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LISTEN: Systems thinking and medicine -- brilliant lecture on systemic problem-solving

The lecturer for the BBC's 2014 Reith lectures is Dr Atul Gawande, a celebrated author and MD whose book The Checklist Manifesto: How to Get Things Right is a classic on how to think about systemic problem solving (which pays attention to how different people and activities come together to make and solve problems).

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Photos of forgotten brains in a mental hospital

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In the basement of the University of Texas Mental Hospital, photographer Adam Voorhes stumbled upon hundreds of strange brains in formaldehyde that had been abandoned for decades.

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Tech projects vein maps during blood donations

The Australian Red Cross Blood Service is testing a technology to project a vein map on the arms of blood donors during the phlebotomy.

"Vein visualisation technology uses near infrared technology to project an image of the vein onto the skin," says Dr. Dan Waller, a senior researcher with the organization. "Veins have a lot of deoxygenated haemoglobin that absorbs near infrared light and the device is able to use this information to project the image. The machines have settings to manage individual differences.

"World-first vein viewing tech trial is... not in vain!" (Australian Red Cross)

Pakistan's scorpion hunters

In Pakistan, a black scorpion weighing 60 grams sells for around $50,000 to medical researchers. Al Jazeera's Maham Javaid investigates the country's scorpion trade and its possible harm to the country's ecosystem. From Al Jazeera:

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Shahid and Sohail, two friends who grew up together in a housing colony in Sindh province's Thatta district, have never been scared of the scorpion's venomous sting.

"As teenagers, we caught and killed scorpions as a game," Sohail told Al Jazeera. "Last year we found out that if we caught a live one, we could be instant millionaires."

On the hottest nights of the year, these hunters search for the nocturnal creatures in the 200-hectare dry forest behind their colony. Scorpions hibernate in cold weather, so Sohail says it is easier to catch them when it's hot.

Their broker, Faraz, is constantly in contact with other brokers who can sell the scorpion to foreign companies for thousands of dollars.

"I spend all my spare time connecting scorpion buyers with sellers," Faraz, who also works at Karachi Port Trust, told Al Jazeera. "When a big deal goes through, it will be like winning the lottery."

"The scorpion hunters of Pakistan

Scientific evidence of very brief "life after death"?

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The largest scientific study of "life after death" and near death experiences in cardiac arrest patients (who were resuscitated) suggests that some people may sustain several minutes of awareness after the heart stops.

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Lab-grown penises ready for testing

In the next few years, researchers at the Wake Forest Institute for Regenerative Medicine hope to transplant lab-grown penises into people who need them due to congenital abnormalities, disease, or traumatic injury.

The penises are grown from the patient's own cells on a 3D collagen scaffold made from a donor penis. Studies on rabbits "were very encouraging," says tissue engineering pioneer Anthony Atala, director of the Institute. From The Guardian:

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Because the method uses a patient's own penis-specific cells, the technology will not be suitable for female-to-male sex reassignment surgery.

"Our target is to get the organs into patients with injuries or congenital abnormalities," said Atala, whose work is funded by the US Armed Forces Institute of Regenerative Medicine, which hopes to use the technology to help soldiers who sustain battlefield injuries.

As a paediatric urological surgeon, Atala began his work in 1992 to help children born with genital abnormalities. Because of a lack of available tissue for reconstructive surgery, baby boys with ambiguous genitalia are often given a sex-change at birth, leading to much psychological anguish in later life. "Imagine being genetically male but living as a woman," he said. "It's a firmly devastating problem that we hope to help with."

Dery on disease and art

Over at Thought Catalog, BB contributor Mark Dery goes deep into the pathological sublime with Richard Barnett, author of "The Sick Rose: Disease and the Art of Medical Illustration":

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Running as little as 30 minutes a week reduces your risk of early death

"Three's a crowd" by Thomas Rousing, a photo shared in the Boing Boing Flickr Pool.


"Three's a crowd" by Thomas Rousing, a photo shared in the Boing Boing Flickr Pool.

A study released this week in the Journal of the American College of Cardiology found that participants who ran less than one hour each week received the same health benefits as people who ran more.

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Sex toy in woman's vagina for 10 years

Physicians examining a Scottish woman were surprised (as was she) to discover that a five-inch sex toy had been inside her vagina for a decade.

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Heartbreaking photos of uninsured Americans waiting for care

Photographer Lucian Perkins documented the thousands of Virginians who camped out in cars and waited in the rain earlier this month to get access to basic dental, vision, and medical treatment at a traveling clinic.

Prescient Nature article on forgotten smallpox samples

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Yesterday, the CDC announced the discovery of several vials of smallpox virus, forgotten in a storage room since the 1950s. Back in April, Nature's Sara Reardon wrote about the risks (and benefits) of just this sort of thing.

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The dirty business of hospice care

Hospice used to be charity work run by religious organizations. Now it's big business, complete with all-too-predictable horrifying corruption unmasked in an expose by Ben Hallman at Huffington Post.

Lab mistakes are wasting millions in research funding

Medicine starts with cells in a petri dish. But, increasingly, scientists are realizing they’ve been studying the wrong cells, writes Maggie Koerth-Baker.

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Fake drugs and the plague that never lifts

To pharmaceutical firms, legitimate replicas and outright fakes are much the same: neither make them money. But to sufferers in the developing world, the difference is life and death. Charles Ebikeme on the big business of counterfeit medicine in the developing world.

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Squirrels contaminated my flesh!

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From the January 2014 issue of the journal Case Reports in Emergency Medicine: "While report of animal bites contaminating wounds is reported commonly, direct wound contamination with squirrel flesh has never been reported in the literature." Until now.

This is a story that involves a teenage boy, a 12 gauge shotgun, an injury to the right buttock, and (last, but not least) a squirrel.

According to the patient he was using the butt of his 12 G shotgun to dislodge a dead squirrel from a branch over his head during a hunting trip and shot himself with a load of birdshot in the right buttock. He presented with stable vital signs and reported no pain other than at the wound.

On physical exam the patient appeared in no distress with mild tachycardia with a heart rate of 116. A  cm deep wound on the right buttocks was hemostatic (Figure 1). The edges of the wound were black and ragged, while there was circumferential surrounding erythema that extended 4 cm beyond the wound. Rectal exam revealed normal tone without gross blood and no palpable foreign bodies near the rectum. Debris was observed in the margin of the wound. The rural transporting EMS personnel promptly identified the material as “squirrel parts.”

Copious wound irrigation with saline irrigation and debridement occurred in the emergency room, during which more pieces of animal flesh were found grossly contaminating the wound. There was also concern that the trajectory and final positioning of the buckshot in his buttock rested near the anus (Figure 2). Questioning of the patient revealed that the birdshot likely traveled through the rear pouch of his hunting vest which contained several squirrels killed earlier in the day.

(Via MedPage Today)

Image: Some rights reserved by Peter Trimming.

Could this simple sea creature hold the key to treating Parkinson's?

A comb jelly, via Whitney laboratory for Marine Biosciences, University of Florida.  REUTERS/Whitney laboratory for Marine Biosciences, University of Florida.


A comb jelly (University of Florida).

A scientist in Florida who studies simple sea animals known as comb jellies says he has discovered a path to a new form of brain development that may one day lead to treatments for Parkinson's, Alzheimer's and other neurodegenerative diseases.

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A surgeon looks at Rodin's hands

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For many years, Stanford University surgeon James Chang has been fascinated by Rodin's hands, sculptures made by the French artist in the 19th century. Chang uses Rodin's hands in what sounds to be a marvelous undergraduate seminar titled "Surgical Anatomy of the Hand: From Rodin to Reconstruction" in which he combines 3D scans of the sculptures, a process seen above, with medical imaging of human bones, nerves, and blood vessels.

Rodins hands dig preview final

Now, Chang has collaborated on an exhibition at Satnford that lies at the intersection of science and art. “Inside Rodin’s Hands: Art, Technology, and Surgery” opens next week at Sanford's Cantor Arts Center.

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Filmmaker seeks people with sleep paralysis experiences

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Do you have experience with sleep paralysis? Many scientists believe that sleep paralysis is the biological answer to such mysteries as spirit visitations, alien abductions, incubi/succubi, and out-of-body experiences. My old friend Rodney Ascher, director of the excellent film Room 237 and other movies, is making a documentary about the phenomenon and would love to hear from you. Rodney writes:

I'm working on on a new film - it's about Sleep Paralysis, a surprisingly common phenomenon where people wake-up totally frozen from the eyeballs down, unable even to make a noise, and they frequently see sinister intruders and other disturbing visions. I've been obsessed with it ever since it used to happen with me (in my case, I saw sort of a living, 3D shadow looming over in me in judgement).

The film is going to be largely built on interviews with people who've had vivid, first-person experiences with it (and have given some serious thought to what's really happening to them) - if anyone wants to share their stories, the easiest way is to contact us via the film's Facebook page.

The Nightmare: A Nonfiction Film About An Unreal Experience

You Are Not So Smart podcast 017: Alternative Medicine - Tim Farley

You are Not So Smart is hosted by David McRaney, a journalist and self-described psychology nerd. In each episode, David explores cognitive biases and delusions, and is often joined by a guest expert. David concludes each episode by eating a delicious cookie baked from a recipe sent in by a listener.

Where is the line between medicine and alternative medicine? Are Eastern medicine and Western medicine truly at odds, and if so, who is right and who is wrong? What harm is there in using complementary or integrative treatments in an effort to improve wellness?

In this episode we discuss alternative medicine with Tim Farley, creator and curator of What's The Harm, a website that tracks the harmful effects that result from seeking out alternative treatments and cures before or instead of seeking out science-based medicine. Tim also created the website Skeptical Software Tools, and he tweets at @krelnik.

This episode of You Are Not So Smart is brought to you by Squarespace, the all-in-one platform that makes it fast and easy to create you own professional website or online portfolio. For a free trial and ten percent off go to Squarespace.com and use the offer code PIPE.

YANSS: RSS | iTunes | Download this episode | Stitcher

Who is still imprisoned in Guantanamo?


With Obama pledging in the latest State of the Union address to finally shutter the prison camp at Guantanamo Bay -- something he's been promising to do since his 2008 election campaign -- it's worth revisiting the people who remain imprisoned there, more than a decade after the GW Bush administration declared its War on Terror.

There are 155 men in Guantanamo. 77 have been cleared for transfer but there is no country to which they can be sent. 45 men are in "indefinite detention" -- unable to be prosecuted, often because of the brutal torture inflicted on them by Guantanamo's jailers, but unable to be released because the US government considers them to be a threat. 31 more are awaiting prosecution.

This month, the American Psychology Association dropped all proceedings against a member who designed, oversaw, and participated in the torture at Guantanamo. They had previously denied a request to censure other members who participated in torture.

The protocol designed by John Leso, the doctor that the APA will not censure, involved intravenously hydrating a victim until he urinated on himself; sleep deprivation; forcing the victim to bark like a dog; keeping the victim naked and subjecting him to extreme cold; spinning the victim in a swiveling chair to disorient him; putting the victim into stress positions; depriving the victim of mattresses and other bedding; keeping the victim in isolation from all human contact; and more.

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Lighting scars on eyes of man blinded by electric shock

A case study in the New England Journal of Medicine details the tragic story of an electrician who received a shock of 14,000V and was blinded as part of his injuries. Accompanying the article is this striking photo of the scars on his eyes, which resemble the plasma ball effects, the sort of thing you'd expect from a science fiction movie.

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Born without fingerprints

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Adermatoglyphia is a very rare genetic condition causing you to be born without fingerprints. In 2011, a small group of researchers pinpointed the genetic mutation behind it. One of them, dermatologist Peter Itin, was drawn to the mystery after he was contacted by a Swiss woman who found trouble at the US border when immigration agents couldn't take her prints… because she doesn't have any. "Adermatoglyphia: The Genetic Disorder Of People Born Without Fingerprints" (Smithsonian)

Hospitals will happily tell you the cost of parking; procedures, not so much

Fourteen-year-old Jillian Bernstein got herself published in the Journal of the American Medical Association by comparing the transparency of medical costs at Philadelphia hospitals with the transparency of parking rates at the same hospitals. Out of 20 hospitals, 19 were happy to provide information on the cost to park a car. Only three, however, were willing to tell her how much it would cost an uninsured person to get an electrocardiogram, and those prices were ridiculously variable — $137, $600 and $1,200, depending on the hospital.

Can a penis really get stuck in a vagina?

For once, the answer to a question in the headline is, "Well, quite possibly."

It's been 100 years since a well-documented case of penis captivus — i.e., penis-stuck-in-vagina syndrome — appeared in the medical literature. But that doesn't mean it's a total myth. The BBC's Health Check discusses the physiological mechanisms that could lead to such an unpleasant event and explains why there are lots of anecdotal stories surrounding something that's thought to be "vanishingly rare" from a medical perspective. Hint: While very, very, very few people end up needing medical treatment for penis captivus, there may be many more who get temporarily-but-disconcertingly stuck for a few seconds.

Some rights reserved by ganesha.isis

The laissez faire world of dietary supplements

Every year, more than 2000 Americans experience a serious negative effect (either death or illness) from taking over-the-counter dietary supplements. Since 1994, it's been legal to sell supplements without prior safety testing. Even when someone gets sick, the burden of proof is on the FDA to prove the supplement caused it, rather than on the supplement company to prove it didn't. The Dallas Morning News reports on the lack of oversight and what it costs us.

The Franken Berry Stool (aka red poop)

NewImage 300x404 In 1972, Franken Berry cereal, then a brand new product, was the subject of a paper in the medical journal Pediatrics because it caused a 12-year-old to have red poop. He had been hospitalized for several days for what appeared to be rectal bleeding but turned out to have been the red dye (FD&C Red No. 2 and No. 3) in the Franken Berry. In related news, Booberry can turn your stool green. "Benign Red Pigmentation of Stool Resulting from Food Coloring in a New Breakfast Cereal (The Franken Berry Stool)" (Pediatrics via Smithsonian)

A moving long read about a medical school dissection class

Mark Johnson of the Milwaukee Journal Sentinel has put together an amazing four-part story about medical students entering a human dissection lab for the first time. Interweaving the stories of the students, their teachers, and people who have chosen to donate their bodies to science, the series really gives you a sense of how emotionally intense the experience can be for students, and how it brings together all these different lives. Powerful stuff.

Why we pay $1000 for a $20 medical test

Pap smears — the pre-cancer-screening that most women get annually when they visit a gynecologist — should only cost about $20 or $30, writes Dr. Cheryl Bettigole in The New England Journal of Medicine. So, why then, are more women (and/or their insurance companies) paying much, much more — sometimes upwards of $1000? A big part of the problem is add-on tests — extra screenings that haven't been shown to make women healthier, but do add a lot to the cost of an annual exam. Turns out, medical laboratories have started marketing these pap+ tests, using some of the same techniques pharmaceutical companies have long used to sell more expensive treatments to doctors.

Nobel Prizes 2013: The shipping machinery of cells

If the cells that make up your body are little factories, then the shipping department just picked up a Nobel Prize this morning with the award for physiology or medicine going to researchers Randy Schekman of the University of California at Berkeley, James Rothman of Yale University, and Thomas Südhof of Stanford. These scientists don't work together, but their research does overlap and play off each other in important ways. In fact, this isn't the first time some of these men have shared major research awards.

What makes their work so important? It's really all about increasing our understanding of how individual cells operate and participate in major bodily systems like immunity or hormone control. If you built little models of cells back in grade school, you probably have a mental image of them as a sort of lumpy sack with a couple of things inside — a big fat nucleus and some squirrelly little mitochondria, mostly. But it turns out that there's a lot more happening in the interior of a cell than that. Much of that activity is centered around vesicles — bubbles in the fluid that fills a cell. There are many different kinds of vesicles doing many different jobs, but one of the important things they do is move molecules, either within the cell or from the cell to the outside world.

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