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The North American Spine Society and the Society of Interventional Radiology have pointed to flaws in both studies. And earlier studies, published over 15 years, found major benefits to kyphoplasty and a related procedure called vertebroplasty. "We're missing opportunities for patients to receive a safe and effective treatment that can significantly reduce their pain and disability," said Malamis, an interventional radiologist. The procedures are used to treat vertebral compression fractures in patients with osteoporosis and other conditions that result in brittle bones. In a vertebroplasty, an acrylic cement is injected into a fractured vertebra. In a kyphoplasty, a balloon-tipped catheter first is inserted into the fracture. The balloon is inflated to restore the height and shape of the vertebra before the cement is injected. Neva Nelson, 74, of Naperville, Ill., said a kyphoplasty that Malamis performed in October, 2009, has greatly reduced her pain in a vertebra in her lower back that she fractured after falling on ice. Before her kyphoplasty, Nelson had to sit on cushions. Walking, and especially standing, were painful. "I had to do something," she said. "I could not go on like that." Nelson said that since undergoing her kyphoplasty, "I don't have to worry about my back any more." In the controversial studies, patients were randomly assigned to receive a vertebroplasty or a placebo-like "sham" procedure. In the sham procedure, patients received an injection of anesthetic, but no cement. However, patients in severe pain are reluctant to enroll in a trial where there's a 50 percent chance of receiving a sham treatment. In one of the studies, researchers had to screen 1,813 patients to enroll just 131 subjects. In the other study, only 78 of 219 eligible patients were enrolled. This low enrollment rate raises the possibility that the patients who did enroll were not representative. Patients experience the greatest pain during the first three months after a compression fracture. Thereafter, pain gradually subsides. Thus, a vertebroplasty or kyphoplasty provides the greatest benefit when performed within a week or two of the fracture. But the studies enrolled patients up to 12 months after fractures. In addition to reducing pain and disability, a kyphoplasty can reduce the risk of subsequent fractures by improving the angle and height of the spine. The studies evaluated vertebroplasty alone, and did not include the more innovative and very different kyphoplasty procedure. Malamis suggests the medical community wait for the results of additional studies now underway before passing final judgment on vertebroplasty or kyphoplasty. In the mean time, he notes that Medicare still covers the procedures.

The difference between pointing by the Great Ape Trust bonobos - the only ones in the world with receptive competence for spoken English - and other captive apes that make hand gestures is explained by the culture in which they were reared, according to the paper's authors: Janni Pedersen, an Iowa State University Ph.D. candidate conducting research for her dissertation at Great Ape Trust; Pär Segerdahl, a scientist from Sweden who has published several philosophical inquires into language; and William M. Fields, an ethnographer investigating language, culture and tools in non-human primates. Fields also is Great Ape Trust's director of scientific research. Because Kanzi, Panbanisha and Nyota were raised in a culture where pointing has a purpose - The Trust's hallmark Pan/Homo environment, where infant bonobos are reared with both bonobo (Pan paniscus) and human (Homo sapiens) influences - their pointing is as scientifically meaningful as their understanding of spoken English, Fields said. The pointing study supports and builds on previous research on the effect of rearing culture on cognitive capabilities, including the 40-year research corpus of Dr. Duane Rumbaugh, Dr. Sue Savage-Rumbaugh and Fields, which is the foundation of the scientific inquiry at Great Ape Trust. Those studies included the breakthrough finding that Kanzi and other bonobos with receptive competence for spoken English acquired language as human children do - by being exposed to it since infancy. The bonobos adopted finger-pointing behavior for the same reasons, because they were reared in a culture where pointing has meaning.