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At least 847 records · Page 47

Structure-Based Discovery and Development of Highly Potent Dihydroorotate Dehydrogenase Inhibitors for Malaria Chemoprevention

Malaria remains a serious global health challenge, yet treatment and control programs are threatened by drug resistance. Dihydroorotate dehydrogenase (DHODH) was clinically validated as a target for treatment and prevention of malaria through human studies with DSM265, but currently no drugs against this target are in clinical use. We used structure-based computational tools including free energy perturbation (FEP+) to discover highly ligand efficient, potent, and selective pyrazolebased Plasmodium DHODH inhibitors through a scaffold hop from a pyrrole-based series. Optimized pyrazole-based compounds were identified with low nM-to-pM Plasmodium falciparum cell potency and oral activity in a humanized SCID mouse malaria infection model. The lead compound DSM1465 is more potent and has improved absorption, distribution, metabolism and excretion/pharmacokinetic (ADME/PK) properties compared to DSM265 that support the potential for once-monthly chemoprevention at a low dose. This compound meets the objective of identifying compounds with potential to be used for monthly chemoprevention in Africa to support malaria elimination efforts.

60 APPLIED LIFE SCIENCES↗

Subseasonal Variability of Elevated Dust Concentrations Over South Florida

Dust mass concentrations have been measured daily at Miami, Florida, in the summer months, and biweekly throughout the remaining months, since 1974. The 43-year record of dust mass concentrations indicate large daily, seasonal, and interannual variations, with most of the dust arriving within 5–8 episodes each summer. On average, dust arrives to Miami, Florida, 10 days after emission from North Africa, with measured concentrations depending on characteristics of the lower free-tropospheric winds due to the vast travel distance. Daily dust mass concentrations from July and August, the months that contribute the most to the annual mean, are used to characterize the synoptic conditions most favorable for dust transport. Two key regions are linked with the highest daily dust mass concentrations above Miami: (i) easterly winds, averaged over 850–500 mb, over the Tropical West Atlantic [15–25°N, 45–80°W], and (ii) southerly winds, similarly averaged, over the Florida Peninsula [20–30°N,75–80°W]. Winds within these two regions are enhanced when the North Atlantic subtropical high is displaced south and zonally elongated, relocating the western edge over Florida. A dust-transport-efficiency index, based on the maximum potential for dust to arrive above Miami with limited loss to deposition or mixing, identifies high-dust loading cases on the subseasonal scale. Monthly dust-transport-efficiency values agree well with the monthly dust trends over the 43-year time span. While seasonal dust loadings have been decreasing over Florida in the past decade, the transport efficiency has been increasing, possibly due to trends in the North Atlantic subtropical high.

54 ENVIRONMENTAL SCIENCES↗

An Observational Comparison of Level of Neutral Buoyancy and Level of Maximum Detrainment in Tropical Deep Convective Clouds

Tropical deep convective clouds are important drivers of large-scale atmospheric circulation representing the main vertical transport pathway through the depth of the troposphere for heat, momentum, water, and chemical species. The strength and depth of this transport are impacted by the convective updraft size and intensity that are driven by buoyancy, dynamical forcing, and mixing of environmental air, i.e., entrainment. In this paper, we identify tropical deep convective systems with well-defined forward anvils using Atmospheric Radiation Measurement (ARM) ground-based profiling radars, at three ARM fixed-sites in the Tropical Western Pacific (TWP; i.e., Manus, Nauru, Darwin) and three ARM Mobile Facility deployments in Niamey, Niger; Gan Island, Maldives; and Manacapuru, Brazil. We use the difference between the level of neutral buoyancy (LNB) and the level of maximum detrainment (LMD) as a proxy for the effective bulk convective entrainment (εproxy). The LNB, the theoretical height that a parcel raised above the level of free convection would reach with no mixing, is calculated based on pre-convection radiosonde measurements using parcel theory. The LMD is the height of the maximum reflectivity observed in forward anvil clouds by profiling radars. Deep convective systems over the TWP show higher LNBs that extend to 16.3 km on average and larger εproxy (median LNB minus LMD up to 6.5 km) compared to their continental counterparts in the Amazon and West Africa. Oceanic conditions show larger convective available potential energy (CAPE) coupled with higher moisture at low levels which favors larger εproxy. In contrast, continental cases initiate and develop under high convective inhibition, steeper environmental lapse rate, and high wind shear conditions, which show smaller offset between LNB and LMD. Deep convective cases that promote significant cold pools at the surface experience less εproxy. Using a Random Forest regression algorithm, CAPE is associated with the highest feature importance score for predicting convective εproxy, followed by low-level relative humidity. For continental cases, the low-level wind shear also indicates higher importance.

54 ENVIRONMENTAL SCIENCES↗

Predictive Proxies of Present and Future Lightning in a Superparameterized Model

Abstract A superparameterized climate model is used to assess the global performance of several previously proposed proxies for lightning. In particular, predictors incorporating hydrometeor (ice, graupel) profiles and convective vertical velocities are compared to observations, then used to estimate changes in flash rates with global warming. The choice of microphysics parameterization is also investigated, with all predictors showing higher correlations with Lightning Imaging Sensor/Optical Transient Detector observations when using a 2‐moment scheme compared to a 1‐moment representation. All proxies generally agree in their response to warming over tropical land, with notable decreases in Africa, the Middle East, and northern South America, but disagree over oceans and the midlatitudes. The product of convective available potential energy and precipitation predicts increases over these latter areas, as do the 2‐moment ice‐based proxies, while those of the 1‐moment model tend to show decreases, highlighting the importance of cloud microphysics when using climate models to simulate lightning.

54 ENVIRONMENTAL SCIENCES↗

Megadrought: A Series of Unfortunate La Niña Events?

Megadroughts are multidecadal periods of aridity more persistent than most droughts during the instrumental period. Paleoclimate evidence suggests that megadroughts occur in many parts of the world, including North America, Central America, western Europe, eastern Asia, and northern Africa. It remains unclear to what extent such megadroughts require external forcing or whether they can arise from internal climate variability alone. A novel statistical–dynamical approach is used to evaluate the possibility that such events arise solely as a function of interannual tropical sea surface temperature (SST) variations. A statistical emulator of tropical SST variations is constructed by using an empirical moving-blocks bootstrap approach that randomly samples multiyear sequences of the observational SST record. This approach preserves the power spectrum, seasonal cycle, and spatial pattern of El Niño-Southern Oscillation (ENSO) but removes longer timescale fluctuations embedded in the observational record. These resampled SST anomalies are then used to force an atmospheric model (the Community Atmosphere Model Version 5). As megadroughts emerge in this run, they should, therefore, be solely a consequence of La Niña sequences combined with internal atmospheric variability and persistence driven by soil moisture storage and other land-surface processes. We indeed find that megadroughts in this simulation have an amplitude-duration rate that is generally indistinguishable from the rate documented in paleoclimate records of the western United States. Our findings support the idea that megadroughts may occur randomly when the unforced climate system evolves freely over a sufficiently long period of time, implying that an unforced unusual but statistically plausible series of La Niña events may be sufficient to generate megadrought.

54 ENVIRONMENTAL SCIENCES↗

Brown Carbon Fuel and Emission Source Attributions to Global Snow Darkening Effect

Snow and ice albedo reduction due to deposition of absorbing particles (i.e., snow darkening effect (SDE)) warms the Earth system and is largely attributed to black carbon (BC) and dust. Absorbing organic aerosol (BrC) also contributes to SDE but has received less attention due to uncertainty and challenges in model representation. This work incorporates the SDE of absorbing organic aerosol (BrC) from biomass burning and biofuel sources into the Snow Ice and Aerosol Radiative (SNICAR) model within a variant of the Community Earth System Model (CESM). Additionally, 12 different emission regions of BrC and BC from biomass burning and biofuel sources are tagged to quantify the relative contribution to global and regional SDE. BrC global SDE (0.021–0.056 Wm -2 ) is larger than other model estimates, corresponding to 37%–98% of the SDE from BC. When compared to observations, BrC simulations have a range in median bias (-2.5% to +21%), with better agreement in the simulations that include BrC photochemical bleaching. The largest relative contributions to global BrC SDE are traced to Northern Asia (23%–31%), Southeast Asia (16%–21%), and South Africa (13%–17%). Transport from Southeast Asia contributes nearly half of the regional BrC SDE in Antarctica (0.084–0.3 Wm -2 ), which is the largest regional input to global BrC SDE. Lower latitude BrC SDE is correlated with snowmelt, in-snow BrC concentrations, and snow cover fraction, while polar BrC SDE is correlated with surface insolation and snowmelt. This indicates the importance of in-snow processes and snow feedbacks on modeled BrC SDE.

54 ENVIRONMENTAL SCIENCES↗

Salt Diapir‐Driven Recycling of Gas Hydrate

Abstract By harnessing both hypothetical, synthetic basin and gas hydrate (GH) system models and real‐world models of well‐studied salt diapir‐associated GH sites at Green Canyon (Gulf of Mexico) and Blake Ridge (U.S. Atlantic coast), we propose and demonstrate salt movement (and in particular, diapirism) to be a new mechanism for the recycling of marine GH. At Green Canyon, for example, we show that by considering this newly proposed diapir‐driven recycling mechanism in conjunction with previously proposed lithological control on sandy‐reservoir‐hosted hydrate at the base of the GH stability zone (BGHSZ; ∼bottom‐simulating reflector, BSR), modeled GH saturations match drilling data. Overall, salt diapir movement‐induced GH recycling provides a temperature‐driven mechanism by which GH saturations at the BGHSZ may reach >90 vol. % and by which GH volumes near and free gas volumes beneath the BGHSZ may be increased significantly through time. Interestingly, comparison of salt diapir‐driven recycling and sediment burial‐driven recycling scenarios suggests notably higher rates of recycling via diapir‐driven versus burial‐driven processes. Our results suggest that GH and associated free gas accumulations above salt diapir crests represent particularly attractive targets for unconventional and conventional hydrocarbon resource exploration and for scientific and academic drilling expeditions aimed at exploiting GH systems. Salt basins containing GH systems—including passive margin basins of the Gulf of Mexico, southeastern Brazil, and southwestern Africa—are therefore compelling localities for studying salt‐driven GH recycling and for salt diapir‐associated natural gas exploration.

58 GEOSCIENCES↗

Modeling Land-Atmosphere Coupling at Cloud-Resolving Scale Within the Multiple Atmosphere Multiple Land (MAML) Framework in SP-E3SM

Representing subgrid variabilities of land surface processes and their upscaled effects is crucial for global climate modeling. Here, we implement a Multiple Atmosphere Multiple Land (MAML) framework in the superparamaterized version of E3SM (SP32 E3SM) to explicitly simulate the subgrid variabilities of land states and fluxes at cloud-resolving scale and their interactions with atmosphere. Comparing to the standard SP-E3SM in which all the atmospheric columns of the cloud resolving model embedded within the global atmospheric model grid interact with the same land surface (i.e., Multiple Atmosphere Single Land (MASL)), the impact of MAML on the strength of land-atmosphere coupling is limited, partly because the current implementation mainly facilitates one-way coupling between the cloud-resolving model and the land surface model. Despite such limitation, MAML increases the surface latent heat flux at the expense of sensible heat flux, and increases precipitation in India, Amazon, and Central Africa, reducing the model dry bias compared to the standard SP-E3SM. By employing a normalized gross moist stability (NGMS) diagnostic framework, we find that the increase in precipitation minus evaporation (PE) is primarily driven by the change in large-scale moisture convergence, particularly by the increase of water vapor in the lower atmosphere, while the local effect of total surface energy flux plays a minor role in the P-E change. More specifically, MAML changes the surface energy partitioning (evaporative fraction), increases the atmosphere water vapor, and further increases P-E by decreasing the NGMS. Finally, future development in the MAML framework is discussed.

54 ENVIRONMENTAL SCIENCES↗

New Lightning-Derived Vertical Total Electron Content Data Provide Unique Global Ionospheric Measurements

A newly released, novel ionospheric data set of global gridded vertical total electron content (VTEC) is introduced in this paper. This VTEC data set, provided by Los Alamos National Laboratory (LANL), is derived from very high frequency (VHF; defined as 30–300 MHz) broadband radio-frequency (RF) measurements of lightning made by U.S. Department of Defense sensing systems on board Global Positioning System (GPS) satellites. This paper presents the new data set (LANL VTEC), discusses the errors inherent in VHF TEC estimation due to ionospheric dispersion, and compares the LANL VTEC to two community standard VTEC gridded products: Jet Propulsion Laboratory's Global Ionospheric Model (JPL GIM) and the CEDAR community's Open Madrigal VTEC gridded measurements of L-band GNSS (global navigation satellite systems) TEC. We find that the LANL VTEC data have an offset of 3 TECU from CEDAR Madrigal GNSS VTEC and a full-width-half-maximum (FWHM) of 6 TECU. In comparison, the offset between LANL VTEC and the JPL GIM model is –3 TECU, but with a FWHM of 5 TECU. We also compare to Jason-3 VTEC measurements over the ocean, finding an offset of less than 0.5 TECU and an FWHM of <5 TECU. Because this technique uses a completely different methodology to determine TEC, the sources of errors are distinct from the typical ground-based GNSS L-band (GHz) TEC measurements. Also, because it is derived from RF lightning signals, this data set provides measurements in regions that are not well covered by ground-based GPS measurements, such as over oceans and over central Africa.

79 ASTRONOMY AND ASTROPHYSICS↗

Systematic Underestimation of Canopy Conductance Sensitivity to Drought by Earth System Models

The response of vegetation canopy conductance (g c ) to changes in moisture availability ($γ^{m}_{gc}$) is a major source of uncertainty in climate projections. While vegetation typically reduces stomatal conductance during drought, accurately modeling how and to what degree stomata respond to changes in moisture availability at global scales is particularly challenging, because no global scale g c observations exist. Here, we leverage a collection of satellite, reanalysis and station-based near-surface air and surface temperature estimates, which are physically and statistically linked to $γ^{m}_{gc}$ due to the local cooling effect of g c through transpiration, to develop a novel emergent constraint of $γ^{m}_{gc}$ in an ensemble of Earth System Models (ESMs). We find that ESMs systematically underestimate $γ^{m}_{gc}$ by ~33%, particularly in grasslands, croplands, and savannas in semi-arid and bordering regions of the Central United States, Central Europe, Southeastern South America, Southern Africa, Eastern Australia, and parts of East Asia. We show that this underestimation occurs because ESMs inadequately reduce g c when soil moisture decreases. As g c controls carbon, water and energy fluxes, the misrepresentation of modeled $γ^{m}_{gc}$ contributes to biases in ESM projections of gross primary production, transpiration, and temperature during droughts. Our results suggest that the severity and duration of droughts may be misrepresented in ESMs due to the impact of sustained g c on both soil moisture dynamics and the biosphere-atmosphere feedbacks that affect local temperatures and regional weather patterns.

54 ENVIRONMENTAL SCIENCES↗

The Thunderstorms With the Greatest Lightning Densities on Earth

The most intense thunderstorms on Earth were surveyed using the comprehensive meteorological instrumentation on the Tropical Rainfall Measuring Mission (TRMM) satellite. Expansive land-based Mesoscale Convective Systems (MCSs) were consistently identified among the Earth's most intense thunderstorms, with their organization into many convective cells spanning a large areal extent permitting exceptional overall flash rates for these storms. In this study, we identify a new class of extreme thunderstorm. Lightning-dense thunderstorms are relatively compact convective storms whose concentrated lightning activity hinders our ability to accurately measure their flash rates. The top storms have a flash rate of one flash spanning many seconds, as there is insufficient separation to distinguish one flash from another. While any particularly active convective cell could be capable of producing high lightning densities, we find that thunderstorms with the greatest lightning densities on Earth are found in maritime thunderstorms that have not been appreciated in prior work due to the inaccurate flash rate measurements. These storms that are mostly found throughout the Gulf of Mexico and east of South Africa (among other coastal and oceanic regions) have measured TRMM proxies for convective intensity that rival the top MCS thunderstorms, but their horizontal and vertical dimensions are small by comparison. Thus, the necessary microphysical elements for electrification processes are more highly concentrated, enabling the observed extreme lightning densities.

54 ENVIRONMENTAL SCIENCES↗

Investigating the Impact of Irrigation on Malaria Vector Larval Habitats and Transmission Using a Hydrology‐Based Model

Abstract A combination of accelerated population growth and severe droughts has created pressure on food security and driven the development of irrigation schemes across sub‐Saharan Africa. Irrigation has been associated with increased malaria risk, but risk prediction remains difficult due to the heterogeneity of irrigation and the environment. While investigating transmission dynamics is helpful, malaria models cannot be applied directly in irrigated regions as they typically rely only on rainfall as a source of water to quantify larval habitats. By coupling a hydrologic model with an agent‐based malaria model for a sugarcane plantation site in Arjo, Ethiopia, we demonstrated how incorporating hydrologic processes to estimate larval habitats can affect malaria transmission. Using the coupled model, we then examined the impact of an existing irrigation scheme on malaria transmission dynamics. The inclusion of hydrologic processes increased the variability of larval habitat area by around two‐fold and resulted in reduction in malaria transmission by 60%. In addition, irrigation increased all habitat types in the dry season by up to 7.4 times. It converted temporary and semi‐permanent habitats to permanent habitats during the rainy season, which grew by about 24%. Consequently, malaria transmission was sustained all‐year round and intensified during the main transmission season, with the peak shifted forward by around 1 month. Lastly, we evaluated the spatiotemporal distribution of adult vectors under the effect of irrigation by resolving habitat heterogeneity. These findings could help larval source management by identifying transmission hotspots and prioritizing resources for malaria elimination planning.

60 APPLIED LIFE SCIENCES↗

Higher‐Order Gravity Waves and Traveling Ionospheric Disturbances From the Polar Vortex Jet on 11–15 January 2016: Modeling With HIAMCM‐SAMI3 and Comparison With Observations in the Thermosphere and Ionosphere

Abstract In Vadas et al. (2024, https://doi.org/10.1029/2024ja032521 ), we modeled the atmospheric gravity waves (GWs) during 11–14 January 2016 using the HIAMCM, and found that the polar vortex jet generates medium to large‐scale, higher‐order GWs in the thermosphere. In this paper, we model the traveling ionospheric disturbances (TIDs) generated by these GWs using the HIAMCM‐SAMI3 and compare with ionospheric observations from ground‐based Global Navigation Satellite System (GNSS) receivers, Incoherent Scatter Radars (ISR) and the Super Dual Auroral Radar Network (SuperDARN). We find that medium to large‐scale TIDs are generated worldwide by the higher‐order GWs from this event. Many of the TIDs over Europe and Asia have concentric ring/arc‐like structure, and most of those over North/South America have planar wave structure and occur during the daytime. Those over North/South America propagate southward and are generated by higher‐order GWs from Europe/Asia which propagate over the Arctic. These latter TIDs can be misidentified as arising from geomagnetic forcing. We find that the higher‐order GWs that propagate to Africa and Brazil from Europe may aid in the formation of equatorial plasma bubbles (EPBs) there. We find that the simulated GWs, TIDs and EPBs agree with EISCAT, PFISR, GNSS, and SuperDARN measurements. We find that the higher‐order GWs are concentrated at N at 200 km, in agreement with GOCE and CHAMP data. Thus the polar vortex jet is important for generating TIDs in the northern winter ionosphere via multi‐step vertical coupling through GWs.

Vadas, Sharon L. [Northwest Research Associates Bo↗

The Collaborative Seismic Earth Model: Generation 2

Geological interpretations, earthquake source inversions and ground motion modeling, among other applications, require models that jointly resolve crustal and mantle structure. With the second generation of the Collaborative Seismic Earth Model (CSEM2), we present a global multi-resolution tomographic Earth model that serves this purpose. The model evolves through successive regional- and global-scale refinements. While the first generation aggregated regional models, with this study, we ensure consistency between all individual submodels, resulting in a model that accurately explains wave propagation across scales. Recent regional tomographic models were incorporated, comprising continental-scale inversions for Asia and Africa, as well as regional inversions for the Western US, Central Andes, Iran, and Southeast Asia. Across all regional refinements, over 793,000 source-receiver pairs contributed. Moreover, the long-wavelength Earth model (LOWE) introduces large-scale structures outside of pre-existing local refinements. A full-waveform inversion for global anisotropic P-and S-wave speed structure over a total of 194 iterations with a minimum period of 50 s on a large data set of 1 hr of waveform data from 2,423 earthquakes and over 6 million source-receiver pairs ensures that regional updates in the crust and uppermost mantle translate into updates of deeper, global-scale structure. To test the performance of CSEM2, we evaluate waveform fits between observed and synthetic seismograms at 50 s for an independent data set on the global scale, and on the regional scale for lower periods. We accurately simulate waveforms within and across regional refinements, maintaining the original resolution of the submodels embedded in the global framework.

58 GEOSCIENCES↗

Exceptional subgenome stability and functional divergence in the allotetraploid Ethiopian cereal teff

Teff (Eragrostis tef) is a cornerstone of food security in the Horn of Africa, where it is prized for stress resilience, grain nutrition, and market value. Here, we report a chromosome-scale assembly of allotetraploid teff (variety Dabbi) and patterns of subgenome dynamics. The teff genome contains two complete sets of homoeologous chromosomes, with most genes maintaining as syntenic gene pairs. TE analysis allows us to estimate that the teff polyploidy event occurred ~1.1 million years ago (mya) and that the two subgenomes diverged ~5.0 mya. Despite this divergence, we detect no large-scale structural rearrangements, homoeologous exchanges, or biased gene loss, in contrast to many other allopolyploids. The two teff subgenomes have partitioned their ancestral functions based on divergent expression across a diverse expression atlas. Together, these genomic resources will be useful for accelerating breeding of this underutilized grain crop and for fundamental insights into polyploid genome evolution.

54 ENVIRONMENTAL SCIENCES↗

Future changes in the trading of virtual water

Water stressed regions rely heavily on the import of water-intensive goods to offset insufficient food production driven by socioeconomic and environmental factors. The water embedded in these traded commodities, virtual water, has received increasing interest in the scientific community. However, comprehensive future projections of virtual water trading remain absent. Here we show, for the first time, changes over the 21st century in the amount of various water types required to meet international agricultural demands. Accounting for evolution in socioeconomic and climatic conditions, we estimate future interregional virtual water trading and find trading of renewable water sources may triple by 2100 while nonrenewable groundwater trading may at least double. Basins in North America, and the La Plata and Nile Rivers are found to contribute extensively to virtual water exports, while much of Africa, India, and the Middle East relies heavily on virtual water imports by the end of the century.

54 ENVIRONMENTAL SCIENCES↗

End of Green Sahara amplified mid- to late Holocene megadroughts in mainland Southeast Asia

Between 5 and 4 thousand years ago, crippling megadroughts led to the disruption of ancient civilizations across parts of Africa and Asia, yet the extent of these climate extremes in mainland Southeast Asia (MSEA) has never been defined. This is despite archeological evidence showing a shift in human settlement patterns across the region during this period. We report evidence from stalagmite climate records indicating a major decrease of monsoon rainfall in MSEA during the mid- to late Holocene, coincident with African monsoon failure during the end of the Green Sahara. Through a set of modeling experiments, we show that reduced vegetation and increased dust loads during the Green Sahara termination shifted the Walker circulation eastward and cooled the Indian Ocean, causing a reduction in monsoon rainfall in MSEA. Our results indicate that vegetation-dust climate feedbacks from Sahara drying may have been the catalyst for societal shifts in MSEA via ocean-atmospheric teleconnections.

54 ENVIRONMENTAL SCIENCES↗

Hormonal contraception alters vaginal microbiota and cytokines in South African adolescents in a randomized trial

Young women in sub-Saharan Africa are disproportionally affected by HIV infection and unintended pregnancies. However, hormonal contraceptive (HC) use may influence HIV risk through changes in genital tract microbiota and inflammatory cytokines. To investigate this, 130 HIV negative adolescent females aged 15–19 years were enrolled into a substudy of UChoose, an open-label randomized crossover study (NCT02404038), comparing acceptability and contraceptive product preference as a proxy for HIV prevention delivery methods. Participants were randomized to injectable norethisterone enanthate (Net-En), combined oral contraceptives (COC) or etonorgesterol/ethinyl estradiol combined contraceptive vaginal ring (CCVR) for 16 weeks, then crossed over to another HC for 16 weeks. Cervicovaginal samples were collected at baseline, crossover and exit for characterization of the microbiota and measurement of cytokine levels; primary endpoints were cervical T cell activation, vaginal microbial diversity and cytokine concentrations. Adolescents randomized to COCs had lower vaginal microbial diversity and relative abundance of HIV risk-associated taxa compared to Net-En or CCVR. Cervicovaginal inflammatory cytokine concentrations were significantly higher in adolescents randomized to CCVR compared to COC and Net-En. This suggests that COC use may induce an optimal vaginal ecosystem by decreasing bacterial diversity and inflammatory taxa, while CCVR use is associated with genital inflammation.

59 BASIC BIOLOGICAL SCIENCES↗