OncologyLive® is the flagship publication of OncLive®. Each issue delivers expert insights and clinical oncology news and updates, which impact the day-to-day clinical practice of oncology professionals who work tirelessly to help improve patient outcomes.

	PC users, is the impending April 3 iPad release giving you tablet envy? Well, rest assured: Coinciding with the iPad’s arrival, 

(HP) expects to release the HP EliteBook 2740p, an ultra-thin, multi-touch—enabled, convertible tablet optimum for business and healthcare professionals on the go. The EliteBook 2740p (starting at $1599) combines the full functional capability of an HP notebook PC with the unrestrained flexibility of a tablet. The hybrid device easily transforms from a notebook to a tablet through the simple manipulation of a convertible hinge. Starting at 3.8 pounds, the 2-in-1 EliteBook 2740p is easily transported, allowing you to remain productive in any situation. It comes standard with a 12.1-inch diagonal LED display, with the option to purchase a screen that enhances viewing in natural light. Users can operate the tablet with an included stylus or the touch screen, which allows swift navigation via simple finger taps and screen swipes. The device comes loaded with HP software, including HP QuickWeb, which enables Web access when the computer is shut down, and a trial version of HP SkyRoom, which allows high-

	definition videoconferencing. An HP 2740 Ultra-Slim Expansion Base (starting at $299) can be purchased to dock the PC for use with peripherals.

	Tired of always relying on a crowded, distraction-filled Starbucks as your WiFi hotspot? Using the mobile network, Connect

 allows you to create your own personal hotspot wherever and whenever you want. Wi-REACH

, which retails for $99, is ideal for healthcare professionals who frequently travel. The small, plastic device resembles a battery charger and allows you to use your existing 3G USB dongle (a mobile broadband modem that provides Internet access via 3G signaling). The

	dongle easily connects and slips inside the top of the Wi-REACH

. You can also purchase a model that comes with an embedded 3G dongle. Once you are set up, the push of a button connects your WiFi-enabled device to Wi-REACH

 via WiFi, and then to the Internet through the mobile network. It requires no installation or client software and the wireless links are secure. Each Wi-REACH

 allows you to simultaneously use up to 10 devices through password-protected connections. The standalone Wi-REACH

 runs on a rechargeable battery that lasts several hours.

 Wireless Keyboard is a handheld mini keyboard that allows multimedia wireless control in any working environment. Oncologists and other healthcare professionals may find the Rii Mini useful for conferences, presentations, and lecturing. The device has a full QWERTY keyboard with 69 keys, an integrated touchpad that works horizontally and vertically, and a laser pointer. The portable unit measures 151 mm x 59 mm x 13 mm, weighs 103 g, can operate from a 30-meter range, and connects to the device of your choice via a 2.4-GHz USB receiver. Twenty-six bright LED lights backlight the Rii Mini for use in darker environments. Its built-in, rechargeable, lithium-ion battery should last for 1 month. The Rii Mini also facilitates PC multimedia entertainment, as home theater PC users can relax on their couch and use the Rii Mini as easily as their TV remote control. The device retails for $92 and comes with a USB receiver and USB cable. For additional product analysis, be sure to check out the 7.5-minute 

Articles

Oncology Gadget Watch: April 27, 2010

	In October 2000, a team of researchers at Stanford University led by Vijay Pande, PhD, debuted a distributed computing project designed to simulate the protein folding process. These simulations were developed to complement and aid formal experiments. Dubbed Folding@home (FAH), the project uses autonomous individual computer processors around the world to run complex computing algorithms that would otherwise take a single supercomputer millions of times longer. In its original format, with the help of Adam Beberg’s distributed computing advice, Dr Pande’s algorithms were integrated into a screensaver PC users could download that would run when their machine idled. To date, the project has received computational results from over 4.51 million devices and has over 400,000 active donor clients throughout the world using both desktop computers and PlayStation 3 consoles. This distributed supercomputer is the largest and most efficient of its kind and has contributed to the research of biomedical problems such as Alzheimer’s disease, Parkinson’s disease, cancer, and many cancer-related syndromes. In Dr Pande’s words, “The simulation world now can give us insights that we couldn’t get experimentally and these insights can be taken from the simulations and put directly into the real world.” More than 60 research papers have been written directly from the project’s results. To see the project’s eye-catching simulations, visit the Pande group’s 

	Proteins are essential to the body’s stability and function—they take shape as enzymes, structural elements, and antibodies. As enzymes, they are the catalysts for the body’s biochemical reactions; as structural components, they are the main building blocks of bones, blood vessels, and muscles; as antibodies, they identify and help eliminate foreign bodies. There are literally thousands of different proteins and each type has its own function. Each potential function not only requires a protein to be composed of a particular sequence of amino acids, the protein must also take a specific shape. Proteins essentially assemble themselves using a process called “folding.” One of the goals of the FAH project is to simulate the protein folding process to better understand how proteins are able to fold so quickly&mdash;some as fast as a microsecond&mdash;and how they generally fold so reliably. This project also helps to unravel the mysteries of what happens when proteins take shape incorrectly, called “misfolding.” This malformation is particularly destructive because it encourages the misfolding of other proteins, which can result in an aggregation of toxicity. This aggregate material is thought to contribute to diseases such as Alzheimer’s disease, cystic fibrosis, and many cancers. The group’s first cancer-related finding was published in 2005 and was focused on protein 53 (p53). Approximately 50% of cancers involve a mutation in p53, a tumor- suppressing guardian cell. When p53 breaks down or folds incorrectly or too slowly, it is unable to perform its vital function and cells with damaged DNA are neither repaired nor destroyed. This area of the project’s research is aiming to predict the relevant mutations.

The Need for Extraordinary Processing Power 

	The speed at which proteins fold makes using traditional research methods utilizing a single computer’s simulation capabilities completely unrealistic. It takes about 24 hours to simulate one nanosecond of the process, but proteins fold on the microsecond time scale; thus, it would take 10,000 CPU days (or 30 CPU years) to simulate the folding of one result. Also, proteins often do not transition directly from their unfolded state into their intended folded state. Pande compares the process to parallel parking, where multiple trajectory adjustments and realignments are often necessary, lengthening the time needed to accomplish the goal.

	While it may seem counterintuitive that the simulation of a linear process could be distributed over thousands of individual computers, the project’s research methods seem perfectly fitted to its resources. The group has developed multiple ways of simulating the protein folding process, including a method called Markov State Models. This adaptive sampling tool is used to simultaneously simulate multiple stages of the process using a kinetic model built for the specific process. The team determines the series of a process’ states, then the rates between the states. The project’s clients’ machines are used to complete these rate calculations—each individual processor calculates tiny portions of the folding process at a time. Data is periodically collected from each client by a connection to the FAH server to share its work units, in the form of data packets used to perform the calculations. When all of the data are collected, the research team identifies what states are reasonable and initiates further calculation of those states’ rates. This research method’s emphasis on states and clustering is perfectly fitted to the project’s division of labor.

	Petascale computing is a relatively new frontier in the scientific research tool arsenal and overcomes the timescale barrier in the study of molecular dynamics. The processing speed of this type of system is measured in FLOPS, which stands for Floating point Operations Per Second. The FAH computing cluster is measured in PFLOPS (petafl ops), meaning quadrillions (10

 or 1000 trillion) of operations per second. In December 2009, FAH was the fastest cluster of its kind, reporting over 7.8 petaflops of processing power, with nearly one-third of the processing power contributed just by donor clients running on PlayStation 3 systems. Another large portion of the power was contributed by clients using nVidia and ATI’s GPU-based client designed for the project.

	The exceptional efficiency of the distributed computing system is twofold: it saves an extraordinary amount of time and also greatly

	reduces operating expenses. The cooling of one centralized supercomputer capable of the sheer volume of these types of calculations would be incredibly expensive, so each client’s contribution is measured not only in additional processing speed, but also in maintenance savings. Besides the satisfaction of contributing to a worthy endeavor, one of the incentives for volunteering is

	generated by the project’s point system, which stirs up friendly competition among teams of volunteers and directly benefits the project. Teams can monitor their progress on the project’s Website, which updates the stats every hour. Further, contributing to the project is simple and painless. While the client’s machine idles, it connects to the project’s server and grabs a bit of data to process, works on it, and uploads the results. Because the program is designed to be the lowest priority process on the client’s computer or console, any programs run by the user will have first dibs on CPU time.

	The FAH project is one of a growing number of distributed computing programs that allow users to generate meaningful results with minimal cost and effort using idle computer processing power. Unlike FAH, many of the larger distributed computing projects are powered by BOINC, the Berkeley Open Infrastructure for Network Computing, which was originally created to support the security integrity of the SETI@home project. One such program is Rosetta@home, which also researches protein misfolding diseases, but does so less exclusively than FAH. Taking yet another approach, the Help Conquer Cancer project is dedicated to enhancing the results of protein X-ray crystallography, which is used to identify diagnostic markers and determine which proteins may have a functional relationship with cancer. For more information about the project and team, visit this 

	Distributed computing technology has been applied to numerous areas of study, including art, mathematics, artificial intelligence, medicine, gaming, and physics. WorldCommunityGrid.org, a resource sponsored by IBM, offers a varied list of research programs such as FightAIDS@home, Discovering Dengue Drugs — Together, and Nutritious Rice for the World, which all use distributed computing technology to advance their varied areas of research. This particular network’s donors can choose to participate in just one of the programs or contribute to several simultaneously. For another extensive list of distributed computing 

	Dr Pande sees the future of the project eventually including a way for clients to store information remotely, tentatively called Storage@home. With that much data being amassed, storage capacity needs to scale with the project’s capabilities. The volunteer-based storage system would also significantly cut operational expenses. Just as an example, their backup costs for the data volume they collect in a single year total $25,000.

	If you are interested in contributing to FAH, the team suggests downloading and running their free client software. Downloads are available for Windows, Linux, and Mac users. If you own a PlayStation 3 (version 1.6 or later), FAH is included in the “Life with PlayStation” application. Work units have been set to take approximately 8 hours of processing time on the PlayStation 3, which enables the user to run the process overnight and yield a meaningful result. To learn more about the project and how to enable your idle electronic equipment to contribute, visit the 

In October 2000, a team of researchers at Stanford University led by Vijay Pande, PhD, debuted a distributed computing project designed to simulate the protein folding process. 

Folding@home: How Distributed Computing Is Unraveling the Mysteries of Protein Folding

	Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and most feared side effects of chemotherapy. When CINV occurs, it may decrease treatment compliance and result in nutritional deficiencies or dehydration, reduced performance status, and decreased quality of life. Preventing and controlling CINV is imperative for optimizing the care of patients receiving chemotherapy. Although there are numerous treatments in the oncology arsenal, including antiemetics, there are also steps that patients can take to decrease their risk of CINV and manage it when it occurs. We examine five Web resources that can help patients learn about CINV and cope with this debilitating side effect. Some include resources that healthcare providers may also find useful. 

Chemotherapy Side Effects, Radiation Side Effects, Postoperative Side Effects, Symptom Relief, and Treatment Options

 is sponsored by an unrestricted grant from Genentech USA, Inc, and is endorsed by the European Oncology Nursing Society. The site’s tagline is “the site that helps patients help themselves,” which it achieves by providing patients with important information and tools to get a better handle on their CINV. In addition to informative articles on 

, the site includes several resources that patients may find especially useful. One such resource is a 

, where patients can keep a detailed record of the frequency and severity of their nausea or vomiting following treatment using a simple questionnaire. Being able to present their physicians and nurses with a detailed record of their CINV experience may help patients improve communication with their healthcare providers, allowing better CINV-control strategies to be employed. The 

 can be downloaded as a PDF or Word document and is available in English, Spanish, German, and Italian, as is much of the information on the site.

, outlining simple eating tips that patients can use to prevent CINV or dehydration if vomiting occurs. The list also includes a link to an article on Cancer.gov that provides a more comprehensive overview of eating before, during, and after cancer treatment. Patients with questions regarding CINV may find answers in the Website’s 

 section, whereas those looking for guidance on communicating with their healthcare provider may find some of the tip sheets in the 

 section helpful. The site also includes a 

, Ensuring patients understand the medical vocabulary, and a 

 section that links to other credible Websites that provide cancer information.

	Patients who prefer not to review the information online can print the 

, which is downloadable as a PDF and contains all of the same information. The site includes a 

 (downloadable as a PDF), which offers an overview of antiemetics and provides guidance on selecting the right one, but it was published in the United Kingdom in 2003 and doesn’t contain information on some newer therapies, such as palonosetron or the granisetron transdermal system.

2. American Cancer Society— Coping with Physical & Emotional Changes

 includes a section for patients on coping with treatment, including CINV. 

 article in this section provides a comprehensive overview of CINV, reviewing its incidence, potential complications, risk factors, types (eg, acute, delayed, refractory), and treatments, including antiemetics and alternative strategies such as self-hypnosis and music therapy.

	The article also provides nutritional information, including tips on how to prevent CINV, such as by eating a light snack before chemotherapy, and also covers nausea and vomiting resulting from radiation therapy. Patients seeking further information can click on links to countless other useful resources, such as guides to understanding chemotherapy or radiation therapy, as well as to various organizations that include patient support resources.

	Patients interested in obtaining more nutrition-related 

 from the American Cancer Society can access several other 

Managing Eating Problems Caused By Certain Treatments

, which include tips based on treatment. There are articles geared for patients undergoing surgery, radiation therapy, or chemotherapy, as well as for those with weak immune systems from advanced cancers.

3. National Cancer Institute — Nausea and Vomiting PDQ

) Nausea and Vomiting PDQ provides patients with a brief 

 of nausea and vomiting and reviews its causes and treatments. All key terms in the articles are hyperlinked to an NCI dictionary, and clicking on any of these terms pulls up their definition in a small window to the side of the article. The section on 

 provides a bulleted list of risk factors for each type of nausea and vomiting, including anticipatory, acute, and delayed. It also discusses potential causes of nausea and vomiting in advanced cancer and in those undergoing radiation therapy. The section on 

 reviews strategies and pharmacotherapies that can be used to treat each type of nausea, and includes a section on alternative therapies. A 

 of this PDQ is also available, and both this version and the patient version can be read in English or Spanish. Patients with questions about CINV or another cancer-related issue can call the NCI’s Cancer Information Service at (800) 4-CANCER (1-800-422-6237).

 provides patients with cancer with a host of information via its articles, newsfeeds, videos, and podcasts. Patients about to undergo chemotherapy or those suffering from CINV may find the Website’s 

 especially useful. Here patients can access 

, which features an article geared toward alleviating patient fears regarding CINV; 

, which is set up in a question and answer format and provides an overview of CINV and its management, answering questions like “Are some treatments more likely to cause nausea and vomiting?”; and 

, which includes an article that examines complimentary medicine.

, patients will find links to articles from some of the aforementioned sections of the Nausea and Vomiting Information Center, as well as 

, a site where patients can get up-to-date information on over 2000 clinical trials in oncology. They can also find links here to sign up for any of Cancer Consultants 32 cancer-specific newsletters or the 

 newsletter; at the registration page, the 

 are accessible. Patients may also find a link to the 

, where they may connect with other patients to share their experiences and ask or answer questions.

, which covers health, wellness, prevention, and treatment issues in patients with cancer and survivors. There is also a link to the Website’s 

, where patients can purchase skin care products designed specifically for patients undergoing chemotherapy or radiation; books covering a broad range of cancer topics, including several nutritional guides; and a host of other products, such as baseball caps, visors, and wristbands.

 is a registered charity in the United Kingdom. The organization seeks to fulfill its “We Change Lives” mission by providing patients with practical, emotional, and financial support, though the latter is only available to individuals living in the United Kingdom. Although the site is not geared to US patients, its 

 includes information missed by some other sites on CINV, reviewing potential side effects of antiemetics and what to do if they occur. It also examines how antiemetics work and how they are administered. In addition, patients will find a list of simple steps that they can take to cope with their CINV; however, because this article is not geared specifically for patients receiving chemotherapy or radiation treatments, there is a note at the beginning of the article that indicates that patients receiving these treatments should read this article along with the site’s general information on these regimens.

Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and most feared side effects of chemotherapy. 

March 2010 | Oncology Live®

Oncology Gadget Watch: April 27, 2010

Folding@home: How Distributed Computing Is Unraveling the Mysteries of Protein Folding

5 CINV Web Resources for Patients