Milena Gianfrancesco, PhD, MPH
Assistant Professor
Education
Honors and Awards
- K Supplement to Promote Research Continuity, National Institutes of Health, NIAMS, 2021
- Bechtel Junior Faculty Award, UCSF Division of Rheumatology, 2021
- Career Development Bridge Funding Award: K Supplement, Rheumatology Research Foundation, 2020
- NIH Loan Repayment Program, National Institutes of Health, NIAMS, 2017
- Lawren H. Daltroy Health Professional Preceptorship, Rheumatology Research Foundation, 2017
Publications
Sattui SE, Conway R, Putman MS, Seet AM, Gianfrancesco MA, Beins K, Hill C, Liew D, Mackie SL, Mehta P, Neill L, Gomez G, Salinas MIH, Maldonado FN, Mariz HA, de Sousa Studart SA, Araujo NC, Knight A, Rozza D, Quartuccio L, Samson M, Bally S, Maria AT, Chazerain P, Hasseli R, Müller-Ladner U, Hoyer BF, Voll R, Torres RP, Luis M, Ribeirio SLE, Al-Emadi S, Sparks JA, Hsu TY, D'Silva KM, Patel NJ, Wise L, Gilbert E, Almada MV, Duarte-García A, Ugarte-Gil M, Jacobsohn L, Izadi Z, Strangfeld A, Mateus EF, Hyrich KL, Gossec L, Carmona L, Lawson-Tovey S, Kearsley-Fleet L, Schaefer M, Sirotich E, Hausmann JS, Sufka P, Bhana S, Liew JW, Grainger R, Machado PM, Wallace ZS, Yazdany J, Robinson PC, Global Rheumatology Alliance. Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study. 2021. PMID: 34778843
Gianfrancesco MA, Goldstein ND. A narrative review on the validity of electronic health record-based research in epidemiology. 2021. PMID: 34706667
Izadi Z, Brenner EJ, Mahil SK, Dand N, Yiu ZZN, Yates M, Ungaro RC, Zhang X, Agrawal M, Colombel JF, Gianfrancesco MA, Hyrich KL, Strangfeld A, Carmona L, Mateus EF, Lawson-Tovey S, Klingberg E, Cuomo G, Caprioli M, Cruz-Machado AR, Mazeda Pereira AC, Hasseli R, Pfeil A, Lorenz HM, Hoyer BF, Trupin L, Rush S, Katz P, Schmajuk G, Jacobsohn L, Seet AM, Al Emadi S, Wise L, Gilbert EL, Duarte-García A, Valenzuela-Almada MO, Isnardi CA, Quintana R, Soriano ER, Hsu TY, D'Silva KM, Sparks JA, Patel NJ, Xavier RM, Marques CDL, Kakehasi AM, Flipo RM, Claudepierre P, Cantagrel A, Goupille P, Wallace ZS, Bhana S, Costello W, Grainger R, Hausmann JS, Liew JW, Sirotich E, Sufka P, Robinson PC, Machado PM, Griffiths CEM, Barker JN, Smith CH, Yazdany J, Kappelman MD, Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 Infection (PsoProtect), Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 Infection (PsoProtect). Association Between Tumor Necrosis Factor Inhibitors and the Risk of Hospitalization or Death Among Patients With Immune-Mediated Inflammatory Disease and COVID-19. 2021. PMID: 34661663
Bermas BL, Gianfrancesco M, Tanner HL, Seet AM, Aguiar MC, Al Adhoubi NK, Emadi SA, Cunha BM, Flood R, Kusevich DA, McCarthy EM, Patel NJ, Ruderman E, Sattui SE, Sciascia S, Siddique F, Valenzuela-Almada MO, Wise LM, Worthing AB, Zell J, Bhana S, Costello W, Duarte-Garcia A, Grainger R, Gossec L, Hausmann JS, Hyrich K, Lawson-Tovey S, Liew JW, Sirotich E, Sparks J, Sufka P, Wallace Z, Machado PM, Strangfeld A, Clowse MEB, Yazdany J, Robinson PC. COVID-19 in women with rheumatic disease who are pregnant: Data from the COVID-19 Global Rheumatology Alliance. 2021. PMID: 34470798
Anastasiou C, Trupin L, Glidden DV, Li J, Gianfrancesco M, Shiboski S, Schmajuk G, Yazdany J. Mortality among Hospitalized Individuals with Systemic Lupus Erythematosus in the United States between 2006 and 2016. 2020. PMID: 32558160
Hammam N, Li J, Evans M, Kay JL, Izadi Z, Anastasiou C, Gianfrancesco MA, Yazdany J, Schmajuk G. Epidemiology and treatment of Behçet's disease in the USA: insights from the Rheumatology Informatics System for Effectiveness (RISE) Registry with a comparison with other published cohorts from endemic regions. 2021. PMID: 34461986
Schmajuk G, Montgomery AD, Leonard S, Li J, Gianfrancesco M, Seet A, Izadi Z, Yazdany J, Keyhani S. Factors Associated With Hospitalization and Death After COVID-19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data. 2021. PMID: 34423917
Gianfrancesco MA, Crowson CS. Where There's Smoke, There's a Joint: Passive Smoking and Rheumatoid Arthritis. 2021. PMID: 34347946
Sparks JA, Wallace ZS, Seet AM, Gianfrancesco MA, Izadi Z, Hyrich KL, Strangfeld A, Gossec L, Carmona L, Mateus EF, Lawson-Tovey S, Trupin L, Rush S, Katz P, Schmajuk G, Jacobsohn L, Wise L, Gilbert EL, Duarte-García A, Valenzuela-Almada MO, Pons-Estel GJ, Isnardi CA, Berbotto GA, Hsu TY, D'Silva KM, Patel NJ, Kearsley-Fleet L, Schäfer M, Ribeiro SLE, Al Emadi S, Tidblad L, Scirè CA, Raffeiner B, Thomas T, Flipo RM, Avouac J, Seror R, Bernardes M, Cunha MM, Hasseli R, Schulze-Koops H, Müller-Ladner U, Specker C, Souza VA, Mota LMHD, Gomides APM, Dieudé P, Nikiphorou E, Kronzer VL, Singh N, Ugarte-Gil MF, Wallace B, Akpabio A, Thomas R, Bhana S, Costello W, Grainger R, Hausmann JS, Liew JW, Sirotich E, Sufka P, Robinson PC, Machado PM, Yazdany J, COVID-19 Global Rheumatology Alliance. Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: Results from the COVID-19 Global Rheumatology Alliance physician registry. 2021. PMID: 34049860
M. Gianfrancesco, J. LI, M. Evans, M. Petersen, G. Schmajuk, J. Yazdany. OP0117 REAL-WORLD EFFECTIVENESS OF TNFI VERSUS NON-TNFI BIOLOGICS ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS: DATA FROM THE ACR’S RISE REGISTRY. 2021. PMID:
Hyrich KL, Schäfer M, Strangfeld A, Carmona L, Gossec L, Mateus EF, Lawson-Tovey S, Gianfrancesco M, Robinson PC, Yazdany J, Machado PM. Response to: 'Correspondence on 'Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician reported registry'' by Rosenbaum et al. 2021. PMID: 33985941
. The racial/ethnic and sociocultural aspects of the pandemic in rheumatology. 2021. PMID: 33648855
Gianfrancesco MA, Leykina LA, Izadi Z, Taylor T, Sparks JA, Harrison C, Trupin L, Rush S, Schmajuk G, Katz P, Jacobsohn L, Hsu TY, D'Silva KM, Serling-Boyd N, Wallwork R, Todd DJ, Bhana S, Costello W, Grainger R, Hausmann JS, Liew JW, Sirotich E, Sufka P, Wallace ZS, Machado PM, Robinson PC, Yazdany J. Race/ethnicity association with COVID-19 outcomes in rheumatic disease: Data from the COVID-19 Global Rheumatology Alliance Physician Registry. 2020. PMID: 33146001
Strangfeld A, Schäfer M, Gianfrancesco MA, Lawson-Tovey S, Liew JW, Ljung L, Mateus EF, Richez C, Santos MJ, Schmajuk G, Scirè CA, Sirotich E, Sparks JA, Sufka P, Thomas T, Trupin L, Wallace ZS, Al-Adely S, Bachiller-Corral J, Bhana S, Cacoub P, Carmona L, Costello R, Costello W, Gossec L, Grainger R, Hachulla E, Hasseli R, Hausmann JS, Hyrich KL, Izadi Z, Jacobsohn L, Katz P, Kearsley-Fleet L, Robinson PC, Yazdany J, Machado PM. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry. 2021. PMID: 33504483
Liew JW, Gianfrancesco MA, Heckbert SR, Gensler LS. The relationship between body mass index, disease activity, and exercise in ankylosing spondylitis. 2021. PMID: 33502113
Izadi Z, Schmajuk G, Gianfrancesco M, Subash M, Evans M, Trupin L, Yazdany J. Rheumatology Informatics System for Effectiveness (RISE) Practices See Significant Gains in Rheumatoid Arthritis Quality Measures. 2020. PMID: 32937026
Manuel F. Ugarte-Gil, Claudia D. L. Marques, Deshire Alpizar-Rodriguez, Guillermo J. Pons-Estel, Daniel Xibille-Friedmann, Eduardo Paiva, Erick A. Zamora-Tehozol, Rocío V. Gamboa-Cárdenas, Rosana Quintana, Tatiana S. Rodriguez-Reyna, Ana María Sepúlveda, Milena Gianfrancesco, Michael Evans, Zachary Wallace, Emily Sirotich, Evelyn Omedo, Jonathan S. Hausmann, Graciela S. Alarcón, Philip C. Robinson, Jinoos Yazdany. Characteristics associated with Covid-19 in patients with Rheumatic Disease in Latin America: data from the Covid-19 Global Rheumatology Alliance physician-reported registry. 2020. PMID:
Hyrich KL, Gianfrancesco M, Machado PM, Yazdany J, Robinson PC. Rheumatic disease activity, glucocorticoid use and COVID-19. Response to: 'Comment on 'Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported re 2020. PMID: 32895239
Gianfrancesco M, Yazdany J, Robinson PC. Epidemiology and outcomes of novel coronavirus 2019 in patients with immune-mediated inflammatory diseases. 2020. PMID: 32675715
Norgeot B, Quer G, Beaulieu-Jones BK, Torkamani A, Dias R, Gianfrancesco M, Arnaout R, Kohane IS, Saria S, Topol E, Obermeyer Z, Yu B, Butte AJ. Minimum information about clinical artificial intelligence modeling: the MI-CLAIM checklist. 2020. PMID: 32908275
Gianfrancesco M, Hyrich KL, Yazdany J, Machado PM, Robinson PC. COVID-19 Global Rheumatology Alliance Registry, anti-IL-6 therapy, shared decision-making and patient outcomes. Response to: 'Correspondence on 'Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the C 2020. PMID: 32796043
Briggs FBS, Gianfrancesco MA, George MF. More on Covid-19 in Immune-Mediated Inflammatory Diseases. 2020. PMID: 32649070
Gianfrancesco MA, McCulloch CE, Trupin L, Graf J, Schmajuk G, Yazdany J. Reweighting to address nonparticipation and missing data bias in a longitudinal electronic health record study. 2020. PMID: 32807591
Gianfrancesco M, Hyrich KL, Yazdany J, Machado PM, Robinson PC. Response to: 'Glucocorticoid-induced relapse of COVID-19 in a patient with sarcoidosis' by Györfi et al. 2020. PMID: 32606045
Konig MF, Gianfrancesco M, Yazdany J, Robinson PC. Patients with systemic lupus erythematosus using hydroxychloroquine or chloroquine develop severe COVID-19 at similar frequency as patients not on antimalarials: need to explore antithrombotic benefits for COVID-19 coagulopathy. Response to: 'Clinical cou 2020. PMID: 32475834
Gianfrancesco M, Hyrich KL, Al-Adely S, Carmona L, Danila MI, Gossec L, Izadi Z, Jacobsohn L, Katz P, Lawson-Tovey S, Mateus EF, Rush S, Schmajuk G, Simard J, Strangfeld A, Trupin L, Wysham KD, Bhana S, Costello W, Grainger R, Hausmann JS, Liew JW, Sirotich E, Sufka P, Wallace ZS, Yazdany J, Machado PM, Robinson PC. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. 2020. PMID: 32471903
Konig MF, Kim AH, Scheetz MH, Graef ER, Liew JW, Simard J, Machado PM, Gianfrancesco M, Yazdany J, Langguth D, Robinson PC. Baseline use of hydroxychloroquine in systemic lupus erythematosus does not preclude SARS-CoV-2 infection and severe COVID-19. 2020. PMID: 32381561
Gianfrancesco MA. Initial data from the COVID-19 Global Rheumatology Alliance provider registries - Authors' reply. 2020. PMID: 32377642
Gianfrancesco MA, Hyrich KL, Gossec L, Strangfeld A, Carmona L, Mateus EF, Sufka P, Grainger R, Wallace Z, Bhana S, Sirotich E, Liew J, Hausmann JS, Costello W, Robinson P, Machado PM, Yazdany J. Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries. 2020. PMID: 32309814
Gandrup J, Li J, Izadi Z, Gianfrancesco M, Ellingsen T, Yazdany J, Schmajuk G. Three Quality Improvement Initiatives Improved Performance of Rheumatoid Arthritis Disease Activity Measures in Electronic Health Records: Results from an Interrupted Time Series Study. 2019. PMID: 30740931
Lanata CM, Paranjpe I, Nititham J, Taylor KE, Gianfrancesco M, Paranjpe M, Andrews S, Chung SA, Rhead B, Barcellos LF, Trupin L, Katz P, Dall'Era M, Yazdany J, Sirota M, Criswell LA. A phenotypic and genomics approach in a multi-ethnic cohort to subtype systemic lupus erythematosus. 2019. PMID: 31467281
Izadi Z, Katz PP, Schmajuk G, Gandrup J, Li J, Gianfrancesco M, Yazdany J. Effects of language, insurance and race/ethnicity on measurement properties of the PROMIS Physical Function Short Form 10a in rheumatoid arthritis. 2018. PMID: 30099861
Gianfrancesco MA, Briggs FBS. Does early high body mass index influence onset of pediatric multiple sclerosis? 2019. PMID: 31044421
Gianfrancesco MA, Trupin L, McCulloch CE, Shiboski S, Schmajuk G, Yazdany J. Differences in Longitudinal Disease Activity Between Research Cohort and Noncohort Participants with Rheumatoid Arthritis Using Electronic Health Record Data. 2019. PMID: 31777787
Ying D, Gianfrancesco MA, Trupin L, Yazdany J, Greidinger E, Schmajuk G. Increased risk of ischemic stroke in systemic sclerosis: a national cohort study of US veterans. 2019. PMID: 30877213
Norgeot B, Glicksberg BS, Trupin L, Lituiev D, Gianfrancesco M, Oskotsky B, Schmajuk G, Yazdany J, Butte AJ. Assessment of a Deep Learning Model Based on Electronic Health Record Data to Forecast Clinical Outcomes in Patients With Rheumatoid Arthritis. 2019. PMID: 30874779
Patterson S, Schmajuk G, Evans M, Aggarwal I, Izadi Z, Gianfrancesco M, Yazdany J. Gaps in Ambulatory Patient Safety for Immunosuppressive Specialty Medications. 2019. PMID: 30686706
Gianfrancesco MA, Trupin L, Shiboski S, van der Laan M, Graf J, Imboden J, Yazdany J, Schmajuk G. Smoking Is Associated with Higher Disease Activity in Rheumatoid Arthritis: A Longitudinal Study Controlling for Time-varying Covariates. 2018. PMID: 30504507
Schmajuk G, Jafri K, Evans M, Shiboski S, Gianfrancesco M, Izadi Z, Patterson SL, Aggarwal I, Sarkar U, Dudley RA, Yazdany J. Pneumocystis jirovecii pneumonia (PJP) prophylaxis patterns among patients with rheumatic diseases receiving high-risk immunosuppressant drugs. 2018. PMID: 30449650
Gianfrancesco MA, Tamang S, Yazdany J, Schmajuk G. Potential Biases in Machine Learning Algorithms Using Electronic Health Record Data. 2018. PMID: 30128552
Mowry EM, Hedström AK, Gianfrancesco MA, Shao X, Schaefer CA, Shen L, Bellesis KH, Briggs FBS, Olsson T, Alfredsson L, Barcellos LF. Incorporating machine learning approaches to assess putative environmental risk factors for multiple sclerosis. Volume 24. 2018. PMID: 30005356
Li J, Yazdany J, Trupin L, Izadi Z, Gianfrancesco M, Goglin S, Schmajuk G. Capturing a Patient-Reported Measure of Physical Function Through an Online Electronic Health Record Patient Portal in an Ambulatory Clinic: Implementation Study. Volume 6 of Issue 2. 2018. PMID: 29743158
Gianfrancesco MA, Yazdany J, Schmajuk G. The impact of smoking on disease measures in rheumatoid arthritis: the need for appropriate adjustment of time-varying confounding. Volume 38 of Issue 2. 2017. PMID: 29209792
Jafri K, Ogdie A, Qasim A, Patterson SL, Gianfrancesco M, Izadi Z, Katz P, Yazdany J, Schmajuk G. Discordance of the Framingham cardiovascular risk score and the 2013 American College of Cardiology/American Heart Association risk score in systemic lupus erythematosus and rheumatoid arthritis. Volume 37 of Issue 2. 2017. PMID: 28993952
Gianfrancesco MA, Stridh P, Shao X, Rhead B, Graves JS, Chitnis T, Waldman A, Lotze T, Schreiner T, Belman A, Greenberg B, Weinstock-Guttman B, Aaen G, Tillema JM, Hart J, Caillier S, Ness J, Harris Y, Rubin J, Candee M, Krupp L, Gorman M, Benson L, Rodriguez M, Mar S, Kahn I, Rose J, Roalstad S, Casper TC, Shen L, Quach H, Quach D, Hillert J, Hedstrom A, Olsson T, Kockum I, Alfredsson L, Schaefer C, Barcellos LF, Waubant E. Genetic risk factors for pediatric-onset multiple sclerosis. 2017. PMID: 28980494
Gianfrancesco MA, Schmajuk G, Haserodt S, Trupin L, Izadi Z, Jafri K, Shiboski S, Sirota M. Hydroxychloroquine dosing in immune-mediated diseases: implications for patient safety. Volume 37 of Issue 10. 2017. PMID: 28748425
Hedström AK, Katsoulis M, Hössjer O, Bomfim IL, Oturai A, Sondergaard HB, Sellebjerg F, Ullum H, Thørner LW, Gustavsen MW, Harbo HF, Obradovic D, Gianfrancesco MA, Barcellos LF, Schaefer CA, Hillert J, Kockum I, Olsson T, Alfredsson L. The interaction between smoking and HLA genes in multiple sclerosis: replication and refinement. Volume 32 of Issue 10. 2017. PMID: 28597127
Marshall DA, MacDonald KV, Robinson JO, Barcellos LF, Gianfrancesco M, Helm M, McGuire A, Green RC, Douglas MP, Goldman MA, Phillips KA. The price of whole-genome sequencing may be decreasing, but who will be sequenced? Volume 14 of Issue 3. 2017. PMID: 28993792
Gianfrancesco MA, Stridh P, Rhead B, Shao X, Xu E, Graves JS, Chitnis T, Waldman A, Lotze T, Schreiner T, Belman A, Greenberg B, Weinstock-Guttman B, Aaen G, Tillema JM, Hart J, Caillier S, Ness J, Harris Y, Rubin J, Candee M, Krupp L, Gorman M, Benson L, Rodriguez M, Mar S, Kahn I, Rose J, Roalstad S, Casper TC, Shen L, Quach H, Quach D, Hillert J, Bäärnhielm M, Hedstrom A, Olsson T, Kockum I, Alfredsson L, Metayer C, Schaefer C, Barcellos LF, Waubant E. Evidence for a causal relationship between low vitamin D, high BMI, and pediatric-onset MS. Volume 88 of Issue 17. 2017. PMID: 28356466
Gianfrancesco MA, Glymour MM, Walter S, Rhead B, Shao X, Shen L, Quach H, Hubbard A, Jónsdóttir I, Stefánsson K, Strid P, Hillert J, Hedström A, Olsson T, Kockum I, Schaefer C, Alfredsson L, Barcellos LF. Causal Effect of Genetic Variants Associated With Body Mass Index on Multiple Sclerosis Susceptibility. Volume 185 of Issue 3. 2017. PMID: 28073764
Rhead B, Bäärnhielm M, Gianfrancesco M, Mok A, Shao X, Quach H, Shen L, Schaefer C, Link J, Gyllenberg A, Hedström AK, Olsson T, Hillert J, Kockum I, Glymour MM, Alfredsson L, Barcellos LF. Mendelian randomization shows a causal effect of low vitamin D on multiple sclerosis risk. Volume 2 of Issue 5. 2016. PMID: 27652346
George MF, Briggs FB, Shao X, Gianfrancesco MA, Kockum I, Harbo HF, Celius EG, Bos SD, Hedström A, Shen L, Bernstein A, Alfredsson L, Hillert J, Olsson T, Patsopoulos NA, De Jager PL, Oturai AB, Søndergaard HB, Sellebjerg F, Sorensen PS, Gomez R, Caillier SJ, Cree BA, Oksenberg JR, Hauser SL, D'Alfonso S, Leone MA, Martinelli Boneschi F, Sorosina M, van der Mei I, Taylor BV, Zhou Y, Schaefer C, Barcellos LF. Multiple sclerosis risk loci and disease severity in 7,125 individuals from 10 studies. Volume 2 of Issue 4. 2016. PMID: 27540591
Gianfrancesco MA, Balzer L, Taylor KE, Trupin L, Nititham J, Seldin MF, Singer AW, Criswell LA, Barcellos LF. Genetic risk and longitudinal disease activity in systemic lupus erythematosus using targeted maximum likelihood estimation. Volume 17 of Issue 6. 2016. PMID: 27467283
Hedström AK, Mowry EM, Gianfrancesco MA, Shao X, Schaefer CA, Shen L, Olsson T, Barcellos LF, Alfredsson L. High consumption of coffee is associated with decreased multiple sclerosis risk; results from two independent studies. Volume 87 of Issue 5. 2016. PMID: 26940586
Gianfrancesco MA, Barcellos LF. Obesity and Multiple Sclerosis Susceptibility: A Review. Volume 1 of Issue 7. 2016. PMID: 27990499
Gianfrancesco MA, Acuna B, Shen L, Briggs FB, Quach H, Bellesis KH, Bernstein A, Hedstrom AK, Kockum I, Alfredsson L, Olsson T, Schaefer C, Barcellos LF. Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors. Volume 8 of Issue 5. 2014. PMID: 25263833
Hedström AK, Lima Bomfim I, Barcellos L, Gianfrancesco M, Schaefer C, Kockum I, Olsson T, Alfredsson L. Interaction between adolescent obesity and HLA risk genes in the etiology of multiple sclerosis. Volume 82 of Issue 10. 2014. PMID: 24500647
Gianfrancesco MA, Triche EW, Fawcett JA, Labas MP, Patterson TS, Lo AC. Speed- and cane-related alterations in gait parameters in individuals with multiple sclerosis. Volume 33 of Issue 1. 2010. PMID: 20952198
Lo AC, Chang VC, Gianfrancesco MA, Friedman JH, Patterson TS, Benedicto DF. Reduction of freezing of gait in Parkinson's disease by repetitive robot-assisted treadmill training: a pilot study. Volume 7. 2010. PMID: 20946640