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Introduction: Controlled clinical trials (CCTs) have traditionally been limited to urban academic clinical centers. Implementation of CCTs in rural setting is challenged by lack of resources, the inexperience of patient care team members in CCT conductance and workflow interruption, and global inexperience with remote data monitoring. Methods: We report our experience during the coronavirus disease 2019 (COVID-19) pandemic in activating through remote monitoring a multicenter clinical trial (the Study of Efficacy and Safety of Canakinumab Treatment for cytokine release syndrome (CRS) in Participants with COVID-19-induced Pneumonia [CAN-COVID] trial, ClinicalTrials.gov Identifier: NCT04362813) at a rural satellite hospital, the VCU Health Community Memorial Hospital (VCU-CMH) in South Hill, VA, that is part of the larger VCU Health network, with the lead institution being VCU Health Medical College of Virginia Hospital (VCU-MCV), Richmond, VA. We used the local resources at the facility and remote guidance and oversight from the VCU-MCV resources using a closed-loop communication network. Investigational pharmacy, pathology, and nursing were essential to operate the work in coordination with the lead institution. Results: Fifty-one patients with COVID-19 were enrolled from May to August 2020, 35 (69%) at VCU-MCV, and 16 (31%) at VCU-CMH. Among the patients enrolled at VCU-CMH, 37.5% were female, 62.5% Black, and had a median age of 60 (interquartile range 56–68) years. Conclusion: Local decentralization of this trial in our experience gave rural patients access to a novel treatment and also accelerated enrollment and more diverse participants’ representative of the target population.

The current study examined how contextual information, defined as information represented at the level of the situation model, influenced memory for minimally and maximally counterintuitive stories. The first two experiments investigated whether the presence of explicit instructions to make sense of “strange information” in the stories influenced memory for maximally counterintuitive stories. Although no such effect was observed, post hoc analyses indicated that maximally counterintuitive stories that support a global inference that integrates the counterintuitive ideas are better recalled compared to stories that do not support such an inference. A third experiment was conducted to directly test the “global-inference” hypothesis. The results from the three experiments highlight the significant role of inferential processing in the integration of counterintuitive ideas, especially for maximally counterintuitive studies.

Purzycki and Willard (2015) provided a much-needed critique of the minimal counterintuitiveness (MCI) hypothesis, survey the current state of the cognitive science of religion, and propose future d...