Initial validation of a virtual blood draw exposure paradigm for fear of blood and needles

Fear of blood, injections, and needles commonly prevents or delays individuals' receipt of health care, such as vaccines or blood draws. Innovative methods are needed to overcome these fears and reduce anxiety related to activities of this nature. The present study describes initial testing of an arm illusion paradigm that may prove useful during early phases of graded exposure for people with blood and needle fear. Seventy-four undergraduate students aged 18-29 years were tested. In line with study aims, results indicated that the virtual blood draw paradigm promoted strong perceptions of arm ownership and elicited significant changes in physiological indices (blood pressure, heart rate, electrodermal activity, respiratory rate) in response to key procedure elements (e.g., needle insertion). Further, bivariate correlations indicated that individual differences in self-reported blood and needle fear collected prior to the illusion paradigm were significantly associated with presyncopal symptoms reported following the procedure. In regression analyses, self-reported measures of blood and needle fear explained unique variance in presyncopal symptoms even after controlling for general state anxiety. These findings provide initial support for the virtual blood draw paradigm as a promising tool to help provide graded exposure to medical procedures involving needles and blood draw

Problems associated with direct displacement-based design of concrete bridges with single-column piers, and some suggested improvements

Currently available displacement-based design (DBD) procedures for bridges are critically evaluated with a view to identifying extensions and/or modifications of the procedure, for it to be applicable to final design of a fairly broad class of bridges. An improved direct DBD procedure is presented, including a suite of comprehensive design criteria and proper consideration of the degree of fixity of the pier top. The design of an overpass bridge (originally designed to a current European Code), applying the improved ‘direct’ displacement-based design (DDBD) procedure is presented and both ‘conventional’ and displacement-based designs are assessed using non-linear response-history analysis (NLRHA); comparisons are made in terms of both economy and seismic performance of the different designs. It is seen that DDBD provided a more rational base shear distribution among piers and abutments when compared to the force-based design procedure and adequately captured the displacement pattern, closely matching the results of the more rigorous NLRHA

Water Infiltration in Methylammonium Lead Iodide Perovskite: Fast and Inconspicuous

While the susceptibility of CH3NH3PbI3 to water is well documented, water influence on device performance is not well understood. Herein we use infrared spectroscopy to show that water infiltration into CH3NH3PbI3 occurs much faster and at much lower humidity than previously thought. We propose a molecular model where water molecules have a strong effect on the hydrogen bonding between the methylammonium cations and the Pb-I cage. Furthermore, the exposure of CH3NH3PbI3 to ambient environment increases the photocurrent of films in lateral devices by more than one order of magnitude. The observed slow component in the photocurrent buildup indicates that the effect is associated with enhanced proton conduction when light is combined with water and oxygen exposure.C.M. and M.S. acknowledge support by the Heidelberg Graduate School of Fundamental Physics. A.A.B. is a Royal Society University Research Fellow.This is the author accepted manuscript. The final version is available from the American Chemical Society via http://dx.doi.org/10.1021/acs.chemmater.5b0388

Performance-Based Seismic Design and Assessment of Bridges

Current trends in the seismic design and assessment of bridges are discussed, with emphasis on two procedures that merit some particular attention, displacement-based procedures and deformation-based procedures. The available performance-based methods for bridges are critically reviewed and a number of critical issues are identified, which arise in all procedures. Then two recently proposed methods are presented in some detail, one based on the direct displacement-based design approach, using equivalent elastic analysis and properly reduced displacement spectra, and one based on the deformation-based approach, which involves a type of partially inelastic response-history analysis for a set of ground motions and wherein pier ductility is included as a design parameter, along with displacement criteria. The current trends in seismic assessment of bridges are then summarised and the more rigorous assessment procedure, i.e. nonlinear dynamic response-history analysis, is used to assess the performance of bridges designed to the previously described procedures. Finally some comments are offered on the feasibility of including such methods in the new generation of bridge codes

Tissue Doppler echocardiographic quantification. Comparison to coronary angiography results in Acute Coronary Syndrome patients

BACKGROUND: Multiples indices have been described using tissue Doppler imaging (DTI) capabilities. The aim of this study was to assess the capability of one or several regional DTI parameters in separating control from ischemic myocardium. METHODS: Twenty-eight patients with acute myocardial infarction were imaged within 24-hour following an emergent coronary angioplasty. Seventeen controls without any coronary artery or myocardial disease were also explored. Global and regional left ventricular functions were assessed. High frame rate color DTI cineloop recordings were made in apical 4 and 2-chamber for subsequent analysis. Peak velocity during isovolumic contraction time (IVC), ejection time, isovolumic relaxation (IVR) and filling time were measured at the mitral annulus and the basal, mid and apical segments of each of the walls studied as well as peak systolic displacement and peak of strain. RESULTS: DTI-analysis enabled us to discriminate between the 3 populations (controls, inferior and anterior AMI). Even in non-ischemic segments, velocities and displacements were reduced in the 2 AMI populations. Peak systolic displacement was the best parameter to discriminate controls from AMI groups (wall by wall, p was systematically < 0.01). The combination IVC + and IVR< 1 discriminated ischemic from non-ischemic segments with 82% sensitivity and 85% specificity. CONCLUSION: DTI-analysis appears to be valuable in ischemic heart disease assessment. Its clinical impact remains to be established. However this simple index might really help in intensive care unit routine practice