Given a passage and a query based on the passage, generate an unambiguous, concise and simple answer to the query from information in the passage. Note that the answer may not be present in exact form.

If you are under 25 years old when you obtain your first learner’s permit and then turn 25, the MVA will permit you to take a driving skills test if you have held the permit at for least 45 days (the 45 days may include the days you held the permit before your 25th birthday). Apply for provisional driving licence online. Apply for a provisional driving licence online.You require a valid UK passport no more than five years old and you won’t have to provide a photo. Online is quicker and cheaper than with a postal application. What is the procedure for obtaining a provisional license if I have a learner's permit through the MVA's Rookie Driver Program? Requirements before obtaining a provisional license: You must drive with the learner's permit conviction-free for a minimum of 9 months before applying for a provisional license. Your permit must not have been suspended or revoked. You may not have been granted probation before judgement (PBJ) for a moving violation. Your driver's license, or proof of your licensure; 1  Proof of your age If you need a class B, C or M license - you must be at least 16 years, 6 months. If you need a class A license - you must be at least 18 years, 0 months; Fees: 1  There is no additional fee for the provisional license if you are a new driver in the Rookie Driver program and have a valid learner's permit. 2  There is a fee for the provisional license if you have a license from another state or another country. You must hold the provisional license, conviction-free of a moving violation, for at least 18 months before you can apply for a full Maryland driver's license. If your learner's permit expires or you are not able to complete/pass the required skills tests before it expires, you will be required to reapply for a new permit, pass the Vision and Knowledge tests and pay the required fees. Penalty points on your provisional licence. You must not drive before you receive your provisional driving licence. Three penalty points on the driving licence and a maximum fine of £1000 are the penalties for breaking this law. If a driver has 6 or more points on their provisional licence then if they get 1 or more points after passing their test within 24 months their licence will be revoked. The provisional license you receive will expire 60 days after your 21st birthday. Or if you are 21 years of age or older, 8 years after the license is issued on the month and day of your birth. While you are driving with a provisional license and are less than 18 years of age, the following restrictions apply: You can apply for the provisional driving licence up to 3 months before your 16 th birthday. You can start driving a car when you are 17. At 16, you can begin to ride a moped or a light quad bike. Your driver's license or proof of your licensure; 1  Proof of your age If you need a class B, C or M license - you must be at least 16 years, 6 months. If you need a class A license - you must be at least 18 years, 0 months; 2  Proof of your identity and residency; Query: how long do you have your provisional license
You must hold the provisional license, conviction-free of a moving violation, for at least 18 months before you can apply for a full Maryland driver's license.

Creatine Alpha-Ketoglutarate – Creatine alpha-ketoglutarate is creatine attached to alpha-ketoglutarate. Like with arginine alpha-ketoglutarate, the popular nitric oxide booster, this form of creatine is supposed to be better absorbed by the body than monohydrate. Most studies use a high-dose loading strategy, which can rapidly elevate your muscle creatine content. Although this is not necessary, it will help you reap the benefits of creatine after just a few days . To load with creatine, take four 5-gram servings throughout the day for about 5-7 days. After that, take 3-5 grams per day to maintain your muscle creatine stores . The key point to take away from this article is that creatine supplementation can certainly enhance performance output, especially anaerobically, and it does this through a variety of mechanisms (one of which appears to be by enhancing recovery during intermittent, high-intensity exercise). Creatine works. Weight lifters know this, professors know this, the marketers who sell the stuff know this. But nobody should put anything in their body without weighing the benefits and risks first. That goes for everything from beer to marshmallows to the amazing amino acid called creatine. It’s not anything scary. Some research shows that taking 20 grams of creatine daily for 5 days followed by 5 grams daily for 5 days does not improve muscle strength. But other research shows that taking 20 grams daily for 4-10 days does improve strength. Research on creatine in the elderly is also conflicting. Over the last couple of decades, creatine has become a supplement staple for guys looking to build strength and lean muscle mass. At the very least, you've probably seen guys around the gym taking creatine in the form of powder, capsules, or as part of a pre-made shake. “[But] the best effect in healthy humans is seen when creatine is combined with resistance exercise training.” Creatine causes gastrointestinal upset. True—but it’s rare. Tarnopolsky says his studies show 5 to 7 percent of people experience either stomach aches, diarrhea, or both. Creatine will help you run a faster 5K. Myth. The Iranian researchers concluded that since myostatin levels were lower in the subjects taking creatine, one way that creatine may work to increase muscle size and strength is by reducing myostatin levels, which reduces the limitation that this protein places on muscle growth. In children with the certain creatine deficiency syndromes, oral creatine supplements might improve some symptoms. Heart failure. There isn't enough evidence to recommend use of oral creatine as a heart failure treatment. Taking creatine while taking Tagamet may increase the risk of kidney damage. Drugs that affect the kidneys. Using creatine along with any medication that affects the kidneys may raise the risk of kidney damage. Probenecid. Taking creatine while taking probenecid, a drug used to treat gout, may increase the risk of kidney damage. Query: how does creatine help with strength
One way that creatine may work to increase muscle size and strength is by reducing myostatin levels, which reduces the limitation that this protein places on muscle growth.

Total bilirubin is now often measured by the 2,5-dichlorophenyldiazonium (DPD) method, and direct bilirubin is often measured by the method of Jendrassik and Grof. Blood levels. The bilirubin level found in the body reflects the balance between production and excretion. Blood test results should always be interpreted using the reference range provided by the laboratory that performed the test, but typical [0.3 to 1.9 mg/dL]s for adults and [340 µmol/L] for new borns: Jaundice occurs as a result of excess bilirubin in. the blood. It is a hallmark of liver disease but. not always present in liver disease. Jaundice. occurs when the liver fails to adequately. secrete bilirubin from the blood into the bile. Bilirubin: Bilirubin,, a brownish yellow pigment of bile, secreted by the liver in vertebrates, which gives to solid waste products (feces) their characteristic colour. It is produced in bone marrow cells and in the liver as the end product of red-blood-cell (hemoglobin) breakdown. Normally the body produces a total of about 260 mg of bilirubin per day. Almost 99 per cent of this is excreted in the feces; the remaining 1 per cent is excreted in the urine as urobilinogen. Bilirubin is a pigment in bile created during the breakdown of haemoglobin, which is then excreted from the body in bile. It is bilirubin which gives people the characte…ristic yellow colour in jaundice (whether that be caused by liver failure, obstruction or an increased breakdown of haemoglobin). the liver. To be transported in blood, bilirubin must be solubilized. By the very nature of being reversible, noncovalent binding to albumin the Unconjugated bilirubin bound to albumin is transported to the liver, where it is taken up by hepatocytes through carrier-mediated membrane transport and solubilised. Bilirubin metabolism: Applied physiology Xia Wang, Jayanta Roy Chowdhury , Namita Roy Chowdhury Albert Einstein College of Medicine, New York, USA KEYWORDS Bilirubin; Bilirubin glucuro-nides; UGT1A1; ABCC2 Summary Bilirubin is the breakdown product of the haem moiety of haemoglobin and other haemoproteins. Because of internal hydrogen bonding, bilirubin is water-insoluble and requires enzyme-mediated glucuronidation in the liver for biliary excretion. In normal circumstances, plasma bilirubin is mostly unconjugated and is tightly bound to circulating albumin. Urine bilirubin may also be clinically significant. Bilirubin is not normally detectable in the urine of healthy people. If the blood level of conjugated bilirubin becomes elevated, e.g. due to liver disease, excess conjugated bilirubin is excreted in the urine, indicating a pathological process. Unconjugated bilirubin is not water-soluble and so is not excreted in the urine. Biliary Excretion of Waste Products: Elimination of Bilirubin The liver is well known to metabolize and excrete into bile many compounds and toxins, thus eliminating them (usually) from the body. Examples can be found among both endogenous molecules (steroid hormones, calcium) and exogenous compounds (many antibiotics and metabolities of drugs). Bilirubin is conjugated with glucuronic acid in the liver and excreted in the bile, giving the stools their characteristic colour. When it cannot escape freely into the bowel it accumulates in the blood, staining the skin to cause JAUNDICE. Query: how is bilirubin excreted from the body

Bilirubin is a brownish yellow pigment of bile, secreted by the liver in vertebrates, which gives to solid waste products their characteristic colour. It is produced in bone marrow cells and in the liver as the end product of red-blood-cell (hemoglobin) breakdown.

