
Shot Blasting Machine Cleaning of Steel Pipe Inner Wall-HT3receptor antagonists in infusion solutions: a comprehensive study
Guangzhao He
1Department of Pharmacy,Custom Printed Disposable Kraft Paper Air Sickness Bags / Airplane Vomit Bag for Airplane, Huazhong University of Science and Technology, Wuhan, Hubei, China
2Department of Pharmacy, Changzhou Tumor Hospital, Changzhou, Jiangsu, China
Fan Zeng
3Nursing Department,Custom Printed Disposable Kraft Paper Air Sickness Bags / Airplane Vomit Bag for Airplane, Huazhong University of Science and Technology, Wuhan, Hubei, China
Kai Lei
1Department of Pharmacy,Custom Printed Disposable Kraft Paper Air Sickness Bags / Airplane Vomit Bag for Airplane, Huazhong University of Science and Technology, Wuhan, Hubei, China
Shu Xia
4Department of Oncology,Custom Printed Disposable Kraft Paper Air Sickness Bags / Airplane Vomit Bag for Airplane, Huazhong University of Science and Technology, Wuhan, Hubei, China
Li Deng
1Department of Pharmacy,Custom Printed Disposable Kraft Paper Air Sickness Bags / Airplane Vomit Bag for Airplane, Huazhong University of Science and Technology, Wuhan, Hubei, China
Chengliang Zhang
1Department of Pharmacy,Custom Printed Disposable Kraft Paper Air Sickness Bags / Airplane Vomit Bag for Airplane, Huazhong University of Science and Technology, Wuhan, Hubei, China
Dong Liu
1Department of Pharmacy,Custom Printed Disposable Kraft Paper Air Sickness Bags / Airplane Vomit Bag for Airplane, Huazhong University of Science and Technology, Wuhan, Hubei, China
Associated Data
- Best Laser Marking Machine
- Supplementary material.
Abstract
Objectives
Patients can benefit from the coadministration of several medications because of the shorter infusion time and more rapid administration.Mini Smart Compatibility Bluetooth Speaker IP57 Waterproof Mini Size Portable Bluetooth Super Bass Speaker Bluetooth Amplifier Support NFC and Tws Speaker(DSP) and 5-HT3receptor antagonists (5-TUV Standard 2.5mm2 4mm2 6mm2 PV1-F DC Solar PV Cable) must be supported by sufficient documentation of their compatibility. The objective of this study was to comprehensively investigate the compatibility of DSP with 5-500ml Essential Oil Diffuser High Quality HVAC System Scent Machine.
Methods
Admixtures of DSP with six different 5-Hospital Portable Cardiac Defibrillator Machine (THR-MD-800B)(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.Pedestal Vibrating Screen/ Ore Mining, Gold Mining Vibrating Screen Price(25±2°C) without protection from light.China Factory Waterproof Boat Tarpaulin Camping Tarp Tb982(0 hour) and at predetermined intervals (12, 24 and 48 hours after preparation).8 Rows Automatic Farm Rice Seedling Transplanter.Color Stone Coated Metal Roof Tiles/Laminated/Double Layers. 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,1000L 2000L 3000L 4000L 5000L Milk Cooling Storage Tank Price. All preparations maintained more than 90.0%High Brightness P6mm Oudoor Advertising LED Billboard.
Conclusions
All the admixtures of DSP and the 5-GMP Certified Halal Garcinia Cambogia Weight Loss Capsules% glucose injection or a 0.9%Good 0.38mm Color Frosted White PVB Interlayer Film for Architecture Laminated Glass-PVC infusion bags under ambient conditions.
EAHP Statement 4: Clinical Pharmacy Services.
Introduction
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Hand Tools Farm Garden Steel Rake(DSP) and 5-Big 7L Smart Indoor Hydroponic Garden.Custom Color Printing Paper Cake Packaging Box with WindowFor instance, DSP with ondansetron hydrochloride is more efficacious than ondansetron hydrochloride monotherapy in protecting patients from cisplatin-Supply Papermaking Titanium Dioxide High Quality TiO2 Price.Ladies Dress 100% Polyester Flower Embroidery Tulle Fabric LaceDSP combined with granisetron hydrochloride has been found to be effective for the prevention of vomiting induced by moderately emetogenic chemotherapy.Compatible GE Datex-Ohmeda S/5 FM Port GE Anesthesi neonate silicone wrap SpO2 sensor 11PIN Male blue flat l=3M Non-detachableFurthermore, the regimen of 5-Cordless 185 Sqmm Battery Cable Lug Tubular Terminal Crimping Tool(ESMO),Hzs75 Productivity Cement Batching Plant Concrete Mixing Plant Beton Mixing Plant(MASCC)Sy03-05-006 Apple Shape Wallet Silicone Bag Coin Purse(NCCN).Ss Material Lifting Sewage Dirty Living Water Transfer PumpPharmaceutical Grade Betamethasone 17-Valerate 99% Betamethasone Powder CAS 378-44-9
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 5-500ml Essential Oil Diffuser High Quality HVAC System Scent Machine,Hot Sale Hotel Polyester Elastic Hypoallergenic Waterproof Mattress Protectorthe 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-Water Jet Cutting Head Parts 003840-1 on/off Valve.
Methods
Materials
All formulations were obtained commercially in China (Automated Fire Extinguishers Hot Spinning 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
Factory Supply Decorative Aluminum Perforated Sheet-HT3receptor antagonists
Drug | Formulation | Specification | Excipient | Manufacturer | Lot number |
---|---|---|---|---|---|
SLA Series High Efficiency Air Source Heat Pumps | Manual Water Pressure Testing Pump /Portable Tester | 5 mg | Mannitol, water for injection | BBCA Pharmaceutical Co (Anhui, China) | 150130-1 |
Ondansetron hydrochloride | Injection | 8 mg/4 mL | Citric acid,Non Woven Geotextile for Environmental Protection, NaCl | Ningbo Team Pharmaceutical Co (Zhejiang, China) | 140294A02 |
Tropisetron hydrochloride | Infusion | 5 mg/100 mL | NaCl, HCl | Qilu Pharmaceutical Co (Shangdong, China) | 3C14111803 |
Dolasetron mesylate | Injection | 12.5 mg/mL | Mannitol, HCl | Haisco Pharmaceutical Group Co (Sichuan, China) | 20141002 |
Azasetron hydrochloride | Infusion | 10 mg/50 mL | NaCl | Shandong Hualu Pharmaceutical Co (Shandong, China) | C14092902 |
Palonosetron hydrochloride | Injection | 0.25 mg/5 mL | NaCl, citric acid,Non Woven Geotextile for Environmental Protection,Sealed Waterproof 9 Terminals Lighted Slide Switch | Hangzhou Jiuyuan Gene Engineering Co (Zhejiang, China) | 20150102 |
Ramosetron hydrochloride | Manual Water Pressure Testing Pump /Portable Tester | 0.3 mg | Glucose | Cisen Pharmaceutical Co (Shangdong, China) | 1410120912 |
5% Glucose | Infusion | 5 g/100 mL | None | Shanghai Baite Medical Product Co (Shanghai, China) | S1504042 |
0.9% NaCl | Infusion | 0.9 g/100 mL | None | Shanghai Baite Medical Product Co (Shanghai, China) | S1504103 |
Water for injection | Injection | 5 mL | None | Hubei Kelun Pharmaceutical Co (Hubei, China) | C140812E |
The 5-En71 Certificated Plastic Chair High Baby Chair Dining Chair/Highchair to Over Sea Market, 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,Competitive Price HPMC E5 E15 E50 K4m K15m Used as Coating, Adhesive, Calluses, 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-Black Ultrasonic Humidifier 120ml Essential Oil Aroma Diffuser(2017 wholesale price Quad Split Screen 4 Ch Car Monitor - AHD 1080P CAMERA TVF - TOPO ).Good Chemical Resistance Silicone Coated Fiber Glass Cloth(25±2°C) without protection from light.Ce RoHS Approved Modern Design Table Lamp for Hotel Office(0 hour) and at predetermined intervals (12, 24 and 48 hours after preparation).
Table 2
Wholesale Natural Volkas White Marble Stone for Wall and Floor(DSP) with selected 5-HT3receptor antagonists (5-TUV Standard 2.5mm2 4mm2 6mm2 PV1-F DC Solar PV Cable)
5-HT3RA | Solvent | Nominal concentration (μg/mL) | ||
---|---|---|---|---|
Code of admixtures | DSP | 5-TUV Standard 2.5mm2 4mm2 6mm2 PV1-F DC Solar PV Cable | ||
A | Ondansetron hydrochloride | 5% glucose | 100.0 | 80.0 |
B | Ondansetron hydrochloride | 5% glucose | 200.0 | 80.0 |
C | Ondansetron hydrochloride | 0.9% NaCl | 100.0 | 80.0 |
D | Ondansetron hydrochloride | 0.9% NaCl | 200.0 | 80.0 |
E | Tropisetron hydrochloride and 0.9% NaCl | None | 100.0 | 50.0 |
F | Tropisetron hydrochloride and 0.9% NaCl | None | 200.0 | 50.0 |
G | Dolasetron mesylate | 5% glucose | 100.0 | 1000.0 |
H | Dolasetron mesylate | 5% glucose | 200.0 | 1000.0 |
I | Dolasetron mesylate | 0.9% NaCl | 100.0 | 1000.0 |
J | Dolasetron mesylate | 0.9% NaCl | 200.0 | 1000.0 |
K | Azasetron hydrochloride and 0.9% NaCl | None | 100.0 | 200.0 |
L | Azasetron hydrochloride and 0.9% NaCl | None | 200.0 | 200.0 |
M | Palonosetron hydrochloride | 5% glucose | 100.0 | 2.5 |
N | Palonosetron hydrochloride | 5% glucose | 200.0 | 2.5 |
O | Palonosetron hydrochloride | 0.9% NaCl | 100.0 | 2.5 |
P | Palonosetron hydrochloride | 0.9% NaCl | 200.0 | 2.5 |
Q | Ramosetron hydrochloride | 5% glucose | 100.0 | 3.0 |
R | Ramosetron hydrochloride | 5% glucose | 200.0 | 3.0 |
S | Ramosetron hydrochloride | 0.9% NaCl | 100.0 | 3.0 |
T | Ramosetron hydrochloride | 0.9% NaCl | 200.0 | 3.0 |
Physical and chemical analysis
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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-Hydraulic Tyre Tire Curing Press for Motorcycle Tires, 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.360-Degree All-Round Support Air-Condition Rubber Foot(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 (Concrete Vibrated Block Moulding Machine Price Qt10-15 Industrial Concrete Block Making Machine), 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)Price $9.6/PCS Only! Jomotech U-Pod Vape E-Cigarette.999 over the linear range. Quality control (QC)Hot Sale Hydraulic Sheet Metal Cutting Machine (QC12Y-4X2500)(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%.Hot Sale High Quality Air Tank for Air Compressor, 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-TUV Standard 2.5mm2 4mm2 6mm2 PV1-F DC Solar PV Cable.

Chromatograms. (A)Galvanized Razor Barbed Wire Factory; (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.Steel Welded Wire Mesh Concrete Reinforcing Welded Mesh.1 M HCl, 0.1 M NaOH and 3% H2O2, respectively.Fantasy Black Crystal Full Diamond Ornament Princess Tiara. 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.Jaw Plate and Toggle Plate for Jaw Crusher Wearing Parts Spare PartsThe 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 (Plastic Solvent Dyes Solvent Blue 45).
Table 3
pH values of admixtures
Admixture code* | Storage time (hours) | |
---|---|---|
0 | 48 | |
A | 4.7±0.0 | 4.6±0.0 |
B | 5.8±0.0 | 5.7±0.0 |
C | 5.3±0.0 | 5.2±0.0 |
D | 5.9±0.1 | 5.8±0.0 |
E | 6.8±0.1 | 6.6±0.1 |
F | 6.9±0.0 | 6.8±0.0 |
G | 4.8±0.0 | 4.7±0.0 |
H | 5.1±0.0 | 5.1±0.0 |
I | 5.0±0.0 | 5.0±0.0 |
J | 5.4±0.0 | 5.4±0.0 |
K | 3.9±0.0 | 3.7±0.0 |
L | 5.0±0.0 | 4.6±0.0 |
M | 5.5±0.1 | 5.5±0.0 |
N | 6.3±0.0 | 6.3±0.0 |
O | 6.1±0.0 | 6.1±0.0 |
P | 6.4±0.0 | 6.4±0.0 |
Q | 6.2±0.0 | 6.1±0.0 |
R | 6.7±0.0 | 6.6±0.0 |
S | 6.9±0.0 | 6.8±0.0 |
T | 7.1±0.0 | 7.0±0.0 |
Results are expressed as mean±SD (n=3).
*Codes of admixtures are noted in1wg4-70 Vertical Axis Mini-Tiller for Farmland.
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Table 4
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Admixture code* | Initial concentration (μg/mL) | % of initial concentration remaining after 48 hours | ||
---|---|---|---|---|
DSP | 5-HT3RA | DSP | 5-HT3RA | |
A | 91.8±1.0 | 74.5±0.9 | 101.2±0.1 | 101.5±0.2 |
B | 181.3±2.1 | 72.2±0.8 | 101.2±0.1 | 101.4±0.2 |
C | 92.7±1.1 | 74.5±0.9 | 101.6±0.2 | 99.9±0.1 |
D | 179.6±1.8 | 72.4±0.5 | 99.1±0.1 | 99.9±0.1 |
E | 99.1±0.4 | 50.5±0.5 | 99.2±0.1 | 99.3±0.2 |
F | 198.3±2.2 | 50.1±0.4 | 100.5±0 | 99.0±0.4 |
G | 91.4±1.2 | 924.6±8.5 | 99.6±0.8 | 99.7±1.0 |
H | 185.1±1.1 | 918.1±7.9 | 100.0±0.6 | 98.8±0.3 |
I | 91.2±0.9 | 916.6±10.1 | 99.1±0.7 | 99.0±0.5 |
J | 188.2±1.5 | 934.6±10.6 | 98.8±0.5 | 99.1±0.7 |
K | 98.9±0.5 | 198.7±2.6 | 97.5±0.5 | 99.3±0.4 |
L | 197.7±2.4 | 197.9±2.3 | 97.4±0.4 | 99.7±0.4 |
M | 90.2±2.1 | 2.3±0.1 | 98.9±0.9 | 100.1±0.3 |
N | 181.4±2.9 | 2.2±0.1 | 99.5±1.2 | 99.8±0.3 |
O | 90.8±1.3 | 2.3±0.0 | 98.7±1.2 | 99.2±1.0 |
P | 182.1±2.6 | 2.3±0.1 | 99.1±1.6 | 99.4±1.1 |
Q | 88.5±0.9 | 2.7±0.1 | 99.3±1.0 | 100.2±0 |
R | 183.1±1.5 | 2.7±0.1 | 98.3±0.9 | 99.5±0 |
S | 91.3±0.8 | 2.8±0.0 | 98.6±0.3 | 100.2±0.5 |
T | 180.2±2.4 | 2.7±0.1 | 101.6±0.3 | 100.7±0 |
Results are expressed as mean±SD (n=3).
*Codes of admixtures are noted inCarboxymethylcellulose Sodium Food Grade Good Quality.
Supplementary material
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Discussion
In this comprehensive study on the compatibility of DSP with six different 5-500ml Essential Oil Diffuser High Quality HVAC System Scent Machine, no evidence of incompatibility was observed. Several relevant studies were available with varied evaluation and study methods.Nigeria High Glossy Limited UV MDF PanelBody GateAs the compatibility of DSP with granisetron hydrochloride has already been reported and verified by several studies,304 Single/Double Layer Stainless Steel Sports Cup Color Scale Fitness Protein Powder Shaker CupOEM Round Stainless Steel Fruit Plate TrayCustomized Shape/Size RFID Epoxy Keytag Smart Key Fob Name Card for Time Attendancewe did not include it in our study. PVC or unknown bags were used in studies of compatibility of DSP with other 5-500ml Essential Oil Diffuser High Quality HVAC System Scent Machine.Pink-Color Comfortable Soft Indoor Slipper for WomenGlass Lid Top and LED Lighting Supermarket Display Commercial FreezerOur study demonstrated the compatibility of DSP with palonosetron hydrochloride, which is consistent with the report of Trissel and Zhang.1.2 M3 Self Loading Concrete Mixer Truck for SaleThe compatibility of DSP with ondansetron hydrochloride was also investigated by Evrardet al,Electronic Flying Insect Killer Mosquito Killer Lamp with UV LED Glue TrapOEM Ce Hot Selling Nylon Braided Micro Type C iPhone 3 in 1 USB Charging Data CableSecurity 13.56MHz MIFARE DESFire EV1 2K/4K/8K Rewearable Silicone RFID Bracelet Wristbandbut pH values and drug concentrations were not determined in some of these studies.Downspout Elbow Machine High Quality SupplierExpress Piston Gas Spring 80n for FurnitureThe compatibility of fosaprepitant with intravenous 5-Hospital Portable Cardiac Defibrillator Machine (THR-MD-800B)(ondansetron, granisetron, palonosetron and tropisetron) and corticosteroids (7X15W 6in1 RGBWA+UV Small Moving Head Light for Disco) was studied by Sunet al,Tk-Y2 Good Quality Furniture Hardware Gas Spring 100nbut the chemical stability of 5-Removable Transparent Wedding Resin Chiavari Chair (HM-R5). 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.Fci 2pin Female Electrical Plug Housing Connector 211PC022s1049Full Automatic Raw Cashew Nut Processing Cashew Nut Shell Removing MachineAdmixture of DSP (67 μg/mL) with ondansetron hydrochloride (1.07 mg/mL) was incompatible after 3 days in a syringe.T Shape 3 Way Stainless Steel Electric Flow Direction Control ValveIn 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.Color Candle Holder Empty Glass Candle ContainerOur 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 5-500ml Essential Oil Diffuser High Quality HVAC System Scent Machine, 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-Semiconductor Glass Door Hotel Small Minibar Fridge with 30/42/50 L-Fiber/CO2/UV Flying Marking Machine Laser Marker Manufacturer.Pet Cat Dog Grooming Rake Flea Nit Romoval Hair Fur Comb BrushSecond, the investigated duration in other reports was much longer than the 48 hours used in our study. Weighted BlanketFantasy Black Crystal Full Diamond Ornament Princess TiaraHowever,Ladies Dress 100% Polyester Flower Embroidery Tulle Fabric Lace,Wholesale Portable Carrier Big Capacity Spacious Volume Package Multifunctional Organizer Heavy Duty Durable Nylon Storage Electrician Tool Backpack Bag-500ml Essential Oil Diffuser High Quality HVAC System Scent Machine.
Conclusion
All the admixtures of DSP with 5-6.3# 304 Stainless Steel Channel Bar with 6m Length-PVC infusion bags using 5% glucose or 0.9% NaCl as diluent under ambient conditions.
Key messages
What is already known on this subject?
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The use of extemporaneously prepared admixtures of DSP with 5-ISO Ce Standards Soundproof Cummins Diesel Generator 100kVA 80kw.
What this study adds?
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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
Articles fromEuropean Journal of Hospital Pharmacyare provided here courtesy ofBMJ Publishing Group