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George Whitesides has developed a prototype for paper "chip" technology that could be used in the developing world to cheaply diagnose deadly diseases such as HIV, malaria, tuberculosis, hepatitis and gastroenteritis. The first products will be available in about a year, he said. His efforts, which find their inspiration from the simple designs of comic books and computer chips, are surprisingly low-tech and cheap. Patients put a drop of blood on one side of the slip of paper, and on the other appears a colorful pattern in the shape of a tree, which tells medical professionals whether the person is infected with certain diseases. Water-repellent comic-book ink saturates several layers of paper, he said. The ink funnels a patient's blood into tree-like channels, where several layers of treated paper react with the blood to create diagnostic colors. It's not entirely unlike a home pregnancy test, Whitesides said, but the chips are much smaller and cheaper, and they test for multiple diseases at once. They also show how severely a person is infected rather than producing only a positive-negative reading.

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 researchers, led by professor of applied and engineering physics Harold Craighead, made a device just 200 nanometers thick and a few microns long with an oscillating cantilever hanging off one end. (A nanometer is one-billionth of a meter; a micron is one-millionth of a meter.) They identified exactly how to tune its sensitivity -- a breakthrough that could lead to advanced sensing technologies. The experiments detailed online Feb. 8 in Journal of Applied Physics show how these oscillators, which are nanoelectromechanical systems (NEMS), could one day be made into everyday devices by lining up millions of them and treating each cantilever with a certain molecule. "The big purpose is to be able to drive arrays of these things all in direct synchrony," said first author Rob Ilic, a research associate at the Cornell NanoScale Science and Technology Facility. "They can be functionalized with different chemistries and biomolecules to detect various pathogens -- not just one thing."