"WakeUp" for Vigilance Following Lunch
"WakeUp" for Vigilance Following Lunch
This is a single center, double-blind, placebo and active controlled clinical trial comprised
 of a single drink of WakeUp beverage (in 3 doses) compared to Caffeine (100mg) and placebo
 given to health volunteers.

 Participants will be randomized regarding the order of the various beverages. Healthy
 volunteers or stable (under treatment) patients with chronic diseases) will be included. They
 will be studied 5 times, in a 2-14 days period, each time during noontime (between 11:30 and
 15:00).

 Each day of the study, the participants will follow the following schedule:

 Lunch any time between 11:30 and 13:30 Time 0: Immediately after lunch a baseline set of
 assessment. Time 30min: Participants will then consume a beverage (which will be either
 placebo or 100mg caffeine or single/double/triple dose of WakeUp in the various days) Time
 60min: Repeat the same set of assessments as done 30min after beverage Time 150min: Repeat
 the same set of assessments 2 hours after beverage Time 180min: End of day assessment
This is a randomized, double-blind, controlled study with placebo and active control, to test
 the efficacy and safety of WakeUp on alertness and function in 30 healthy or chronically ill
 but stable adult volunteers.

 Participants and recruitment Thirty volunteers will be recruited via advertisements (in the
 hospital and university environment). Initial assessment of inclusion and exclusion criteria
 will take place on the primary visit, and once participants have met the criteria for
 participation and sign an informed consent, they will enter the study and undergo
 randomization. It is permitted for participants to have any chronic disease (such as
 hypertension or diabetes) if they are stable and controlled. Participants will continue
 taking their own medications (as long as they are not stimulants or sedating, in which case
 the subject will be excluded).

 Study procedure and schedule This is a single center, double-blind, placebo and active
 controlled clinical trial comprised of a single drink of WakeUp® beverage (in 3 doses)
 compared to caffeine (100mg) and placebo given to health volunteers. Participants will be
 randomized regarding the order of the various beverages.

 The following visits and schedule will comprise the study:

 1. Screening visit: In this visit study procedures will be expained, inclusionqexclusion
 criteria determined, informed consent signed).

 2. Visit 1: Participants eats their regular lunce following which a first set of studies
 takes place (see below). Immediately thereafter the participant drinks the tested
 beverage (marked A, B, C, D, E or F, randomized order regarding which beverage of the 6
 is drank at each specific study day, blinded to the participant and the staff). Thirty
 minutes after drinking a second set of studies will take place (exactly equal to the
 previous set of studies). A third set of studies (exactly the same as the previous two)
 will take place 2 hours following the drink.

 3. Visits 2, 3, 4, and 5 are exactly like visit 1, just that the beverage is one of the
 others (randomized), such that each participants after completing 5 visits had all
 tested beverages: placebo, 100mg Caffeine, WakeUp® regular dose, WakeUp® double dose,
 WakeUp® triple dose.

 4. Visit 7: A telephone call or a face-to-face visit (based on the preference of the
 participants) one week after the study to make sure there are no side effects and to
 close participation.

 The time between screening and visit 1 can be any time between 0 (screening and visit 1 on
 the same day) to 1 month.

 The time between any two other visits (visit 1 to 2, 2 to 3 etc) can be any time between 1 to
 14 days.

 Each one of visits 1 to 5 will begin after lunch, between 11:30 and 15:00, preferable at the
 same time in all visits 1 to 5.

 Randomization Treatment will be randomized for the order of beverage tested (A to E) in
 visits 1 to 5 by a computer-generated randomization scheme (randome function written in
 JAVA). At the beginning of visit 1 randomization will be performed for the whole study period
 (i.e. for which of beverages A,B,C,D,E to be drunk on which of the visits 1,2,3,4,5).

 Blinding Blinding will be kept by the manufacturer of the beverages (Frutarom USA, Inc). All
 5 beverages (placebo, 100mg Caffeine, WakeUp® regular dose, WakeUp® double dose, and WakeUp®
 triple dose) will be marked by a letter beween A to E, which will be blinded to the
 participants and the staff of the study. Only after the completion of the study (all 30
 participants), and statistical analysis and reporting will the various beverages (letters)
 will be unblinded. The only occasion of unblinding prior to study completion will be the
 unexpected occasion of a serious side effect.

 Set of testing for the study

 At all testing times (3 times at every visit from visit 1 to 5, each time point after lunch,
 30min after beverage, 2h after beverage) the following tests will be performed:

 Vital signs (blood pressure and pulse rate) Asking about side effects Visual Analog Scale for
 Alertness (see above) Immediate word recall test (see above) Neurocognitive function testing
 by Cambridge Cognition on an ipad tablet.

 The following neurocognitive function tests will be performed:

 Attention:

 RTI- Reaction Time - 2-3 minutes

 The participant must select and hold a button at the bottom of the screen. Circles are
 presented above (one for the simple mode, and five for the five-choice mode.) In each case, a
 yellow dot will appear in one of the circles, and the participant must react as soon as
 possible, releasing the button at the bottom of the screen, and selecting the circle in which
 the dot appeared. Outcome measures are divided into reaction time and movement time for both
 the simple and five-choice variants.

 RVP - Rapid Visual Information Processing - 7 minutes

 A white box is shown in the centre of the screen, inside which digits from 2 to 9 appear in a
 pseudo-random order, at the rate of 100 digits per minute. Participants are requested to
 detect target sequences of digits (for example, 2-4-6, 3-5-7, 4-6-8). When the participant
 sees the target sequence they must respond by selecting the button in the centre of the
 screen as quickly as possible. The level of difficulty varies with either one- or
 three-target sequences that the participant must watch for at the same time. Outcome measures
 cover latency (speed of response), probability of false alarms and sensitivity.

 Executive Function:

 MTT- Multitasking Test- 8 minutes

 The test displays an arrow which can appear on either side of the screen (right or left) and
 can point in either direction (to the right or to the left). Each trial displays a cue at the
 top of the screen that indicates to the participant whether they have to select the right or
 left button according to the "side on which the arrow appeared" or the "direction in which
 the arrow was pointing". In some sections of the task this rule is consistent across trials
 (single task) while in others it may change from trial to trial in a randomised order
 (multitasking). Using both rules in a flexible manner places a higher demand on cognition
 than using a single rule.

 Some trials display congruent stimuli (e.g. arrow on the right side pointing to the right)
 whereas other trials display incongruent stimuli, which require a higher cognitive demand
 (e.g. arrow on the right side of the screen pointing to the left). Outcome measures for the
 Multitasking Test include response latencies and error scores that reflect the participant's
 ability to manage multitasking and the interference of incongruent task-irrelevant
 information on task performance (i.e. a Stroop-like effect).

 SSP- Spacial Span - 5 minutes

 White squares are shown on the screen, some of which briefly change colour in a variable
 sequence. The participant must then select the boxes which changed colour in the same order
 that they were displayed by the computer (for the forward variant) or in the reverse order
 (for backward variant). The number of boxes in the sequence increases from two at the start
 of the test, to nine at the end and the sequence and colour are varied through the test.
 Outcome measures cover span length (the longest sequence successfully recalled), errors,
 number of attempts and latency (speed of response).

 Memory:

 SWM-Spatial Working Memory - 4 minutes

 The test begins with a number of coloured squares (boxes) shown on the screen. The aim of
 this test is that by selecting the boxes and using a process of elimination, the participant
 should find one yellow 'token' in each of a number of boxes and use them to fill up an empty
 column on the right-hand side of the screen. Depending on the difficulty level used for this
 test, the number of boxes can be gradually increased until a maximum of 12 boxes are shown
 for the participants to search. The colour and position of the boxes used are changed from
 trial to trial to discourage the use of stereotyped search strategies. Outcome measures
 include errors (selecting boxes that have already been found to be empty and revisiting boxes
 which have already been found to contain a token) and strategy and latency.

 The data for vital signs, potential side effects, alertness and iWRT will be kept in a local
 case report form. The data of the Cambridge Cognition tests are stored in the tablet, or sent
 to the cloud if the tablet is connected to wifi at that time. All data are sent to the cloud
 whenever the tablet connects to wifi. The data are compiled by Cambridge and the raw data are
 put into a CSV file which can be downloaded from the tablet directly and can open in
 Microsoft Excel. The secure private cloud environment is provided by HIPAA-accredited
 supplier Armor. The data are secured via military grade encryption (256-bit key file
 encryption) and are only accessible to authorized users. As an additional security measure,
 Cambridge Cognition commissions an independent security check on the system each year and
 Cambridge Cognition and the CANTAB Connect platform have been audited by the Medicines and
 Healthcare products Regulatory Agency and British Standards Institute, as well as external
 audits arranged by customers.
Inclusion Criteria:

 1. Healthy volunteers or chronically ill patients in stable condition

 2. Adults age 18 and above

 3. Volunteers who are willing and able to sign the informed consent

 Exclusion Criteria:

 1. Children aged less than 18 years.

 2. Subjects participating in another study

 3. Subjects who are unable to comply with the study procedures.

 4. Patients in an unstable medical condition.

 5. Patients who are treated with sedating or stimulant medications

 6. Subjects who have taken a dietary supplement within one week of the study initiation

 7. Subjects who have drunk or eaten any caffeine-containing beverage or food after 7:00
 in the morning of any test day

 8. Any reason that, in the opinion of the investigator, may make the subject unfit for
 this clinical trial