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Article ; Online: Comparisons between White and Black Patients Hospitalized with Postliver Transplant Complications/Failure.

Abu, Sherifatu / Chen, Po-Hung / Harris, Ché Matthew

2023 Volume 116, Issue 7, Page(s) 524–529

Abstract: Objectives: The impact of race on patients presenting to North American hospitals with postliver transplant complications/failure (PLTCF) has not been studied fully. We compared in-hospital mortality and resource utilization outcomes between White and ... ...

Abstract	Objectives: The impact of race on patients presenting to North American hospitals with postliver transplant complications/failure (PLTCF) has not been studied fully. We compared in-hospital mortality and resource utilization outcomes between White and Black patients hospitalized with PLTCF. Methods: This was a retrospective cohort study that evaluated the years 2016 and 2017 from the National Inpatient Sample. Regression analysis was used to determine in-hospital mortality and resource utilization. Results: There were 10,805 hospitalizations for adults with liver transplants who presented with PLTCF. White and Black patients with PLTCF made up 7925 (73.3%) hospitalizations from this population. Among this group, 6480 were White (81.7%) and 1445 were Black (18.2%). Blacks were younger than Whites (mean age ± standard error of the mean: 46.8 ± 1.1 vs 53.6 ± 0.39 years, Conclusions: Compared with White patients hospitalized for PLTCF, Black patients had higher in-hospital mortality and resource use. Investigation into causes leading to this health disparity is needed to improve in-hospital outcomes.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Black or African American/statistics & numerical data ; Hospital Mortality/ethnology ; Hospitalization/economics ; Hospitalization/statistics & numerical data ; Retrospective Studies ; United States/epidemiology ; White/statistics & numerical data ; Liver Transplantation/adverse effects ; Liver Transplantation/mortality ; Liver Transplantation/statistics & numerical data ; Facilities and Services Utilization/economics ; Facilities and Services Utilization/statistics & numerical data ; Hospital Charges/statistics & numerical data ; Length of Stay/economics ; Length of Stay/statistics & numerical data
Language	English
Publishing date	2023-07-01
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.14423/SMJ.0000000000001578
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Article: Environmental and Economic Analysis on Sailing from Taiwan through Arctic Passages

Chen, Po-Hung / Liu, Ta-Kang

Water. 2022 June 30, v. 14, no. 13

2022

Abstract: Maritime transportation is a key means for Taiwan to transport the cargo in the global trade. Global warming has led to two new navigation channels for arctic passages, the Northeast Passage and Northwest Passage. Research has increasingly addressed the ... ...

Abstract	Maritime transportation is a key means for Taiwan to transport the cargo in the global trade. Global warming has led to two new navigation channels for arctic passages, the Northeast Passage and Northwest Passage. Research has increasingly addressed the unknown economic costs of these passages, and the increase of navigational activity in the Arctic Ocean has also resulted in CO₂ emissions. Taiwan has one of the leading merchant fleets in the world; however, study on this aspect in Taiwan is not available. We use Port of Taipei, Taiwan as the starting place to compare the two arctic shipping routes and developed a model to determine the shipping costs and as well the CO₂ emission. The results showed that a voyage from the Port of Taipei to the Port of Rotterdam through the Northeast Passage would be 2107 nautical miles shorter than voyage along the current sea route to Europe but 2% to 3% costlier; CO₂ emissions would be 3% lower. Sailing to New York Harbor through the Northwest Passage would shorten voyages by 2459 nautical miles and reduce both costs and CO₂ emissions by 7%. Therefore, if tolls were lowered or sailing speeds increased, sailing through the Arctic Passages could be a great opportunity for shipping industries and enable Taiwan to develop its shipping economy while protecting the marine environment.
Keywords	carbon dioxide ; international trade ; marine environment ; sea transportation ; water ; Arctic Ocean ; Arctic region ; Europe ; New York ; Taiwan
Language	English
Dates of publication	2022-0630
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2521238-2
ISSN	2073-4441
ISSN	2073-4441
DOI	10.3390/w14132099
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Article ; Online: Substance Use Among Patients With Incident Crohn's Disease in the United States, 2010 to 2019: A Medicaid Observational Study.

Chen, Po-Hung / Patel, Reeha / Miller, Steven D / Jasper, Ryan / Chander, Geetanjali / Hutfless, Susan

Gastro hep advances

2023 Volume 2, Issue 6, Page(s) 747–754

Abstract: Background and aims: Substance use among persons with Crohn's disease (CD) is associated with symptomatic exacerbation and poorer quality of life. However, data on the prevalence of substance use among individuals with CD are limited. Therefore, our ... ...

Abstract	Background and aims: Substance use among persons with Crohn's disease (CD) is associated with symptomatic exacerbation and poorer quality of life. However, data on the prevalence of substance use among individuals with CD are limited. Therefore, our study aimed to estimate the burden of alcohol and drug use among individuals with incident CD in the United States. We also assessed the associations between CD-related interventions and substance use after CD diagnosis. Methods: Our retrospective cohort study of the national Medicaid databases from 2010 to 2019 identified participants with newly diagnosed CD and defined substance use (ie, alcohol, opioids, cocaine, amphetamine, and cannabis) using diagnosis codes. Multivariable logistic regression models assessed the associations between CD-related interventions and substance use after CD diagnosis. Results: Overall, 16.3% of Medicaid enrollees with incident CD had substance ever-use, most commonly alcohol or opioids (each 8.0%). Any substance use saw an absolute decrease of 3.8% after CD diagnosis, but changes were less than 1% in either direction for each substance. CD-related hospitalization was associated with increased alcohol or opioid use post-CD diagnosis. Surgery was associated with lower use post-CD of opioids but not alcohol. CD medications (except steroids) were generally associated with decreased post-CD alcohol or opioid use. Conclusion: Among Medicaid enrollees with incident CD, alcohol and opioid use were more frequent than previously published estimates for the general US population (6% and 4%, respectively, in 2019). Consequently, medical communities must be more aware of substance use by patients with CD to provide quality patient-centered care.
Language	English
Publishing date	2023-03-17
Publishing country	Netherlands
Document type	Journal Article
ISSN	2772-5723
ISSN (online)	2772-5723
DOI	10.1016/j.gastha.2023.03.019
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Article ; Online: Tobacco use in Crohn's disease patients and association with disease outcomes in the United States Medicaid population, 2010-2019.

Jasper, Ryan A / Chen, Po-Hung / Patel, Reeha / Joseph, Shelly / Miller, Steven D / Hutfless, Susan

JGH open : an open access journal of gastroenterology and hepatology

2023 Volume 7, Issue 4, Page(s) 291–298

Abstract: Background and aim: To identify demographic factors associated with tobacco use in Crohn's disease (CD) patients in the US Medicaid population and examine how tobacco use affects disease outcomes.: Methods: We included Medicaid-eligible patients who ... ...

Abstract	Background and aim: To identify demographic factors associated with tobacco use in Crohn's disease (CD) patients in the US Medicaid population and examine how tobacco use affects disease outcomes. Methods: We included Medicaid-eligible patients who had ≥1 ICD code for CD, and 1 year of eligibility before and after the initial encounter. We used ICD codes to identify tobacco use with respect to the time of diagnosis and used logistic regression to identify the association between age, sex, and race with tobacco use at any point before diagnosis and after diagnosis, and determine the association of tobacco use before and after diagnosis on disease outcomes. Results: We identified 98 176 eligible patients; 74.5% had no documented use of tobacco and 25.5% used tobacco at some point; 21.1% had used tobacco before their CD diagnosis and 11.8% had used tobacco after diagnosis. The population that used tobacco had a higher proportion of women, those who were White, non-Hispanic, and those in their middle ages (21-60) than the group that did not use tobacco. Tobacco use before diagnosis resulted in higher risk of hospitalization and surgery (OR: 1.85 and 1.36, respectively). Conclusion: Within the CD Medicaid population, tobacco use is more common in women than men, which differs from the general population, which is possibly a result of using diagnostic codes rather than survey data. Smoking cessation efforts should especially be directed at younger people who are at risk for CD, due to increased risk for more adverse outcomes among those who use tobacco before diagnosis.
Language	English
Publishing date	2023-03-31
Publishing country	Australia
Document type	Journal Article
ISSN	2397-9070
ISSN (online)	2397-9070
DOI	10.1002/jgh3.12893
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Article ; Online: CSF-1R: A promising therapeutic target for various diseases.

Wen, Chen-Yueh / Chen, Po-Hung / Hsieh, Feng-Renn / Chang, Renin / Wu, Meng-Yu / Yong, Su-Boon / Li, Chia-Jung

Pharmacological research

2024 Volume 204, Page(s) 107196

Language	English
Publishing date	2024-04-25
Publishing country	Netherlands
Document type	Letter
ZDB-ID	1003347-6
ISSN	1096-1186 ; 0031-6989 ; 1043-6618
ISSN (online)	1096-1186
ISSN	0031-6989 ; 1043-6618
DOI	10.1016/j.phrs.2024.107196
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Article ; Online: Burden of Crohn's Disease in the United States Medicaid Population, 2010-2019.

Hutfless, Susan / Jasper, Ryan A / Chen, Po-Hung / Joseph, Shelly / Miller, Steve / Brant, Steven R

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

2023 Volume 22, Issue 5, Page(s) 1087–1097.e6

Abstract: Background & aims: Twenty-five percent of the United States population is enrolled in Medicaid. Rates of Crohn's disease (CD) have not been estimated in the Medicaid population since the Affordable Care Act expansion in 2014. We aimed to estimate the ... ...

Abstract	Background & aims: Twenty-five percent of the United States population is enrolled in Medicaid. Rates of Crohn's disease (CD) have not been estimated in the Medicaid population since the Affordable Care Act expansion in 2014. We aimed to estimate the incidence and prevalence of CD by age, sex, and race. Methods: We identified all 2010-2019 Medicaid CD encounters using codes from the International Classification of Diseases, Clinical Modification versions 9 and 10. Individuals with ≥2 CD encounters were included. Sensitivity analyses were performed on other definitions (eg, ≥1 CD encounter). Incidence required ≥1 year of Medicaid eligibility prior to first CD encounter date (2013-2019). We calculated CD prevalence and incidence using the entire Medicaid population as the denominator. Rates were stratified by calendar year, age, sex, and race. Poisson regression models examined CD-associated demographic characteristics. We compared demographics and treatments of the entire Medicaid population with the multiple CD case definitions using percent and median. Results: A total of 197,553 beneficiaries had ≥2 CD encounters. The CD point prevalence per 100,000 persons rose from 56 (2010) to 88 (2011) to 165 (2019). CD incidence per 100,000 person-years was 18 (2013) and 13 (2019). Higher incidence and prevalence rates correlated with female, white, or multiracial beneficiaries. Prevalence rates rose in later years. Incidence decreased over time. Conclusions: From 2010 to 2019, Medicaid population CD prevalence increased while incidence decreased from 2013 to 2019. Overall Medicaid CD incidence and prevalence ranges align with prior large administrative database studies.
MeSH term(s)	Humans ; United States/epidemiology ; Female ; Crohn Disease/epidemiology ; Male ; Medicaid/statistics & numerical data ; Adult ; Middle Aged ; Incidence ; Young Adult ; Prevalence ; Adolescent ; Aged ; Child ; Cost of Illness
Language	English
Publishing date	2023-05-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2119789-1
ISSN	1542-7714 ; 1542-3565
ISSN (online)	1542-7714
ISSN	1542-3565
DOI	10.1016/j.cgh.2023.05.002
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Article ; Online: Longitudinal Trends in Pregnancy Outcomes Among Women With Inflammatory Bowel Disease in the Era of Biologics: A 20-Year Nationwide Analysis.

Prakash, Preeti / Dua, Anoushka / Blumenfeld, Yair / Chen, Po-Hung / Parian, Alyssa M / Limketkai, Berkeley N

Inflammatory bowel diseases

2023

Abstract: Background: Many women with inflammatory bowel disease (IBD) are diagnosed by their reproductive years. Prior literature suggests that women with IBD may be at increased risk of adverse pregnancy outcomes. Biologics have revolutionized IBD treatment, ... ...

Abstract	Background: Many women with inflammatory bowel disease (IBD) are diagnosed by their reproductive years. Prior literature suggests that women with IBD may be at increased risk of adverse pregnancy outcomes. Biologics have revolutionized IBD treatment, and current evidence favors continuation during pregnancy. We sought to examine trends in pregnancy outcomes over 20 years with the evolution of IBD treatment. Methods: Using the National Inpatient Sample, IBD and non-IBD obstetric hospitalizations were identified between 1998 and 2018 using International Classification of Diseases 9 and 10 codes. Outcomes of interest included cesarean delivery, gestational diabetes, preeclampsia/eclampsia, premature rupture of membranes (PROM), preterm delivery, fetal growth restriction (FGR), fetal distress, and stillbirth. Stratified by Crohn's disease (CD), ulcerative colitis (UC), and non-IBD deliveries, temporal trends and multivariable logistic regression were analyzed. Results: There were 48 986 CD patients, 30 998 UC patients, and 69 963,805 non-IBD patients. Between 1998 and 2018, CD deliveries increased from 3.3 to 12.9 per 10 000 deliveries (P < 0.001) and UC deliveries increased from 2.3 to 8.6 per 10 000 deliveries (P < 0.001). Cesarean deliveries, gestational diabetes, preeclampsia/eclampsia, PROM, FGR, and fetal distress increased over time for IBD and non-IBD women, while preterm deliveries decreased (P < 0.001). Multivariable analyses demonstrated that IBD patients had higher risk of cesarean delivery, preeclampsia/eclampsia, PROM, and preterm delivery compared with non-IBD patients. Conclusion: Over a 20-year period, live deliveries amongst women with IBD have increased. Trends in pregnancy outcomes have followed a similar trajectory in patients with and without IBD. However, there is still demonstrable risk of adverse pregnancy outcomes in patients with IBD.
Language	English
Publishing date	2023-10-19
Publishing country	England
Document type	Journal Article
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1093/ibd/izad250
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Article ; Online: Poor Graft and Patient Survival After Liver Transplantation in Sarcoidosis.

Thuluvath, Avesh J / Savva, Yulia / Chen, Po-Hung

Journal of clinical gastroenterology

2020 Volume 54, Issue 10, Page(s) 884–890

Abstract: Goals and background: There are limited data on post-liver transplantation (LT) outcomes of patients with sarcoidosis.: Study: We examined the clinical characteristics and post-LT outcomes of patients with sarcoidosis using the United Network for ... ...

Abstract	Goals and background: There are limited data on post-liver transplantation (LT) outcomes of patients with sarcoidosis. Study: We examined the clinical characteristics and post-LT outcomes of patients with sarcoidosis using the United Network for Organ Sharing database from 1985 to 2016 and compared them to patients (entire cohort as well as age, gender, and year of LT-matched counterparts) with primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). For the matched design, a conditional logistic regression was used for categorical variables and marginal generalized estimating equation regression models for continuous variables. Survival functions were constructed using the Kaplan-Meier estimator. Results: A total of 206 patients with sarcoidosis, transplanted during the study period, were compared with 3933 patients with PBC and 5323 with PSC. In total, 197 patients with sarcoidosis were compared with 576 with PBC and 576 with PSC in the 1:3 matched analysis. The sarcoidosis group had a higher proportion of blacks (53.3%) and a higher prevalence of obesity and type II diabetes mellitus. The graft and patient survival for sarcoidosis patients were lower when compared with unmatched PBC and PSC patients. The results remained unchanged in the matched analysis. At 5-year, patient survival was ~15% lower for the sarcoidosis group when compared with PBC and PSC. In multivariate analysis using matched data, hazard ratios (HRs) for graft (HR=1.68, 95% confidence interval=1.03-2.75, P=0.04), and patient (HR=2.01, confidence interval=1.22-3.34, P<0.01) survival were higher for sarcoidosis. Conclusions: Patients who underwent LT for sarcoidosis had a lower graft and patient survival when compared with those with PBC or PSC. That being said, 66% of patients survived 5 years after transplantation, suggesting that LT is an acceptable option in this population.
MeSH term(s)	Cholangitis, Sclerosing ; Diabetes Mellitus, Type 2 ; Graft Survival ; Humans ; Liver Cirrhosis, Biliary/surgery ; Liver Transplantation ; Sarcoidosis
Language	English
Publishing date	2020-10-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	448460-5
ISSN	1539-2031 ; 0192-0790
ISSN (online)	1539-2031
ISSN	0192-0790
DOI	10.1097/MCG.0000000000001289
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Article: Behavioral Treatment for Patients With Alcohol-Related Liver Disease: A Primer for Hepatologists.

Ting, Peng-Sheng / Wheatley, Jason / Chen, Po-Hung

Clinical liver disease

2020 Volume 15, Issue 1, Page(s) 31–35

Language	English
Publishing date	2020-02-25
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2657644-2
ISSN	2046-2484
ISSN	2046-2484
DOI	10.1002/cld.854
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Article ; Online: COVID-19 in Chronic Liver Disease and Liver Transplantation: A Clinical Review.

Mohammed, Abdul / Paranji, Neethi / Chen, Po-Hung / Niu, Bolin

Journal of clinical gastroenterology

2021 Volume 55, Issue 3, Page(s) 187–194

Abstract: The coronavirus disease 2019 (COVID-19) pandemic has brought challenges to clinicians caring for patients with chronic liver disease. In the past 6 months, COVID-19 has led to over 150,000 deaths in the United States and over 660,000 deaths around the ... ...

Abstract	The coronavirus disease 2019 (COVID-19) pandemic has brought challenges to clinicians caring for patients with chronic liver disease. In the past 6 months, COVID-19 has led to over 150,000 deaths in the United States and over 660,000 deaths around the world. Mounting evidence suggests that chronic liver diseases can have an adverse effect on the clinical outcomes of patients with COVID-19. We present a comprehensive review of the latest literature on preexisting liver diseases and its interrelationship with COVID-19 infection in cirrhosis, hepatocellular carcinoma, nonalcoholic fatty liver disease, autoimmune hepatitis, and viral hepatitis B. As social distancing and telemedicine gain new footing, we synthesize recommendations from 3 major hepatology societies [American Association for the Study of Liver Disease (AASLD), the European Association for the Study of Liver (EASL), and the Asian Pacific Association for the Study of Liver (APASL)] to present the best approaches for caring for patients with liver diseases as well as those requiring liver transplantation.
MeSH term(s)	COVID-19/diagnosis ; COVID-19/mortality ; COVID-19/therapy ; COVID-19/virology ; Health Status ; Host-Pathogen Interactions ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/adverse effects ; Liver/surgery ; Liver/virology ; Liver Diseases/diagnosis ; Liver Diseases/mortality ; Liver Diseases/surgery ; Liver Diseases/virology ; Liver Transplantation/adverse effects ; Liver Transplantation/mortality ; Risk Assessment ; Risk Factors ; SARS-CoV-2/pathogenicity ; Treatment Outcome
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2021-01-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	448460-5
ISSN	1539-2031 ; 0192-0790
ISSN (online)	1539-2031
ISSN	0192-0790
DOI	10.1097/MCG.0000000000001481
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