Uncovering the challenges of managing cachexia in advanced cancer: Preliminary results from semi-structured interviews with healthcare professionals in a regional cancer centre

Background: Cancer cachexia is a complex metabolic syndrome characterised by severe and progressive weight loss which is predominantly muscle mass. It is a devastating and distressing complication of advanced cancer with profound bio-psycho-social implications for patients and their families. At present there is no curative treatment for cachexiain advanced cancer therefore the most important healthcare response entails the minimisation of the psycho-social distress associated with it. However the literature suggests healthcare professionals’are missing opportunities to intervene and respond to the multi-dimensional needs of this population.

Objective:The objective of this study was to explore healthcare professionals’ response to cachexia in advanced cancer.

Methods: An interpretative qualitative approach was adopted in this study. A purposive sample of doctors, nurses, specialist nurses and dieticians were recruited from a regional cancer centre between November 2009 and November 2010. Data was collection was twofold: two multi-professional focus groups were conducted first to uncover the main themes and issues in cachexia management. This data then informed the interview schedule for the following 25 individual semi-structured interviews.

Results: Preliminary data analysis of the semi-structured interviews revealed distinct differences between disciplines in their perceptions of cancer cachexia which influenced their response to it in clinical practice. The commonality between disciplines, with the exception of palliative care, was a reliance on the biomedical approach to cancer cachexia management.

Discussion and Conclusions: Cancer cachexia is a complex and challenging syndrome which needs to be addressed from a holistic model of care to reflect the multi-dimensional needs of this patient group. The perspectives of those involved in care delivery is required in order to inform the development of interventions aimed at minimising the distress associated with this devastating syndrome.

Influence of embedded length on strength of BFRP rods bonded parallel to the grain in low grade timber by pullout-bending tests

Bonded-in rod connections in timber possess many desirable attributes in terms of efficiency, manufacture, performance, aesthetics and cost. In recent years research has been conducted on such connections using fibre reinforced polymers (FRPs) as an alternative to steel. This research programme investigates the pull-out capacity of Basalt FRP rods bonded-in in low grade Irish Sitka Spruce. Embedded length is thought to be the most influential variable contributing to pull- out capacity of bonded-in rods after rod diameter. Previous work has established an optimum embedded length of 15 times the hole diameter. However, this work only considered the effects of axial stress on the bond using a pull-compression testing system which may have given an artificially high pull out capacity as bending effects were neglected. A hinge system was utilised that allows the effects of bending force to be taken in to consideration along with axial forces in a pull-out test. This paper describes an experimental programme where such pull-bending tests were carried out on samples constructed of 12mm diameter BFRP bars with a 2mm glueline thickness and embedded lengths between 80mm and 280mm bonded-in to low-grade timber with an epoxy resin. Nine repetitions of each were tested. A clear increase in pull-out strength was found with increasing embedded length.

A Programming Model and Runtime System for Significance-Aware Energy-Efficient Computing.

We introduce a task-based programming model and runtime system that exploit the observation that not all parts of a program are equally significant for the accuracy of the end-result, in order to trade off the quality of program outputs for increased energy-efficiency. This is done in a structured and flexible way, allowing for easy exploitation of different points in the quality/energy space, without adversely affecting application performance. The runtime system can apply a number of different policies to decide whether it will execute less-significant tasks accurately or approximately.

The experimental evaluation indicates that our system can achieve an energy reduction of up to 83% compared with a fully accurate execution and up to 35% compared with an approximate version employing loop perforation. At the same time, our approach always results in graceful quality degradation.

Accelerating integer-based fully homomorphic encryption using Comba multiplication

Fully Homomorphic Encryption (FHE) is a recently developed cryptographic technique which allows computations on encrypted data. There are many interesting applications for this encryption method, especially within cloud computing. However, the computational complexity is such that it is not yet practical for real-time applications. This work proposes optimised hardware architectures of the encryption step of an integer-based FHE scheme with the aim of improving its practicality. A low-area design and a high-speed parallel design are proposed and implemented on a Xilinx Virtex-7 FPGA, targeting the available DSP slices, which offer high-speed multiplication and accumulation. Both use the Comba multiplication scheduling method to manage the large multiplications required with uneven sized multiplicands and to minimise the number of read and write operations to RAM. Results show that speed up factors of 3.6 and 10.4 can be achieved for the encryption step with medium-sized security parameters for the low-area and parallel designs respectively, compared to the benchmark software implementation on an Intel Core2 Duo E8400 platform running at 3 GHz.

Automatically Annotating Structured Web Data Using a SVM-Based Multiclass Classifier

In this paper, we propose a new learning approach to Web data annotation, where a support vector machine-based multiclass classifier is trained to assign labels to data items. For data record extraction, a data section re-segmentation algorithm based on visual and content features is introduced to improve the performance of Web data record extraction. We have implemented the proposed approach and tested it with a large set of Web query result pages in different domains. Our experimental results show that our proposed approach is highly effective and efficient.

Pool Evolution: A Parallel Pattern for Evolutionary and Symbolic Computing

We introduce a new parallel pattern derived from a specific application domain and show how it turns out to have application beyond its domain of origin. The pool evolution pattern models the parallel evolution of a population subject to mutations and evolving in such a way that a given fitness function is optimized. The pattern has been demonstrated to be suitable for capturing and modeling the parallel patterns underpinning various evolutionary algorithms, as well as other parallel patterns typical of symbolic computation. In this paper we introduce the pattern, we discuss its implementation on modern multi/many core architectures and finally present experimental results obtained with FastFlow and Erlang implementations to assess its feasibility and scalability.

Conceptual Design and Workspace Analysis of an Exechon-inspired Parallel Kinematic Machine

Inspired by the commercial application of the Exechon machine, this paper proposed a novel parallel kinematic machine (PKM) named Exe-Variant. By exchanging the sequence of kinematic pairs in each limb of the Exechon machine, the Exe-Variant PKM claims an arrangement of 2UPR/1SPR topology and consists of two identical UPR limbs and one SPR limb. The inverse kinematics of the 2UPR/1SPR parallel mechanism was firstly analyzed based on which a conceptual design of the Exe-Variant was carried out. Then an algorithm of reachable workspace searching for the Exe-Variant and the Exchon was proposed. Finally, the workspaces of two example systems of the Exechon and the Exe-Variant with approximate dimensions were numerically simulated and compared. The comparison shows that the Exe-Variant possesses a competitive workspace with the Exechon machine, indicating it can be used as a promising reconfigurable module in a hybrid 5-DOF machine tool system.

Stiffness Analysis and Experiment of a Novel 5-DoF Parallel Kinematic Machine Considering Gravitational Effects

In order to carry out high-precision machining of aerospace structural components with large size, thin wall and complex surface, this paper proposes a novel parallel kinematic machine (PKM) and formulates its semi-analytical theoretical stiffness model considering gravitational effects that is verified by stiffness experiments. From the viewpoint of topology structure, the novel PKM consists of two substructures in terms of the redundant and overconstrained parallel mechanisms that are connected by two interlinked revolute joints. The theoretical stiffness model of the novel PKM is established based upon the virtual work principle and deformation superposition principle after mapping the stiffness models of substructures from joint space to operated space by Jacobian matrices and considering the deformation contributions of interlinked revolute joints to two substructures. Meanwhile, the component gravities are treated as external payloads exerting on the end reference point of the novel PKM resorting to static equivalence principle. This approach is proved by comparing the theoretical stiffness values with experimental stiffness values in the same configurations, which also indicates equivalent gravity can be employed to describe the actual distributed gravities in an acceptable accuracy manner. Finally, on the basis of the verified theoretical stiffness model, the stiffness distributions of the novel PKM are illustrated and the contributions of component gravities to the stiffness of the novel PKM are discussed.