutras is an associate professor in the microbiology-immunology department of Northwestern University Feinberg School of Medicine, and a member of Northwestern’s Center for Human Immunobiology.

Jutras’s lab was recently named a Phase 3 winner in LymeX Diagnostics, the Steven & Alexandra Cohen Foundation’s $10 million competition to accelerate the development of Lyme disease diagnostics, and in 2021 he won the Bay Area Lyme Foundation Emerging Leader Award.

Piperacillin has already been FDA-approved as a safe treatment for pneumonia.

To reach the conclusion that the penicillin relative would be the most effective and targeted treatment, the team screened nearly 500 medicines in a drug library, using a molecular framework to understand potential interactions between antibiotics and the Borrelia bacteria.

Once the group had a short list of potentials, they performed additional physiological, cellular and molecular tests to identify compounds that did not impact other bacteria.

Prevents bacteria from growing

They found that piperacillin exclusively interfered with the unusual cell wall synthesis pattern common to Lyme bacteria, preventing the bacteria from growing or dividing and ultimately leading to its death.

Historically, piperacillin has been administered as part of a two-drug cocktail to treat severe strep infections because strep can break down beta-lactams (piperacillin’s class of antibiotics) unless accompanied by tazobactam, which is an inhibitor of the enzyme that inactivates piperacillin.

Jutras wondered if using the same two medications, rather than piperacillin alone, would be a more effective bacteria killer.

“Bacteria are clever,” Jutras said. “Strep and some other bacteria combat antibiotics by secreting beta-lactamases that inactivate piperacillin. We found the approach is totally irrelevant in the context of Lyme disease and another way that makes piperacillin more specific. Adding the beta-lactamase inhibitor doesn’t improve the therapy because Lyme Borrelia don’t produce beta-lactamase, but the cocktail does negatively impact the microbiome by becoming more broadly functional against beneficial residents.”

The study was supported by the Bay Area Lyme Foundation and United States Department of Agriculture (VA-160113), the Dennis Dean Research Grant (Virginia Tech), the National Institutes of Allergy and Infectious Disease (R01AI173256, R01AI178711), the Steven & Alexandra Cohen Foundation and the Global Lyme Alliance.

Click here for more about the study.

SOURCE: Northwestern University

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**Comment**

A few points:

  1. Early treatment CAN prevent neurological problems, arthritis, & other chronic symptoms, but fails to do so in a subset of patients.
  2. Doxycycline does has a negative impact upon the gut, but far more than 10-20% go on to suffer long-term symptoms (chronic Lyme), with one researcher estimating the percentage to be more like 60%.  A little factoid: the current research which comes up with 10-20% doesn’t include patients who are diagnosed and treated late, and this is somewhere between 30-40% of patients!
  3. Independent research has proven the climate has nothing to do with tick and disease proliferation.  Further, the entire climate narrative is fraught with fraud and deceit and many experts continue to state there is no climate crisis, atmospheric CO2 emissions can not cause ‘global warming’, and that green energy policies have made the climate worse. Researchers really need to cease and desist with the climate mantra.  
    1. But this ‘tell’ reveals that those doling out federal research grants hold all the cards, and researchers know they must comply with the narrative to get the dollars. These same public health ‘experts’ and politicians also own patents on the very things (drugs, tests, vaccines, etc) they are entrusted to protect the public from as well as set treatment guidelines.
  4. Researcher Kim Lewis out of Northeastern University has also identified compounds that are highly active and selective against Lyme disease in the mouse model. Going all the way back to 2015, he found hygromycin A to be highly effective against Lyme, yet here we are in 2025 with nadda.
  5. Lewis also proved what Dr. Burrascano clinically discovered – that by treating with antibiotics for a period and then stopping for a period (cycling) – if they did this four times, they discovered no bacteria in the petri dishes.
    1. Burrascano and Dr. Alan McDonald also proved patients can test negative but still be actively infected as well as the fact that dosage makes a difference as well.  Mainstream research and medicine are clueless about these nuances and just continue to use a completely antiquated and faulty paradigm.
    2. This is why I hold little hope in any research that is federally funded.  While advocates continue to bemoan lack of federal funding, I say good riddance.  Nothing good ever comes from that quarter anyway.  As long as federal funding is involved, the fraudulent Lyme narrative will taint everything that is done.
    3. Further, the federal government is complicit in tick research that purposely weaponized ticks to deliver deadly bacteria to be incapacitating and dropped them out of airplanes.  Hello!
  6. Don’t believe me?  Listen to Willy Burgdorfer, the “discoverer” of Lyme disease himself:

“The controversy in Lyme disease research is a shameful affair. I say that because the whole thing is politically tainted. Money goes to people that have for the past 30 years produced the same thing. NothingSerology or serology plus has to be started from scratch with people that don’t know beforehand the results of their research.

BOOM.

Sadly, the current research above is taking the same old tack that people are simply struggling with inflammation (PTLDS) – not an active infection.  While this is always true, it is often only a partial truth, with active infection being the driver to the inflammation.  In other words, treat the infection and symptoms get better or go away entirely.  If only inflammation is treated, symptoms will continue until the infection(s) is/are dealt with.  And this brings up another point entirely dismissed by mainstream research and medicine: this is commonly a polymicrobial issue – meaning more than one infectious organism is involved requiring yet more savvy, complex treatments.  

Until these issues are addressed, I don’t want another dime of my money going to the same people that have done nothing for the past 40 years.

For more:

http://  Approx. 3 Min

Could Piperacillin Be the Lyme Breakthrough We Need?

Dr. Danial Cameron

May 6, 2025

Targeting the “Motor” That Helps Lyme Spread Through the Body

https://www.lymedisease.org/motor-behind-lyme-and-syphilis/

Targeting the “motor” that helps Lyme spread through the body

By Stephen D’Angelo, Cornell Research & Innovation

3/31/25

Researchers have identified a new way to fight infections like Lyme disease and syphilis by disrupting the bacteria’s ‘motor,’ preventing it from spreading through the body.

The findings could have wide-ranging impacts on the treatment of infections in the future as concern about antibiotic-resistant strains grows. The study was published in ACS Chemical Biology.

“Many types of bacteria must be able to move to infect their host organisms, including humans,” said Brian Crane, director of the Weill Institute for Cell and Molecular Biology, corresponding author on the publication.

“Motility can be important to move between hosts—ticks to humans, for example—and also for disseminating within the host, colonizing the most advantageous tissue, and evading the immune system.”

Disrupting the ability to move

In the study, funded by the National Institutes of Health and the Bay Area Lyme Foundation, the researchers exploited a crucial relationship in the bacteria’s movement system by disrupting the germ’s ability to propel itself through tissues, and significantly weakening its chances to spread and infect.

Click here to see video of the Lyme Disease bacterial spirochete in action. 

Spirochetes are thin, corkscrew-shaped bacteria that spiral through body tissues using a hidden propeller-like motor, protected by a membrane that shields it from the host’s immune system.

Central to its ability to accelerate is a long strand called a flagella that is joined by a hook to the organism’s motion-generating machinery. Built from self-assembled protein subunits called FlgE, the hook is tightly held together by molecular bridges known as lysinoalanine (LAL) cross-links.

“When LAL formation is disrupted, a spirochetes’ flagella hook and motor are unable to work together to move effectively. This, in turn, prevents the spirochete from swimming through body tissues and significantly reduces the ability to spread and infect,” said Michael Lynch, research associate in the Crane Group (A&S), a Cornell Weill Institute lab, and the study’s first author.

After testing a collection of existing, clinically approved drug compounds, the researchers identified three—hexachlorophene, triclosan, and dichlorophene—that could be used as inhibitors to interfere with the connections between LAL molecules and the flagella hook.

A new way to fight infections

In one experiment on the spirochete linked to gum disease, treatment with hexachlorophene significantly reduced the bacteria’s ability to move, demonstrating that stopping their motility could be a powerful new way to fight infections.

Spirochetes, including Borrelia (Lyme disease), Treponema (syphilis), and Leptospira (leptospirosis, a bacterial infection that causes mild flu-like illness to severe kidney or liver damage), are highly invasive and capable of penetrating virtually every tissue in the human body, even crossing the blood-brain barrier.

According to the researchers, many of these infections are persistent, difficult to diagnose early, and sometimes resistant to standard medicines. Current treatments rely primarily on antibiotics, which target bacteria and cells indiscriminately, affecting both harmful and beneficial bacteria.

“In contrast, our approach is highly specific, targeting the formation of LAL in flagella within pathogenic spirochetes—the only known bacteria that catalyze the formation of LAL cross-links between flagella subunits,” Lynch said. “This specificity has the potential to reduce collateral damage to beneficial bacteria, such as microbiota in the gut microbiome, which is a significant advantage over conventional antibiotic treatments.”

Antibiotic resistence

According to the researchers, the need for novel antimicrobial strategies to combat spirochetes is pressing, as antibiotic-resistant strains evolve and emerge. This puts available drug options for individuals, and even public health efforts combating certain diseases, at risk, they said.

The researchers’ approach focusing on bacteria mobility could expand the number of targets for antibiotic drug development, helping to address the challenge that disease-causing bacteria are developing resistance to today’s common antibiotics.

“While bacterial motility has been studied extensively, this is the first research to target LAL cross-links in the flagella hook as an antimicrobial strategy,” Crane said. “Ultimately, because motility is widely recognized as an enhancement in pathogenic spirochetes’ ability to cause disease, our results establish LAL cross-linking as a legitimate target for antimicrobial therapeutic development.”

SOURCE: Cornell Research & Innovation

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For More:

Lyme Disease Increases Gynecological Health Risks in Women

https://www.lymedisease.org/lyme-disease-reproductive-health/

Lyme disease increases gynecological health risks in women

By Lonnie Marcum

3/17/25

A new study has uncovered significant findings about how Lyme disease can impact the female reproductive system.

While previous research primarily focused on the effects of Borrelia (Lyme) on pregnancy, this study explores how the infection affects the reproductive system in non-pregnant mice and compares this to its effect on human gynecological disorders.

In a MedRxiv article entitled, Lyme disease increases risk for multiple gynecological conditions, MIT researchers Michal Caspi Tal, PhD, and Paige S. Hansen Colburn teamed up with researchers from the Fred Hutchinson Cancer Center, Nasa Sinnott-Armstrong, PhD, and colleagues.

“This changes how we understand Lyme”

Dr. Tal says, “For years, people have been asking if Lyme disease might cause miscarriage and other pregnancy problems. Our study shows a strong link, and more research is vital. This research changes how we understand Lyme. It’s a much bigger problem than we thought, especially for women.”

Tracking the illness for months, the team demonstrated that Lyme disease can cause prolonged and severe infection in the reproductive organs of female mice.

The study documented infected gynecological tissue, and problems such as enlarged uterus, ovarian cysts, thickening of the vaginal lining and inflammation of the internal and external tissues. Notably, older mice experienced more severe outcomes when infected.

Hansen Colburn says, “Our research both supports previous studies on Lyme in pregnancy and also highlights novel implications for Lyme in women’s health outside of the reproductive lens.”

In addition, using clinical and survey data, the researchers found associations between Lyme disease and an increased risk of endometriosis, dysmenorrhea (menstrual cramps), menorrhagia (heavy periods), miscarriage, uterine polyps, and endometriosis (uterine tissue growing outside the uterus).

Supporting evidence from human data

These findings were corroborated with data from a Finnish database, which showed higher rates of gynecological issues like miscarriage, vulvovaginitis, uterine fibroids, and dysmenorrhea in women with Lyme disease.

Hansen Colburn says, “We still need to learn exactly how the bacteria cause this damage. Is it the bacteria themselves, or is it collateral damage from the body’s immune response?”

It’s known that men and women exhibit different symptoms of Lyme disease. For example, men tend to develop a larger more typical Lyme rash than women. Men are also more likely to have a CDC-positive two-tier test for Lyme. But why?

In order to prevent miscarriage, women’s bodies are designed to alter their hormones and immune response when pregnant. It may be that female hormones or this immune response set women up for chronic Lyme.

Elevated risk

“Lyme disease appears to elevate risk of many gynecological diseases, and we still have a lot to learn about what else might result from Borrelia infection. This is just the beginning,” says Sinnott-Armstrong.

This study emphasizes the importance of:

  • tracking gender in Lyme disease studies
  • tracking age-related status
  • understanding the hormonal phase at the time of infection, during treatment and post-infection (eg. pre & post-pubescent, peri & post-menopausal)
  • understanding hormone levels and hormone dysregulation
  • tracking reproductive pathologies in both male and female patients with Lyme disease.

Findings from MyLymeData

In 2019, LymeDisease.org published results of a MyLymeData study, Gender Bias in Chronic Lyme Disease, showing that women are at a disadvantage when it comes to Lyme disease. Not just because women’s bodies respond differently to infection, but also because women represent a smaller percentage of participants in acute Lyme disease research.

A follow-up MyLymeData study, Does Biological Sex Matter in Lyme Disease? The Need for Sex-Disaggregated Data in Persistent Illness, published in 2023, found that women encountered lengthier diagnostic delays, grappled with more severe symptoms, and suffered greater functional impairment compared to men.

The MyLymeData authors concluded, “Our results indicate that biological sex should be integrated into Lyme disease research as a distinct variable. Future Lyme disease studies should include sex-based disaggregated data to illuminate differences that may exist between men and women with persistent illness.” (Disaggregated means that you separate out the data from male and female patients, so that you can look for trends in each group.)

Next steps

Today, we owe a huge thank you to the Tal Research Group and the Sinnott-Armstrong lab for demonstrating that Lyme disease increases the risk for gynecological disorders in women.

Dr Tal tells me the next step is to work on treatment protocols. “We’re very interested in the intersection of hormones and immune responses to infection, and we’ll be testing out different treatment protocols for the infection and also modulating the immune response to the infection to try to understand once this gynecological damage has happened, if antibiotic treatment alone be sufficient to reverse it.”

The Tal Research Group at MIT has also found Borrelia bacteria in the male reproductive tract, which is currently being investigated further.

The CDC estimates there are 475,000 annual cases of Lyme disease, however they make no meaningful analysis of sex differences in their list of symptoms or progression of disease.

Furthermore, approximately 5 million women in the U.S. suffer from endometriosis. Perhaps some of them would benefit from exploring a diagnosis and treatment for Lyme disease?

We look forward to the continued MIT research results and further understanding of chronic illness following infection.

LymeSci is written by Lonnie Marcum, a physical therapist and mother of a daughter with Lyme. She served two terms on a subcommittee of the federal Tick-Borne Disease Working Group. Follow her on X: @LonnieRhea   Email her at: lmarcum@lymedisease.org.

Reference

HansenColburn PS, Blacker G, Galloway S, Feng Q, Padmanabham PS, Pisani G, Lee BT, Loeser G, Perez MW, Liu K, Kuan J, Von Saltza E, Strausz S, Mattei L, Nahass GR, Kitjasateanphun A, Potula HS, Shoham MA, Mascetti VL, Gars E, Ollila HM, Bruner-Tran KL, Weissman IL, You S, Pollack B, Griffith L, Sinnott-Armstrong N, Tal MC. (2025). Lyme disease increases risk for multiple gynecological conditions. medRxivhttps://doi.org/10.1101/2025.03.03.25323258.

Acknowledgement

This research was supported, in part, by the Emily and Malcolm Fairbairn donor advised fund.

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