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It is rated on a 5-point Likert scale from 0 to 4 for each item, ranging from never to always, with questions 1 and 4 being positively assigned and questions 2 and 3 being negatively assigned

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I know because I tested it myself a few months back (spoiler: I still have one in my car today)

On a Tour This tour picks you up at your accommodation and takes you to Puerto Morelos to snorkel for an hour, enjoy the beach and have lunch on the beach

One theory is that estrogen blocks the anion exchange transporter (see above) in the kidney, causing more uric acid to be excreted in the urine, and thus lowering the level of uric acid in the blood