. It is found in coffee, of course, but also in tea, chocolate-flavored products and cola-based beverages, etc. 1 Due to its behavioral and psychomotor stimulating properties, it is used to maintain vigilance, memory, and performance levels during limited sleep deprivation. [2][3][4][5][6][7][8] Some prolonged sleep deprivation and wake-sleep rhythm disruptions are common in everyday life, especially in emergency cases, during rescue operations, in the army, or during transmeridian flights. These situations lead to a certain number of vigilance and performance alterations, which in turn lead to a decrease in efficacy or to the onset of penalizing symptomatology. [9][10][11][12] However, the results obtained with the use of caffeine to increase vigilance and performance level vary greatly. Sometimes, the results are very positive; an increase in performance mainly in visual vigilance tasks 13 can be observed as well as an increase in the level of awakeness-measured by electrophysiological techniques 2 -for unusual situations such as night work. Other studies reported an absence of effects or heterogeneous results 14 and sometimes negative effects such as the onset of tolerance during repeated intake of caffeine 15 or the onset of anxiety with still relatively low doses (325 mg). 16 In a general way, all the studies selected from a bibliographic research report an unquestionable stimulating and awaking effect of caffeine, but the effect has a limited power-especially compared with amphetamine-and duration. 17,18 Moreover, repeated caffeine intake can lead to the onset of deleterious cardiovascular or neurological side effects when the dose exceeds 600 mg. Therefore, it seemed interesting to assess the effects of a new galenic form of caffeine called " slowrelease " caffeine (SR caffeine) Stinergic. The release of Study Objectives: The aim of this study is to assess the interest of the intake of a new galenic form of caffeine called " slowrelease " caffeine (SR caffeine) during a decrease of vigilance due to a limited sleep deprivation. Design: The controlled method used compared three doses of SR caffeine (150, 300 and 600 mg) with a placebo. Tests were performed 2, 9 and 13 hours after each treatment. Wakefulness level was assessed subjectively through questionnaires and analog visual scales, and objectively with the Multiple Sleep Latency Test. Performance level was also assessed regularly with an attention test, a grammatical reasoning test, a spatial recognition test, a mathematical processing test, a visual tracking test, a memory search test, and a dual task. The motor activity was evaluated by wrist actimeter and safety of treatment was observed by regular clinical examination. Setting: NA Participants: Twenty-four young and healthy volunteers (12 men and 12 women) participated in a 32-hour sleep deprivation. Interventions: NA Results: The results show a significant effect of slow-release caffeine vs. placebo, and on vigilance and performance when subjects became tired. The effects of SR caffeine lasted 13...

Risk taking, decision making, and stress factors are strongly associated in military operations. The authors used the Bond and Lader mood and alertness scale and a new scale, Evaluation of Risks (EVAR), to assess risk proneness in a maritime counter-terrorism exercise. EVAR items are distributed among five factors: self-control, danger seeking, energy, impulsiveness, and invincibility. In the study, 10 pilots were submitted to strenuous night flights with limited sleep deprivation. Compared with baseline data, pilots reported an increase in impulsiveness, whereas EVAR factors were consistent in a control group composed of 9 navy crew member. Correlations were observed between mood and alertness and risk factors. These results illustrate how EVAR can be used to evaluate change in risk proneness in individuals submitted to various stressors. But further studies are required to weigh stress factors and environmental conditions in risk propensity with a larger population of various age and personality traits.

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similar at baseline and the HexTP group was significantly higher than the other groups at various intermittent times. At baseline, creatinine in the TP group was significantly higher and remained higher than that of HexTP and Hex throughout, but peak level differences did not reach statistical significance. Alanine transaminase (ALT) levels were similar between groups at baseline; however, higher levels were seen for the TP group than the HexTP group at each time point (p<.05). Final study results are not available but projected completion date is at the end of 2017.Conclusions: Based on initial results in this animal model of hemodynamically significant combat trauma, initial resuscitation with Terlipressin is not statistically different from Hextend, the current TCCC standard, when comparing our primary endpoint (death) or secondary endpoints (blood lactate levels, acidosis, kidney injury or liver damage). The study's design inherently limits direct application or extension to human battlefield injuries. Our results, however, provide encouragement to continue with much-needed future research regarding alternatives to colloid resuscitation in trauma. Terlipressin may have a meaningful role in this research and possible additional applications.