We discuss our preliminary results in building a configurable accelerator for differential equation time stepping and iterative methods for algebraic equations. Relative to prior efforts in building ...hardware accelerators for numerical methods, our focus is on the following: 1) Demonstrating a higher order of numerical convergence that is needed to actually support existing numerical algorithms. 2) Providing the capacity for wide vectors of variables by keeping the hardware design components as simple as possible. 3) Demonstrating configurable hardware support for a variety of numerical algorithms that form the core of scientific computation libraries. These efforts are toward the goal of making the accelerator democratically accessible by computational scientists.
There are currently no approved treatments for cancer cachexia. One of the main barriers to developing a treatment for this indication is the lack of consensus on clinically important tools for ...assessing functional impairment in this setting. This issue is of critical importance because functional improvement is likely to be required for approval by regulatory agencies. This cross-sectional study aimed to evaluate various functional performance measures and establish their association with body composition, energy expenditure, biomarkers, and patient-reported quality of life (QOL).
Physical function, body composition, energy expenditure, cytokines, testosterone, and patient-reported QOL were compared between men with solid tumors with cachexia (CAC; N = 48), without cachexia (CNC; N = 48), and weight-stable patients without cancer (CON; N = 37). Receiver Operator Characteristic curves and multivariate regression were performed to identify functional impairment cut-points and predictors of physical function, respectively.
Patients with CAC displayed lower total lean and appendicular lean mass, stair climb power (SCP), upper body strength, and bioavailable testosterone, and displayed higher energy expenditure than CNC or CON (p ≤ 0.03); CAC showed lower handgrip, respiratory quotient, and appetite, and higher cytokines and fatigue than CON (p ≤ 0.032). A cut-point of 336 Watts for SCP provided 78% sensitivity and 77% specificity for classification of CAC (p = 0.001); SCP also performed better than other measures tested when compared to CON-derived normatives. Upper body strength exhibited moderate sensitivity and specificity for classification of CAC (p ≤ 0.02). Elevated relative energy expenditure and cytokines negatively predicted, and muscle mass positively predicted, various muscle strength outcomes.
Stair climb power and upper body strength may have potential as discriminatory tests for functional impairment in patients with cancer cachexia.
•Patient distress and anxiety significantly improved following circulating tumor DNA (ctDNA) surveillance testing for HPV (+) oropharyngeal squamous cell carcinoma (OPC).•Overall, 95.5% of patients ...responded ctDNA surveillance testing was beneficial, while 100% felt “somewhat” or “extremely” confident in ctDNA as a monitoring tool.•While 58.1% of patients would be willing to pay out of pocket for ctDNA surveillance, only 25.6% would be willing to continue the test indefinitely.
Circulating tumor DNA assays have robust potential as molecular surveillance tools. They may also exacerbate patient distress without improving outcomes. We investigate patient acceptability of a validated ctHPVDNA assay (NavDx) during cancer surveillance for HPV(+) oropharyngeal cancer (OPC).
Consented HPV(+) OPC participants completed the NCCN Distress Thermometer, the Hospital Anxiety Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General (FACT-G) scale both (1) before NavDx blood draw, and (2) after results were provided. Patients then completed a series of focused questions related to their perceptions of the assay.
Overall, 55 patients completed the study, with 98.2 % showing no recurrence. For the NCCN Distress Thermometer, median patient distress decreased (2.0 (IQR 1–5) vs. 1.0 (IQR 0–3)) (p < 0.001) in association with NavDx. Using scores ≥ 4 as a cutoff point to define clinically elevated distress, scores also improved (36.4 % vs. 18.2 %, p = 0.031). For HADS, anxiety significantly improved (5.0 (IQR 2.0–7.0) vs. 3.0 (IQR 1.0–6.5)) (p = 0.037), but not depression (3.0 (IQR 1.0–7.0) vs. 3.0 (IQR 1.0–6.5)) (p = 0.870). FACT-G scores showed no substantial differences. On survey questionnaires, 95.5 % of patients believed the test to be helpful, and 100 % felt “somewhat” or “extremely” confident in the assay as a monitoring tool. While 59.1 % felt that it reduced anxiety, 88.4 % concordantly felt that it did not introduce anxiety.
ctHPVDNA as a molecular surveillance tool reduced distress levels in HPV(+) OPC patients, with notably high patient confidence in the approach. Further investigation is warranted to judiciously incorporate this emerging modality in surveillance guidelines.
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