Non-use of information and communication technology as a predictor of frailty in postmenopausal midlife and older women.

BACKGROUND: Frailty is a clinically discernible state in which decreased physiological reserve and function result in a reduced ability to cope with stressors. Information and communication technology (ICT) has been proposed as an aid to help with frailty, yet the use of ICT by older people, particularly women, is an understudied area. AIM: To analyze the association between use of ICT (specifically internet functions and social media) and frailty status in postmenopausal midlife and elderly women. METHODS: A cross-sectional study was designed to investigate whether frailty status is related to ICT use in postmenopausal midlife and older women. Community-dwelling women attending primary health care centers for health checks were invited to participate in the study. Postmenopausal status was the only inclusion criterion, whereas limitations that could interfere with use of ICT were exclusion criteria. The Fried phenotype was used to assess frailty. Four types of ICT use were examined: the internet for e-mail, the internet for other functions, and social media (WhatsApp or Facebook). Chi-square test and multivariate multinomial regression analysis were used to examine the association between frailty status and ICT use. RESULTS: We included 409 women (age = 67.45 ± 7.81 years, mean ± SD), who were frail (n = 135, 33.01%), pre-frail (n = 159, 38.87%), or robust (n  =  115, 28.11%). Frailty status was significantly and inversely associated with any ICT use, showing a strong association with use of WhatsApp (P < 0.001) and internet searches (P < 0.001). ICT non-use was a predictor of frailty, while ICT users were more likely to be robust (OR 10.62; 95% [CI], 5.34-21.10) or pre-frail (OR 9.03; [CI], 95% 5.18-15.74). CONCLUSION: Postmenopausal midlife and older women not using ICT were more likely to be frail.

Targeted next-generation sequencing of circulating-tumor DNA for tracking minimal residual disease in localized colon cancer.

BACKGROUND: A high percentage of patients diagnosed with localized colon cancer (CC) will relapse after curative treatment. Although pathological staging currently guides our treatment decisions, there are no biomarkers determining minimal residual disease (MRD) and patients are at risk of being undertreated or even overtreated with chemotherapy in this setting. Circulating-tumor DNA (ctDNA) can to be a useful tool to better detect risk of relapse. PATIENTS AND METHODS: One hundred and fifty patients diagnosed with localized CC were prospectively enrolled in our study. Tumor tissue from those patients was sequenced by a custom-targeted next-generation sequencing (NGS) panel to characterize somatic mutations. A minimum variant allele frequency (VAF) of 5% was applied for variant filtering. Orthogonal droplet digital PCR (ddPCR) validation was carried out. We selected known variants with higher VAF to track ctDNA in the plasma samples by ddPCR. RESULTS: NGS found known pathological mutations in 132 (88%) primary tumors. ddPCR showed high concordance with NGS (r = 0.77) for VAF in primary tumors. Detection of ctDNA after surgery and in serial plasma samples during follow-up were associated with poorer disease-free survival (DFS) [hazard ratio (HR), 17.56; log-rank P = 0.0014 and HR, 11.33; log-rank P = 0.0001, respectively]. Tracking at least two variants in plasma increased the ability to identify MRD to 87.5%. ctDNA was the only significantly independent predictor of DFS in multivariable analysis. In patients treated with adjuvant chemotherapy, presence of ctDNA after therapy was associated with early relapse (HR 10.02; log-rank P < 0.0001). Detection of ctDNA at follow-up preceded radiological recurrence with a median lead time of 11.5 months. CONCLUSIONS: Plasma postoperative ctDNA detected MRD and identified patients at high risk of relapse in localized CC. Mutation tracking with more than one variant in serial plasma samples improved our accuracy in predicting MRD.