Question on this GPU for Mac Pro 5,1

Hello Folks, I'm new to this community.

I am thinking to upgrade the GPU to this on Mac Pro 5,1 (firmware flashed flashed 4,1 > 5,1) so I can run newer Mac OS using OCLP.

Few questions:

How is this GPU?

I have Monterey installed using OCLP. If I buy this GPU, do I start again from a fresh install or can I patch the current install ?

Also, does this card need Pixelmod or just 6 pin to 8 pin adapter is sufficient?

Does this support natively on High Sierra?

Thank you.