Access the GP in hours syndromic surveillance bulletins on GOV.UK GP out-of-hours syndromic surveillance system

Lund, E (1980). To the last drop. Chesterfield: Longden technical Publications. ISBN 0-9507063-0-2. a b Niu, DM; Pan, CC; Lin, CY; Hwang, BT; Chung, MY (2002). "Mosaic or chimera? revisiting an old hypothesis about the cause of 46,XX/46,XY hermaphrodite". J Pediatr. 140 (6): 732–735. doi: 10.1067/mpd.2002.124321. PMID 12072878. The energy represented by the numerology number 46 sustains and evolves itself and creates its own support according to its own determination — generally focused on building a secure foundation for the future. In humans, sexual dimorphism is a consequence of the XY sex-determination system. In normal prenatal sex differentiation, the male and female embryo is anatomically identical until week 7 of the pregnancy, when the presence or the absence of the SRY gene on the Y chromosome causes the undetermined gonadal tissue to undergo differentiation and eventually become a pair of testes or ovaries respectively. [ citation needed] The cells of the developing testes produce anti-Müllerian hormone (AMH) and androgens, causing the reproductive tract and the genitals of the fetus to differentiate. [2] As individuals with 46,XX/46,XY partially express the SRY gene, the normal process by which an embryo normally develops into a phenotypic male or phenotypic female may be significantly affected causing variation in the gonads, the reproductive tract and the genitals. [3] Despite this, there have been cases of completely normal sex differentiation occurring in 46,XX/46,XY individuals reported in the medical literature. [4] [5] [6] 46,XX/46,XY chimerism can be identified during pregnancy by prenatal screening or in early childhood through genetic testing and direct observation. [7]Access the emergency department syndromic surveillance bulletins on GOV.UK Ambulance syndromic surveillance system

Farag, T I; Al-Awadi, S A; Tippett, P; el-Sayed, M; Sundareshan, T S; Al-Othman, S A; el-Badramany, M H (December 1987). "Unilateral true hermaphrodite with 46,XX/46,XY dispermic chimerism". Journal of Medical Genetics. 24 (12): 784–786. doi: 10.1136/jmg.24.12.784. ISSN 0022-2593. PMC 1050410. PMID 3430558. Though some individuals with 46,XX/46,XY have ovarian tissue and testicular tissue simultaneously, there have been no reported cases of both gonads being functional in the same person, with the portion of fertile cases mostly favoring functionality of the ovarian tissue. [7] a b c d e f Fitzgerald, PH; Donald, RA; Kirk, RL (1979). "A true hermaphrodite dispermic chimera with 46, XX and 46, XY karyotypes". Clin Genet. 15 (1): 89–96. doi: 10.1111/j.1399-0004.1979.tb02032.x. PMID 759058. S2CID 39280592. In Science, 46 is the atomic number of Palladium. It is also the number of human chromosomes in the body. The molar mass of Ethanol is 46. 46 is also used as the name of a defensive scheme used in American football. The Catholic version of the Bible has 46 Old Testament books, that is if the book of Lamentations is counted as a book separate from Jeremiah.Yeoman (June 1984). "Class 46: Update on a dying breed". Rail Enthusiast. EMAP National Publications. p.22. ISSN 0262-561X. OCLC 49957965. Whilst seeing intermittent use on freight trains, Class 46s were regular performers on passenger turns, particularly North East-South West, Trans-Pennine and secondary North East-London trains, [2] [6] and depot allocations reflected this with locos at Gateshead and Plymouth in 1977 [7] giving a typical spread. Long-distance freight workings were common, particularly "clay hoods" carrying china clay from Cornwall to the Stoke-on-Trent area. Therefore, the factors of 46 are the exact divisors of that number. How to Calculate the Factors of 46? The essence of the numerology number 46 is by nature self-sufficient. Nothing is needed for continued existence and evolvement. Dowler, H. J.; Molyneaux, T. C. K.; Miles, J. C. (1987). "Analysis of the forces on a nuclear fuel transport flask in an impact by a train". Proceedings of the Institution of Mechanical Engineers, Part A: Power and Process Engineering. 201 (11): 55. doi: 10.1243/PIME_PROC_1987_201_007_02. S2CID 111297025.

Individuals with the condition do not experience cognitive impairment. [1] Genetic mechanism [ edit ] In Roman Numerals, 46 is written as XLVI. When reversed, it becomes 64. It is a deficient and even number. Its expression in words is forty six. Repeat Steps 1 and 2, using 23 as the new focus. Find the smallest prime factor that isn’t 1, and divide 23 by that number. In this case, 23 is the new smallest prime factor: Three have been preserved: 46 010 (formerly D147) at the Nottingham Heritage Railway, 46 035 Ixion (formerly D172) at Peak Rail owned by the Waterman Railway Trust and D182 (46 045) at the Midland Railway - Butterley, in Derbyshire.Japanese idol group franchise Sakamichi Series, which consists of Nogizaka46, Keyakizaka46, Hinatazaka46, and Yoshimotozaka46

thirteenth discrete semiprime ( 2 × 23 {\displaystyle 2\times 23} ) and the eighth of the form (2.q), where q is a higher prime. Marsden, Colin J.; Fenn, Graham B. (1988). British Rail Main Line Diesel Locomotives. Sparkford: Haynes. pp.196–199. ISBN 9780860933182. OCLC 17916362.See the article About Numerology Number Meanings for an introduction to the essence of the energies that numbers represent and deriving meanings for individual numbers depending on what the number pertains to or is associated with.