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 »We’ll just have to wait for the results of the laboratory tests.« These words are familiar to many patients. It then usually takes several days for specimens to be sent to the laboratory and analyzed and for the doctor to receive the results. For many illnesses, however, a speedy diagnosis is crucial if the treatment is to be successful. In future, the patient might only have to sit in the waiting room for a few minutes until the results are ready. In a joint project, researchers from seven Fraunhofer institutes have developed a modular platform for in vitro diagnosis which enables various types of bioanalysis – of blood and saliva for example – to be conducted in the doctor’s surgery. »Thanks to its modular design our IVD platform is so flexible that it can be used for all possible bioanalytical tasks,« states Dr. Eva Ehrentreich-Förster from the Fraunhofer Institute for Biomedical Engineering (IBMT) in Potsdam-Golm.The core element of the mini-laboratory is a disposable cartridge made of plastic which can be fitted with various types of sensor. For an analysis the doctor fills the cartridge with reagents – binding agents which indicate the presence of certain substances such as antigens in the specimen material. Various tests or assays are available for different types of analysis. To perform an assay, the doctor only has to place the relevant substances in the cartridge and the test then takes place automatically. »We have optimized the assays so that up to 500 assay reactions can be conducted in parallel in a single analysis step,« explains Dr. Ehrentreich-Förster. Even in the case of complex analyses the doctor obtains a result within about 30 minutes. A new module on the reverse side of the cartridge also makes it possible to analyze the specimen material at DNA level.Once the cartridge has been prepared, the doctor places it in the measurement system. The results can be read out with either optical or electrochemical biosensors. The researchers have installed a readout window for both methods in the measurement system, which features a bypass through which the specimen is pumped.

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.

"How old you are matters, but beyond that it's your interpretation that has far-reaching implications for the process of aging," said Markus H. Schafer, a doctoral student in sociology and gerontology who led the study. "So, if you feel old beyond your own chronological years you are probably going to experience a lot of the downsides that we associate with aging. "But if you are older and maintain a sense of being younger, then that gives you an edge in maintaining a lot of the abilities you prize." Schafer and co-author Tetyana P. Shippee, a Purdue graduate who is a research associate at Purdue's Center on Aging and the Life Course, compared people's chronological age and their subjective age to determine which one has a greater influence on cognitive abilities during older adulthood. Nearly 500 people ages 55-74 were surveyed about aging in 1995 and 2005 as part of the National Survey of Midlife Development in the United States. In 1995, when people were asked what age do you feel most of the time, the majority identified with being 12 years younger than they actually were. "We found that these people who felt young for their age were more likely to have greater confidence about their cognitive abilities a decade later," Schafer said. "Yes, chronological age was important, but the subjective age had a stronger effect. "What we are not sure about is what comes first. Does a person's wellness and happiness affect their cognitive abilities or does a person's cognitive ability contribute to their sense of wellness. We are planning to address this in a future study."

"As far as we can tell, this is the first time this type of behavior has been reported in cells that are part of a larger organism," says Peter T. Cummings, John R. Hall Professor of Chemical Engineering, who directed the study that is described in the March 10 issue of the Public Library of Science journal PLoS ONE. The discovery was the unanticipated result of a study the Cummings group conducted to test the hypothesis that the freedom with which different cancer cells move - a concept called motility - could be correlated with their aggressiveness: That is, the faster a given type of cancer cell can move through the body the more aggressive it is. "Our results refute that hypothesis—the correlation between motility and aggressiveness that we found among three different types of cancer cells was very weak," Cummings says. "In the process, however, we began noticing that the cell movements were unexpectedly complicated." Then the researchers' interest was piqued by a paper that appeared in the February 2008 issue of the journal Nature titled, "Scaling laws of marine predator search behaviour." The paper contained an analysis of the movements of a variety of radio-tagged marine predators, including sharks, sea turtles and penguins. The authors found that the predators used a foraging strategy very close to a specialized random walk pattern, called a Lévy walk, an optimal method for searching complex landscapes. At the end of the paper's abstract they wrote, "...Lévy-like behaviour seems to be widespread among diverse organisms, from microbes to humans, as a 'rule' that evolved in response to patchy resource distributions." This gave Cummings and his colleagues a new perspective on the cell movements that they were observing in the microscope. They adopted the basic assumption that when mammalian cells migrate they face problems, such as efficiently finding randomly distributed targets like nutrients and growth factors, that are analogous to those faced by single-celled organisms foraging for food. With this perspective in mind, Alka Potdar, now a post-doctoral fellow at Case Western Reserve University and the Cleveland Clinic, cultured cells from three human mammary epithelial cell lines on two-dimensional plastic plates and tracked the cell motions for two-hour periods in a "random migration" environment free of any directional chemical signals. Epithelial cells are found throughout the body lining organs and covering external surfaces. They move relatively slowly, at about a micron per minute which corresponds to two thousandths of an inch per hour. When Potdar carefully analyzed these cell movements, she found that they all followed the same pattern. However, it was not the Lévy walk that they expected, but a closely related search pattern called a bimodal correlated random walk (BCRW). This is a two-phase movement: a run phase in which the cell travels primarily in one direction and a re-orientation phase in which it stays in place and reorganizes itself internally to move in a new direction. In subsequent studies, currently in press, the researchers have found that several other cell types (social amoeba, neutrophils, fibrosarcoma) also follow the same pattern in random migration conditions. They have also found that the cells continue to follow this same basic pattern when a directional chemical signal is added, but the length of their runs are varied and the range of directions they follow are narrowed giving them a net movement in the direction indicated by the signal.