Liver Transplantation and Older Adults

As the population of older adults in the United States grows, not only will there be an increased number of potential older adult organ donors, but the number of older adults with end-stage liver disease who need liver transplantation will also increase. As a transplant community, it is imperative to know how to utilize these older donors and care for older liver transplant recipients. First, the underutilization of older liver donors (age≥70) represents a possible expansion of the donor pool. However, older donor grafts have been historically associated with poor outcomes and higher discard rates, but clinical protocols, organ allocation, and the donor pool have changed in the last 15 years. Using national registry data from 2003-2016, we estimated the odds of discard of older liver donors was two-fold higher every year compared to younger liver donors and that discard of older liver donors increased over this time period. Yet, outcomes in older liver donor recipients improved over time (40% lower risk of graft loss and 41% lower risk of mortality), and these were more marked improvements than seen in younger liver donor recipients (Chapter 2). Secondly, given the increased burden of end-stage liver disease in older adults, we focused on temporal trends in the incidence of transplantation and outcomes for older liver transplant recipients (Chapter 3). Using national registry data, we found that liver transplantation in older recipients increased five-fold from 2003 to 2016 and that length of stay, acute rejection, graft loss, and mortality improved over time. Finally, as the average age of waitlisted liver candidates and liver transplant recipients continues to increase, we sought to quantify the association of waitlist mortality and frailty, a state of decreased physiologic reserve by candidate age. We found that older candidates experienced higher rates of frailty than younger candidates. However, regardless of age, frailty was associated with nearly two-fold increased risk of waitlist mortality. Overall, this dissertation quantifies the utilization of older liver donors, outcomes for recipients of older liver donors, outcomes of older liver transplant recipients, and delves into the relationship between age and frailty in liver transplant candidates

En analyse av sentrale faktorer for prestasjonsutvikling blant jenter som har valgt toppidrett fotball på videregående skole

Masteroppgave - Lektor i kroppsøving og idrettsfag - 202

Assessment of dietary intake of molybdenum in relation to tolerable upper intake level. Opinion of the Panel on Nutrition, Dietetic Products, Novel Food and Allergy of the Norwegian Scientific Committee for Food and Environment

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Assessment of dietary intake of manganese in relation to tolerable upper intake level. Opinion of the Panel on Nutrition, Dietetic Products, Novel Food and Allergy of the Norwegian Scientific Committee for Food and Environment

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Assessment of dietary intake of chromium (III) in relation to tolerable upper intake Level. Opinion of the Panel on Nutrition, Dietetic Products, Novel Food and Allergy of the Norwegian Scientific Committee for Food and Environment

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Assessment of dietary intake of vitamin K and maximum limits for vitamin K in food supplements. Opinion of the Panel on Nutrition, Dietetic Products, Novel Food and Allergy of the Norwegian Scientific Committee for Food and Environment

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MRI adipose tissue segmentation and quantification in R (RAdipoSeg)

Background: Excess adipose tissue is associated with increased cardiovascular and metabolic risk, but the volume of visceral and subcutaneous adipose tissue poses different metabolic risks. MRI with fat suppression can be used to accurately quantify adipose depots. We have developed a new semi-automatic method, RAdipoSeg, for MRI adipose tissue segmentation and quantification in the free and open source statistical software R. Methods: MRI images were obtained from wild-type mice on high- or low-fat diet, and from 20 human subjects without clinical signs of metabolic dysfunction. For each mouse and human subject, respectively, 10 images were segmented with RAdipoSeg and with the commercially available software SliceOmatic. Jaccard difference, relative volume difference and Spearman’s rank correlation coefficients were calculated for each group. Agreement between the two methods were analysed with Bland–Altman plots. Results: RAdipoSeg performed similarly to the commercial software. The mean Jaccard differences were 10–29% and the relative volume differences were below ( ±) 20%. Spearman’s rank correlation coefficient gave p-values below 0.05 for both mouse and human images. The Bland–Altman plots indicated some systematic and proporitional bias, which can be countered by the flexible nature of the method. Conclusion: RAdipoSeg is a reliable and low cost method for fat segmentation in studies of mice and humans.publishedVersio

Prevalence of frailty among kidney transplant candidates and recipients in the United States: Estimates from a National Registry and Multicenter Cohort Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154612/1/ajt15709.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154612/2/ajt15709_am.pd

Cognitive functioning in a group of adolescents at risk for psychosis.

peer reviewedCognitive deficits are a core feature of schizophrenia, and impairments are present in groups at-risk for psychosis. Most at-risk studies include young adults and not younger age-groups, such as adolescents. Participants are usually help-seeking individuals, even though risk factors may also be present in non-help seeking adolescents. We aim to explore cognitive functions in a group of non-help-seeking 15-year-old adolescents at risk for psychosis compared to age- and gender matched controls, including particular focus on specific cognitive domains. Hundred participants (mean age = 15.3) were invited after completing the 14-year-old survey distributed by the Norwegian Mother-, Father- and Child Study. At-risk adolescents were selected based on high scores on 19 items assessing both psychotic experiences and anomalous self-experiences. Matched controls were selected from the same sample. Cognitive functioning was assessed using the MATRICS Consensus Cognitive Battery and IQ using Wechsler's Abbreviated Test of Intelligence. We found that the adolescents at-risk for psychosis had significantly poorer scores than controls on the composite score of the MCCB. IQ scores were also significantly lower in the at-risk group. The results highlight general cognitive deficits as central in a group of non-help-seeking adolescents at-risk for psychosis. Results indicate that the development of cognitive impairments starts early in life in at-risk groups. It is still unclear whether specific cognitive domains, such as verbal learning, are related to psychotic symptoms or may be specifically vulnerable to symptoms of depression and anxiety

Assessment of dietary intake of chromium (III) in relation to tolerable upper intake Level. Opinion of the Panel on Nutrition, Dietetic Products, Novel Food and Allergy of the Norwegian Scientific Committee for Food and Environment

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