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A number of papers given at the third annual summer school of the Institute of Contemporary British History have been collected in What Difference Did the War Make?, ed. Brian [...]

HISTORIANS of twentieth-century British politics are fixated on party. Hence monographs on party themes abound and every leading party politician attracts a biographer. On their individual merits, such works often [...]

Thirteen essays on the history of Britain since 1945, some of which originated as papers to the first summer school of the Institute of Contemporary British History, have been collected [...]

The BBC is often said to have made a crucial contribution to the unity and morale of the British people during the Second World War. As Sian Nicholas shows in [...]

Introduction: Respiratory rate (RR) is a crucial vital sign in patient monitoring and is often the best marker of the deterioration of a sick patient. It can be used to help diagnose numerous medical conditions and has been demonstrated to be an independent predictor of patient outcomes in various critical care settings and is incorporated in many clinical early warning scores. Here, we report on the performance of depth-camera-based system for the noncontact monitoring of RR during a ramped RR protocol. The ramped breathing protocol was developed specifically to test the relatively rapid changes in rates, which include clinically important low and high ranges of RRs., Materials and Methods: We performed a series of experimental runs with healthy volunteers who were instructed to breathe over a wide range of RRs, where the rates were ramped up from 4 breaths/min to 50 breaths/min then back down to 4 breaths/min in a series of ramped steps. Depth information was acquired from the scene and used to determine a respiratory rate (RRdepth), and this was compared to capnograph or spirometer respiratory rate reference (RRref). A total of 9,482 contemporaneous data pairs (RRdepth, RRref) were collected during the study for comparison., Results: A Pearson correlation coefficient of 0.995 was achieved and a line of best fit given by RRdepth = 0.99 × RRref + 0.36 breaths/min. The overall root mean squared difference (RMSD) across the runs was 1.29 breaths/min with a corresponding bias of 0.16 breaths/min, respectively. The associated Bland-Altman analysis found limits of agreement of -2.45 and 2.75 breaths/min. When the data were subdivided according to low, medium, and high RRs, corresponding to ≤10, >10 to 20, and >20 breaths/min, the RMSD accuracies were found to be 0.94, 1.34, and 1.55 breaths/min, respectively., Conclusions: The technology performed well, exhibiting an RMSD accuracy well within our target of 3 breaths/min, both across the whole range and across each individual subrange. In summary, our results indicate the potential viability of continuous noncontact monitoring for the determination of RR over a clinically relevant range., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Introduction: Rapidly changing hemodynamic conditions, such as uncontrolled hemorrhage and the resulting hypovolemic shock, are a common contributor to active duty military deaths. These conditions can cause cerebral desaturation, and outcomes may improve when regional cerebral oxygen saturation (CrSO2) is monitored using near-infrared spectroscopy (NIRS) and desaturation episodes are recognized and reversed. The purpose of this porcine study was to investigate the ability of NIRS monitoring to detect changes in regional cerebral and regional renal perfusion during hypovolemia, resuscitation by volume infusion, and vasoconstriction., Materials and Methods: Hemorrhagic shock was induced by removing blood through a central venous catheter until mean arterial pressure (MAP) was <40 mmHg. Each blood removal step was followed by a 10-minute stabilization period, during which cardiac output, blood pressure, central venous pressure, blood oxygen saturation, and CrSO2 and regional renal oxygen saturation (RrSO2) were measured. Shock was reversed using blood infusion and vasoconstriction separately until MAP returned to normal. Statistical comparisons between groups were performed using the paired t-test or the Wilcoxon signed-rank test., Results: Using volume resuscitation, both CrSO2 and RrSO2 returned to normal levels after hypovolemia. Blood pressure management with phenylephrine returned CrSO2 levels to normal, but RrSO2 levels remained significantly lower compared to the pre-hemorrhage values (P < .0001). Comparison of the percent CrSO2 as a function of MAP showed that CrSO2 levels approach baseline when a normal MAP is reached during volume resuscitation. In contrast, a significantly higher MAP was required to return to baseline CrSO2 during blood pressure management with phenylephrine (P < .0001). Evaluation of carotid blood flow and CrSO2 indicated that during induction of hypovolemia, the two measures are strongly correlated. In contrast, there was limited correlation between carotid blood flow and CrSO2 during blood infusion., Conclusions: This study demonstrated that it is possible to restore CrSO2 by manipulating MAP with vasoconstriction, even in profound hypotension. However, MAP manipulation may result in unintended consequences for other organs, such as the kidney, if the tissue is not reoxygenated sufficiently. The clinical implications of these results and how best to respond to hypovolemia in the pre-hospital and hospital settings should be elucidated by additional studies., (© The Association of Military Surgeons of the United States 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The South American curculionid Listronotus bonariensis (Kuschel) is an important pest of pastures in New Zealand. Population census data were gathered for L. bonariensis in northern New Zealand pastures during 1980-1983 in the absence of parasitism and again in 1991-1996 after the introduction and establishment of the braconid parasitoid Microctonus hyperodae Loan as a biological control agent. M. hyperodae achieved high rates of parasitism, with 75-90% of overwintering L. bonariensis parasitized within 3 yr of the parasitoid establishing at a site. Multistratum analysis of variance (ANOVA), with allowance for variation in host plant resource (numbers of Neotyphodium-free grass tillers), indicated reduction in the abundance of L. bonariensis life stages in the early part of life cycle. Although providing evidence for suppression of L. bonariensis, these analyses indicated the regulatory role of M. hyperodae was weak because L. bonariensis populations continued to exhibit marked intergenerational variability in abundance. Analyses of life tables indicated larval + pupal survival contributed most to intergenerational changes in abundance, irrespective of presence or absence of M. hyperodae. However, the density dependence of the stage survivals was modified in the presence of the parasitoid, with loss of density-dependent mortality in overwintering adults and increased density dependence in population natality. Regression analyses indicated dual contribution of parasitism and host plant resource to regulation of population natality and population trend in L. bonariensis. We conclude that M. hyperodae is a useful adjunct to host plant resistance in reducing the economic status of L. bonariensis populations in northern New Zealand pastures.