Using Light to Facilitate Circadian Entrainment from Day to Night Flights.

BACKGROUND: As part of a larger project to provide recommendations regarding limitations and best practices for shifting aviators from day to night operations, a study was conducted to assess the efficacy of high energy visible (HEV) light to shift the circadian rhythm in humans. The study attempted to replicate the patterns of military aviators who could be required to shift abruptly from day to night flight operations.METHODS: Simulated flight performance and salivary melatonin levels of 10 U.S. military aviators were collected over a 3-night period using a within-subject dim light melatonin onset (DLMO) study design. Data were collected in a laboratory with participants returning home to sleep following each of the three evenings/nights of data collection. Light treatment included a single 4-h exposure of blue-enriched white light (∼1000 lux) on night 2. Data collected included melatonin levels, light exposure, sleepiness, cognitive workload, and simulated flight performance.RESULTS: The average delay in melatonin onset was 1.32 ± 0.37 h (range: 53 min to 1 h 56 min). Sleepiness (P = 0.044) and cognitive workload (P = 0.081) improved the night following the light treatment compared to the baseline. No systematic differences were identified in flight performance.DISCUSSION: The HEV light treatment successfully delayed the circadian phase of all participants even though participants' ambient light levels (including daylight) outside the laboratory were not controlled. These findings were used to develop circadian synchronization plans for aviators who are asked to transition from day to night operations. These plans will be assessed in a follow-on study in an operational unit.Shattuck NL, Matsangas P, Reily J, McDonough M, Giles KB. Using light to facilitate circadian entrainment from day to night flights. Aerosp Med Hum Perform. 2023; 94(2):66-73.

A Review of the Types of Training Aids Used for Canine Detection Training.

The canine detection community is a diverse one, ranging from scientific fields such as behavior, genetics, veterinary medicine, chemistry, and biology to applications in law enforcement, military, medicine, and agricultural/environmental detection. This diversity has allowed for a flourishing and innovative community, yet it has also led to little acceptance and agreement on terminology. This is especially true when discussing the variety of training aids used in olfactory-based exercises. In general, authentic materials and pseudo-scents are the most commonly discussed, with the former accepted widely for training and certification, and the latter more often disregarded. However, as advances are made in the creation of training materials, alternative training aids are being introduced that do not fit into either of these categories. The misconceptions surrounding how these alternative training aids are manufactured has led to confusion on their classification, and therefore their reliance as an effective tool. This manuscript will review the existing language surrounding canine training aids, address relevant research revealing effectiveness, and clarify the different types based on their manufacture, chemical nature, and fundamental function.

Assessing the efficacy of kidney paired donation--performance of an integrated three-site program.

BACKGROUND: Kidney paired donation (KPD) has emerged as a viable option for renal transplant candidates with incompatible living donors. The aim of this study was to assess the "performance" of a three-site KPD program that allowed screening of multiple donors per recipient. METHODS: We reviewed retrospectively the activity of our KPD program involving three centers under the same institutional umbrella. The primary goal was to achieve a transplant that was both ABO compatible and had a negative or low-positive flow cytometric crossmatch (+XM). RESULTS: During the 40-month study period, 114 kidney transplant candidates were enrolled-57% resulting from a +XM and 39% resulting from ABO incompatible (ABOi) donors. Important outcomes were as follows: (1) 81 (71%) candidates received a transplant and 33 (29%) were still waiting; (2) 368 donors were evaluated, including 10 nondirected donors; (3) 82% (37/45) of ABOi candidates underwent transplantation; (4) 56% (36/65) of +XM candidates underwent transplantation (however, all but four of these had a cPRA less than 95%); (5) at the end of the study period, 97% (28/29) of +XM candidates still waiting had a cPRA greater than 95%. CONCLUSIONS: These data suggest evaluating large numbers of donors increases the chances of KPD. Patients with a cPRA greater than 95% are unlikely to receive a negative or low-positive +XM, suggesting the need for desensitization protocols in KPD.

Desensitization in the era of kidney paired donation: the Mayo Foundation 3-site experience.

Sensitized renal allograft candidates face significant barriers to transplantation. While several options exist, including: kidney paired donation (KPD), desensitization, or pursuing a deceased donor kidney transplant, it is unclear from existing data what is the appropriate protocol for an individual patient. In this study, we seek to devise a balance between waiting for a paired donor and combining desensitization with KPD.