Caffeine maintains vigilance and improves run times during night operations for Special Forces

PURPOSE: This study examined the effects of caffeine (CAF) on vigilance, marksmanship, and run performance during 27 h of sustained wakefulness in Special Forces personnel. METHODS: There were 31 soldiers (29.8 +/- 5.4 yr, 86.4 +/- 8.6 kg) who were divided into placebo (PLAC, n = 15) and CAF (n = 16) groups. A 6.3-km control run was completed on the morning of Day 1. In the evening of Day 2, soldiers performed a control observation and reconnaissance vigilance task (ORVT) in the field. This 90-min task was repeated twice more between 02:00 and 06:00 on Day 3 during an overnight period of sleep deprivation. Marksmanship was assessed before and after the ORVT. PLAC or 200 mg of CAF gum was administered at 01:45, 03:45, and approximately 06:30 on Day 3. A final 6.3-km run commenced within 30 min of receiving the final dose. RESULTS: ORVT was maintained in CAF at control levels of 77 +/- 13% during the overnight testing. However, values decreased significantly for PLAC from 77 +/- 15% to 54 +/- 29% and 51 +/- 31% during the first and second overnight testing periods, respectively. CAF had no effect on marksmanship but improved 6.3-km run times by 1.2 +/- 1.8 min. Run times slowed for PLAC by 0.9 +/- 0.8 min from approximately 35 min during the control run; the changes in performance were significant between groups. CONCLUSIONS: It was concluded that CAF maintained vigilance and improved running performance during an overnight field operation for Special Forces personnel.     

Radiographic parameters as prognostic indicators for healing of class II furcation defects

OBJECTIVE: To evaluate radiographic measurements for use as prognostic indicators for healing of class II furcation defects following regenerative therapy. MATERIAL AND METHODS: In 17 patients (eight females), 33 class II furcation defects (mandibular buccal (n=10) and lingual (n=12), and maxillary buccal (n=11)) were treated using the barrier membrane technique. Twenty-six furcations were treated using a bioabsorbable membrane, while a nonresorbable membrane was used to treat the remaining seven furcation defects. Clinical parameters and standardized radiographs were obtained before as well as 6 and 24 months after therapy. All radiographs were digitized and evaluated by an examiner blinded to the clinical data. The following distances were measured: cemento-enamel junction line (CEJ-line) to alveolar crest (AC) at the furcation site (AC-CEJ line), CEJ-line to the furcation fornix (Fx-CEJ line), width of the furcation at the level of the AC (FW) as well as the distance from Fx to a straight line between the AC mesial and distal of the tooth (Fx-AC line). RESULTS: Statistically significant (p<0.001) horizontal attachment gains could be observed 6 and 24 months after therapy (6 months: 1.49+/-0.85 mm; 24 months: 1.14+/-0.91 mm). However, a small but statistically significant (p=0.031) attachment loss of 0.35 mm was observed between the 6 and 24 months examination. Multilevel regression analyses identified baseline probing depth (p=0.0017) and 3 of the radiographic distances as prognostic factors: Fx-CEJ line (p=0.014), FW (p=0.0535), Fx-AC line (p=0.0827). CONCLUSION: The analysis of presurgical radiographs may yield information on the success of the regenerative therapy of buccal and lingual class II furcation defects. A long root trunk, a wide furcation entrance and an Fx coronal to the AC have negative influences on the success of therapy. Further, a deep probing depth at the furcation site at baseline increases the likelihood for more favourable horizontal attachment gain in furcations.     

Visual neglect: occurrence and patterns in pilots in a simulated overnight flight

INTRODUCTION: Visual neglect is the unconscious inability to recognize or acknowledge some visual information in the presence of a structurally intact visual system, and was hypothesized to occur with less than 24 h of continuous wakefulness. Visual perception was evaluated in military pilots during a simulated overnight flight to explore for the possible occurrence of visual neglect. METHODS: There were eight military pilots (male, 31-52 yr of age, mean 37 yr) on flight status who were recruited to perform the primary task of flying a simulated 12.5 h overnight mission after a day of continuous wakefulness and the secondary task of responding to repeated 20 min presentations of single- and double-light stimuli displayed in random sequence at 15 degrees intervals across the cockpit instrument panel. In addition to the visual performance task, simulator shutdowns occurring when the tolerances of the simulator were exceeded were measured and simple reaction time on the psychomotor vigilance task was assessed. Total continuous wakefulness was 26.5 h. RESULTS: Combined performance on the visual perception task showed response omissions increasing at 19 h of continuous wakefulness. Patterns included omissions at all stimulus locations, of primarily peripherally located stimuli, and of one of two simultaneously presented stimuli. Simulator shutdowns began at 21.5 h of continuous wakefulness. Correlation of visual task response omissions with simulator shutdowns was r = 0.95, p < 0.0001. CONCLUSIONS: Significant neglect of visual stimuli occurred in pilots beginning at 19 h of continuous wakefulness in a simulated overnight fixed wing aircraft flight, preceded simulator shutdowns, and correlated at 0.95 with simulator shutdowns.     

Zur Erklärungskraft des heutigen soziodemografischen Risikostrukturausgleichsmodells

Zusammenfassung  Eine wesentliche Voraussetzung für effizienzsteigernden regulierten Wettbewerb in sozialen Krankenversicherungssystemen ist die weitgehende Aufhebung von Selektionsanreizen und Antiselektionseffekten durch Risikoausgleichsmechanismen. Damit solche Mechanismen wirksam sind, ist es u. a. wichtig, dass individuelle Unterschiede im Risiko der Verursachung von Leistungsausgaben hinreichend genau abgebildet werden. Internationale Erfahrungen haben gezeigt, dass Ausgleichsmodelle mit Alter und Geschlecht als alleinige Risikoindikatoren nur einen recht geringen Teil der individuellen Leistungsausgaben erklären. Diese Erkenntnis bestätigt sich auch in der vorliegenden Arbeit an den Daten einer ostdeutschen Regionalkasse. Ein weiteres Ergebnis ist, dass die zusätzliche Verwendung eines Indikators für den Bezug einer Erwerbsminderungsrente die Erklärungskraft des deutschen Risikostrukturausgleichsmodells deutlich verbessert. Allerdings ist auch ein solches soziodemografisches Modell nicht in der Lage, Selektionsanreize ausreichend aufzuheben. Insbesondere bei Hochkostenfällen, BU/EU-Rentnern und Versicherten ab 60 Jahren kann mit beträchtlichen Abweichungen zwischen den mit diesen Ausgleichsparametern als risikobedingt veranschlagten und den tatsächlichen Ausgaben gerechnet werden.

Bcl-2 targeting siRNA expressed by a T7 vector system inhibits human tumor cell growth in vitro

A T7 promoter driven siRNA expression vector system (Bcl-2/T7) that targets Bcl-2 mRNA in MCF-7 human cancer cells was designed in the present study. In the presence of prebound T7 RNA polymerase, successful expression of Bcl-2 siRNA as well as its function was demonstrated via cell proliferation assays, Bcl-2 Elisa, and TUNEL assay. MCF-7 breast cancer cells transfected with Bcl-2/T7 show decreased levels of Bcl-2 expression at the protein level as well as decreased cell proliferation. Also, the number of apoptotic cells was increased in cells expressing Bcl-2 siRNA. Previous studies have shown that Bcl-2 levels are increased in a large number of different types of cancer. Therefore, the ability of Bcl-2/T7 to produce functional Bcl-2 siRNA in breast cancer cells suggests a potential role for this delivery system in cancer gene therapy.     

In vitro targeted killing of human endothelial cells by co-incubation of human serum and NGR peptide conjugated human albumin protein bearing alpha (1-3) galactose epitopes

The NGR/alpha1,3Gal-HSA peptide was designed to specifically target CD13 positive cells and induce cell lysis. NGR is the targeting component of the peptide in that it binds the CD13 isoform (aminopeptidase) that is expressed in tumor vessels. Galactose alpha1,3-galactose terminal carbohydrate epitope (alpha1,3Gal) induces a strong antibody reaction in human and Old World Monkeys and in vivo, this reaction leads to organ rejection. The human serum albumin (HSA) bearing alpha1,3Gal epitope was therefore used to lyse cells. In the present study, we were able to demonstrate that NGR/alpha1,3Gal-HSA binds CD13 positive human umbilical vein endothelial cells (HUVEC). We also found by live/dead fluorescent staining that NGR/alpha1,3Gal-HSA was able to induce lysis of HUVECs upon incubation with human serum. Therefore, by conjugating NGR to HSA bearing alpha1,3Gal epitopes, we are able to specifically target and lyse cells expressing CD13. This strategy may be potentially useful in tumor anti-angiogenesis therapy.     

Influence of the intramural innervation on the morphogenesis of the enteroendocrine cells and the genetic construct involved (review)

The influence of intramural intestinal innervation on the morphogenesis of the mucosa and in particular of the enteroendocrine cells (EECs) has been studied on male Wistar rats with morphometric, autoradiographic and immuno-histochemical methods in the duodenum, proximal and distal jejunum and ilium before and after myenteric ablation with benzalkonium chloride (BAC). Twenty-one days after denervation alterations were observed in the mucosal structure with thickening of the mucosa, increase in the proliferation rate and with changes in numerical and spatial distribution of D-cells, I-cells, N-cells, glucagon and glicentin i.r. L-cells and 5-HT i.r. cells which myenteric ablation caused. Analysis of the genetic constructs involved in the alterations of EECs on the EECs provide evidence for the cAMP responsive elements as the main mediator.     

Circadian rhythm of serum cortisol after repeated inhalation of the new topical steroid ciclesonide

The new inhalative glucocorticoid ciclesonide which is activated in lung to a more potent metabolite was hypothesized to have low risk for systemic and local side-effects in man. Therefore, a placebo-controlled, randomized, double-blind, four-period, change-over equivalence study in 12 healthy male volunteers (age 21-28 yr, body weight 62-90 kg) was conducted to assess the influence of three dosage regimens (800 microg in the morning, 800 microg in the evening, 400 microg twice daily for 7 d, metered inhalers) on the circadian time serum cortisol rhythm. RESULTS: Serum cortisol showed the typical circadian rhythm. The geometric mean of the 24-h mesor (AUC((0-24 h))/24 h) was 7.22 microg/dl for placebo, 6.75 microg/dl for the 800 microg ciclesonide morning dose, 7.08 microg/dl for the 800 microg evening dose, and 6.75 microg/dl for 400 microg ciclesonide inhaled twice daily. Because there was also no influence on cortisol amplitude and acrophase (time of maximum), the profiles after ciclesonide were equivalent to the placebo control. The small differences were considered not to be of clinical significance. In conclusion, inhaled ciclesonide in daily doses of 800 microg for 7 d is without clinically relevant effects on the hypothalamic-pituitary-adrenal axis independent of the time of administration.