Caterham Dene Hospital

The 8p23.1 duplication syndrome (8p23.1 DS) is a recurrent genomic condition with an estimated prevalence of 1 in 58,000. The core 3.68 Mb duplication contains 32 genes of which five are currently candidates for the phenotypic features. Here we describe four patients and five families with eight microduplications of 8p23.1 ranging from 187 to 1082 kb in size and one atypical duplication of 4 Mb. These indicate that a minimal region of overlap (MRO) in medial 8p23.1 can give rise to features of 8p23.1 DS including developmental delay, dysmorphism, macrocephaly and otitis media, but not congenital heart disease (CHD). This MRO spans 776 kb (chr8:10,167,881-10,943,836 hg19) and contains SOX7 and seven of the other 32 core 8p23.1 DS genes. In centromeric 8p23.1, microduplications including GATA4 can give rise to non-syndromic CHD but the clinical significance of two smaller centromeric microduplications without GATA4 was uncertain due to severe neurological profiles not usually found in 8p23.1 DS. The clinical significance of three further 8p23.1 microduplications was uncertain due to additional genetic factors without which the probands might not have come to medical attention. Variable expressivity was indicated by the almost entirely unaffected parents in all five families and the mildly affected sibling in one. Intronic interruptions of six genes by microduplication breakpoint intervals had no apparent additional clinical consequences. Our results suggest that 8p23.1 DS is an oligogenetic condition largely caused by the duplication and interactions of the SOX7 and GATA4 transcription factors.

BACKGROUND: Streptococcus equi represents a common hazard to equids worldwide. Environmental contamination with bacteria shed from an infected horse may represent a significant source of contagion and further knowledge of ex vivo bacterial survival under different conditions is important for disinfection and isolation protocols. OBJECTIVES: To determine the potential duration of survival and vigour of growth of S. equi inoculated onto surfaces relevant to equine veterinary practice and stabling in summer and winter. STUDY DESIGN: Repeat sampling of environmental inocula of S. equi. METHODS: Cultures of S. equi were inoculated onto wood, a shoe sole, cotton overalls, inside a nasogastric tube, inside a dental rasp, in a wet plastic bucket and onto a fence post both in the summer and winter seasons. Frequent resampling and culture from the inoculated sites was conducted until no viable bacteria were found. Bacterial viability was determined by both duration (time to first negative culture) and vigour of growth (growth score over the first 3 days of culture) and compared between inoculated sites and times of year. RESULTS: Bacterial viability was enhanced by a wet local environment and by the winter season. Survival tended to be short in the summer (up to 9 days in wet sites and up to 2 days in dry sites) but much longer in the winter (up to 34 days in wet sites and up to 13 days in dry sites). Vigour of bacterial growth was also greater in the winter than in the summer as judged by 3-day-growth scores. MAIN LIMITATIONS: Direct comparison with the variable size and nature of naturally shed infectious material is difficult. CONCLUSIONS: Veterinarians and personnel handling horses should be aware that S. equi may survive in an equine environment for longer than previously found, especially when protected by wet and cold conditions.

A computational fluid dynamics study of the influence of wing span has been conducted for an inverted wing with endplates in ground effect. Aerodynamic coefficients were determined for different spans at different ground clearances, highlighting a trend for shorter spans to delay the onset of both separation and resulting loss of negative lift. The vortices at the wing endplates were not observed to change significantly in terms of strength and size; thus, at shorter spans, their influence over a larger percentage of the wing helped the flow stay attached and reduced the severity of the adverse pressure gradient which invokes separation at greater spans. Consequently, it was shown that, compared to a large-span wing, a wing with a shorter span may have a lower lift coefficient but can operate closer to the ground before performance is adversely affected.

The drawings of children have been studied by many observers during the past forty years, and have yielded valuable information for the psychologist, the ethnologist and the pedagogue. Many of the studies were concerned with the development over a period of years of the drawings of a single child (Luquet (12), Stern (19), Eng (3)). Others were concerned with drawings taken from a large number of children of varying ages. Principal among these studies is that of Rouma (17) in 1912, drawn from a wide field, carefully and accurately observed, and published with a wealth of illustration. More recent researchers have employed the quantitative method, and McCarty's (14) study, published in 1924, is of value principally for its elaborate statistical survey.

States that, for over a decade, knowledge management (KM) has been viewed as the way forward for information management and that it has become associated with Internet technology. Reveals that experience showed that KM projects were too often attempts by information communication technology (ICT) departments to prove that they understood how information was used by their businesses when in fact and they did not. Proposes that KM did not achieve what it set out to do because it is expensive and is not functionally straightforward, creating poorly understood operational problems. Concludes that records management is now emerging as the preferred tool for information storage because it is easily understood by all, relatively low cost, highly adaptable and low in staffing costs.

Ten patients in whom the clinical findings were consistent with the syndrome variously described as 'benign myalgic encephalomyelitis', 'epidemic neuromyasthenia', 'Royal Free disease' and 'Icelandic disease' were investigated for blood levels of myoglobin and various enzymes. Although there is no clinical resemblance between the two diseases, the biochemical pattern bears a close similarity to that found in Duchenne muscular dystrophy (DMD) though differing sharply in that no rise in creatinine kinase levels was found. These findings are discussed with particular reference to recent suggestions that the permeability of cell membranes may be impaired by changes in intracellular energy mechanisms.

A standard xylose absorption test was carried out in 14 people with Down's syndrome (DS) and in 14 age-matched mentally deficient controls; a further 30 people with DS were similarly investigated. Mentally deficient people as a group were found to have impaired xylose absorption, the matched DS subjects having a significantly reduced xylose absorption (P less than 0.001) when compared to the mentally deficient controls. Ninety percent of the DS subjects had a xylose excretion below the normal range. At present it is not possible to identify the cause of the malabsorption but it is highly likely that the malabsorption plays a role in a number of the vitamin and mineral deficiencies found in people with DS.

Three-dimensional laser Doppler anemometry is a powerful, non-intrusive measurement technique. The high data rate point measurement allows direct quantification of turbulence quantities. However, for this type of study, a very high level of laser beam alignment is required; without good alignment only mean flow measurements are possible. We report here on an alignment procedure that is simple and cost-effective, yet results in much higher data rates than traditional, pinhole-based methods.

Hepatic disease is a known risk factor for the development of bone infection in human beings. Three dogs with portosystemic shunting and concurrent physitis are presented here and an association is postulated between both disease processes. Portosystemic shunting may be a risk factor for the development of physitis in dogs. Skeletal structures should not be overlooked when reviewing diagnostic imaging studies of dogs with portosystemic shunts. Skeletal infections should be considered as a differential diagnosis in dogs with liver disease and concurrent skeletal abnormalities.

THE relation of congenital syphilis to mental deficiency has for long been the subject of numerous investigations. In 1912 Mott 10 stated that ' if syphilis can produce arrest of development of the reproductive organs there is surely no reason why it should not lead to arrest of development of the most highly differentiated and specialized tissue of the body, viz., the cerebral cortex, or cause pathological variations in its structure and function. ' Since the introduction of the Wassermann reaction in 1906, an extensive literature dealing with the incidence of positive Wassermann reactions in mental deficiency has made its appearance, unfortunately with widely divergent results.

Serological tests on the blood of mental defectives have been, both here and in other countries, the subject of numerous investigations, but the cerebrospinal fluids of the entire population of a large mental defective institution have never, as far as I am aware, been systematically examined. This paper deals with the results of such an investigation in 2,000 cases of mental deficiency of both sexes, all ages and grades, patients at Caterham Mental Hospital during the last four years, and with the complications following lumbar puncture.

The treatment of congenital syphilis, in spite of the advances in the general treatment of syphilis in the last thirty years, still leaves much to be desired. Veeder, after treating some 500 cases of congenital syphilis in St. Louis between 1912 and 1920, came to the conclusion that the results of treatment were most unsatisfactory, and that very little was to be gained by the treatment of the syphilitic child. He advocated the treatment of the parents to prevent the birth of syphilitic children. Nabarro is of opinion that the criterion of cure should be the complete cessation of any symptoms of activity and a normal blood and cerebro-spinal fluid. He has not been able to fix any limit of time after which he can regard the patient as cured. He mentions a case of his which relapsed with interstitial keratitis after having had a negative Wasser mann reaction for eight years. Ambrose King doubts whether congenital syphilis is ever really cured; he states that “cases had been seen in which manifestations of congenital syphilis appeared only after the lapse of a number of years, and others in which active lesions occurred, but with a negative Wassermann”.

Multidisciplinary teams (MDTs) play a pivotal role in the care of cancer patients. With a progressive rise in the incidence of cancer diagnoses in the African subcontinent, there is an expectation that oncologic care should be standardized and fairly available, and central to this care is the establishment of a cancer MDT. This study aimed to explore the availability and role of oncologic MDTs in various centers in the African subcontinent. Data on Cancer MDTs were searched using keywords on PubMed, African Journal Online, and Google Scholar. Other relevant searches were conducted using the reference list of primary studies. There has been a 34% increase in the prevalence of MDT meetings among institutions in sub-Saharan Africa, spanning all regions of Africa, based on a survey conducted by the African Organisation for Research and Treatment in Cancer network in 2013 and repeated in 2021. Although there is an increase in the prevalence of MDT meetings in sub-Saharan Africa, spanning all regions of Africa, the mortality rate of cancer patients remains disproportionately high, with a mortality rate higher than that of Europe. Several centers across African countries do not have access to functioning oncologic MDTs, and those with access do have members frequently missing. Several factors mitigate against the establishment of cancer MDTs in Africa, including the lack of specialists, motivation of the healthcare staff, poor financial remuneration, and government policies. To ensure improved cancer care in Africa, efforts should be made to involve key stakeholders, including healthcare professionals, the government, and the private sector.

Caterham Mental Hospital accommodates upwards of 2,000 patients, the great majority of whom are defectives. The medical staff numbers 7, and all other staff about 500. The patients are of all ages, and are described as “unimprovable adults” and “children of school age”. The type of patient has altered very little in the past five years, but a hostel has been added which accommodates 34 high-grade boys. These are selected from the other institutions of the London County Council, and, as a certain number prove unsuitable and do not wish to return to the institutions they came from, a number of higher grade patients have accumulated in the main institution. There are also, on the female side, laundry workers of high grade who have been sent for that specific work.

This paper examines the astronomical content of Samuel Pepys' Diary. The period covered by the Diary (1660–69) coincides with the formative decade of the Royal Society. Pepys was elected a Fellow in 1665 and became President in 1684. In addition, Pepys' friendship with Richard Reeves, a leading instrument maker of the day, is discussed. Pepys is best remembered as a recorder of his times, but he was also a keen observer of scientific progress. His role as an amateur astronomer is revealed by the Diary entries. Pepys' involvement with the Royal Society during 1665–69 is also highlighted.

The term “dysentery” in mental hospitals may be regarded as applicable to a clinical entity characterized by symptoms of abdominal pain, rise of temperature and passage of blood and mucus. The causative organisms are various, but that occurring most frequently and persistently is the Bacillus dysenteriæ of Flexner. This paper deals exclusively with this type of asylum dysentery.

A new record of the rare species Mirocastnia pyrrhopygoides (Houlbert) from Ecuador is reported, along with range extensions for M. smalli (J. Y. Miller) and M. canis (Lathy). In addition, the genus Mirocastnia J. Y. Miller is revised and the diagnostic phenotypic characteristics of males and females, as well as male genitalia, are illustrated. Details on its natural history, biogeography, and biology are included with the purpose of solving the confusion in the taxonomy of the genus. All taxa previously considered to be species are herein relegated to subspecific status, i.e. M. pyrrhopygoides canis stat. nov. and M. p. smalli stat. nov.

Since 1993 the national media, league tables and more recently OFSTED have alerted those in education to the problem of boys' underachievement.

THE association of hydrocephalus with congenital syphilis is not as common as may be inferred from the relative frequency with which the disease attacks the central nervous system in young subjects. Jeans 1 found that in a series of 2I4 congenitally syphilitic children, the cerebro-spinal fluid in 33 per cent. showed evidence of infection. Of 402 mentally defective children at Cater- ham Mental Hospital, 37 have been found to be the subjects of inherited syphilis, and of these the cerebro- spinal fluid in I2, or approximately one-third, gave abnormal reactions, such as positive Wassermann reac- tion, increase of cells and globulin, and colloidal gold curve; hydrocephalus, however, only occurred in two of the 37, one of whom has since died, and forms the subject- matter of this paper. Of the other 365 non-syphilitic cases, there were 7 cases of hydrocephalus. In pre- Wassermann days Fournier 2 reported 3 cases of hydro- cephalus in his series of 233 congenital syphilitics. Since the introduction of the Wassermann reaction many workers have written on this subject. Dean3 (I909) found 4 hydrocephalics among 5I congenital syphilitics. Gordon4 (I9I3) ,, I ,, ,, 66

This study embarks on a comprehensive journey into the intricate and multifaceted world of economic growth models, with a particular emphasis on the mathematical principles that underpin and drive them. At its very core, it meticulously examines the Solow Growth model, a fundamental and highly influential theory that has long been a cornerstone in the realm of economics. Through the sophisticated application of differential equations, the Solow model constructs a dynamic and powerful framework designed to analyze the long - term evolution of economies with remarkable precision. Capital accumulation, which encompasses the gradual process by which an economy builds up its stock of physical capital, such as machinery and infrastructure, as well as human capital through education and training, is identified as a key driver of growth. Meanwhile, labor or population growth supplies the necessary workforce for production, ensuring the continuous operation of economic activities. Technological progress, often considered the most transformative and game - changing factor, continuously enhances productivity by introducing new methods, tools, and knowledge. Together, these elements are not only crucial for gaining a deep - rooted understanding of the underlying mechanisms of economic growth but also for formulating well - informed policies that can effectively foster sustainable development in the long run.