The Functional Assessment of Cancer Therapy Scale: Development and Validation of the General Measure

PURPOSE

We developed and validated a brief, yet sensitive, 33-item general cancer quality-of-life (QL) measure for evaluating patients receiving cancer treatment, called the Functional Assessment of Cancer Therapy (FACT) scale.

METHODS AND RESULTS

The five-phase validation process involved 854 patients with cancer and 15 oncology specialists. The initial pool of 370 overlapping items for breast, lung, and colorectal cancer was generated by open-ended interview with patients experienced with the symptoms of cancer and oncology professionals. Using preselected criteria, items were reduced to a 38-item general version. Factor and scaling analyses of these 38 items on 545 patients with mixed cancer diagnoses resulted in the 28-item FACT-general (FACT-G, version 2). In addition to a total score, this version produces subscale scores for physical, functional, social, and emotional well-being, as well as satisfaction with the treatment relationship. Coefficients of reliability and validity were uniformly high. The scale's ability to discriminate patients on the basis of stage of disease, performance status rating (PSR), and hospitalization status supports its sensitivity. It has also demonstrated sensitivity to change over time. Finally, the validity of measuring separate areas, or dimensions, of QL was supported by the differential responsiveness of subscales when applied to groups known to differ along the dimensions of physical, functional, social, and emotional well-being.

CONCLUSION

The FACT-G meets or exceeds all requirements for use in oncology clinical trials, including ease of administration, brevity, reliability, validity, and responsiveness to clinical change. Selecting it for a clinical trial adds the capability to assess the relative weight of various aspects of QL from the patient's perspective.

Stateful Three-Input Logic with Memristive Switches

Memristive switches are able to act as both storage and computing elements, which make them an excellent candidate for beyond-CMOS computing. In this paper, multi-input memristive switch logic is proposed, which enables the function X OR (Y NOR Z) to be performed in a single-step with three memristive switches. This ORNOR logic gate increases the capabilities of memristive switches, improving the overall system efficiency of a memristive switch-based computing architecture. Additionally, a computing system architecture and clocking scheme are proposed to further utilize memristive switching for computation. The system architecture is based on a design where multiple computational function blocks are interconnected and controlled by a master clock that synchronizes system data processing and transfer. The clocking steps to perform a full adder with the ORNOR gate are presented along with simulation results using a physics-based model. The full adder function block is integrated into the system architecture to realize a 64-bit full adder, which is also demonstrated through simulation.

Compact modeling of CRS devices based on ECM cells for memory, logic and neuromorphic applications

Dynamic physics-based models of resistive switching devices are of great interest for the realization of complex circuits required for memory, logic and neuromorphic applications. Here, we apply such a model of an electrochemical metallization (ECM) cell to complementary resistive switches (CRSs), which are favorable devices to realize ultra-dense passive crossbar arrays. Since a CRS consists of two resistive switching devices, it is straightforward to apply the dynamic ECM model for CRS simulation with MATLAB and SPICE, enabling study of the device behavior in terms of sweep rate and series resistance variations. Furthermore, typical memory access operations as well as basic implication logic operations can be analyzed, revealing requirements for proper spike and level read operations. This basic understanding facilitates applications of massively parallel computing paradigms required for neuromorphic applications.

Nanobatteries in redox-based resistive switches require extension of memristor theory

Redox-based nanoionic resistive memory cells are one of the most promising emerging nanodevices for future information technology with applications for memory, logic and neuromorphic computing. Recently, the serendipitous discovery of the link between redox-based nanoionic-resistive memory cells and memristors and memristive devices has further intensified the research in this field. Here we show on both a theoretical and an experimental level that nanoionic-type memristive elements are inherently controlled by non-equilibrium states resulting in a nanobattery. As a result, the memristor theory must be extended to fit the observed non-zero-crossing I-V characteristics. The initial electromotive force of the nanobattery depends on the chemistry and the transport properties of the materials system but can also be introduced during redox-based nanoionic-resistive memory cell operations. The emf has a strong impact on the dynamic behaviour of nanoscale memories, and thus, its control is one of the key factors for future device development and accurate modelling.

Beyond von Neumann--logic operations in passive crossbar arrays alongside memory operations

The realization of logic operations within passive crossbar memory arrays is a promising approach to expand the fields of application of such architectures. Material implication was recently suggested as the basic function of memristive crossbar junctions, and single bipolar resistive switches (BRS) as well as complementary resistive switches (CRS) were shown to be capable of realizing this logical functionality. Based on a systematic analysis of the Boolean functions, we demonstrate here that 14 of 16 Boolean functions can be realized with a single BRS or CRS cell in at most three sequential cycles. Since the read-out step is independent of the logic operation steps, the result of the logic operation is directly stored to memory, making logic-in-memory applications feasible.

Capacity based nondestructive readout for complementary resistive switches

Complementary resistive switches (CRS) were recently suggested to solve the sneak path problem of larger passive memory arrays. CRS cells consist of an antiserial setup of two bipolar resistive switching cells. The conventional destructive readout for CRS cells is based on a current measurement which makes a considerable call on the switching endurance. Here, we report a new approach for a nondestructive readout (NDRO) based on a capacity measurement. We suggest a concept of an alternative setup of a CRS cell in which both resistive switching cells have similar switching properties but are distinguishable by different capacities. The new approach has the potential of an energy saving and fast readout procedure without decreasing cycling performance and is not limited by the switching kinetics for integrated passive memory arrays.

The Functional Assessment of Cancer Therapy scale: development and validation of the general measure

PURPOSE

We developed and validated a brief, yet sensitive, 33-item general cancer quality-of-life (QL) measure for evaluating patients receiving cancer treatment, called the Functional Assessment of Cancer Therapy (FACT) scale.

METHODS AND RESULTS

The five-phase validation process involved 854 patients with cancer and 15 oncology specialists. The initial pool of 370 overlapping items for breast, lung, and colorectal cancer was generated by open-ended interview with patients experienced with the symptoms of cancer and oncology professionals. Using preselected criteria, items were reduced to a 38-item general version. Factor and scaling analyses of these 38 items on 545 patients with mixed cancer diagnoses resulted in the 28-item FACT-general (FACT-G, version 2). In addition to a total score, this version produces subscale scores for physical, functional, social, and emotional well-being, as well as satisfaction with the treatment relationship. Coefficients of reliability and validity were uniformly high. The scale's ability to discriminate patients on the basis of stage of disease, performance status rating (PSR), and hospitalization status supports its sensitivity. It has also demonstrated sensitivity to change over time. Finally, the validity of measuring separate areas, or dimensions, of QL was supported by the differential responsiveness of subscales when applied to groups known to differ along the dimensions of physical, functional, social, and emotional well-being.

CONCLUSION

The FACT-G meets or exceeds all requirements for use in oncology clinical trials, including ease of administration, brevity, reliability, validity, and responsiveness to clinical change. Selecting it for a clinical trial adds the capability to assess the relative weight of various aspects of QL from the patient's perspective.

Permeability of thermally damaged skin v: permeability over the course of maturation of a deep partial-thickness wound

The permeability of eschar is an important factor governing rational approaches to topical control of burn wound sepsis. Previous work has shown the burn wound to have a highly variable permeability immediately after burning depending on the manner of burning. But the burn is also a dynamic wound and its physical state changes during the process of maturation. The present studies are an early attempt to characterize wound permeability as a function of maturation. Hairless mice were burned dorsally for 15 seconds on a metal surface maintained at 80 degree C. The time and temperature conditions were chosen to effect a deep partial-thickness to full-thickness injury on the animal. Mice were sacrificed daily post burn over a 2-week period and the permeabilities of 3H-methanol and 14C-butanol through the excised eschar were measured. Te eschar permeability coefficients were directly compared to permeability coefficients for the same compounds found with abdominal skin sections taken concurrently from each animal. It was observed that the branding initially caused a 50 per cent increase in the permeability of methanol and a 300-400 per cent increase in the permeability of maturation. Thereafter permeabilities tended to increase, gradually at first, but accelerating to a maximum which was observed at approximately 10 days. At the maximum, methanol's permeability was 20 times and butanol's 12 times their normal values. For both compounds permeability of eschar decreased past the maximum until termination of the studies at 14 days.

The therapeutic effect of epsilon-aminocaproic acid on anetoderma Jadassohn

The therapeutic results achieved in the treatment of anetoderma of Jadassohn with ε-aminocaproic acid is reported, which constitutes the first case in the literature which produced a permanent cure. Although the mechanism of action of ε-aminocaproic acid is not clear, the indisputable disappearance of the erythematous plaques and the subsequent prevention of the development of herniated lesions and bag-like protrusions are clear evidence of the therapeutic efficacy of this drug. Because an inflammatory process preceded these lesions, which was suppressed by the administration of ε-aminocaproic acid, the possibility is assumed that this anti-fibrinolytic drug may act by indirectly diminishing the amount of activity of the inflammatory peptides bradykinin, or similar substances.