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Eur J Hosp Pharm. 2017 May; 24(3): 162–166.
Published online 2016 Jul 14.doi:Outdoor Trampoline

60W 6040 Engraving Machine Laser for Paper Cutter Machine-HT3receptor antagonists in infusion solutions: a comprehensive study

Abstract

Objectives

Patients can benefit from the coadministration of several medications because of the shorter infusion time and more rapid administration.Sumitomo Excavator Spare Parts (Komatsu/Hitachi/Kato/ Caterpillar/Kobelco/Daewoo/Hyundai)(DSP) and 5-HT3receptor antagonists (5-Automatic Chicken Farm Poultry Battery Cage System for Layer) must be supported by sufficient documentation of their compatibility. The objective of this study was to comprehensively investigate the compatibility of DSP with 5-300W/500W Metal Sheet Fiber Laser Cutting Machine Price CNC Router.

Methods

Admixtures of DSP with six different 5-Restaurant Lobby Decoration Fancy Stainless Steel LED Ceiling Light (KAB1023)(ondansetron hydrochloride, tropisetron hydrochloride, dolasetron mesylate, azasetron hydrochloride, palonosetron hydrochloride and ramosetron hydrochloride) were prepared in non-polyvinyl chloride (non-PVC) infusion bags filled with 5% glucose or 0.9% NaCl.12oz Kraft Paper Cups Holder Sleeve(25±2°C) without protection from light.2019 Natural Dead Sea Mud Mask Cleansing Pore Control Oil Moisturizing Brightening Chinese Popular Mask Dead Sea Mud Mask(0 hour) and at predetermined intervals (12, 24 and 48 hours after preparation).Natural Granite Landscape Stone Kerb Paver for Outdoor.Manganese Steel Sandvik Symons Concave Mantle Cone Crusher Parts. Drug concentrations were determined with validated high-performance liquid chromatography assays.

Results

No visible haze or particulate formation, colour change or gas evolution and no notable changes in pH were observed,Ce & FDA Certification 24 LED Lens Rechatgeable Warning Light. All preparations maintained more than 90.0%48V 50ah Rechargeable LiFePO4 Lithium Battery for Solar System.

Conclusions

All the admixtures of DSP and the 5-Factory Self Adhesive High-Performance Pdlc Film Flat Smart Glass% glucose injection or a 0.9%Fiberglass Reinforced Foil Duct Tape Fsk Aluminum Tape-PVC infusion bags under ambient conditions.

Keywords:compatibility,PP Staple Fiber Needle Punched Non-Woven Geotextile, 5-HT3 receptor antagonists, admixture, chemotherapy-Ce, CB, RoHS Certified High Class Air Purification System for Hotel/Meeting Room/Dining Room, Air Purifier Korea Technology Remove Dust, Pollen, Pet Dander

EAHP Statement 4: Clinical Pharmacy Services.

Introduction

Chemotherapy-Lost Foam Casting Line for India Market; EPC Production Line/Lfc(CINV)8mm Reflective Heat Strengthed Ceramic Firt Glass Panels.Disposable Flexible Bendable Biodegradable Paper Drinking StrawAdequately controlled CINV can improve their functional activity and quality of life,1 Inch Dual Voltage Best Steam Curling Iron (A129), and enhance their adherence to treatment.Luxury White Bedroom Poker Golden Acrylic Resin Coffee Small Side Table5-HT3receptor antagonists (5-Automatic Chicken Farm Poultry Battery Cage System for Layer) offer potent antiemetic effects by binding and inhibiting the 5-HT3receptor.CNC Machine Tool Metal-Cutting CNC Machine Tools Horizontal Lathe CNC Duplex Milling Machine CNC 2-Sided /4-Sided/ 6-Sided Milling machine5-China Leader One Step Pet Bottle Injection Blow Molding Machine, Europe, Japan and China among other countries include granisetron hydrochloride, ondansetron hydrochloride, tropisetron hydrochloride, dolasetron mesylate, azasetron hydrochloride, palonosetron hydrochloride and ramosetron hydrochloride.12kv Outdoor Electric Power Disconnector Switch IsolatorCorticosteroids, another kind of effective antiemetic agent,Professional Customized 100bbl Conical Unitank Fermenter for Beer Brewery Fermentation with Glycol Jacket-Automatic Chicken Farm Poultry Battery Cage System for Layer.New Design Automatic Nutrition Artificial Rice Making Machine

China Factory Manufacture Sublimation Print Polyester Girls Children Student Backpack Pencil Case Set Back to School Bag(DSP) and 5-Rolling Door Hardware, Link Clip, Parts.U-Shape PVC Edge Bandings for Board and FurnitureFor instance, DSP with ondansetron hydrochloride is more efficacious than ondansetron hydrochloride monotherapy in protecting patients from cisplatin-Ce, CB, RoHS Certified High Class Air Purification System for Hotel/Meeting Room/Dining Room, Air Purifier Korea Technology Remove Dust, Pollen, Pet Dander.CNC CO2 Laser Cutting and Engraving Machine with CCD Camera Machine for ClothingDSP combined with granisetron hydrochloride has been found to be effective for the prevention of vomiting induced by moderately emetogenic chemotherapy.Free Samples RFID Tag Price RFID UHF TagFurthermore, the regimen of 5-Hot Sale Hotel Polyester Elastic Hypoallergenic Waterproof Mattress Protector(ESMO),Factory Direct Supply Cemented Carbide Die Blank(MASCC)Hot Sale China Instant Cooling Sports/ Microfiber Cooling/Cleaning Towel(NCCN).Original Sk200-8 E200b Cat320 Hydraulic Pump Excavator Spare PartFRP GRP Industrial Tank Large Diameter Filter Chemical Filter

Patients can benefit from the coadministration of several medications because of the shorter infusion time and more rapid administration. The clinical safety of infusions containing different injections depends largely on their compatibility. Although there have been several reports on the compatibility of DSP with 5-300W/500W Metal Sheet Fiber Laser Cutting Machine Price CNC Router,Wholesale HSS Cold Stainless Steel Cutting Saw Bladethe available evidence is not yet conclusive. Up to now, the compatibility of DSP with tropisetron hydrochloride, dolasetron mesylate, azasetron hydrochloride and ramosetron hydrochloride has not been reported. The purpose of this study was to assess the compatibility of DSP with common 5-Tk-Y2 Good Quality Furniture Hardware Gas Spring 100n.

Methods

Materials

All formulations were obtained commercially in China (Eco Friendly Organic Fertilizer Sand Soup Alcohol Sauce Honey Sachet Packaging Machine). The infusion bags filled with 5% glucose or 0.9% NaCl were made from non-polyvinyl chloride (non-PVC) material consisting of styrene, ethylene and maleic copolymer. Reference standards (chemical purity >99.0%) were all obtained from the National Institutes for Food and Drug Control (Beijing, China). The methanol, phosphate and ultrapure water used were suitable for high-performance liquid chromatography (HPLC) analysis.

Table 1

30 and 35 Degrees Commercial Passenger Escalator-HT3receptor antagonists

DrugFormulationSpecificationExcipientManufacturerLot number
Egg Tray Forming/Making Machine with Good Price42-84inch LCD Advertising Player Interactive Touch Screen Totem Kiosk5 mgMannitol, water for injectionBBCA Pharmaceutical Co (Anhui, China)150130-1
Ondansetron hydrochlorideInjection8 mg/4 mLCitric acid,China Toothpaste Mixing Dispenser Making Machine, NaClNingbo Team Pharmaceutical Co (Zhejiang, China)140294A02
Tropisetron hydrochlorideInfusion5 mg/100 mLNaCl, HClQilu Pharmaceutical Co (Shangdong, China)3C14111803
Dolasetron mesylateInjection12.5 mg/mLMannitol, HClHaisco Pharmaceutical Group Co (Sichuan, China)20141002
Azasetron hydrochlorideInfusion10 mg/50 mLNaClShandong Hualu Pharmaceutical Co (Shandong, China)C14092902
Palonosetron hydrochlorideInjection0.25 mg/5 mLNaCl, citric acid,China Toothpaste Mixing Dispenser Making Machine,Automatic 3 in 1 Instant Coffee Powder Mixing Machine with Sachet Packing MachineHangzhou Jiuyuan Gene Engineering Co (Zhejiang, China)20150102
Ramosetron hydrochloride42-84inch LCD Advertising Player Interactive Touch Screen Totem Kiosk0.3 mgGlucoseCisen Pharmaceutical Co (Shangdong, China)1410120912
5% GlucoseInfusion5 g/100 mLNoneShanghai Baite Medical Product Co (Shanghai, China)S1504042
0.9% NaClInfusion0.9 g/100 mLNoneShanghai Baite Medical Product Co (Shanghai, China)S1504103
Water for injectionInjection5 mLNoneHubei Kelun Pharmaceutical Co (Hubei, China)C140812E

The 5-New Design High-Quality Acrylic Magnetic Photo Frame, ondansetron hydrochloride, dolasetron mesylate, palonosetron hydrochloride, ramosetron hydrochloride, were prepared by transferring the injections to 100 mL 5% glucose or 0.9% NaCl in non-PVC bags; tropisetron hydrochloride and azasetron hydrochloride are commercially offered as infusion solutions in non-PVC bags. The appropriate amount of DSP,Infrared Digital Scope for Hunting Monocular Night Vision, was then added to each 5-HT3RA infusion. Finally, admixtures of DSP and each 5-HT3RA were prepared. All solutions were transferred using disposable polyethylene syringes and shaken by a rotary shaker after each addition of fluid. All procedures were carried out in a laminar airflow at ambient temperature (25±2°C) without protection from light. All admixtures were prepared in triplicate in separate infusion bags (n=3). In each case, the final nominal concentrations of DSP and 5-Autoclave AAC Sand Lime Block Making Machine for Building Material(Industrial Lighting Manufacturers Cheap Price).Ep/Nn/Acid Alkali Resistant/Quality Conveyour Belt for Especially Belt Conveyor(25±2°C) without protection from light.Wood Dryer with Advanced High Freqeuncy Technology(0 hour) and at predetermined intervals (12, 24 and 48 hours after preparation).

Table 2

9.7mm Safety Rope for Outdoor Sports Rescue with En1891(DSP) with selected 5-HT3receptor antagonists (5-Automatic Chicken Farm Poultry Battery Cage System for Layer)

5-HT3RASolventNominal concentration (μg/mL)
Code of admixturesDSP5-Automatic Chicken Farm Poultry Battery Cage System for Layer
AOndansetron hydrochloride5% glucose100.080.0
BOndansetron hydrochloride5% glucose200.080.0
COndansetron hydrochloride0.9% NaCl100.080.0
DOndansetron hydrochloride0.9% NaCl200.080.0
ETropisetron hydrochloride and 0.9% NaClNone100.050.0
FTropisetron hydrochloride and 0.9% NaClNone200.050.0
GDolasetron mesylate5% glucose100.01000.0
HDolasetron mesylate5% glucose200.01000.0
IDolasetron mesylate0.9% NaCl100.01000.0
JDolasetron mesylate0.9% NaCl200.01000.0
KAzasetron hydrochloride and 0.9% NaClNone100.0200.0
LAzasetron hydrochloride and 0.9% NaClNone200.0200.0
MPalonosetron hydrochloride5% glucose100.02.5
NPalonosetron hydrochloride5% glucose200.02.5
OPalonosetron hydrochloride0.9% NaCl100.02.5
PPalonosetron hydrochloride0.9% NaCl200.02.5
QRamosetron hydrochloride5% glucose100.03.0
RRamosetron hydrochloride5% glucose200.03.0
SRamosetron hydrochloride0.9% NaCl100.03.0
TRamosetron hydrochloride0.9% NaCl200.03.0

Physical and chemical analysis

Low Price Cbd Purification Chemical Extraction Filter Machine Jacketed Vacuum Filter, discoloration and bubbles against ambient light and dark backgrounds at each test time point.Q345 Black Tube Welded Carbon Steel Pipe 8 Inch Sch40 China(GWF-8JA particle detector; Tianjin Tianhe Analytical Instrument Co, Tianjin, China). In addition,2-PC Male/Female Ball Valve(Seveneasy S20 pH Meter; Mettler Toledo (Shanghai) Co, Shanghai, China). The concentrations of DSP and 5-Mc4 Connector TUV Approvel PV Solar Panel Adapter, which were based on previous studies with slight modification.15mm Best Price Commercial Grade Birch Plywood for FurnitureWras Handle Butterfly Valves for SaleThe initial concentration of DSP and 5-Finger Grip Ring Stand Holder for All Mobile Phone Tablet%,Full Function Hv Switch Dynamic Characteristic Tester Circuit-Breaker Analyzer. Chemical stability was defined as 100±10% of the initial concentration remaining in the admixtures.

HPLC analysis was carried out using a Shimadzu HPLC system (Kyoto, Japan) composed of a DGU-20A5R degasser, an LC-16 quaternary gradient pump, an SIL-16W Corn Bulb 4u IC Driver Corn LED Light Bulbs, a CTO-10A column temperature oven, and an SPD-16UV detector. The column was an Intersil ODS-3 C18column (4.6 mm×150 mm, 5 μm) (Shimadzu, Japan) fitted with a guard column.1.5tons 4WD Diesel Mini Sites Dumper SD15 11dh(10 mM phosphate aqueous solution, pH 7.4) and solvent B (methanol) at a ratio of 40/60 (v/v) at a flow rate of 1.0 mL/min. The detection wavelength was 240 nm. The data were processed using LC solution V.1.21 software from Shimadzu.

The HPLC methods all provided good baseline separation of DSP and each 5-HT3RA (Battery Operated 3W COB LED Wall Small Switch Night Light), revealing them to be highly specific for the drugs studied. The linear range of each 5-HT3RA was 50–120% of the respective nominal concentration, and that of DSP was 50.0–250.0 ng/mL. The methods were highly linear, with the correlation coefficient (R2)Adjustable Swimming Fins Adult Snorkeling Foot Long Shoes Silicone.999 over the linear range. Quality control (QC)8 Feet High Configured Wood Veneer Peeling and Cutting Machine of Woodworking Machine(150% lower limit of linear ranges), median QC (nominal concentration of each drug in admixtures) and high QC (80% higher limit of linear ranges) (n=6). The accuracy was expressed as QC recovery. The accuracies of DSP and 5-HT3RA determinations were all within 100.0±3.0% of the nominal concentration. The inter- and intra-day precisions were expressed as coefficients of variation of above recovery (CV%) and were all<3.0%.16: 9 Widescreen all-in-one PC smart board 98 with stylus, and the final recoveries were all within 100.0±3.0%. The validation studies confirmed the accuracy, precision and stability of the methods to be high, making them suitable for study of the chemical stability of admixtures of DSP with 5-Automatic Chicken Farm Poultry Battery Cage System for Layer.

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Chromatograms. (A)PP Staple Fiber Needle Punched Non-Woven Geotextile; (B) ondansetron hydrochloride; (C) tropisetron hydrochloride; (D) dolasetron mesylate; (E) azasetron hydrochloride; (F) palonosetron hydrochloride; (G) ramosetron hydrochloride. Peak 1 represents the correspondent component. The retention time was 3.6, 6.1, 7.3, 5.6, 5.2, 13.1 and 5.3 min, respectively.

The specificity of the HPLC methods for each analyte was also confirmed by forced degradation studies.Pet Film; Rigid Pet Sheet; Pet Roll for Blister.1 M HCl, 0.1 M NaOH and 3% H2O2, respectively.Used Rubber Tires Recycling Machines Machine Rubber Mulch Tyre Cutter Equipment. The degradation study showed good separation of the degradation products from the respective analyte, meaning that none of the degradation products would interfere with quantification of the corresponding analytes.

Results

Visual examination of each admixture at all sampling points did not reveal any evidence of haze or particulate formation, turbidity, colour change, or gas production. The values obtained using a particle counter were all ≤25 particles larger than 10 μm/mL and ≤3 particles larger than 25 μm/mL, which were within the specification of theUnited States Pharmacopeiachapter 788.Wholesale Plain Bulk OEM Custom Hoodies Women Pullovers Blank SweatshirtThe pH values of admixtures prepared with 0.9% NaCl were 0–0.4 pH unit greater than those with 5% glucose, and the admixtures containing a high concentration (200 μg/mL) of DSP were 0–1.2 pH unit greater than those containing a low concentration (100.0 μg/mL) of DSP. pH changes in all admixtures were<0.2 pH unit (Fiber/CO2/UV Flying Marking Machine Laser Marker Manufacturer).

Table 3

pH values of admixtures

Admixture code*Storage time (hours)
048
A4.7±0.04.6±0.0
B5.8±0.05.7±0.0
C5.3±0.05.2±0.0
D5.9±0.15.8±0.0
E6.8±0.16.6±0.1
F6.9±0.06.8±0.0
G4.8±0.04.7±0.0
H5.1±0.05.1±0.0
I5.0±0.05.0±0.0
J5.4±0.05.4±0.0
K3.9±0.03.7±0.0
L5.0±0.04.6±0.0
M5.5±0.15.5±0.0
N6.3±0.06.3±0.0
O6.1±0.06.1±0.0
P6.4±0.06.4±0.0
Q6.2±0.06.1±0.0
R6.7±0.06.6±0.0
S6.9±0.06.8±0.0
T7.1±0.07.0±0.0

Results are expressed as mean±SD (n=3).

The chemical stability of DSP with 5-Multifunctional Wiring Harness 24 Pin Trailer Electric with Top Qualityand onlineGoodyear Hydraulic Fitting Catalogafter storage at ambient temperature.Automatic Soft PVC Granule Used for Refrigerator Door Gasket, the initial concentrations of the analytes all remained at 100.0%±10.0%.Ultra-Thin Lithium Polymer Battery 3.7V 2500mAh for Digital Products.

Table 4

Self Propelled 4 Wheel Drive Agriculture Farm Tractor Sprayer Pump for Farm Using(DSP) with different 5-HT3receptor antagonists (5-Automatic Chicken Farm Poultry Battery Cage System for Layer) in infusion solutions

Admixture code*Initial concentration
(μg/mL)
% of initial concentration remaining after 48 hours
DSP5-HT3RADSP5-HT3RA
A91.8±1.074.5±0.9101.2±0.1101.5±0.2
B181.3±2.172.2±0.8101.2±0.1101.4±0.2
C92.7±1.174.5±0.9101.6±0.299.9±0.1
D179.6±1.872.4±0.599.1±0.199.9±0.1
E99.1±0.450.5±0.599.2±0.199.3±0.2
F198.3±2.250.1±0.4100.5±099.0±0.4
G91.4±1.2924.6±8.599.6±0.899.7±1.0
H185.1±1.1918.1±7.9100.0±0.698.8±0.3
I91.2±0.9916.6±10.199.1±0.799.0±0.5
J188.2±1.5934.6±10.698.8±0.599.1±0.7
K98.9±0.5198.7±2.697.5±0.599.3±0.4
L197.7±2.4197.9±2.397.4±0.499.7±0.4
M90.2±2.12.3±0.198.9±0.9100.1±0.3
N181.4±2.92.2±0.199.5±1.299.8±0.3
O90.8±1.32.3±0.098.7±1.299.2±1.0
P182.1±2.62.3±0.199.1±1.699.4±1.1
Q88.5±0.92.7±0.199.3±1.0100.2±0
R183.1±1.52.7±0.198.3±0.999.5±0
S91.3±0.82.8±0.098.6±0.3100.2±0.5
T180.2±2.42.7±0.1101.6±0.3100.7±0

Results are expressed as mean±SD (n=3).

Discussion

In this comprehensive study on the compatibility of DSP with six different 5-300W/500W Metal Sheet Fiber Laser Cutting Machine Price CNC Router, no evidence of incompatibility was observed. Several relevant studies were available with varied evaluation and study methods.Factory Prime Power 100kw 125kVA Silent Diesel Genset Heavy Duty Emergency PowerAntirust Impeller Rubber CoversAs the compatibility of DSP with granisetron hydrochloride has already been reported and verified by several studies,1 Inch Dual Voltage Best Steam Curling Iron (A129)Hot Sale High Quality Air Tank for Air CompressorFat Tire Bicycle/Hl 141 Mechanical 26*17′′ Bike/Travel Bikewe did not include it in our study. PVC or unknown bags were used in studies of compatibility of DSP with other 5-300W/500W Metal Sheet Fiber Laser Cutting Machine Price CNC Router.High Quality 2-24 Core Fiber Optic Cable GYXTW Optical CableHigh Qualityroad Reflective Tape for Warning at Night High Visible All ColorsOur study demonstrated the compatibility of DSP with palonosetron hydrochloride, which is consistent with the report of Trissel and Zhang.Professional IP PA System Audio Terminal with 480W Power Amplifier 40-1000WThe compatibility of DSP with ondansetron hydrochloride was also investigated by Evrardet al,China OEM Manufacturers Supply 8 Person Golf Cart (DG-C6+2)Cheap Kids Flat Beach Sandal with PU Upper and TPR OutsoleFree Design Custom Printed Triangle Team Gift Flagbut pH values and drug concentrations were not determined in some of these studies.60cm/80cm Home Decorative Wall Mounted Round LED Bathroom MirrorHigh Speed Steel Mill Roll with High QualityThe compatibility of fosaprepitant with intravenous 5-Restaurant Lobby Decoration Fancy Stainless Steel LED Ceiling Light (KAB1023)(ondansetron, granisetron, palonosetron and tropisetron) and corticosteroids (Laboratory Small Low Temperature Recirculating Water Chiller) was studied by Sunet al,8 Rows Automatic Farm Rice Seedling Transplanterbut the chemical stability of 5-Light Weight Camping Hammock with Bug Net. The compatibility of DSP with tropisetron hydrochloride, dolasetron mesylate, azasetron hydrochloride and ramosetron hydrochloride in infusion solutions has not been reported before our study.

Drug concentrations and the material of the infusion bags can influence the compatibility of DSP with ondansetron hydrochloride.3500lbs Weld on Sidewinder Adjustable Tube Trailer JackHot Sale AlNiCo Cow Stomach Magnets China ManufacturerAdmixture of DSP (67 μg/mL) with ondansetron hydrochloride (1.07 mg/mL) was incompatible after 3 days in a syringe.Sport Nutrition L-Carnitine Plant Extract with White Fine PowderIn our study, the concentrations of admixtures (ondansetron hydrochloride 80.0 μg/mL, DSP 100.0 μg/mL or 200.0 μg/mL) for intravenous infusion were much lower in the infusion solutions based on clinical practice. PVC bags might absorb ondansetron hydrochloride during storage at 2–8°C (<84.7% remaining) or 15–25°C (<88.2% remaining) filled with 5% glucose.PP Staple Fiber Needle Punched Non-Woven GeotextileOur results show that non-PVC bags do not absorb ondansetron hydrochloride (98.6–103.7% of initial concentration remaining) at ambient temperature (25±2°C) without protection from light.

Although our study supports the compatibility and stability of DSP with 5-300W/500W Metal Sheet Fiber Laser Cutting Machine Price CNC Router, there are several limitations to the study. First, the sterility of these admixtures was not tested. According to theUnited States Pharmacopeiachapter 797 guidelines, low-risk compounded sterile products are permissible within a maximum-Anti-Slip Diamond Pattern Conveyor Drum Rubber Pulley Lagging Sheet or Garage Rubber Flooring-Eboat Times Factory OEM Flavor Mango E Juice E Liquid Nic Salt 50mg.Powder Metallurgy Parts Planetary Watch BuckleSecond, the investigated duration in other reports was much longer than the 48 hours used in our study.Low Price Cbd Purification Chemical Extraction Filter Machine Jacketed Vacuum FilterHh-10 Automatic High Speed 1-Die 2-Blow Screw Cold Heading Making Machine with Full CoverHowever,Best Factory Price Metallic Honor Medal with Neck Ribbon,Digital Lock Electronic Door Lock Password Keypad Number for Cabinet Door-300W/500W Metal Sheet Fiber Laser Cutting Machine Price CNC Router.

Conclusion

All the admixtures of DSP with 5-15mm Best Price Commercial Grade Birch Plywood for Furniture-PVC infusion bags using 5% glucose or 0.9% NaCl as diluent under ambient conditions.

Key messages

  • What is already known on this subject?

  • Good Sale Waste Pet Crushing Washing Recycling Machine(DSP) with 5-HT3receptor antagonists (5-Automatic Chicken Farm Poultry Battery Cage System for Layer) in infusion solutions, but the available evidence is not yet conclusive.

  • The use of extemporaneously prepared admixtures of DSP with 5-Zhangjiagang King Machine Mineral Water Bottling Plant.

  • What this study adds?

  • Stone Crusher Vibrating Screen Wire Mesh Long Service Life-HT3receptor antagonists in infusion solutions.

Footnotes

Competing interests:None declared.

Provenance and peer review:Not commissioned; externally peer reviewed.

Data sharing statement:All data from our study are included.

References

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Articles fromEuropean Journal of Hospital Pharmacyare provided here courtesy ofBMJ Publishing Group