Mr Fantastic Meets The Invisible Man : An Illusion of Invisible Finger Stretching

Our brain continually integrates bottom-up sensory signals to create a coherent experience of the body. This bodily experience is also constrained by top-down knowledge of body appearance. However, the extent of these constraints has been challenged. Here, we explore top-down limits on body ownership with the invisible finger stretching illusion, in which synchronous visuotactile stimulation applied to the real fingers and an area of empty space elicits the illusion of owning elongating fingers. The results demonstrate that it is possible to experience stretchy fingers like Mr Fantastic without visual stimuli of a fake hand, even if we do not actually feel invisible like The Invisible Man

Report on the 2010 external review of the International Development Research Centre (IDRC) Evaluation Unit

This report presents the assessment by an external review panel of key aspects of the performance of IDRC’s Evaluation Unit (EU) from 2005 to 2010, with an overview of findings and observations followed by relevant contextual factors. It provides the external review panel’s identification of questions and issues that should be considered by IDRC as it maps out its direction, strategic intent and priorities for the coming five years. The review panel considers that the provision of financial accountability information internally is a management responsibility rather than part of the evaluation unit mandate

The evidence base for emergency use authorizations for COVID-19 treatments : A rapid review

Background and Aims During the COVID-19 pandemic, US Food and Drug Administration (FDA) permitted emergency use authorizations (EUAs) for vaccines/treatments with promising data. Eight treatments were issued EUAs by May 31, 2021; one of these was approved (Remdesivir for certain populations) and two were revoked (chloroquine phosphate/hydroxychloroquine and bamlanivimab) by September 30, 2021. The aim of this study is to find out what evidence the EUAs were based on and how many studies were published while they remained active (up to September 30, 2021). Methods A review of published clinical studies for the 6 months before each EUA was issued, and the time after (until September 30, 2021, or until revoked). PubMed and the identified systematic reviews were the sources for identifying published literature. Results The number of clinical studies published pre-EUA varied from a single case study (for chloroquine phosphate/hydroxychloroquine) to numerous studies of multiple types (for convalescent plasma). Four treatments had a single randomized controlled trial (RCT) as evidence (bamlanivimab monotherapy, REGN-COV, bamlanivimab + etesevimab,sotrovimab) and two also had other study types (remdesivir and baricitinib). The number of clinical studies published post-EUA (for those active on September 30, 2021) was widely varied. Eighteen RCTs were published for Convalescent plasma, while Remdesivir had eight. Baricitinib, REGN-COV, and bamlanivimab + etesevimab all had one, but none were published for sotrovimab. Conclusion The number of trials for treatments with EUAs was limited in all cases before the EUA was issued, and in most cases for those with EUAs ongoing at the end of September 2021. The presence of EUAs may discourage participation in relevant clinical trials, which delays the widespread implementation of evidenced-based therapies. Large, robust RCTs should be completed, such as the RECOVERY trial in the United Kingdom, to quickly find the answers desperately required during a pandemic

Hyper-realistic Face Masks in a Live Passport-Checking Task

Hyper-realistic face masks have been used as disguises in at least one border crossing and in numerous criminal cases. Experimental tests using these masks have shown that viewers accept them as real faces under a range of conditions. Here, we tested mask detection in a live identity verification task. Fifty-four visitors at the London Science Museum viewed a mask wearer at close range (2 m) as part of a mock passport check. They then answered a series of questions designed to assess mask detection, while the masked traveller was still in view. In the identity matching task, 8% of viewers accepted the mask as matching a real photo of someone else, and 82% accepted the match between masked person and masked photo. When asked if there was any reason to detain the traveller, only 13% of viewers mentioned a mask. A further 11% picked disguise from a list of suggested reasons. Even after reading about mask-related fraud, 10% of viewers judged that the traveller was not wearing a mask. Overall, mask detection was poor and was not predicted by unfamiliar face matching performance. We conclude that hyper-realistic face masks could go undetected during live identity checks

Communication interventions for medically unexplained symptom conditions in general practice : a systematic review and meta-analysis of randomised controlled trials

Background Medically unexplained symptoms (MUS) account for 3–50% of all General Practitioner (GP) consultations and are difficult to diagnose due to their unknown aetiology, symptom overlap between conditions, and lack of effective treatment options. MUS patients’ and primary care clinicians frequently face challenges during consultations, with GPs reporting difficulty identifying and classifying MUS, whilst patients report stigma and feeling illegitimised by clinicians. Communication interventions have been proposed as a method to facilitate the doctor-patient relationship and aid the management of MUS. Aim This systematic review aims to evaluate the effectiveness of primary care based communication interventions at improving MUS patients’ and/or clinician outcomes. Method Four electronic databases were searched from inception to November 2021. Two researchers independently undertook screening, data extraction and quality appraisal. Given the heterogeneous nature of the studies identified, narrative syntheses were conducted, along with meta-analyses where possible to pool data. Results 9 papers from 10 Randomised Controlled Trials were included. The included studies displayed considerable risk of bias and poor reporting. Some limited evidence suggests that communication interventions tailored to MUS and not following a pre-specified model (such as reattribution) could improve pain, mental and physical functioning whilst reattribution training may improve clinician confidence treating MUS. However, methodological limitations mean that these findings should be interpreted with caution. Conclusion A range of interventions for improving communication with MUS patients in primary care have been evaluated. However, the heterogeneous nature of existing evidence and poor study quality mean we cannot conclude whether these interventions are effective. Before considering further randomised controlled trials researchers should focus on developing a new or modified communication intervention for MUS patients and their clinicians. Trail registration The systematic review was prospectively registered with PROSPERO (registration record CRD42020206437)

Patient and primary care practitioners’ perspectives on consultations for fibromyalgia: a qualitative evidence synthesis

Background: Fibromyalgia presents a challenge to both the patients experiencing symptoms and the staff aiming to treat them. This qualitative review aimed to synthesise how patients and practitioners experience primary care consultations, develop a rounded picture of how they perceive each other, the challenges to primary care consultation and how they might be tackled. Methods: CINAHL, Embase, CENTRAL and Medline were searched from inception to November 2021. Qualitative studies were included if they explored the perspectives and experiences of either fibromyalgia patients or primary care practitioners. Quantitative data, studies not published in English, not set in primary care or that did not distinguish the type of patient or clinician were excluded. Included studies were analysed using thematic synthesis and their quality assessed. Results: In total, 30 studies met the inclusion criteria. Thematic synthesis identified three overarching themes: (1) life turned upside down – exploring the chaos experienced by patients as they seek help; (2) negative cycle – highlighting how patient and practitioner factors can create a detrimental cycle; and (3) breaking the cycle – validating patient–doctor relationships underpinned by clear communication can help break the negative cycle. Conclusions: Fibromyalgia patients experience uncertainty and chaos that can clash with the attitudes of GPs and the help they can feasibly provide. Difficult consultations in which neither the GP nor patient are satisfied can easily occur. Promoting supportive, reciprocal and open patient–doctor relationships is essential. Future research is required to further explore GP attitudes and to develop an intervention that could improve consultations, patient outcomes and GP satisfaction

Systematic review assessing the evidence for the use of stem cells in fracture healing

Background Bone demonstrates good healing capacity, with a variety of strategies being utilised to enhance this healing. One potential strategy that has been suggested is the use of stem cells to accelerate healing. Objectives Identify and assess the current evidence for the use of stem cells in fracture healing, focussing on the intervention procedure and outcome measurement. Data Sources MEDLINE, CENTRAL, EMBASE, Cochrane Database of Systematic Reviews, WHO-ICTRP, ClinicalTrials.gov, and reference checking of included studies. Study Eligibility Criteria Population: Any adults who have sustained a fracture, not including those with pre-existing bone defects. Intervention: Use of stem cells from any source in the fracture site by any mechanism. Control: Fracture healing without the use of stem cells. Studies without a comparator were also included. Outcome: Any reported outcomes. Study design: Randomised Controlled Trials (RCTs), non-randomised or observational studies, and case series. Synthesis Ninety-four eligible studies were identified. The clinical and methodological aspects of the studies were too heterogeneous for a meta-analysis to be undertaken. A narrative synthesis examined study characteristics, stem cell methods (source, aspiration, concentration, application) and outcomes. Conclusions: Insufficient high-quality evidence is available to determine the efficacy of stem cells for fracture healing. The studies were heterogeneous in population, methods, and outcomes. Work to address these issues and establish standards for future research should be undertaken. Registration ID: CRD4201914204

Capturing residents' values for urban green space: mapping, analysis and guidance for practice

Planning for green space is guided by standards and guidelines but there is currently little understanding of the variety of values people assign to green spaces or their determinants. Land use planners need to know what values are associated with different landscape characteristics and how value elicitation techniques can inform decisions. We designed a Public Participation GIS (PPGIS) study and surveyed residents of four urbanising suburbs in the Lower Hunter region of NSW, Australia. Participants assigned dots on maps to indicate places they associated with a typology of values (specific attributes or functions considered important) and negative qualities related to green spaces. The marker points were digitised and aggregated according to discrete park polygons for statistical analysis. People assigned a variety of values to green spaces (such as aesthetic value or social interaction value), which were related to landscape characteristics. Some variables (e.g. distance to water) were statistically associated with multiple open space values. Distance from place of residence however did not strongly influence value assignment after landscape configuration was accounted for. Value compatibility analysis revealed that some values co-occurred in park polygons more than others (e.g. nature value and health/therapeutic value). Results highlight the potential for PPGIS techniques to inform green space planning through the spatial representation of complex human-nature relationships. However, a number of potential pitfalls and challenges should be addressed. These include the non-random spatial arrangement of landscape features that can skew interpretation of results and the need to communicate clearly about theory that explains observed patterns

Identifying strategies to maximise recruitment and retention of practices and patients in a multicentre randomised controlled trial of an intervention to optimise secondary prevention for coronary heart disease in primary care

<p>Abstract</p> <p>Background</p> <p>Recruitment and retention of patients and healthcare providers in randomised controlled trials (RCTs) is important in order to determine the effectiveness of interventions. However, failure to achieve recruitment targets is common and reasons why a particular recruitment strategy works for one study and not another remain unclear. We sought to describe a strategy used in a multicentre RCT in primary care, to report researchers' and participants' experiences of its implementation and to inform future strategies to maximise recruitment and retention.</p> <p>Methods</p> <p>In total 48 general practices and 903 patients were recruited from three different areas of Ireland to a RCT of an intervention designed to optimise secondary prevention of coronary heart disease. The recruitment process involved telephoning practices, posting information, visiting practices, identifying potential participants, posting invitations and obtaining consent. Retention involved patients attending reviews and responding to questionnaires and practices facilitating data collection.</p> <p>Results</p> <p>We achieved high retention rates for practices (100%) and for patients (85%) over an 18-month intervention period. Pilot work, knowledge of the setting, awareness of change in staff and organisation amongst participant sites, rapid responses to queries and acknowledgement of practitioners' contributions were identified as being important. Minor variations in protocol and research support helped to meet varied, complex and changing individual needs of practitioners and patients and encouraged retention in the trial. A collaborative relationship between researcher and practice staff which required time to develop was perceived as vital for both recruitment and retention.</p> <p>Conclusion</p> <p>Recruiting and retaining the numbers of practices and patients estimated as required to provide findings with adequate power contributes to increased confidence in the validity and generalisability of RCT results. A continuous dynamic process of monitoring progress within trials and tailoring strategies to particular circumstances, whilst not compromising trial protocols, should allow maximal recruitment and retention.</p> <p>Trial registration</p> <p>ISRCTN24081411</p

The evidence base for emergency use authorizations for COVID‐19 treatments: A rapid review

Abstract Background and Aims During the COVID‐19 pandemic, US Food and Drug Administration (FDA) permitted emergency use authorizations (EUAs) for vaccines/treatments with promising data. Eight treatments were issued EUAs by May 31, 2021; one of these was approved (Remdesivir for certain populations) and two were revoked (chloroquine phosphate/hydroxychloroquine and bamlanivimab) by September 30, 2021. The aim of this study is to find out what evidence the EUAs were based on and how many studies were published while they remained active (up to September 30, 2021). Methods A review of published clinical studies for the 6 months before each EUA was issued, and the time after (until September 30, 2021, or until revoked). PubMed and the identified systematic reviews were the sources for identifying published literature. Results The number of clinical studies published pre‐EUA varied from a single case study (for chloroquine phosphate/hydroxychloroquine) to numerous studies of multiple types (for convalescent plasma). Four treatments had a single randomized controlled trial (RCT) as evidence (bamlanivimab monotherapy, REGN‐COV, bamlanivimab + etesevimab, sotrovimab) and two also had other study types (remdesivir and baricitinib). The number of clinical studies published post‐EUA (for those active on September 30, 2021) was widely varied. Eighteen RCTs were published for Convalescent plasma, while Remdesivir had eight. Baricitinib, REGN‐COV, and bamlanivimab + etesevimab all had one, but none were published for sotrovimab. Conclusion The number of trials for treatments with EUAs was limited in all cases before the EUA was issued, and in most cases for those with EUAs ongoing at the end of September 2021. The presence of EUAs may discourage participation in relevant clinical trials, which delays the widespread implementation of evidenced‐based therapies. Large, robust RCTs should be completed, such as the RECOVERY trial in the United Kingdom, to quickly find the answers desperately required during a pandemic