Pancreatic adenocarcinoma (PAC) is one of the most aggressive malignancies. Intratumoural molecular heterogeneity impedes improvement of the overall survival rate. Current pathological staging system is not sufficient to accurately predict prognostic outcomes. Thus, accurate prognostic model for patient survival and treatment decision is demanded. Using differentially expressed gene analysis between normal pancreas and PAC tissues, the cancer-specific genes were identified. A prognostic gene expression model was computed by LASSO regression analysis. The PAC-5 signature (LAMA3, E2F7, IFI44, SLC12A2, and LRIG1) that had significant prognostic value in the overall dataset was established, independently of the pathological stage. We provided evidence that the PAC-5 signature further refined the selection of the PAC patients who might benefit from postoperative therapies. SLC12A2 and LRIG1 interacted with the proteins that were implicated in resistance of EGFR kinase inhibitor. DNA methylation was significantly involved in the gene regulations of the PAC-5 signature. The PAC-5 signature provides new possibilities for improving the personalised therapeutic strategies. We suggest that the PAC-5 genes might be potential drug targets for PAC.

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This study aims to understand the characteristics of smart device-based testing (SBT) by comparing the typical characteristics of students' satisfaction with SBT, its usefulness, advantages, and disadvantages when compared with existing testing methods. Methods: A total of 250 students from the first to third year were selected as the final targets of the study and the questionnaire was developed by faculty members who participated in the survey from the start of the SBT. The total number of questions is 12, and the questionnaire used a 4-point scale. The data obtained were analyzed using the IBM SPSS ver. 23.0 (IBM Corp., Armonk, USA). Results: Answers to the "satisfaction with SBT" were generally negative, while answers to the "usefulness of SBT" were generally positive. There was no difference in satisfaction across gender and smart device ownership, whereas there were significant differences across years. With reference to the usefulness of SBT, students responded positively, while about the overall configuration and completeness of SBT, students responded negatively. Students also seemed to show a greater preference toward the pencil-paper test. Conclusion: On the other hand, students generally thought that SBT helped to assess medical knowledge better and was a more objective method of knowledge assessment than a pencil-paper test. We believe that students preferred the traditional paper-pencil test due to their unfamiliarity with SBT. We believe that an appropriate and careful remedy for drawbacks of the SBT will have a significant impact in the accumulation of actual clinical knowledge and in the improvement of practical skills for medical students.

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Background: The older population (≥65 years) has rapidly increased in size in recent years. Among them, the middle-to-oldest-old (≥75 years) tend to have a poor health status. Therefore, subdivision and evaluation of older patients with traumatic injury are required. We focused on the risk of femoral intertrochanteric fractures occurring in older adults due to minor falls and compared young-old and middle-to-oldest-old populations. Methods: The medical records of patients who visited the emergency center due to hip injuries between March 2017 and March 2019 were retrospectively analyzed. Patients were divided into older adult (≥65 years) and non-older (age 18-64 years) groups; the older adult group was subdivided into young-old (65-74 years), middle-old (75-84 years), and oldest-old (≥85 years) groups. This study investigated the occurrence rate of femoral intertrochanteric fractures and related factors. Results: The older adult group had a higher incidence of femoral intertrochanteric fractures than that in the non-older adult group (95.3% vs. 4.7%, p<0.001). However, there was no significant difference between young-old and non-older groups (58.8% vs. 41.2%, p=0.145). Middle-old to oldest-old age and osteoporosis were associated with an increased incidence of femoral intertrochanteric fractures (p<0.001, p=0.004). Conclusion: A higher incidence of femoral intertrochanteric fractures from minor falls was found among middle-old to oldest-old patients compared to that in young-old patients. Therefore, physicians should perform more thorough physical examinations and radiograph reading in middle-old to oldest-old patients even if the patients do not complain of pain.