Dylanfit
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My personal Transformation.

#TRUSTWHATYOUTRAIN #BETHEMOTIVATION Many people believe that I'm a cocky prick or that I'm better than others that I judge everyone in the gym. This is false. Since starting my fitness journey I have seen what it's like to be 140 lbs and a stick, to 185 lbs, I know how hard it is to just get up and out of the bed and go to the gym it's hard hard work! You wanna quit everyday but it's worth it to push forward. I told myself that when I first started I would never be like those ego meat heads in the gym lifting heavy with shitty form that I would know walking into the gym that I was the most knowledgable guy in there. That was my goal. Not to be a cocky prick but to lift others up and teach them what I have learned. To not judge people because you never know their life or why they are in the gym. They could be here because it's the only place they can relax. You never know. My transformation is not just a picture it's a lifestyle because I changed my entire attitude on life. I encourage everyone to try and do the same each day. Set some goals plan it out and DESTROY it.
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I'm going to try and go pro yea just a lot of hard work and consistency!
Incredible job. looking great! Are you going to go pro?
great job mate
Dude good work! You look great
Nice man! How long did it take you to get to where you're at right now?
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A healthy body leads towards a healthy mind
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How Ayurveda cures acute kidney injury?
What is Acute kidney injury? Acute kidney injury, also known as acute renal failure, is a sudden kidney failure within a few hours or days. In this condition, the kidneys lose their ability to remove excess fluids, waste, and toxins from your blood. The toxic waste can build up and cause severe issues. Sometimes, acute kidney injury affects other organs such as the brain, heart, and lungs. Acute kidney injury is a common disorder in people who are already hospitalized to take treatments for other diseases, especially in older people. It is a severe kidney disorder and requires immediate treatment. Acute kidney injury treatment in Ayurveda is the best solution to get relief from this disorder effectively. Signs and symptoms of acute kidney injury may include- Low appetite Vomiting Confusion Nausea Fatigue and tiredness Protein in urine Frequent urge to urination Lack of concentration Pain in the stomach and lower back Weakness of body muscle Chest pain or pressure Irregular heartbeat Causes of acute kidney injury- Acute kidney injury happens when the kidneys are damaged abruptly. The problems that lead to acute kidney injury are: Insufficient blood flow to your kidneys Swelling in eyes, ankles, and legs Fatigue High blood pressure Blood clots in or around the kidneys Severe diarrhea A blockage of the uterus Liver failure Direct trauma or accident to your kidneys Severe infection Blood vessel disorders If you have these health issues, consult a doctor, do a test, and take acute kidney injury treatment in Ayurveda. The treatment is free from noxious effects and compelling enough to purge any disease, no issues if it is kidney failure or proteinuria. Risk factors of acute kidney injury There are high chances of the risk factor of acute kidney injury for people having- Age 65 or above High blood pressure Any underlying kidney disease Chronic kidney disease such as heart disease, liver, and diabetes. When to see a doctor If you notice any signs or symptoms, contact your doctor immediately. Depending on the cause of your acute kidney injury, your doctor will run different tests not only to prevent this condition from getting worse but to cure it permanently. For complete kidney ailment remission, you have faith in Dr. Puneet and take acute kidney injury treatment in Ayurveda. The doctor, with his holistic approach, has assuaged 1,20,000 plus kidney patients. How To Prevent Acute Kidney Injury? Here are some general guidelines to take good care of kidneys health and prevent the disease: Stay hydrated Manage diabetes Control high blood pressure Consume diet low in salt and fat Exercise at least 30 minutes a day Limit alcohol Quit smoking Take acute kidney injury treatment in Ayurveda Diagnosis of acute kidney injury The diagnostic tests involved in acute kidney injury are as follows: Urine test: this test determines the amount of protein and blood in the urine. Blood test: this test helps to detect creatinine, urea, and potassium in the blood. Imaging tests: tests such as ultrasound and CT scan can be used to determine any obstruction or change in kidneys' size. Kidney biopsy: in this test, a tiny piece of kidney tissue is examined under a microscope. Acute Kidney Injury Treatment in Ayurveda Ayurveda is an ancient science that comprises a complete knowledge of the human body and how to keep it healthy for a long time. It focuses on the root cause of the problem and treats them permanently. In Ayurveda, the treatment of kidney disease helps to get rid of waste products from the body. Kidney and Ayurveda treatment is a combination of a healthy diet, exercise, yoga, and intrinsic herbs to cure kidney disorder. The benefits of using Ayurvedic medicines in acute kidney failure are that in most patients, the kidney damage can be reversed, the frequency of dialysis can be reduced and stopped, and the increased risk of kidney failure can be combated. Contact an Ayurvedic doctor in the early stages so that the kidney disorder can be treated. With the help of Ayurvedic treatment in acute kidney injury, the condition can be reversed and strengthen the kidneys.
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Preclinical research
Before a drug or treatment can be tested on people, clinical researchers should ensure whether it can cause potential risks, side effects, or serious harms, also known as toxicity to the patients. Learn Clinical Research Courses. The two types of preclinical research include the following: ● In Vitro ● In Vivo In the US, the FDA stipulates that researchers must use good laboratory practices (GLP), as defined in medical product development regulations for preclinical laboratory studies. The GLP regulations set the minimum basic requirements for: ● study conduct ● personnel ● facilities ● equipment ● written protocols ● operating procedures ● study reports It also establishes a system of quality assurance for each preclinical study to ensure the safety and efficacy of products approved and regulated by the FDA. Generally, preclinical studies are not conducted on a very large scale. However, these studies must provide detailed information on dosing and toxicity levels. Clinical researchers review their results after preclinical testing. Conclusion Preclinical studies encompass various activities that serve as a link between drug discovery and preparation and the initiation of a clinical trial on humans. The laws regulating preclinical trial norms and requirements worldwide can package differences but generally have some common features. Rodent and non-rodent mammalian models are generally used to set forth general safety and identify toxicity patterns that reveal potential target organs likely to suffer the adverse effects. Take Clinical Research Training. Toxicology and safety studies also identify Therapeutic Index for deciding the initial starting doses in clinical trials. More than one or more species can be used for determining the drug's mean residence time in the body. The mean residence time of a drug in the body depends on inherent absorption, distribution, metabolism, and excretion properties.
Top 20 Fastest Double Centuries in Test Cricket.
Test cricket is considered to be a little slower game than ODI and T20 cricket format but for the last few decades, this format of cricket has seen significant changes, In the present environment of test cricket quite comfortably 300 to 350 runs can be scored in a single day's play. Many batsmen of the world have also scored double centuries by facing quite fewer balls in this format also, in this article, we will explain the top 20 fastest double centuries in Test cricket. Top 20 cricketers who are scored the fastest double century in Test cricket. 01. Nathan Astle 02. Ben Stokes 03. Virender Sehwag 04. Virender Sehwag 05. Brendom McCullum 06. Virender Sehwag 07. Herschelle Gibbs 08. Adam Gilchrist 09. Ross Taylor 10. Ian Botham 11. Chris Gayle 12. Virender Sehwag 13. Virender Sehwag 14. Aravinda de Silva 15. Jason Holder 16. M. S. Dhoni 17. Graham Thorpe 18. Gordon Greenidge 19. Mohammad Yousuf 20. Victor Trumper 20. Victor Trumper: Full name... Victor Thomas Trumper. Date of birth... 2 November 1877. Date of death... 28 June 1915. Born territory... Darlinghurst, New South Wales, Australia. Height... Na. Batting genre... Right-handed. Bowling genre... Right arm medium. Main Role in the team... As a Batsman. Victor Trumper has scored 214 runs by facing 247 balls in the first innings of the third test match which was played at Adelaide Oval, Australia, from 07 January to 13 January 2011, during the South Africa tour of Australia. In this Test match, he was played 242 minutes of batting on the crease with the help of 26 fours and zero sixes. The following are the details of his performance in this test match. 19. Mohammad Yousuf: Full name... Mohammad Yousef. Date of birth... 27 August 1974 . Born territory... Lahore, Punjab, Pakistan. Height... 1.78 m. Batting genre... Right-handed. Bowling genre... Right arm medium. Main Role in the team... As a batsman. Mohammad Yousuf has scored 204 runs by facing 243 balls in the first innings of the second test match which was played at MA Aziz Stadium, Chattogram, Bangladesh, from 16 January to 18 January 2002, during the Pakistan tour of Bangladesh. In this Test match, he was played 325 minutes of batting on the crease with the help of 34 fours and two sixes. The following are the details of his performance in this test match. 18. Gordon Greenidge: Full name... Cuthbert Gordon Greenidge. Date of birth... 01 May 1951. Born territory... Black Bess, St Peter, Barbados. Height... Na Batting genre... Right-handed. Bowling genre... Right-arm medium. Main Role in the team... As an opening batsman. Gordon Greenidge has scored 200 runs by facing 232 balls in the second innings of the second test match which was played at Lord's cricket ground, London, England, from 28 June to 03 July 1984, during the West Indies tour of England. In this Test match, he has scored a total of 214 runs from the facing of 242 balls by batting for 302 minutes on the crease with the help of 29 fours and two sixes. The following are the details of his performance in this test match. 17. Graham Thorpe: Full name... Graham Paul Thorpe. Date of birth... 01 August 1969. Born territory... Farnham, Surrey, England. Height... Batting genre... Left-handed. Bowling genre... Right arm medium. Main Role in the team... As a batsman Graham Paul Thorpe has scored 200 runs by facing 231 balls in the 2nd innings of the first test match which was played at AMI Stadium, Christchurch, New Zealand, from 13 March to 16 March 2002, during the England tour of New Zealand. 16. MS Dhoni: Full name... Mahendra Singh Dhoni. Date of birth... 07 July 1981. Born territory... Ranchi, jharkhand, India. Height... 1.75 m. Batting genre... Right-handed. Bowling genre... Na Main Role in the team...Wicket-keeper & batsman Mahendra Singh Dhoni has scored 200 runs by facing 231 balls in the first innings of the first test match which was played at MA Chidambaram Stadium, Chepauk, Chennai, India, from 22 February to 26 February 2013, during the Australia tour of India. In this Test match, he has scored a total of 224 runs from the facing of 265 balls by batting for 365 minutes on the crease with the help of 24 fours and six sixes. The following are the details of his performance in this test match. 15. Jason Holder: Full name... Jason Omar Holder. Date of birth... 05 November 1991. Born territory... Bridgetown, Barbados. Height...02.01 m. Batting genre... Right-handed. Bowling genre...Right-arm fast-medium. Main Role in the team...Bowler & all-rounder. Jason Omar Holder has scored 202 runs by facing 229 balls in the 2nd innings of the first test match which was played at Kensington Oval, Bridgetown, Barbados, from 23 January to 26 January 2019, during the England tour of the West Indies. In this Test match, he was played 384 minutes of batting on the crease with the help of 23 fours and eight sixes. The brief data of his batting performance on this Test match are the following. 14. Aravinda de Silva: Full name... Pinnaduwage Aravinda de Silva. Date of birth... 17 October 1965. Born territory... Colombo, Sri Lanka. Height... 1.65 m. Batting genre... Right-handed. Bowling genre... Right arm off-spin. Main Role in the team... As a batsman Aravinda de Silva has scored 200 runs by facing 229 balls in the first innings of the first test match which was played at P Sara Oval, Colombo, Sri Lanka, from 21 July to 23 July 2002, during the Bangladesh tour of Sri Lanka. In this Test match, he has scored a total of 206 runs from the facing of 234 balls by batting 318 minutes on the crease with the help of 28 fours and one sixes. The following are the details of his performance in this test match. 13. Virender Sehwag: Full name... Virender Sehwag. Date of birth... 20 October 1978. Born territory... Najafgarh, Delhi, India. Height... 1.73 m. Batting genre... Right-handed. Bowling genre... Right arm off break. Main Role in the team... As an opening batsman Virender Sehwag has scored 200 runs by facing 227 balls in the first innings of the second test match which was played at Galle International Stadium, Sri Lanka, from 31 July to 04 August 2008, during the India tour of Sri Lanka. In this Test match, he has scored a total of 201 runs from the facing of 231 balls by batting 348 minutes on the crease with the help of 22 fours and four sixes. The following are the details of his performance in this test match. Kindly click here to continue reading this article. https://www.theindia24.com/2021/04/fastest-double-centuries-in-test.html
Can You Buy Adderall Online
How to reduce Adderall addiction in adults? As we know, Adderall is a prescription medication for children and adults with ADHD. This often Adderall helps narcolepsy as well. ADHD is a condition where a person regularly feels uncommon and finds difficulties while doing daily tasks. Although they are not able to concentrate on certain things. People with ADHD become so distracted that they can not do anything to help themselves to get out of this situation. But it is essential to take any stimulant as descriptive. Not following the description and taking the dosage on your own. can increase the level of dangerous side effects that are an abuse of stimulants. Alongside, In reality, Adderall is a potent stimulant. that can lead to severe and potentially deadly side effects. Overdose and addiction is one of the worst side effects of Adderall abuse. which can lead to heart attack, and liver failure. Taking Adderall with other substances. such as alcohol, which increases the risk of a fatal overdose. For people who take large doses of Adderall for long periods. the risk of becoming physically dependent on the drug comes near. When this happens, medicine's tolerance builds up. meaning it takes more significant and more frequent doses to get the same effects as before. Adderall addiction becomes worse with time. because people thought that this medicine gives them calm and relaxation. so why should they not increase the level of medicine and start to take 2 to 3 times in a day. thus, which is worse for their health. although , the people who take adderall report that it makes them feel strong. self-assured, and full of energy which makes them want to take it more. With this extra energy and confidence, people can do more than generally. without the drug they do not feel overwhelmed or overextended. and they are lazy and exhausted. In addition to extra energy. Adderall also makes changes in appetite that cause weight loss. Adderall can also cause physical changes in the brain'. This can lead to altered behaviors. and it also causes mental disorders like depression. Some Adderall addicts become suicidal after taking the drug for an extended period. Athletes and most actors and singers taking Adderall have died. because overdosage of adderall increased the blood pressure. and it leads to heatstroke and cardiac arrest. Some of the side effects of Adderall abuse may include: Convulsions Irregular heartbeat Loss of appetite Nausea Sleeping problems, Insomnia Hallucinations Depression Anxiety Unusual dry mouth Lack of strength Weight loss Constipation Headache Dizziness Lower back or side pain Seizures How Long Does Adderall Last? Each dose of Adderall Immediate Release lasts between four to six hours. and many people may move to take the drug twice a day. They may also increase their dose after several years. because the initial amount does not manage the symptoms of their ADHD. The most significant recommended daily dose of Adderall. according to the Physicians Desk 2011, is 40 mg for ADHD and 60 mg for narcolepsy. How To Stop Adderall Abuse? Physicians are not likely to reduce the dose of Adderall because they said. The person with an ADHD body has already developed a tolerance to the stimulant. And the person needs medical treatment to manage their condition. Always follow the prescribing instructions about any prescription drug, including Adderall. and let them know if the dosage is no longer effective at its current dose. Alongside, people who struggle with Adderall abuse need help from addiction specialists. To get to know about the few things. At the same time, they may experience withdrawal symptoms. Thus their mental and as well behavioral health will improve with detox rehabilitation. although, the second step to ending adderall's addiction is rehab. Thus, it will help change behaviors related to stimulant drugs. Conclusion: ADHD is a condition where a person loses concentration. although to increase the power of attention, people use medication which is Adderall. Adderall made to treat ADHD and narcolepsy. Adderall, help to make better concentration. but although, if Adderall goes to overdose, it can cause your health to worsen. Because Adderall is a potent stimulant, it has many side effects. Thus, that can go higher with the overdosage of medicine. References: https://www.addictioncenter.com/stimulants/adderall/withdrawal-detox/ https://talbottcampus.com/how-adderall-addiction-starts/ https://www.addictioncenter.com/stimulants/adderall/symptoms-signs/ https://oxfordtreatment.com/prescription-drug-abuse/adderall/tolerance/
How to get fit without going to the gym
Exercising in the gym is always the ideal choice to stay in good shape but often a long and very tight schedule makes it impossible to approach the gym frequently. Given this situation we need to look for alternatives and new ways to keep fit. So now Makeufits prepare you some tips to help you learn how to stay fit without going to the gym. Walking the dog and burning calories Walking the dog in the park or some open space devoted to this activity is an option that will help, as they say, to kill "two birds with one stone." Like you, your pet needs to exercise and stay fit, why not do it together? Thus having a pet is a good reason to stay in shape. A pet needs a responsible and active person who is willing to provide the necessary care and in this case you take a walk and that play with. Taking a walk or better yet, to run, between 30 and 45 minutes a day or at least 3 times a week for the park, is a perfect choice to start keep fit without visiting the gym. It is good for you and good for your pet. Television viewing has never been so healthy You have probably heard or have you found out around that there are several exercises you can do while watching TV you're watching the news or your favorite program. It is a good choice to help you stay in shape without going to the gym and at least you will be giving a more productive the fact of sitting around watching TV. You can exercise watching TV during commercials (most commercials lasts 1 to 3 minutes) or throughout the program. Some of the most common exercises to do while watching TV are: crunches and planks to do during the commercial before the show starts again, yoga postures, stretching, weights, jumping frog, etc... Exercise videos One way to simulate a day in the gym from the home theater is watching a video of exercise routines and special positioning to help you stay in shape. You can buy a videotape, a DVD or even search the web, where you'll find many videos and tutorials that will help you maintain proper exercise routine. We just put in front of the TV with comfortable clothes and follow the instructions of the video. It's easy, safe and private. Nothing better than your own home and if you've lost at any point, simply go back to play the video and try again. Have fun with the kids Have fun, smile and play is another way to stay healthy. The largest source of fun and all are healthy children. Play with them, laugh and run will then be another good option to help you stay fit at the same time as you interact with your children. You can play in our backyard or go to the park, walking, running, jumping or playing sports with them. This will not only be healthy for you but also for children, who love and really need this contact with you, laugh and play with adults. I can not go to the gym but the gym will come to you Whatever the reason, if you think you can not go to the gym, you'd better bring the gym to your home. To do this you should consider getting some exercise equipment and systems for your home. There are a number of models with different sizes, with many functions and possibilities of prices and payment methods. Just need a space at home, may be the garage or a room that has little use. With home appliances no excuses for not exercising every day and the videos accompanying you exercise, you practice all the necessary routines to keep fit without even closer to the gym. Games you exercise? That's right! The Wii game console offers several game options to keep you really busy and that will make you sweat, I assure you, almost like doing exercise at home. With rowing sports games, sword, tennis, golf, boxing, cycling and many more options, playing games is a real option that will make you shake your body and keep moving. Furthermore it is an activity you can do with children. What do you expect to test the Wii Fit? Stay up and helps eliminate calories When you stay standing instead of sitting or lying, you're burning 33% more calories. A good way to stand is when, for example, the phone rings us, instead of sitting down to talk on the phone, stand up, walk and move. Apply this habit is not easy at first but then will become a simple habit. Every time you think you can keep standing instead of sitting: it! Wait for the bus stand, if the journey is short make it stand, walk, stay in an upright posture, etc. If you want more tips to keep in shape without going to the gym, I recommend that you take a look at these fun activities to keep fit and these exercises, you will be very helpful to complement these activities.
How to lose weight without diet: a working and easy scheme for fast weight loss
Dozens of diet options lost pounds and re-acquired in double the size - I went through all the torments of losing weight, dietary restrictions and overload in the gym. I managed to lose 26 kg in just 2 months without torturing myself with a gruelling diet. For more than 3 years the body did not suit me: it is impossible to draw in the stomach, an ugly butt and cellulite on my legs. Needless to say about clothes, you can't find a suitable size. Therefore, I want to share with everyone a working and easy scheme for fast weight loss. A working and easy scheme for fast weight loss Quality weight loss technique 1. Drink clean water. 5-10 minutes before meals, be sure to drink a glass of water. It doesn't matter if you are in a hurry or you don't feel like it, you must do it through force. Thanks to the liquid, all digestive processes are started, and food is absorbed twice as well. 2. Cleansing the body. Food particles remain on the intestinal walls, which, under the influence of high temperatures, begin to rot, and decomposition products are released into the blood. The breakdown of fats slows down, and toxins clog the lymph and blood vessels. Therefore, when you find it hard to breathe, bending over and tying your laces, this is not due to the abdomen, but due to clogged excretory systems. faster way to fat loss How to clean? · Soda water before lunch and dinner. On an empty stomach, 1 tbsp. dissolve in a glass of warm water and drink. It is best to stay at home after the procedure. 3. Scrub and wrap from various products 2-3 times a week. As a rule, these are honey, essential oils, clays, coffee grounds, etc. 4. Eat unhealthy, fatty, starchy foods, sweets for breakfast, immediately after a serving of healthy cereals or fruits. These simple ways will allow you to lose weight without a diet, which has been verified through personal experience. Do not force yourself to eat little or bad food. Compliance with these principles will allow you to remove fat from problem areas in just a few months. Fruit and vegetable diet Overweight problems, they began to bother me after 30 years, when, with an increase of 180 centimetres, my weight, with a constant progressive addition, exceeded the mark of 120 kilograms. Knowing the existing pattern that overweight problems are often associated with metabolic disorders, I decided to radically change my diet. First, I completely eliminated fatty, high-calorie foods from my diet and minimized my consumption of bread. He included fresh vegetables and fruits in his daily menu and limited the use of food prepared by heat treatment to only once every two days. The daily consumption of vegetable salads and fruits allowed me to reduce my weight by 10 kilograms in one month. When I felt the urge to eat, I drank a few sips of clean water and this effectively dulled the feeling of hunger. At the same time, regarding the assortment of vegetables and fruits, as well as the total amount of raw, plant foods I consume, I did not limit myself. Published By Key to a Healthy Lifestyle
Buy adderall online prone to mental disorders
Married women are prone to mental disorders As we know that marriage is something that both genders do to grow their family. Thus, they marry to be happy together. And create some good memories in their lifetime. Therefore, Marriage is something that people rely on. People most often think if they would not get married what would they do in their future. Although marriage is something that people prefer to take as essential. and gives so much importance to it. In India, if one person is aging and hasn't married yet society sees him as awful and they can not resist them. Although, the essential thing to talk about in this article is that. How can married women be prone to mental disorders? Stay stick to this article to get to know about how marriage can cause mental disorders for women. CAN MARRIAGE CAUSE MENTAL HEALTH PROBLEMS? Yes, it is not surprising to hear that marriage can be the cause of mental disorders in women. However, we know that marriage is something that people are happy to stay together. But besides, marriage may be stressful for some people at some point. which may lead to the development of mental health disorders. Marriage is something that not only two people take responsibility for. Thus it is about two families or their mentalities. Alongside, marriage is something that spouses commit with their heart. and gave each other a promise to stay along with each other for a lifetime. Alongside, marriage is not just a biological need for sexual gratification. it is much more than that. Women leave their house to marry a man who can feed them and treat them like no one else does. Although it is more than this. they often dream that they were their love of life and they would spend their whole life with them. In simple words, marriage is one of the most essential events of life. Which affects the social status as well psychological status of both spouses. But, when those dreams can not get true and they’re heart breaks into pieces what would they face? They ultimately face some serious and difficult phases of their life. They might feel mentally disturbed or they get anxiety and depression. which can lead to other mental health disorders. The next question that came up in readers’ minds is that. What are the causes that married women are prone to mental disorders? Studies say it may be because of multiple factors. which result in psychological factors such as, Family issues: Having a good in-laws family is a blessing. Thus, most of them are lucky to have this but not all of them. In most cases, the law's family tortured women for dowry. and many more reasons like this which can cause them stress. Thus they might feel left alone. And spend their whole time alone without any social interaction. Although, responsibilities in taking care of the family: are also the likely cause of having mental disorders. Having fears of not being able to do respond well. can trigger your mental health and cause you chronic disorders. Adjusting to a new family: getting married and trying to adjust to a new family. can also make your thoughts of worries and cause you stress or depression. which can also cause you disorders that harm you. Pregnancy: As we all are aware, getting pregnant is not easy. This period is full of body aches, disturbing mind elements, mood swings, and most of the things. Besides, and having a new responsibility can make you worried. What if you eat this or it causes harm to your child. And thousands of precautions are there to follow. So that differentially can cause you stressful moments. Motherhood: being the mother of a child is not simple as it has shown. and also take responsibility for taking care of the house as well can attack you differently. and it can be impactful that now you have to take care of both things well can cause you stress. and women are likely to have these reasons for their mental disorders. Conclusion: Alongside, these not are the only reasons for having bad mental health in married women. One of the main causes of mental distress in married women is how the in-law’s family treats them. And how does their partner support them in it? Having someone beside you who is constantly supportive. and caring is such a blessing in a disturbing environment. But not having this person and also getting tortured every day can give you a strange vibe. which can lead you to become a mental disorder patient. References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539879/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705689/