The Terrible Beauty of Brain Surgery - The New York Times

I arrived in Tirana, Albania, on a Sunday evening in late August, on a flight from Istanbul. The sun had set while the plane was midflight, and as we landed in the dark, images of fading light still filled my mind. The man next to me, a young, red-haired American wearing a straw hat, asked me if I knew how to get into town from the airport. I shook my head, put the book I had been reading into my backpack, got up, lifted my suitcase out of the overhead compartment and stood waiting in the aisle for the door up ahead to open.

That book was the reason I had come. It was called "Do No Harm," and it was written by the British neurosurgeon Henry Marsh. His job is to slice into the brain, the most complex structure we know of in the universe, where everything that makes us human is contained, and the contrast between the extremely sophisticated and the extremely primitive — all of that work with knives, drills and saws — fascinated me deeply. I had sent Marsh an email, asking if I might meet him in London to watch him operate. He wrote a cordial reply saying that he seldom worked there now, but he was sure something could be arranged. In passing, he mentioned that he would be operating in Albania in August and in Nepal in September, and I asked hesitantly whether I could join him in Albania.

Now I was here.

Tense and troubled, I stepped out of the door of the airplane, having no idea what lay ahead. I knew as little about Albania as I did about brain surgery. The air was warm and stagnant, the darkness dense. A bus was waiting with its engine running. Most of the passengers were silent, and the few who chatted with one another spoke a language I didn't know. It struck me that 25 years ago, when this was among the last remaining Communist states in Europe, I would not have been allowed to enter; then, the country was closed to the outside world, almost like North Korea today. Now the immigration officer barely glanced at my passport before stamping it. She dully handed it back to me, and I entered Albania.

In the arrivals hall, a young man dressed in a bright white shirt came over.

"Welcome to Albania, Mr. Knausgaard. My name is Geldon Fejzo. Mr. Marsh and Professor Petrela are waiting for you at the hotel. The car is right outside."

The car was a black Mercedes, with leather seats and air conditioning. It turned out that Fejzo had just completed his medical training as a neurosurgeon. He was 31 and had studied in Florence. He had also worked as an intern for a few months at a London hospital with Mr. Marsh, as he called him, in the manner long preferred by British surgeons.

"What is he like?" I asked.

"Mr. Marsh?"

I nodded.

"He's a fantastic person," Fejzo said.

Marsh was in Tirana to demonstrate a surgical procedure he helped pioneer, called awake craniotomy, that had never been performed in Albania. The procedure is used to remove a kind of brain tumor that looks just like the brain itself. Such tumors are most common in young people, and there is no cure for them. Without surgery, 50 percent of patients die within five years; 80 percent within 10 years. An operation prolongs their lives by 10 to 20 years, sometimes more. In order for the surgeon to be able to distinguish between tumor and healthy brain tissue, the patient is kept awake throughout the operation, and during the procedure the brain is stimulated with an electric probe, so that the surgeon can see if and how the patient reacts. The team in Albania had been preparing for six months and had selected two cases that were particularly well suited to demonstrating the method.

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http://www.nytimes.com/2016/01/03/magazine/karl-ove-knausgaard-on-the-terrible-beauty-of-brain-surgery.html?

As Home Births Grow in U.S., a New Study Examines the Risks - The New York Times

With a growing number of American women choosing to give birth at home or in birthing centers, debate is intensifying over an important question: How safe is it to have a baby outside a hospital?

A study published Wednesday in The New England Journal of Medicine provides some of the clearest information on the subject to date.

The study analyzed nearly 80,000 pregnancies in Oregon, and found that when women had planned out-of-hospital deliveries, the probability of the baby dying during the birth process or in the first month after — though slight — was 2.4 times as likely as women who had planned hospital deliveries.

Out-of-hospital births also carried greater risk of neonatal seizures, and increased the chances that newborn babies would need ventilators or mothers would need blood transfusions.

On the other hand, out-of-hospital births were far less likely to involve cesarean sections — 5.3 percent compared with 24.7 percent in a hospital. They also involved fewer interventions to augment labor, and mothers had fewer lacerations.

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http://www.nytimes.com/2015/12/31/health/as-home-births-grow-in-us-a-new-study-examines-the-risks.html?

When are you dead? It may depend on which hospital makes the call. - The Washington Post

The narrow, inscrutable zone between undeniably still here and unequivocally gone includes a range of states that look like life but may not be: a beating heart, a functioning digestive system, even moving fingers and toes. Death is less a moment than a process, a gradual drift out of existence as essential functions switch off, be it rapidly or one by one.

It was exactly midnight when Colleen Burns was wheeled into the operating room at St. Joseph's Hospital Health Center in Syracuse, N.Y. She had been deep in a coma for several days after overdosing on a toxic cocktail of drugs. Scans of electrical activity in her brain were poor, and oxygen didn't seem to be flowing. Burns was brain dead, her family was told; if they wanted to donate her organs, now was the time to do it.

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https://www.washingtonpost.com/news/morning-mix/wp/2015/12/29/when-are-you-dead-it-may-depend-on-which-hospital-makes-the-call/?

Who's Afraid of Peer Review? - Science Magazine

A spoof paper concocted by Science reveals little or no scrutiny at many open-access journals.

On 4 July, good news arrived in the inbox of Ocorrafoo Cobange, a biologist at the Wassee Institute of Medicine in Asmara. It was the official letter of acceptance for a paper he had submitted 2 months earlier to the Journal of Natural Pharmaceuticals, describing the anticancer properties of a chemical that Cobange had extracted from a lichen.

In fact, it should have been promptly rejected. Any reviewer with more than a high-school knowledge of chemistry and the ability to understand a basic data plot should have spotted the paper's short-comings immediately. Its experiments are so hopelessly flawed that the results are meaningless.

I know because I wrote the paper. Ocorrafoo Cobange does not exist, nor does the Wassee Institute of Medicine. Over the past 10 months, I have submitted 304 versions of the wonder drug paper to open-access journals. More than half of the journals accepted the paper, failing to notice its fatal flaws. Beyond that headline result, the data from this sting operation reveal the contours of an emerging Wild West in academic publishing.

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http://www.sciencemag.org/content/342/6154/60.full

I Fooled Millions Into Thinking Chocolate Helps Weight Loss. Here's How. - Gizmodo

"Slim by Chocolate!" the headlines blared. A team of German researchers had found that people on a low-carb diet lost weight 10 percent faster if they ate a chocolate bar every day. It made the front page of Bild, Europe's largest daily newspaper, just beneath their update about the Germanwings crash. From there, it ricocheted around the internet and beyond, making news in more than 20 countries and half a dozen languages. It was discussed on television news shows. It appeared in glossy print, most recently in the June issue of Shapemagazine ("Why You Must Eat Chocolate Daily," page 128). Not only does chocolate accelerate weight loss, the study found, but it leads to healthier cholesterol levels and overall increased well-being. The Bild story quotes the study's lead author, Johannes Bohannon, Ph.D., research director of the Institute of Diet and Health: "The best part is you can buy chocolate everywhere."

I am Johannes Bohannon, Ph.D. Well, actually my name is John, and I'm a journalist. I do have a Ph.D., but it's in the molecular biology of bacteria, not humans. The Institute of Diet and Health? That's nothing more than a website.

Other than those fibs, the study was 100 percent authentic. My colleagues and I recruited actual human subjects in Germany. We ran an actual clinical trial, with subjects randomly assigned to different diet regimes. And the statistically significant benefits of chocolate that we reported are based on the actual data. It was, in fact, a fairly typical study for the field of diet research. Which is to say: It was terrible science. The results are meaningless, and the health claims that the media blasted out to millions of people around the world are utterly unfounded.

Here's how we did it.

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http://io9.gizmodo.com/i-fooled-millions-into-thinking-chocolate-helps-weight-1707251800

A Skeptic's Guide to Health News and Diet Fads - On The Media

Brooke Gladstone takes a deep dive into media misdirection on health and diet news, and puts together two Breaking News Consumer's Handbooks to help you navigate the din. First, an object lesson on bogus studies that make headlines with John Bohannon; how to read health news with Gary Schwitzer of HealthNewsReview.org; and Timothy Caulfield, author of Is Gwyneth Paltrow Wrong about Everything?, explains the science behind celebrity-endorsed diet trends and beauty treatments. 

http://www.onthemedia.org/story/skeptics-guide-health-news-and-diet-fads/