why do you flip a cigarette upside down know how some people, when they open new pack of cigarettes, a particular one as a sorta custom? For me that's the 3rd one in the first This could be the origin

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Alveolar macrophages are potent inducers of inflammation and tissue degradation

J Am Med Inform Assoc (2003) 10(6):51522.10.1197/jamia.M1305 78 GibbonsMCWilsonRFSamalLLehmannCUDickersinKLehmannHPet al Impact of Consumer Health Informatics Applications

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In addition, the FDA has issued a guidance to accompany the final rule