KEY POINTS Ketamine is a common anesthetic agent used in research and more recently as medication in treatment of depression. It has known effects on inhibition of interneurons and cortical stimulus-locked responses, the underlying functional network mechanisms are still elusive. Analyzing population activity across all layers within the auditory cortex, we found that with anesthetic doses it induces a stronger activation and stimulus- locked response to pure-tone stimuli. This cortical response is driven by gain enhancement of thalamocortical input processing selectively within granular layers due to an increased recurrent excitation. Time-frequency analysis indicates a higher broadband magnitude response and prolonged phase coherence in granular layers possibly pointing to disinhibition of this recurrent excitation. These results further the understanding of ketamine’s functional mechanisms which will improve the ability to interpret physiological studies moving from anesthetized to awake paradigms and may emporal response dynamics on cortical columnar processing in awake and ketamine-anesthetized animals. We found thalamocortical input processing within granular layers III/IV to be significantly increased under ketamine. This layer-dependent gain enhancement under ketamine was not due to changes in cross-trial phase coherence but was rather attributed to a broadband increase in magnitude reflecting an increase in recurrent excitation. The time-frequency analysis is indicative of a prolonged period of stimulus-induced excitation possibly due to a reduced coupling of excitation and inhibition in granular input circuits-in line with the common hypothesis of cortical disinhibition via suppression of GABAergic interneurons. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.PURPOSE The aim of this study was to evaluate the potential and feasibility of radiomic features extracted from low field strength (0.35T) Magnetic Resonance Images (MRIs) in predicting treatment response for patients with pancreatic cancer undergoing stereotactic body radiotherapy (SBRT). METHODS Twenty patients with unresected, non-metastatic pancreatic ductal adenocarcinoma (PDAC) were enrolled, all of whom received neoadjuvant chemotherapy followed by five fraction MR-guided SBRT with a radiation dose range of 33-50 Gy. For each patient, five daily set-up scans were acquired from a hybrid 0.35T MRI/radiotherapy unit. Tumor heterogeneity quantified with radiomic features extracted from the gross tumor volume (GTV) was averaged over the course of treatment. Random forest (RF) and adaptive least absolute shrinkage and selection operator (LASSO) classification models were constructed to identify radiomics features predictive of treatment response. Predictive capability of the top-performing features was then timely indications of response to treatment. This article is protected by copyright. All rights reserved.OBJECTIVES Research into the link between religion and physical function has shown inconsistent results. Most studies have used self-reported measures of physical function, and many have excluded those who are not religious and only compared levels of religious engagement within those groups that are religious. We aimed to assess the longitudinal associations of religious affiliation and religious attendance on two objective measures of physical function. DESIGN Longitudinal study using five waves of data from the Irish Longitudinal Study on Ageing (TILDA). SETTING Community-dwelling adults in Ireland. PARTICIPANTS Adults aged 50 and over who participated in two or more waves of TILDA (n = 6,122),and a supplementary analysis of a sub-sample aged 65 and over (n = 2,359). MEASUREMENTS Timed Up and Go (TUG) and grip strength were measured on at least two occasions. Data were collected approximately every 2 years over 10 years. Longitudinal linear mixed effects models were estimated to calculate the effect of religious affiliation and attendance on TUG and grip strength over time. RESULTS TUG scores increased by an average of .1 seconds with each year of age, which increased to .3 seconds by age 72 years. Grip strength scores decreased by .2 kg with each year of age and increased to -.3 kg per year by age 72. No overall differences were observed between religious affiliations in scores of TUG or grip strength. CONCLUSION Religious affiliation does not predict performance on objective physical function measures. Results are discussed with reference to the changing religious characteristics of the Irish population. © 2020 The American Geriatrics Society.In the last decade, research in transplant medicine has focused on developing interventions in the management of the deceased organ donor to improve the quality and quantity of transplantable organs. Despite the promise of interventional donor research, there remain debates about the ethics of this research, specifically regarding gaining research consent. PIK90 Here, we examine the concerns and ambiguities around consent for interventional donor research, which incorporate questions about who should consent for interventional donor research and what people are being asked to consent for. We highlight the US and UK policy responses to these concerns and argue that, whereas guidance in this area has done much to clarify these ambiguities, there is little consideration of the nature, practicalities and context around consent in this area, particularly regarding organ donors and their families. We review wider studies of consent in critical care research and social science studies of consent in medical research, to gain a broader view of consent in this area as a relational and contextual process. We contend a lack of consideration has been given to what it might mean to consent to interventional donor research; how families, patients and health professionals might experience providing and seeking this consent; who is best placed to have these discussions; and the socio-institutional contexts affecting these processes. Further, empirical research is required to establish an ethical and sensitive model for consent in interventional donor research, ensuring the principles enshrined in research ethics are met and public trust in organ donation is maintained. © 2020 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.OBJECTIVES Our aim was to (1) describe the clinical characteristics and symptoms of people diagnosed with dementia at the time of admission to inpatient palliative care; and (2) compare the nature and severity of these palliative care-related problems to patients with other chronic diseases. DESIGN Descriptive study using assessment data on point of care outcomes (January 1, 2013, to December 31, 2018). SETTING A total of 129 inpatient palliative care services participating in the Australian Palliative Care Outcomes Collaboration. PARTICIPANTS A total of 29,971 patients with a primary diagnosis of dementia (n = 1,872), lung cancer (n = 19,499), cardiovascular disease (CVD, n = 5,079), stroke (n = 2,659), or motor neuron disease (MND, n = 862). MEASUREMENTS This study reported the data collected at the time of admission to inpatient palliative care services including patients‘ self-rated levels of distress from seven common physical symptoms, clinician-rated symptom severity, functional dependency, and performf care for each individual. Access to appropriately trained palliative care clinicians is important for people with high levels of physical or psychological concerns, irrespective of the care setting or diagnosis. © 2020 The American Geriatrics Society.BACKGROUND Coffee and tea are two of the most widely consumed beverages worldwide and have been associated with reduced risk of mortality in some studies. However, it is unknown whether consumption of these beverages is associated with survival to an advanced age. OBJECTIVE To examine associations of coffee and tea consumption with survival to age 90 years. DESIGN Prospective cohort study among participants from the Women’s Health Initiative, recruited during 1993 to 1998 and followed up until March 31, 2018. SETTING The setting included 40 US clinical centers. PARTICIPANTS A racially and ethnically diverse cohort of 27,480 older women, aged 65 to 81 years at baseline. MEASUREMENTS Women were classified as having either survived to age 90 years or died before this age. Consumption of caffeinated and decaffeinated coffee and caffeinated tea was assessed at baseline and categorized as 0, 1, 2 to 3, or 4 or more cups/day. Associations of coffee and tea consumption with survival to age 90 years were examined using logistic regression models adjusted for sociodemographic characteristics, lifestyle behaviors, dietary quality, and chronic disease history. RESULTS A total of 14,659 (53.3%) women survived to age 90 years during follow-up. Caffeinated coffee, decaffeinated coffee, or caffeinated tea consumption was not significantly associated with survival to age 90 years after adjusting for confounders. Findings did not significantly vary by smoking, body mass index, or race/ethnicity. CONCLUSION No amount of coffee or tea consumption was associated with late-age survival among older women. These findings may be reassuring to older women who consume coffee and tea as part of their daily diets but do not support drinking these beverages to achieve longevity. © 2020 The American Geriatrics Society.BACKGROUND Stage III renal cell carcinoma (RCC) encompasses both lymph node-positive (pT1-3N1M0) and lymph node-negative (pT3N0M0) disease. However, prior institutional studies have indicated that among patients with stage III disease, those with lymph node disease have worse oncologic outcomes and experience survival that is similar to that of patients with American Joint Committee on Cancer (AJCC) stage IV disease. The objective of the current study was to validate these findings using a large, nationally representative sample of patients with kidney cancer. METHODS Patients with AJCC stage III or stage IV RCC were identified using the National Cancer Data Base (NCDB). Patients were categorized as having lymph node-positive stage III (pT1-3N1M0), lymph node-negative stage III (pT3N0M0), or stage IV metastatic (pT1-3 N0M1) disease. Cox proportional hazards models compared outcomes while adjusting for comorbidities. Kaplan-Meier estimates illustrated relative survival when comparing staging groups. RESULTS A mic therapy, more rigorous imaging surveillance, and clinical trial participation. © 2020 American Cancer Society.BACKGROUND Many diseases seem to affect each other. This is particularly true of periodontal diseases that relate to many systemic diseases. For this reason, we have chosen to investigate the relationship between obesity and gingivitis in children by focusing on plasma and salivary metabolomic biochemicals. METHODS Whole saliva and plasma samples were taken from each of 68 11year-old children afflicted by different degrees of both gingivitis and obesity. Gingivitis was evaluated as the percent of sites considered erythematous. Obesity was determined by waist circumference. Untargeted metabolomic analysis defined 29 biochemicals significantly correlated between saliva and plasma, which included the collagen breakdown amino acid hydroxyproline (Hyp). Two-sided t-tests and regression analysis were performed to compare these data from children with obesity alone, gingivitis alone, both and neither. RESULTS Obese children exhibited signs of increased collagen turnover by being taller (14.4 cm) and having more permanent teeth (5.