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BASL is a nominating body for the Research Excellence Framework (REF) 2021 and the latest date by which we can nominate candidates to the REF 2021 expert sub-panels has been extended to 7th September 2020.
Nominations for a REF sub-panel are aimed at career academics that understand REF2021 and are subject to approval by the BASL Committtee. Any enquries from interested BASL members must be with the Secretariat (firstname.lastname@example.org) by noon on Wednesday 19th August 2020, any received after this date will not be considered.
The current nominations’ call is for additional members and assessors with expertise in specific areas, to ensure each sub-panel has an appropriate breadth of expertise and volume of panel members necessary for the assessment of REF submissions.
It is recommended that you visit the REF2021 website for all of the information on REF sub-panels and roles : https://www.ref.ac.uk/panels/nominating-panel-members/ before contacting BASL.
It is with great sadness that we record the passing of Professor Neil McIntyre on 19th July, aged 86. Neil was born on the 1st of May 1934 in Ferndale in the Rhondda Valley in Wales, and was educated at Rhondda County Grammar School for Boys. In 1951 he started his pre-clinical medical studies at King’s College, London, also achieving a 1st class BSc degree in Physiology in 1955. His clinical studies were at King’s College Hospital Medical School and he graduated MB BS in 1958 with distinctions in Pathology and Applied Pharmacology and Therapeutics. Thus he already had academic aspirations at that time, and indeed was co-author of publications in Nature and the British Journal of Experimental Pathology in 1955 and 1956. His early postgraduate training from 1959 to 1960 was at King’s College Hospital and the Hammersmith Hospital. In 1960 he was called up and was posted as a flight lieutenant in the Royal Air Force Medical Branch to what was then the State of Aden, where he spent three years.
On his return, he was appointed to the Royal Free Hospital and School of Medicine as a Medical Research Council Junior Research Fellow, and Registrar in Medicine to Professor Sheila Sherlock on the Academic Unit. His research led to his MD thesis (“Oral glucose tolerance; the physiological importance of the intestine and liver”)(1967). Meanwhile in 1966 he was awarded a two year Medical Research Council Travelling fellow at Harvard Medical School, working in the Gastrointestinal Unit, at the Massachusetts General Hospital with Professor Kurt Isselbacher.
After this in 1968 he returned to the UK and was appointed Senior Lecturer in the Department of Medicine (Liver Unit) at the Royal Free Hospital and School of Medicine, and was promoted through the years to Reader and then Professor. When Sheila Sherlock retired in October 1983, he was appointed to Chairman of the Department. With the joining of the Royal Free and University College Medical Schools he subsequently became Director of the Division of Hepatology at University College London Medical School and The Royal Free Hospital School of Medicine. He also served as Vice Dean and Clinical Sub-Dean until his retirement in 1999.
Neil enjoyed a long and productive academic career. Remarkably, as an undergraduate, he co-authored the two papers described above on the effects of denervation on the histochemical appearance of cholinesterase at the myoneural junction. Few could claim such a distinction. He and his team’s publications focussed on carbohydrate metabolism and insulin secretion, lipids, lipoproteins and cell membranes (particularly lecithin:cholesterol acyltransferase activity in liver disease), and the effect of lipoprotein changes on cell membranes composition and function. However he was the author of a myriad of clinical papers. His wide ranging interests in hepatology reflected the breadth and depth of his expertise, in a time when a narrow range of research topics was less required. Apart from the topics noted above, his publications ranged from haematological disorders in liver disease, portal hypertension, drug induced liver injury, alcoholic liver disease, genetic diseases, primary biliary cholangitis, computers in hospitals (in 1981), and computerised medical information (in 1974). A search of his seminal papers includes a classic description of haemolytic episodes in children and young people with Wilson's disease (New England Journal of Medicine, 1967).
He was the lead editor of the first edition of the Oxford Textbook of Clinical Hepatology in 1992, and co-editor of the second edition in 1999 with other renowned European hepatologists. This textbook presented a comprehensive account of clinical hepatology comprising more than 150 chapters by international experts in two volumes. Other books included 'Therapeutic Agents and the Liver', edited with Sheila Sherlock (1965); 'The Problem Orientated Medical Record: its Use in Hospital, General Practice, and Medical Education', edited with J.C. Petrie (1979); and
'Lipids and Lipoproteins in Clinical Practice' with David Harry in 1991.
Neil McIntyre had a particular lifelong interest in medical education and was instrumental in developing an up-to-date medical student curriculum at the Royal Free Hospital School of Medicine. He was always a stickler for the practice of clinical medicine and emphasized Oslerian traditions of history taking, and examination. He fostered, with considerable enthusiasm, Problem Orientated Medical Records (POMR), and audit. Amongst his more notable papers in these areas is one in the British Medical Journal which he co-authored with Sir Karl Popper, one of Britain’s foremost philosophers and social commentators, entitled “The critical attitude in medicine: the need for a new ethics”.
Neil also contributed to many learned Societies, including as secretary to the Medical Research Society (1972-1977) and the nascent European Association for the Study of the Liver (EASL)(1975-1977), as well as being a Council Member for Europe of the International Association for the Study of the Liver (IASL)(1978-1982). He was also a member of the Committee for the British Association for the Study of the Liver (1976-1978), as well as a member of Council of the British Society of Gastroenterology and of the Association for the Study of Medical Education. Between 1976 and 1978 he was also President of the Osler club of London. In 2006-2007 he was President of the History of Medicine Society of Wales. Neil was a member of Council and a member of the research committee of the Royal College of Physicians of London. He served as an associate editor of the Journal of Hepatology and on the editorial board of Gut
Neil was renowned for his eclectic interests and chose his subjects with considerable perspicacity. A keen medical historian from his student days, he spent much of his time in retirement working on his treatise “How British Women Became Doctors: The Story of the Royal Free Hospital and its Medical School” and on other historical topics. “I was concerned that the school’s remarkable past might be airbrushed from history and that the hospital might also fail to get the attention it deserved,” he said. In this book he described how a group of young female students formed the London School of Medicine for Women in 1874. They had been blocked from qualifying as doctors through any of the British universities, so took matters into their own hands. The Royal Free, then based at Gray’s Inn Road, stepped up to train the 14 students, admitting the women for clinical studies. This initiative “laid the ‘foundation stone’” for the medical education, qualification and licensing of women in Britain and many other countries.
He wrote of his interest in medical statues: “My interest in medical statues began as a student at King’s in the late 1950s when I wrote a short biography of its founder Robert Bentley Todd for the King’s College Hospital Gazette.” This led (as described in the publication of his lecture at the RCP of London) to his novel ‘hobby’: Neil identified more than 300 statues worldwide, and many busts and other monuments to doctors.
However, clinical medicine, basic science, medical education and medical history were not his only enthusiasms. He was a born and bred Welshman who espoused this part of his being enthusiastically throughout his life. He enjoyed rugby, which he played as a student, and cricket, and continued to play golf for as long as he was able. We remember him practicing his putting across his spacious office in the Academic Unit. Through this and the clinical and academic work Neil encouraged the Royal Free “international family” to continue their strong ties as first engendered by Sheila Sherlock. He will be remembered with respect and affection by numerous colleagues nationally and internationally and by a generation of Royal Free graduates.
Neil married Wendy Anne Kelsey in 1966, the year that she qualified from the Royal Free School of Medicine, and she became a highly respected general practitioner and trainer. They had one son, and one daughter and three grandchildren. His daughter also studied medicine at the Royal Free, continuing its proud tradition of women students.
We send our heartfelt condolences to Wendy, and all his family
Geoff Dusheiko and James Dooley
An excellent opportunity has arisen to become a trainee member of the IQILS steering group.
Closing date for applications is 28/8/2020.
For more information regarding the position and how to apply please download the advert for the trainee representative here: Download IQILS SG Advert for trainee rep_Aug20.docx.pdf
If you require further information contact email@example.com .
I recall my first conversation with Dr Williams, nearly forty years ago in November 1980. Adrian Eddleston had accepted my application to join him as a research fellow in immunology on the Liver Unit pending an interview with the head of department. Laura, my first daughter, decided to make an entry on the morning of the interview, not unexpectedly since childbirth after a certain point never is, but certainly not on any planned schedule. I rang the Liver Unit very early that morning to apologise for my failure to attend the interview and to my surprise went straight through to Dr Williams. I had expected some warm words of congratulation, but the message was very short and simple. If I really wanted to work on the unit I must visit as soon as possible. I took that advice and attended for an interview the following week (we only discussed sailing) and as with so many people who preceded or followed me with “Roger” as our mentor it was the point in a career when Hepatology became the only option. That first conversation made me realise the professional commitment that he expected of himself and his colleagues. That conversation also instilled a feeling that persisted over 40 years in all my contacts with Roger that I had never quite worked hard enough. I have never met anyone with such a strong work ethic, nor anyone so driven to continue to research into liver disease. Often a difficult character, with views he held strongly, he earned the respect of all of us in the field and I will remember him with both respect and affection that only increased over 40 years. One word sums him up: unique.
He established the Liver Unit at King’s College Hospital in 1966, leading it for 30 years, by which time the unit was recognised internationally as one of the foremost liver centres for both clinical practice and clinical research. The early work in Acute Liver Failure in particular, was ground-breaking and established a clinical model that has since been copied everywhere. His contribution to clinical practice in Liver Transplantation was a first both in Europe and the UK and several years passed before other UK centres followed his example. Undoubtedly, physicians trained in his unit (or their trainees) comprise a majority of leading Hepatologists now practising in the UK, with many others trained on the Liver Unit leading similar units across the world. Perhaps only two UK physicians are recognised universally as giants in our field with professional lifespans exceeding many decades, namely the late Professor Dame Sheila Sherlock and Professor Roger Williams. He was awarded the order of CBE in the Queen’s Birthday Honours list of 1993, recognition of his outstanding contribution to medicine in the UK and in particular to Hepatology. In 2006 he was further honoured by the Queen, when included in a celebration for those who had continued to contribute to public service beyond the age of 65 years.
On his “retirement” from King’s College Hospital in 1996 Professor Williams continued his career in Hepatology as Professor of Hepatology and Director of the newly established Institute of Hepatology at University College London and also held an appointment as an Honorary Consultant Physician at UCLH NHS Foundation Trust; then in 2010 he established and became Director of the Institute of Hepatology and Foundation for Liver Research, where he remained at work 60 years from the start of his career in liver disease.
He was hyperactive in research (more than 2,500 original peer reviewed papers in a 60-year career with 340 published in the past 10 years); he continued to present keynote and ‘state of the art lectures’ (over 60 in his career with 25 since “retirement” in 1996); he continued to receive recognition from colleagues across the globe and received multiple awards for his contribution to Hepatology including highpoints such as the Hans Popper Life Achievement Award of the International Liver Congress in 2008, the Distinguished Service Award of the International Liver Transplantation Society in 2011 and most notably the Distinguished Achievement Award of the American Association for the Study of Liver Disease (AASLD) in 2013, the first and only time this award had been made to a UK Hepatologist. Similar career recognition by the European Association for the Study of the Liver had been planned for the annual meeting this year.
A major contribution to our field in the past decade was the Lancet Commission on Liver Disease in the UK alongside The Lancet’s Dr Richard Horton. This multi-disciplinary group, both created and held together by the force of Professor William’s character, has now published six annual reports with a seventh under review. Each of these highlights the worrisome prevalence of liver disease and liver cancer in the UK population, problems that increase year on year, are linked clearly to poverty and compounded by inequity of access to adequate liver services. He has illustrated the clinical problem for the next generation to resolve.
Professor Williams spent his life in Hepatology and BASL will undoubtedly celebrate the life of our own pioneer when large gatherings become possible once more. But for now, our thoughts are with his wife Stephanie, his family and his colleagues at the Institute of Liver Studies.
BASL is seeking expressions of interest for the post of President Elect.
The President Elect is nominated and elected by the membership and will work with the BASL President from September 2020 and take up the role of President at the end of the Business Meeting of the Association in September 2021.
The President is the Chairman of the Association and serves for two years and Chairs the Annual Scientific Meeting and the meetings of the Governing Board. Public Affairs are also managed by the President, who liaises closely with the Secretary and Treasurer, and other members of the Governing Board, as required.
The post of President shall be registered with Companies House in the UK as a Director of BASL and registered with the Charities Commission as a Trustee.
Please send your nominations, clearly stating the position that your nomination is for, to the BASL Secretariat firstname.lastname@example.org by the deadline of 09:00 on Monday 10th August 2020.
Candidates wishing to be considered for election will require one BASL member to propose them and a second BASL member to confirm their suitability for the role in writing.
If more than one candidate is nominated, the Secretariat will arrange for an election of the BASL membership. A personal statement, containing no more than approx. 300 words, will be required from each candidate. He/she will be elected by a simple majority of BASL members voting.
The newly elected post will be announced at the next Business Meeting of the Association during BASL2020 in September.
If you need any more information, please contact email@example.com .
This guidance represents the professional advice from the British Association for the Study of the Liver, British Society of Gastroenterology, British Transplantation Society, NHS Blood & Transplant and input from the British Liver Trust.
The patients in the groups below are advised to shield and should consult the government web-site for advice on what that entails:
1. Patients with chronic liver disease who are on immunosuppressants
Data: There are as yet no large enough datasets to support/refute this approach and thus this is based on clinical judgement.
2. Any patient with liver cirrhosis and decompensation or complication as defined by presence/recent history (within 12 months) of ascites, hepatic encephalopathy, hepatocellular carcinoma, variceal bleed or synthetic liver dysfunction.
Data: This is supported by data from the COVID-HEP registry that indicates that patients with decompensated liver cirrhosis have an unadjusted mortality rate 5-28 times higher than patients with liver disease without cirrhosis.
3. Patients who are actively on the liver transplant waiting list or who have received a liver transplant
Data: This is supported by data from NHSBT that indicates that patients who have had liver transplant have an unadjusted mortality rate of 25%.
Shielding is for a patient’s protection rather than a legal obligation. The need for shielding can be flexed further on a case by case basis in consultation with your healthcare team.
Application of this guidance
There are 3 elements:
1. Categorisation as high vulnerability – the guidance above should clarify that. This should be notified to employers etc.
2. Recommended response to that categorisation – This is nationally set, under review and changing with updated guidance from PHE and the CMO. Recommendations are based on complex factors including the current national categorisation of the pandemic, geography, occupation, local and national disease prevalence, R rates, risk factors for exposure etc.
3. Patient choice – Based on the above, patients, with support from clinical teams, are equipped to make personal decisions about what they will then do. Issues to weigh up will include home and family circumstances including age range of those at home and nature of accommodation, the person’s mental health, overall wellbeing, employment status and financial position.
Gilead Sciences Global Grant Program Supporting Investigator-Sponsored Research in COVID-19: COMMIT™ (COvid-19 unMet MedIcal needs and
associated research exTension)
In an effort to further address the unmet medical need in COVID-19, Gilead Medical Affairs is launching the COMMIT program.
Gilead will consider support for research proposals that meet one of the following criteria:
• Expand data on clinical course and outcome in vulnerable populations
• Long-term sequelae
• Real world safety and effectiveness of remdesivir used alone or with other agents.
Projects from across the world will be considered for research grants of up to 250,000 USD each. Gilead will not consider proposals that request COVID-19 screening costs (including test kits) or proposals that request remdesivir or other study drug.
Applications will be accepted from 1st July to 3rd August 2020.
For more information on Gilead Sciences 2020 COMMIT program and how to apply, please visit: https://www.gilead.com/science-and-medicine/research/investigator-sponsored-research/covid19-commit-rfp .
Each year BASL presents the Dame Sheila Sherlock research prize, one of the highlights of the annual meeting. This prize is awarded annually to recognise the enormous contribution of Dame Sheila Sherlock to the development of Hepatology as a discipline in its own right.
Dame Sheila was involved in the foundation of the British Liver Club in 1961, which subsequently evolved into The British Association for the Study of the Liver (BASL). She was one of our past presidents and the first recipient of The BASL Distinguished Service Award. In keeping with Dame Sheila’s enthusiasm for fostering young researchers, this eponymous research prize is awarded to young investigators without substantive posts in either medicine or science for their research contributions in the field of Hepatology.
The winner will receive free registration to the meeting, an award and a prize of £1,000 and an invite to deliver the prize lecture at the BASL Virtual Annual Meeting on 21st - 23rd September 2020.
To apply, please send one A4 sheet outlining your research and another A4 sheet listing up to 5 related publications.
Please send submissions to firstname.lastname@example.org before the deadline of 09:00hrs on Monday 3rd August 2020.
The Andy Burroughs Young Investigator Award was set up in honour of the late Professor Andrew Burroughs.
Professor Burroughs was an eminent and world renowned Professor of Hepatology and Consultant Physician/Hepatologist and among his many achievements include his wide area of expertise in cirrhosis and portal hypertension and significant contribution to liver Transplantation.
This prize is awarded to young investigators who have contributed to clinical or translational research related to liver disorders who are in training or within 2 years of taking up consultant positions (or equivalent); this year the winner will receive free registration to the meeting, an award and a prize of £1,000 and an invite to deliver the prize lecture at the BASL Virtual Annual Meeting on 21st - 23rd September 2020.
To apply, please send one A4 sheet outlining the research and another A4 sheet listing up to 5 related publications.
Please send submissions to email@example.com before the deadline of 09:00hrs on Monday 3rd August 2020.
On Friday 24th April Dr John Walshe celebrates his 100th birthday, and I am sure that we would all wish to send him our best wishes and heartfelt congratulations on this auspicious day. Reaching this age is a tremendous achievement, but his historic contributions to Medicine, and in particular to our current knowledge of Wilson’s disease, its diagnosis and treatment, are unique, and generations of patients with this condition owe their lives and health to him.
So John, we revere you beyond words, and send our best wishes and thoughts to you on this special day.
Dr John Walshe was born on the 24th April 1920 in Kensington, London, to Francis and Bertha Marie (née Dennehy) Walshe. His father was a Consultant Neurologist at the National Hospital for Nervous Diseases, Queen Square; knighted in 1953, Sir Francis was a distinguished, internationally known neurologist. He was elected FRS in 1946.
John Walshe’s first association with Cambridge University was when, as a schoolboy in 1938, he went there to sit his First MB examination. He was accepted at Trinity Hall, Cambridge to study medicine and qualified BA in 1942. He then did his clinical studies at University College Hospital in London (UCH), qualifying MA, MB BChir (Cantab) in 1945. He served with the Royal Army Medical Corps in the Middle East Command between 1946 and 1948, spending time also in Greece and Cyprus. After this he returned to UCH.
His journey towards Wilson’s disease started in the early 1950s at UCH. He was working under Professor Charles Dent, a pioneer in metabolic diseases, and studying changes in amino acid metabolism in liver disease, and in particular in urine using paper chromatography. In one study he found an additional band in the urine, and thought that he might have discovered a new amino acid. However, the patient involved was on penicillin and it transpired that this was ‘penicillamine’, a metabolic product of penicillin. This work was published in the Quarterly Journal of Medicine in 1953. He moved on.
The next event, central to Wilson’s disease and involving his extraordinary mind and insight – an exceptional example of ‘translational medicine’ – occurred in the USA. During his year as a Fulbright Scholar on the Liver Unit at Boston City Hospital (Harvard Medical Unit) in 1955, the hepatology team were approached by the neurological team for advice on the management of a patient with Wilson’s Disease who was not improving as they had hoped on the treatment then available (parenteral British Anti-Lewisite). John Walshe’s scientific insight, knowing the chemical structure of penicillamine, led him to suggest (while crossing a walkway on the way back to their laboratory) that penicillamine might bind copper and lead to its excretion. A small amount of penicillamine was procured. He took some himself (remembering one of Professor Dent’s sayings: ‘You must never give an unknown compound to a patient if you are not prepared to take it yourself’) (see Walshe, 2019), and having no untoward effects, some was then given to the patient. Urine analysis showed an increase in copper excretion.
When he returned to England, he continued to study penicillamine in patients with Wilson’s disease and published the first pivotal papers on a group of patients in 1956. The place of D-penicillamine as an oral treatment for Wilson’s disease has remained ever since, has saved lives and improved the lives of innumerable patients in the ensuing 60 plus years. Many patients have remained in touch with him from those early and subsequent years.
Penicillamine may be associated with adverse effects, and it was because of a patient’s inability to continue with treatment that John Walshe (on the advice of Dr HBF [Hal] Dixon, in the Department of Biochemistry at Cambridge University) chose triethylenetetramine (trientine) dihydrochloride as an alternative copper chelator, and this has also become one of the mainstays of the treatment of Wilson’s disease. Dr Walshe also published early observations on zinc treatment (developed by others in Holland and the USA) and on ammonium tetrathiomolybdate.
In his long career he has published more than 150 papers and book chapters on Wilson’s disease and its link with copper metabolism, both from his own unit and with collaborators abroad. Many deserve mention, but space does not allow. I would, however, like to make note of his invaluable research assistant Kay Gibbs, and his collaboration with Professor Diane Wilson Cox in Canada, a pioneer in molecular genetics of Wilson’s disease.
Most of his career was spent in Cambridge, as Reader in Metabolic Disease and Director of Research in the Department of Medicine between 1957 and 1987. He was also an Honorary Consultant Physician at Addenbrooke’s Hospital, Cambridge, during this period.
He obtained his MRCP in 1952/3, and was awarded his FRCP in 1964, and Doctor of Science (ScD, University of Cambridge) in 1965. He was honoured with an MD (honoris causa) by the University of Uppsala in 1994. He was the Bertram Louis Abrahams lecturer at the Royal College of Physicians of London (‘The Biochemical Lesion in Wilson’s Disease’) in 1966. He has also given the Hudson Memorial Lecture in 1983, and the Worshipful Company of Pewterers’ Lecture at the National Hospital of Nervous Diseases, Queen Square, in 1995. In 1977, he was awarded the gold medal in therapeutics of the Worshipful Company of Apothecaries.
After his retirement from the University of Cambridge and Addenbrooke’s Hospital in 1987, he was given an honorary senior lectureship at UCL and became an Honorary Physician at UCH, allowing him to continue Wilson’s disease clinics at UCH and then the Middlesex Hospital, until finally ‘retiring’ in 2000. Dr Godfrey Gillett, a Consultant in Metabolic Medicine from Sheffield, joined Dr Walshe in these specialist clinics, and continues with them today.
Since this final retirement, Dr Walshe has continued to take an interest in his former patients from his home in Cambridgeshire and regularly attends the annual meeting of the Wilson’s Disease Support Group – UK (a support group for patients, their friends and families, founded in 2000) of which he is Honorary President.
In 1958 he and his wife Ann, who sadly died in 2011 after 55 years of marriage, settled in a wonderful 17th Century Grade II listed house in Hemingford Grey, north of Cambridge. He still lives there cared for by his daughter Susan and son-in-law Philip. His other daughter Clare lives near Oxford.
Throughout his life John Walshe has had a wealth of interests in many areas, but was a very keen photographer particularly of churches and stained glass windows. In his early years at Cambridge he took a particular interest in brass rubbings, making a record of those at Ely Cathedral which he later gave to the Dean of Ely, and which he believes are now stored at the University Library. His house is packed with historic artefacts from around the world, including model elephants – a connection with Wilson’s disease, since patients were asked to draw an elephant to give an assessment of the neurological features of their condition. This appealed to both children and adults.
John Walshe is a polymath, a translational scientist and expert clinician who has changed the lives of patients with Wilson’s disease worldwide. He has remained focussed on this often neglected, challenging and rare disease for much of his professional life. His latest paper on Wilson’s disease (published in the Quarterly Journal of Medicine) was in 2016 when he was 96 years old: incredible – and rarely matched by any other clinician scientist.
John – we are honoured to have benefitted from knowing you, to have enjoyed your encyclopaedic knowledge and to have been able to apply your lifetime’s work to the benefit of our patients.
Many, many congratulations on this very, very, special birthday.
Dr James Dooley
Emeritus Reader in Medicine
UCL Institute of Liver and Digestive Health
(Royal Free Campus)
Hampstead, London NW3
I would like to acknowledge the help of Professor Graeme Alexander, Dr Godfrey Gillett, Dr Bill Griffiths and Dr Rupert Purchase, and the following sources, in writing this account:
JM Walshe. Copper: Quest for a Cure. Bentham Books, eBook, 2009
JM Walshe. Wilson Disease: My Involvement – A Brief Reminiscence. In: Clinical and Translational Perspectives on Wilson Disease. Ed Kerkar N, Roberts EA. Academic Press, 2019.
Dr John Walshe. Biography on the Hemingford Grey Parish Council Website. By Esther Harrod
Rupert Purchase. Dr John Walshe and the treatment of Wilson’s disease (prepared for the Wilson’s Centenary Meeting in 2012).
Rupert Purchase. An Archive of Dr John Walshe’s Publications
Shorvon S, Compston A. Queen Square. A History of the National Hospital and its Institute of Neurology. Cambridge University Press, 2019.