Dynamics of splenic transient elastography in patients with alcohol use disorder.

INTRODUCTION: Splenic stiffness measurement (SSM) is an evolving non-invasive assessment to evaluate portal hypertension. Studies with respect to SSM in patients with alcohol use disorder (AUD) are limited. METHODS: We studied patients seeking treatment for AUD in an inpatient treatment protocol at the NIH and parsed SSM into 3 groups based on degree of change. RESULTS: The "improved" SS group had statistically higher initial SSM and a non-statistically increased liver stiffness measurement (LSM) compared to others. DISCUSSION: SS is dynamic in a subset of patients immediately after alcohol cessation and improved SS is associated with a normalization of platelet count.

Hepatology consultation is associated with decreased early return to alcohol use after discharge from an inpatient alcohol use disorder treatment program.

BACKGROUND: Alcohol cessation is the only intervention that both prevents and halts the progressions of alcohol-associated liver disease. The aim of this study was to assess the relationship between a return to alcohol use and consultation with hepatology in treatment-seeking patients with alcohol use disorder (AUD). METHODS: Two hundred forty-two patients with AUD were enrolled in an inpatient treatment program, with hepatology consultation provided for 143 (59%) patients at the request of the primary team. Patients not seen by hepatology served as controls. The primary outcome was any alcohol use after discharge assessed using AUDIT-C at 26 weeks after discharge. RESULTS: For the primary endpoint, AUDIT at week 26, 61% of the hepatology group and 28% of the controls completed the questionnaire (p=0.07). For the secondary endpoint at week 52, these numbers were 22% and 11% (p = 0.6). At week 26, 39 (45%) patients in the hepatology group versus 31 (70%) controls (p = 0.006) returned to alcohol use. Patients evaluated by hepatology had decreased rates of hazardous alcohol use compared to controls, with 36 (41%) versus 29 (66%) (p = 0.008) of the patients, respectively, reporting hazardous use. There were no significant differences in baseline characteristics between groups and no difference in rates of prescribing AUD therapy. There was no difference in outcomes at 52 weeks. CONCLUSIONS: Patients evaluated by hepatology had significantly lower rates of return to alcohol use and lower rates of hazardous drinking at 26 weeks but not at 52 weeks. These findings suggest that hepatology evaluation during inpatient treatment of AUD may lead to decreased rates of early return to alcohol use.

Computer-aided food engineering.

Computer-aided food engineering (CAFE) can reduce resource use in product, process and equipment development, improve time-to-market performance, and drive high-level innovation in food safety and quality. Yet, CAFE is challenged by the complexity and variability of food composition and structure, by the transformations food undergoes during processing and the limited availability of comprehensive mechanistic frameworks describing those transformations. Here we introduce frameworks to model food processes and predict physiochemical properties that will accelerate CAFE. We review how investments in open access, such as code sharing, and capacity-building through specialized courses could facilitate the use of CAFE in the transformation already underway in digital food systems.