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Immigrants often arrive from countries with high TB endemicity and may experience reactivation of latent TB due to stress, malnutrition, or crowded living conditions in the host country (Pareek et al., 2016)

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One component thats likely playing a role is the job market

A couple of years ago, the last Toyota vehicle with a cigarette lighter rolled off the Princeton, Indiana, plant to no fan fair or, well, anybody really caring

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