The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

AVYekGF73GxhU2acRAwJ3zwbhtAeuQoRvuCI2SG5zSSkZBAdirTJBma7L

SIPS AND SHAPES - ELIGIBILITY SCREENING SURVEY

Welcome! Please fill out the eligibility survey below. If the survey finds that study participation would be safe for you, then you will be asked to provide additional information that will allow us to contact you and further determine if you are a good fit for the study. Thank you!

Page 1 of 2

The option "" can only be selected by itself. Selecting this option will clear your previous selections for this checkbox field. Are you sure?

Do you currently have or have you ever had any of the following? Check all that apply. If none of these apply, please check the last option.

* must provide value

Impaired smell

Impaired taste

Impaired vision that cannot be corrected with glasses or contact lenses

History of head injury (e.g., multiple concussions resulting in loss of consciousness, ever been in a coma)

History of neurologic disease (e.g., epilepsy, narcolepsy)

Chronic medical condition (e.g., diabetes, cystic fibrosis, multiple sclerosis)

Non-removable electronics in the body (e.g., cardiac devices, cochlear implants, drug infusion pumps)

Hairstyle that prevents wet EEG sensor contact with scalp (e.g., glue-in wigs, really thick braids or locs) and no plan to change style any time soon - if you are unsure about your hairstyle's compatibility please leave this option *unchecked* (curly/coily haired: we can work around your hair care/styling schedule)

Intellectual or physical disability that prevents EEG measurements or completion of cognitive/behavioral tasks

None of these apply to me

What is your weight (lbs)? Best guess is fine.

* must provide value

Change the slider above to set a response

reset

What is your height (inches)? Best guess is fine.

56 in = 4 ft 8 in
58 in = 4 ft 10 in
60 in = 5 ft
62 in = 5 ft 2 in
64 in = 5 ft 4 in
66 in = 5 ft 6 in
68 in = 5 ft 8 in
70 in = 5 ft 10 in
72 in = 6 ft
74 in = 6 ft 2 in
76 in = 6 ft 4 in
78 in = 6 ft 6 in
80 in = 6 ft 8 in
82 in = 6 ft 10 in

* must provide value

Change the slider above to set a response

reset

BMI, kg/m2

View equation

Eligibility - EEG compatibility

Exclusion (IRB):
--Olfactory or gustatory impairment;
--Uncorrected auditory or visual impairment;
--Major medical or neurological condition (e.g., cancers, cardiovascular diseases, cystic fibrosis, diabetes, dementia, epilepsy, narcolepsy, neurodegenerative diseases, stroke, traumatic brain injury);
--Scalp or skin hypersensitivity issues that prevent application of the EEG sensor net;
--Hairstyle that prevents EEG sensor access to scalp (e.g., glue-in, weave-in, wig cap, thick braids or locs) with no plans to change hairstyle to one that would allow EEG recording;
--Intellectual or physical disabilities that would preclude informed consent or completion of behavioral tasks or questionnaires;
--Obesity (i.e., body mass index > 40) or underweight (i.e., body mass index < =17);

View equation

Do you currently take any of the following medications on a daily basis and will continue to do so for the foreseeable future to treat a medical condition? Some of these medications can create safety concerns for the study. Please check all that apply. Do not check a box if you use the substance for non-medical reasons.

* must provide value

Allergy medication with strong drowsiness as a side-effect (e.g., Benadryl, Nyquil)

Antibiotics (e.g., Augmentin, Amoxil, Bactrim, Cipro, Zithro)

ADD/ADHD medication (e.g., Adderall, Concerta, Ritalin, Strattera)

Blood thinners (e.g., Coumadin, Heparin, Pradaxa, Plavix)

Blood pressure medications (e.g., Aldactone, Aldomet, Apresoline, Atacand, Betapace, Bumex, Cardizem, Cardura, Catapres, Corgard, Coreg, Diuril, Levatol, Lopressor, Lotensin, Lotrel, Midamar, Minipress, Serpasil, Tenex, Vasocor, Vasotec, Zebeta)

Diabetes medication (e.g., Avandia, Actos, Cyclocet, Glucotrol, Glucophage, Glumetza, Glyset, Micronase, Riomet)

Epilepsy medication (e.g., Amytal, Aptiom, Brevital, Briviact, Carbatrol, Depakene/Depakote, Dilantin, Epidiolex, Lamictal, Luminal, Lyrica, Nembutal, Pentothal, Seconal, Solfoton, Topamax, Trileptal, Zonegran)

GERD medication (e.g., Axis, Pepcid, Tagamet, Zantac)

Hormone-based birth control (e.g., Amethia Lo, Apri, Aranelle, Cyclessa, Daysee, Enpresse, Errin, Jolessa, Leena, LoSeasonique, Lyza, Mircette, Necon 7/7/7, Nora-Be, Ogestrel, Seasonique, Yaz)

Insomnia medication (e.g., Ambien, Dayvigo, Lunesta, Sonata)

Opioid pain-killers (e.g., Dilaudid, Demerol, Lorcet, Norco, OxyContin, Percocet, Vicodin)

Over-the-counter pain-killers (NSAIDs; e.g., Aleve, Advil, Motrin, Tylenol)

Over-the-counter sleep aids (e.g., Nytol, Sleep-Eze, Sominez, Unisom)

MAOIs (e.g., Ensam, Marplan, Nardil, Parnate)

Mood-stabilizing or antipsychotic medication (e.g., Abilify, Depakene/Depakote, Haldol, Lamictal, Lithium, Risperdal, Seroquel, Trileptal, Zypreza)

Muscle relaxants (e.g., Amrix, Dantrium, Lorzone, Metaxall, Robaxin, Skelaxin, Soma)

Narcolepsy medication (e.g., Nuvigil, Provigil, Sunosi, Wakix)

Panic/anxiety attack medication (e.g., Ativan, Klonopin, Valium, Xanax)

TCAs (e.g., Anafranil, Asendin, Elavil, Norpamin, Pamelor)

None of the above

Eligibility - medical reason

Exclusion (IRB):
--Major medical or neurological condition (e.g., cancers, cardiovascular diseases, cystic fibrosis, diabetes, dementia, epilepsy, narcolepsy, neurodegenerative diseases, stroke, traumatic brain injury);
--Major neuropsychiatric condition (e.g., bipolar disorder, psychosis, schizophrenia);

View equation

Are you currently pregnant, nursing, or trying to become pregnant?

* must provide value

What is your birthdate?

* must provide value

Y-M-D

Age, yr

View equation

Eligibility - Protected (minors, pregnant)

Exclusion (IRB)
--Age < 18
--For female participants: currently pregnant, nursing, or trying to become pregnant (note: female
participants will be required to test negative for pregnancy [via urine test] on the first day of the lab phase);

View equation

Now we will ask questions about "drinks" of alcohol. The chart below shows examples of one standard drink (source: NIAAA What Is A Standard Drink?). For example, one drink = 12 fl oz of regular beer = 5 fl oz of table wine and so on. Please keep this unit of measure in mind when answering questions below.

In your lifetime, have you consumed at least 5 drinks containing any kind of alcohol? (not necessarily the same day, 5+ drinks across your entire life)

* must provide value

Yes

reset

Over the past 3 months, was there ever a time when you had at least 1 drink containing any kind of alcohol every day for at least 3 days in a row? Choose only one response.

* must provide value

Over the past 3 months, how often did you have 5 or more (for men) or 4 or more (for women) drinks containing any kind of alcohol within a two-hour period? Choose only one response.

* must provide value

Eligibility - Alc use

Eligible (IRB)= "At least some history of alcohol use (minimum: 5 drinks in the lifetime);"

View equation

Are you currently seeking or in treatment for problematic use of alcohol and/or other substances?

* must provide value

Yes

reset

Are you actively abstaining or engaging in efforts or have active intentions to cut down on use of alcohol and/or other substances?

* must provide value

Yes

reset

Do you have a medical condition for which alcohol consumption is contra-indicated? Examples of these conditions include cancer, cardiovascular disease, diabetes (type 1 or 2), immunosuppresion, and liver disease among others.

* must provide value

Yes

reset

Eligibility - Alc risk

Eligible (IRB)= "Actively trying to abstain from or moderate their alcohol or other addictive drug use";

View equation

*Determine Eligibility******

If eligible to participate in the study, respondent is asked to continue with survey for demographic + contact info. All questions after this point have Branching Logic "______=1".

If ineligible to participate in the study, then respondent reaches the end of the survey, is thanked for their time and referred to website that links to other studies that they might be interested in or eligible for.

View equation

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.

SIPS AND SHAPES - ELIGIBILITY SCREENING SURVEY

Eligibility - EEG compatibility

Eligibility - medical reason

Eligibility - Protected (minors, pregnant)

Eligibility - Alc use

Eligibility - Alc risk

*********Determine Eligibility**************

You have selected an option that triggers this survey to end right now.

*Determine Eligibility******