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African Americans (AA) have historically been targeted by the tobacco industry and have the highest rates of current cigar use among racial/ethnic groups in the U.S. Yet, there is limited evidence on other factors influencing cigar use. Amongst a sample of 78 AA current cigar (any type) smokers, log-linear regression models examined correlates of cigar demand obtained from a validated behavioral economic purchase task. Mean intensity, or cigar demand when free, was 6.68 cigars (standard deviation [SD]: 8.17), while mean breakpoint, or the highest price a participant was willing to pay, was $4.62 (SD: 3.88). Mean maximum daily expenditure, Omax was $15.20 (SD: 25.73) and Pmax, the price at Omax was $5.25 (SD: 3.95). Participants aged 21 to 30 years compared to those aged 18 to 20 years, those with higher levels of dependence, and females compared to males, had a significantly higher intensity. Participants with cannabis use above the sample median in the last 30 days (4 + days) had significantly higher intensity and Omax than those below the median. Further, participants with a high school education or more had a significantly lower intensity, breakpoint, and Omax than those with less than high school education. Individuals with income below the federal poverty line (FPL) also had a significantly lower breakpoint and Omax than those above. Finally, tobacco harm perceptions were inversely associated with Pmax. Stricter policies on cigar products, such as higher taxes and product-specific harm messaging, may have an immediate and sustained impact on health disparities related to cigar use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Purpose: To understand the effect of pro-tobacco marketing on electronic cigarette and combustible cigarette dual use among US middle and high school students under 18 years of age. Design: Data were derived from the 2018 National Youth Tobacco Survey, an annual self-administered school-based cross-sectional survey. Setting: The survey was administered in public and private middle and high schools across the United States. Participants: The probability sample size was 15 238 middle and high school students with complete responses who were under 18 years of age during the study period. Measures: The study measured self-reported exposure to online combustible and electronic cigarette advertisements, dual use of combustible and electronic cigarettes during the past 30 days, exposure to the Real Cost antitobacco campaign advertisements, and other sociodemographic factors (eg, race/ethnicity, gender, and grade). Analysis: Logistic regressions were used to measure pro-tobacco marketing exposure and dual use as a function of pro-tobacco marketing exposure. Results: Descriptive analyses show that 59.0% of respondents were exposed to pro-tobacco online marketing, and 2.9% were dual users. Dual users (odds ratio [OR] = 1.73) and high school students (OR = 1.43) were more likely to report exposure to online pro-tobacco marketing. Conclusions: Findings indicate that a gap in electronic cigarette pro-tobacco marketing regulatory oversight may exist. Further policy action may be warranted to protect the public health of minors and other vulnerable populations who are most susceptible to pro-tobacco marketing.

HIV-1-infected, virologically suppressed adults wanting to simplify or change their non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens may benefit from switching to the single-tablet regimen of elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate (E/C/F/TDF).We examined differences in the proportion of participants with HIV-1 RNA 50 copies/mL (Snapshot analysis), change in CD4 cell count, safety, and patient-reported outcomes in participants switching to E/C/F/TDF from an NNRTI + FTC/TDF (TVD) regimen.STRATEGY-NNRTI was a 96-week, phase 3b, randomized, open-label, study examining the efficacy, safety, and tolerability of switching to E/C/F/TDF in virologically suppressed individuals (HIV-1 RNA 50 copies/mL) on an NNRTI + TVD regimen. Participants were randomized to switch or remain on their NNRTI-based regimen (no-switch).At Week 96, 87% (251/290) of switch and 80% (115/143) of no-switch participants maintained HIV-1 RNA 50 copies/mL (difference 6.1%; 95% CI -1.3 to 14.2%; p = 0.12) according to the FDA-defined snapshot algorithm. Both groups had similar proportions of subjects with virologic failure (2.8% switch, 1.4% no-switch). Discontinuations resulting from adverse events were infrequent (3% [9/291] switch, 2% [3/143] no-switch). Three switch participants (1%) discontinued due to renal adverse events (2 of the 3 before Week 48). Switch participants reported significant improvements in neuropsychiatric symptoms by as early as Week 4, and which were maintained through Week 96.E/C/F/TDF is safe and effective and reduces NNRTI-associated neuropsychiatric symptoms for virologically suppressed HIV-positive adults switching from an NNRTI plus FTC/TDF-based regimen.

Al Capone is a brand of cigar products—little cigars, cigarillos and large cigars—manufactured and distributed in the USA by the Inter-Continental Cigar.1 2 Burger Sohne, which owns the Al Capone brand, has the stated goal of cultivating ‘smiling consumers, loyal to (its) brands, in every continent.’3 To that end, Inter-Continental Cigar relies heavily on online marketing through social media platforms to advertise, market and promote the Al Capone brand of cigar products to consumers.4–6 A specific example of the Al Capone brand’s use of social media marketing is its paid sponsorship and promotional collaboration with cult-favourite battle rap league, Ultimate Rap League (URL). Battle rap is a subgenre of Hip-Hop music that originated in the African-American and Hispanic community of the South Bronx, New York in the late ’70s and early ’80s. A type of lyrical boxing match, battle rap is typified by its poetic ‘braggadocio with the quest for lyrical superiority.’7 As with other forms of transgressive play practices, battle rap is an inherently subversive lyrical exchange where players are offensive for …

In clinical studies GS-US-380-1489 (study 1489) and GS-US-380-1490 (study 1490), bictegravir-emtricitabine-tenofovir alafenamide (B-F-TAF), dolutegravir-abacavir-lamivudine (DTG-ABC-3TC), and dolutegravir plus emtricitabine-tenofovir alafenamide (DTG+F-TAF) treatment achieved high rates of virologic suppression in HIV-1 treatment-naive participants through week 48. Preexisting primary drug resistance was present at levels of 1.3% integrase strand transfer inhibitor resistance (INSTI-R), 2.7% nucleoside reverse transcriptase inhibitor resistance (NRTI-R), 14.1% nonnucleoside reverse transcriptase inhibitor resistance (NNRTI-R), and 3.5% protease inhibitor resistance (PI-R) in the 1,274 participants from these studies. These mutations did not affect treatment outcomes. Resistance analyses in 13 virologic failures found no emergent resistance to study drugs.

Pill burden, dosing frequency, and concerns about safety and tolerability are important obstacles to maintaining adequate medication adherence. Raltegravir (RAL) is indicated for twice-daily dosing and when taken with emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF), it becomes a twice-daily multiple-tablet regimen. Elvitegravir (EVG)/cobicistat (COBI)/FTC/TDF, STB, is the first approved once-a-day integrase strand transfer inhibitor (INSTI) containing single-tablet regimen that combines EVG, an INSTI, and COBI, a novel pharmacoenhancer, with the preferred nucleos(t)ide backbone of FTC/TDF.This was a 48-week prospective, single-arm open-label study of the switch to STB in virologically sup-pressed HIV-1-infected adult patients on FTC/TDF and twice-daily RAL for at least 6 months. Objectives were to evaluate the tolerability and safety of a regimen simplification to once-a-day STB, while maintaining viral suppression through 48 weeks.Forty-eight individuals in the United States were enrolled. The median age was 44 years, 96% were male, and 83% were White. The median time on RAL + FTC/TDF treatment prior to enrollment was 34 months. Ninety-six percent of participants cited regimen simplification as the reason to enroll in the switch study. At base-line, the median CD4 count was 714 cell/µL and estimated glomerular filtration rate (eGFR) was 105 mL/min. At week 48, all assessed study participants remained viro-logically suppressed to the lower limit of quantification (HIV-1 RNA50 copies/mL) and maintained high CD4 cell count (median, 751 cells/mL) and stable eGFR (median, 100.5 mL/min). STB was well tolerated with no discontinuations, no study drug-related serious adverse events, and no study drug-related grade 3/4 adverse events.All participants switching to 1 tablet once-a-day STB from a twice-daily RAL + FTC/TDF regimen remained virologically suppressed. STB was well tolerated. Switching to STB may be a viable option for virologically suppressed patients wanting to simplify from a twice-daily RAL-containing regimen.

Weight loss after bariatric surgery is commonly reported as either a percentage of initial body weight (%IBW) or 100 % minus %IBW which is a percentage of total weight loss (%TWL). These are basically equivalent expressions. Weight loss is also reported as %EWL or as a percentage of excess body mass index loss (%EBMIL). These last two expressions incorporate the concepts of ideal body weight and BMI = 25 as reference points. More straightforward but less commonly used is absolute weight loss. This study compares these various measures using the Bariatric Outcomes Longitudinal Database (BOLD). BOLD data, 2008–2011, was accessed for outcomes on 239,659 gastric bypass (GB) and sleeve gastrectomy (SG) patients with approval of the Surgical Review Corporation. The outcome data was converted into %TWL, %EWL, and %EBMIL. %EBMIL was varied by changing the reference BMI from 1 to 25 kg/m2. The post operation data was analyzed for both procedures. Variation coefficients (VC) were compared using different measurements on the same data pool. We assumed that the lesser the variation, the more reliable the measure is, and therefore, we made use of the VC to compare the different reporting methods. There were 164,247 patients who remained after removal of errors and missing data. Demographics are as follows: 78.1 % female, 73.1 % white, 12.5 % black, 8.71 % Hispanic, 81.6 % GB, 18.4 % SG, mean age of 44.8 years, height of 167.0 cm, weight of 132.0 kg, and BMI of 47.1 kg/m2. GB patients had 26.8 %TWL at 6 months (VC = 21.5) and 34.2 %TWL at 12 months (VC = 27.0). %EWL was 54.7 at 6 months (VC = 27.3) and 69.4 at 12 months (VC = 30.9). Varying the reference BMI for %EBMIL showed the lowest VC to be 0–2 kg/m2 for GB up to 12 months post operation. SG patients had 24.0 %TWL at 6 months (VC = 25.4) and 29.5 at 12 months (VC = 30.5). %EWL was 50.0 % at 6 months (VC = 31.4) and 60.2 % at 12 months (VC = 34.5). Varying the reference BMI for %EBMIL showed that the lowest VC occurred when the reference weight was chosen as 0 kg/m2 for both GB and SG. %TWL or, equivalently, %IBW had the lowest variation coefficient and therefore is the more accurate measure of weight loss following bariatric surgery. For ease and accuracy of comparison, the percentage of initial body weight or percentage of total weight loss should be used for the expression of weight loss after surgery.

Neuronal thread proteins (NTP) are a family of phosphoproteins expressed during neuritic sprouting. The 15 to 18 kD NTP cluster is associated with development and neuronal differentiation, whereas the 21 kD and 39 to 42 kD species are overexpressed in Alzheimer's disease, correlating with neurodegenerative sprouting and synaptic disconnection. Empirical observations suggested that NTP might also be modulated with central nervous system injury and stroke. In this study of both human and experimental (rat) focal cerebral infarcts, in situ hybridization and immunocytochemical staining revealed NTP gene expression up-regulated in perifocal neurons. These findings were confirmed by quantitative Northern and Western blot analyses. Moreover, Western blot analysis demonstrated selectively increased expression of the 15 to 18 kD NTP species during the acute, subacute, and healing phases of cerebral infarction in both humans and experimental animals, corresponding with the expected period of neuronal repair. These results suggest an additional role for the 15 to 18 kD NTP species in neuritic sprouting required for neuronal regeneration after injury in the mature central nervous system.