Rex E. Lee Conference on the Office of the Solicitor General of the United States: Clinton II Panel

I will say a few words about Dickerson, both because Michael has made it impossible not to and also because in some ways it represents the very best about how all of the wonderful, tried-and-true processes of the SG\u27s Office ought to work. Dickerson was very much like the other case that Michael talked about (which is one of, I think, two significant privilege controversies which the Independent Counsel laid on our doorstep). These cases may have appeared to the outside world as paradigmatically cases in which we would be hearing from the White House, or talking to the White House, or thinking about things other than the long-term institutional interests of the United States. But absolutely nothing of the sort ever happened, nor was any effort made by any political person to intrude in our decision-making policy

Skeletal Muscle Desaturation during Moderate and Severe Intensity Cycling Exercise is related to Half-Time from the Reactive Hyperemia Response

Reactive hyperemia responses are a common method for assessing peripheral microvascular function, and the half-time reperfusion response, in particular, has been shown to be highly reproducible and sensitive to vascular dysfunction associated with disease. It is unclear, however, whether this parameter also provides information about microvascular responses during exercise. PURPOSE: The aim of this study was to determine the relationship between reactive hyperemia half-time response and the change in skeletal muscle oxygenation during cycling exercise. METHODS: Thirty young adults (20 men, 10 women; Age: 23 ± 5 y; peak VO2: 35.4 ± 4.4 ml/kg/min) completed a maximal cycling exercise test to determine moderate (95% gas exchange threshold, GET) and severe (75% of the difference between the GET and peak VO2) intensities for a cycling exercise protocol. Upon a follow-up visit, reactive hyperemia was measured using near-infrared spectroscopy (NIRS; PortaLite, Artinis Medical Systems, Netherlands) at the vastus lateralis muscle. Following a five-minute occlusion period, oxygen resaturation rate was recorded, and the half-time was determined as the time to reach 50% of the peak hyperemic response. During cycling exercise, the change in tissue saturation index (TSI) was measured using NIRS at the same location on the vastus lateralis as reactive hyperemia. Steady-state TSI was recorded as the 60-second average at the end of two 4-minute bouts of moderate exercise, and at 60-seconds into one bout of severe exercise. TSI is reported as the change in oxygenation from a 20 Watt cycling baseline. Pearson correlations were used to determine associations, and data are reported as mean ± SD. RESULTS: The half-time resaturation response was found to be 16.5 ± 4.9 seconds. The change in TSI during moderate exercise (-3.4 ± 2.4%) was correlated with the half-time response (r = -0.42, p = 0.01). Additionally, the change in TSI during severe exercise (-7.2 ± 2.8%) was correlated with the half-time response (r = -0.53, p = 0.002). These results remained significant after adjusting for sex or skinfold thickness using partial correlation. CONCLUSION: Our results suggest that lower peripheral microvascular vasodilatory capacity at rest, as indicated by the TSI half-time response, is related to higher rates of desaturation during moderate and severe intensity cycling exercise

The Surviving Sepsis Campaign sepsis change bundles and clinical practice

The Surviving Sepsis Campaign (SSC) is an international effort to reduce mortality in severe sepsis and septic shock. The campaign included the creation of evidence-based guidelines sponsored and endorsed by 11 international organizations. From these guidelines, sepsis change bundles for initial resuscitation (6 hours) and management (24 hours) were created as a performance improvement tool. In this issue of Critical Care, Gao et al. have evaluated performance at their institution by using a close adaptation of the two SSC bundle sets and demonstrated an association between 100% compliance with the bundle elements and clinical outcome. The next step will be to demonstrate that the use of education and feedback for performance improvement will increase compliance and decrease mortality in the patient population in general

Foraging behavior of juvenile loggerhead sea turtles in the open ocean: from Lévy exploration to area-restricted search

Most sea turtle species spend part of, or their entire juvenile stage in pelagic habitats. A key question is how pelagic turtles exploit their environment to optimize prey intake and max imize fitness. This study combined animal telemetry with remote-sensed environmental data to quantify the drivers and patterns of foraging behavior of juvenile loggerhead sea turtles in the pelagic eastern North Atlantic. Juveniles ranged in size from 34 to 58 cm straight carapace length. First-passage time (FPT) analysis, used to quantify search effort, indicated that turtles performed area-restricted searches at nested spatial scales of 10 and 50 to 200 km. High-usage areas, as quantified by FPT, were associated with increased dive activity and weak surface currents, as well as with oceanographic features (high chlorophyll a and shallower bathymetry) thought to stimu late prey availability. Conversely, low-usage areas (i.e. transit areas) were associated with deep, probably exploratory dives, typical from Lévy movement patterns. Further interpretation of dive data indicates greater dive activity in shallow depths (0 to 10 m) during the night and during tran sit. Conversely, greater activity at intermediate depths (10 to 50 m) was observed during daytime, under strong lunar illumination and in high-usage areas, suggesting these depths are major day time foraging layers. This study clarifies the foraging ecology of sea turtles during their develop ment phase in the open sea, providing evidence that these pelagic predators can adjust their for aging strategies and effort in response to the local conditions of their dynamic environment.info:eu-repo/semantics/publishedVersio

Arterial pressure optimization in the treatment of septic shock: a complex puzzle

Arterial pressure optimization in septic shock is a critical, yet poorly understood component of resuscitation. New data suggest that, during the routine management of patients with severe sepsis, there is no association between mean arterial pressure achieved and outcome as long as the mean arterial pressure is maintained at or above 70 mmHg. Although these data add important new evidence to our understanding of arterial pressure management, there are still many unanswered questions upon which future investigations should focus

FLORIDA SANDHILL CRANE RELOCATES EGG DURING INCUBATION

Anecdotal accounts of birds moving their eggs to a new location have been reported in shorebirds, waterfowl, and woodpeckers. We report relocation of an egg, 2 days prior to hatching, by an adult Florida sandhill crane (Grus canadensis pratensis). We do not know why the egg was moved, but egg movement among other species appears to be associated with nest disturbance by humans, animals, or environmental conditions