Use of a Chemotherapy Toxicity Prediction Tool to Decrease Risks for Hospitalization in Older Patients.

Objectives Performance status (PS) scales such as the Eastern Cooperative Oncology Group (ECOG) PS and the Karnofsky Performance Index have limited utility in selecting therapies and predicting related adverse events in older patients with cancer. In July 2016, medical oncologists at our institution adopted the Cancer and Aging Research Group toxicity prediction score (CARG), a toxicity prediction tool, to identify patients who are "fit" for chemotherapy versus those who are "frail" and may experience severe complications. Methods Our retrospective review included referrals of beneficiaries 75 years of age and older who received standard systemic therapy and patients of the same age whose treatment was modified due to CARG.

Quantum fluctuations of entropy production for fermionic systems in the Landauer-Büttiker state.

The quantum fluctuations of the entropy production for fermionic systems in the Landauer-Büttiker nonequilibrium steady state are investigated. The probability distribution, governing these fluctuations, is explicitly derived by means of quantum field theory methods and analyzed in the zero frequency limit. It turns out that microscopic processes with positive, vanishing and negative entropy production occur in the system with nonvanishing probability.

Enhanced electrogastrography: A realistic way to salvage a promise that was never kept?

Aim: To enhance the clinical utility of electrogastrography (EGG), which has been recorded since 1922, but is clinically unutilized.

Methods: An innovative method to salvage the promise of EGG is proposed by introducing a preliminary procedure, while maintaining the electrodes, standardized equipment, and signal processing utilized in the well-established EGG testing of today. The proposed enhanced EGG (EEGG) protocol involves swallowing an ingestible capsule containing miniature electronic oscillator embedded in an expandable, self-disintegratable, biocompatible pseudobesoar residing in the stomach for the duration of the test.

Wearable Microsystem for Minimally Invasive, Pseudo-Continuous Blood Glucose Monitoring: The e-Mosquito.

This paper presents a wearable microsystem for minimally invasive, autonomous, and pseudo-continuous blood glucose monitoring, addressing a growing demand for replacing tedious fingerpricking tests for diabetic patients. Unlike prevalent solutions which estimate blood glucose levels from interstitial fluids or tears, our design extracts a whole blood sample from a small lanced skin wound using a novel shape memory alloy (SMA)-based microactuator and directly measures the blood glucose level from the sample. In vitro characterization determined that the SMA microactuator produced penetration force of 225 gf, penetration depth of 3.

Catheter-based acoustic interrogation device for real-time monitoring of the dynamics of the lower esophageal sphincter: in vitro and pilot canine studies.

This paper presents a novel minimally-invasive catheter-based acoustic interrogation device for real-time monitoring the dynamics of the lower esophageal sphincter (LES). Dysfunction of the LES could result gastrointestinal (GI) diseases, such as gastroesophageal reflux disease (GERD). A micro-oscillator actively emitting sound wave at 16 kHz is located at one side of the LES, and a miniature microphone is located at the other side of the LES to capture the sound generated from the oscillator.

Transcutaneous intraluminal impedance measurement for minimally invasive monitoring of gastric motility: validation in acute canine models.

Transcutaneous intraluminal impedance measurement (TIIM) is a new method to cutaneously measure gastric contractions by assessing the attenuation dynamics of a small oscillating voltage emitted by a battery-powered ingestible capsule retained in the stomach. In the present study, we investigated whether TIIM can reliably assess gastric motility in acute canine models. Methods.

A catheter-based acoustic interrogation device for monitoring motility dynamics of the lower esophageal sphincter.

This paper presents novel minimally-invasive, catheter-based acoustic interrogation device for monitoring motility dynamics of the lower esophageal sphincter (LES). A micro-oscillator actively emitting sound wave at 16 kHz is located at one side of the LES, and a miniature microphone is located at the other side of the sphincter to capture the sound generated from the oscillator. Thus, the dynamics of the opening and closing of the LES can be quantitatively assessed.

Real-time gastric motility monitoring using transcutaneous intraluminal impedance measurements (TIIM).

The stomach plays a critical role in digestion, processing ingested food mechanically and breaking it up into particles, which can be effectively and efficiently processed by the intestines. When the motility of the stomach is compromised, digestion is adversely affected. This can lead to a variety of disorders.

Gastric electrical stimulation for the treatment of obesity: from entrainment to bezoars-a functional review.

GROWING WORLDWIDE OBESITY EPIDEMIC HAS PROMPTED THE DEVELOPMENT OF TWO MAIN TREATMENT STREAMS: (a) conservative approaches and (b) invasive techniques. However, only invasive surgical methods have delivered significant and sustainable benefits. Therefore, contemporary research exploration has focused on the development of minimally invasive gastric manipulation methods featuring a safe but reliable and long-term sustainable weight loss effect similar to the one delivered by bariatric surgeries.

Suture marker lesion detection in the colon by self-stabilizing and unmodified capsule endoscopes: pilot study in acute canine models.

Background: Capsule endoscopy is a noninvasive method for examining the small intestine. Recently, this method has been used to visualize the colon. However, the capsule often tumbles in the wider colon lumen, resulting in potentially missed pathology.

Colometer: a real-time quality feedback system for screening colonoscopy.

Aim: To investigate the performance of a new software-based colonoscopy quality assessment system.

Methods: The software-based system employs a novel image processing algorithm which detects the levels of image clarity, withdrawal velocity, and level of the bowel preparation in a real-time fashion from live video signal. Threshold levels of image blurriness and the withdrawal velocity below which the visualization could be considered adequate have initially been determined arbitrarily by review of sample colonoscopy videos by two experienced endoscopists.

Intraluminal ultrasonic probe for volumetric monitoring of liquid gastroesophageal reflux.

Methods for volumetric monitoring of liquid gastroesophageal reflux (GER) are still lacking. The aim of this study was to develop an automated intraluminal measurement technique which allows ambulatory volumetric quantification of liquid GER utilizing a minimum-cost intraluminal ultrasonic probe. This probe consists of two 2 MHz ultrasonic crystals longitudinally assembled along a multi-channel intraluminal impedance (MII) catheter.

Technical note: Evaluation of tined endoscopically placed mucosal leads for temporary gastric neurostimulation.

Objective: To compare larger diameter corkscrew-tined leads with previously described intracardiac pacing leads for temporary gastric neurostimulation in a canine model.

Materials And Methods: Two mongrel dogs underwent gastroscopy under general anesthesia, with endoscopic placement of two cardiac leads (1 mm tine diameter, 4 mm depth) placed sequentially in 1) transverse configuration in the distal antrum mucosa; 2) longitudinal (1 cm apart) configuration in gastric corpus. Stomach was then stimulated with maximal parameters to induce neutrally mediated contraction.

Self-stabilizing colonic capsule endoscopy: pilot study of acute canine models.

Video capsule endoscopy (VCE) is a noninvasive method for examining the gastrointestinal tract which has been successful in small intestine studies. Recently, VCE has been attempted in the colon. However, the capsule often tumbles in the wider colonic lumen, resulting in missed regions.

Entanglement entropy of one-dimensional gases.

We introduce a systematic framework to calculate the bipartite entanglement entropy of a spatial subsystem in a one-dimensional quantum gas which can be mapped into a noninteracting fermion system. To show the wide range of applicability of the proposed formalism, we use it for the calculation of the entanglement in the eigenstates of periodic systems, in a gas confined by boundaries or external potentials, in junctions of quantum wires, and in a time-dependent parabolic potential.

Design, implementation and testing of an implantable impedance-based feedback-controlled neural gastric stimulator.

Functional neural gastrointestinal electrical stimulation (NGES) is a methodology of gastric electrical stimulation that can be applied as a possible treatment for disorders such as obesity and gastroparesis. NGES is capable of generating strong lumen-occluding local contractions that can produce retrograde or antegrade movement of gastric content. A feedback-controlled implantable NGES system has been designed, implemented and tested both in laboratory conditions and in an acute animal setting.

Comparative gastric motility study of Enterra ™ Therapy and neural gastric electrical stimulation in an acute canine model.

Background: Gastric electrical stimulation (GES) is an avenue for treating gastroparesis and obesity by controlling gastric motility using electrically mediated gastric contractions. Neural gastrointestinal electrical stimulation (NGES) is a GES modality capable of producing strong lumen-occluding local gastric contractions. Conversely, Enterra ™ Therapy, a commercial implantable gastric electrical stimulator, has been utilized to treat symptoms of gastroparesis, but its nominal electrical parameters are not capable of generating lumen-occluding contractions.

Pilot study of longitudinal ultrasonic sensor for dynamic volumetric assessment of gastroesophageal reflux.

In patients with gastroesophageal reflux disease (GERD), esophageal symptoms are traditionally diagnosed by monitoring the contact time between the reflux content and the esophagus using multichannel intraluminal impedance and pH (MII-pH) catheters. However, esophageal catheter for quantifying the volume of reflux content is still lacking. The present work proposes an innovative method to develop a longitudinal ultrasonic catheter and an information extraction system for reflux event detection and reflux volume estimation.

Pilot study of temporary controllable gastric pseudobezoars for dynamic non-invasive gastric volume reduction.

Invasive surgical procedures for gastric volume reduction or bypass have been considered the most effective approach to sustainable long-term weight reduction. However, non-invasive techniques for dynamic volume reduction from inside the stomach are lacking. The aim of this study was to propose temporary, permeable, controllable pseudobezoars for non-invasive, long-term sustainable gastric volume reduction and to test them in pilot human studies.

Implantable functional gastrointestinal neurostimulation.

Neural Gastrointestinal Electrical Stimulation (NGES) is a new microprocessor-based method for invoking gastric or colonic contractions by generating multi-channel, high energy, high frequency waveforms. It has been shown that when applied to the lower stomach, NGES offers the possibility for enhancing propulsive peristalsis for the treatment of gastric motor dysfunctions, or for producing retrograde peristalsis for the treatment of obesity. When applied to the colon, NGES can be utilized either for propulsive control in severe constipation or for invoked retrograde contractility.

Diamagnetically stabilized levitation control of an intraluminal magnetic capsule.

Controlled navigation promotes full utilization of capsule endoscopy for reliable real-time diagnosis in the gastrointestinal (GI) tract, but intermittent natural peristalsis can disturb the navigational control, destabilize the capsule and take it out of levitation. The focus of the present work was to develop an economical and effective real-time magnetic capsule-guiding system that can operate in the presence of naturally existing peristalsis while retaining navigational control. A real-size magnetic navigation system that can handle peristaltic forces of up to 1.

Pilot acute study of feedback-controlled retrograde peristalsis invoked by neural gastric electrical stimulation.

Neural gastric electrical stimulation (NGES) is a new method for invoking gastric contractions under microprocessor control. However, optimization of this technique using feedback mechanisms to minimize power consumption and maximize effectiveness has been lacking. The present pilot study proposes a prototype feedback-controlled neural gastric electric stimulator for the treatment of obesity.

Diamagnetically-stabilized levitation control of an intraluminal magnetic capsule.

Controlled navigation promotes full utilization of capsule endoscopy for reliable real-time diagnosis in the gastrointestinal (GI) tract, but intermittent natural peristalsis can disturb the navigational control, destabilize the capsule and take it out of levitation. A real-size magnetic navigation system that can handle peristaltic forces of up to 1.5 N was designed utilizing the computer-aided design (CAD) system Maxwell 3D (Ansoft, Pittsburg, PA), and was verified using a small-size physical experimental setup.

Feedback control of retrograde peristalsis using Neural Gastric Electrical Stimulation.

Neural Gastric Electrical Stimulation (NGES) is a new method for invoking gastric contractions under microprocessor control. However, optimization of this technique using feedback mechanisms to minimize power consumption and maximize effectiveness has been lacking. The present work proposes a prototype feedback-controlled neural gastric electrical stimulator for the treatment of obesity.

Use of multichannel electrogastrography for noninvasive assessment of gastric myoelectrical activity in dogs.

Objective: To evaluate whether changes in gastric myoelectrical activity in healthy, awake dogs can be detected via multichannel electrogastrography (EGG).

Animals: 6 healthy hound-breed dogs.

Procedures: For each dog, 8-channel EGG was performed after food had been withheld for 12 hours and at 30 minutes after subsequent feeding; 60 minutes after feeding, atropine (0.