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Shih YW, Chang CW, Chang HCR, Tsai JR, Wang WJ, Fang HF, Lin CL, Rias YA, Tsai HT. Mediating Effect of White Blood Cells and Tobacco Exposure on Cervical Neoplasm Risk Among Taiwanese Women. Biol Res Nurs 2024:10998004241229069. [PMID: 38271218 DOI: 10.1177/10998004241229069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Background: Both the high-risk human papillomavirus (HR-HPV) infection and tobacco exposure are significantly associated with cervical neoplasm risk. Immune cells play important roles in carcinogenesis. However, it is still unclear whether immune cells have a mediating effect on the HR-HPV infection and tobacco exposure with cervical neoplasm development. Aim: The aim of this study was to determine how the increased white blood cell (WBC) count affects the relationship between HR-HPV DNA load and tobacco exposure in the development of cervical neoplasia. Methods: A hospital-based case-control study design was conducted with a total of 108 cases of Taiwanese women with ≥ cervical intraepithelial neoplasia (CIN) I confirmed by biopsy, and 222 healthy Taiwanese female subjects with negative findings on a Pap smear were assigned to the control group. The study evaluated HR-HPV status and immune cell counts (WBCs, natural killer (NK) cells) and tobacco exposure by a self-construct questionnaire. Results: Both HR-HPV DNA load and tobacco exposure significantly independently increased cervical neoplasm risk (AORs: 1.28 and 1.42, respectively). Similar significant results were found for WBCs and NK cells, with respective AORs of 1.20 and 1.00. Moreover, increased WBCs (β = 0.04, 95% CI corrected: 0.01-0.07) and tobacco exposure (β = 0.02, 95% CI corrected: 0.01-0.04) mediated the relationship between the high-risk HPV DNA load and cervical neoplasm risk. Conclusions: Elevated WBC count acts as both predictor and mediator in cervical neoplasm development linked to HR-HPV DNA load. Monitoring and maintaining WBC levels within the normal range could be a preventive strategy for cervical neoplasm development.
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Affiliation(s)
- Ya Wen Shih
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Post‑Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ching Wen Chang
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | | | - Jia Ruey Tsai
- Department of Medical Oncology, Taipei Medical University Taipei Cancer Center/Taipei Medical University Hospital, Taipei, Taiwan
| | - Wei-Jun Wang
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan
- Proton Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hui Fen Fang
- Department of Nursing, Taipei Medical University Taipei Cancer Center/Taipei Medical University Hospital, Taipei, Taiwan
| | - Chia Ling Lin
- Department of Pharmacy, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yohanes Andy Rias
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Faculty of Health, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata Kediri, Kediri, Indonesia
| | - Hsiu Ting Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Post‑Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Shih YW, Wang MH, Monsen KA, Chang CW, Rias YA, Tsai HT. Effectiveness of Acupuncture for Relieving Chemotherapy-Induced Bone Marrow Suppression: A Systematic Review with a Meta-analysis and Trial Sequential Analysis. J Integr Complement Med 2023; 29:621-636. [PMID: 37163212 DOI: 10.1089/jicm.2022.0735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Objective: Bone marrow suppression is the most common side effect of chemotherapy that may lead to discontinuation for treatment pertaining to patients during the therapy course. Acupuncture may relieve bone marrow suppression with regulation hematopoietic function during chemotherapy. The purpose of this study is to evaluate the effectiveness of acupuncture in relieving chemotherapy-induced bone marrow suppression and determine the effects of acupuncture on bone marrow function. Design: PubMed, Embase, Cochrane Library, Medline OVID, CINAHL Plus, Web of Science, and Chinese articles in the Airiti Library and China National Knowledge Infrastructure databases were searched up to February 2023. Publications in both English and Chinese were eligible for inclusion without any limitations on the publication date. Only randomized controlled trials investigating the impact of acupuncture on chemotherapy-induced bone marrow suppression were considered. In addition, a trial sequential analysis was performed to assess the adequacy of the current sample size. Results: A total of 25 studies met the inclusion criteria. Acupuncture was found to increase the levels of hematopoietic cytokine granulocyte colony-stimulating factor (G-CSF) (Hedges' g = 0.79, p < 0.001), as well as stimulate the production of white blood cells (Hedges' g = 0.69, p < 0.001), red blood cells (Hedges' g = 0.37, p = 0.01), neutrophils (Hedges' g = 0.66, p < 0.001), absolute neutrophil count (Hedges' g = 0.89, p = 0.01), hemoglobin (Hb) (Hedges' g = 0.37, p = 0.02), platelets (Hedges' g = 0.50, p < 0.001), and natural killer (NK) cells (Hedges' g = 1.30, p = 0.02). Further, the levels of platelets and NK cells were observed to increase cumulatively over time. Conclusions: Acupuncture may improve chemotherapy-induced bone marrow suppression due to increasing levels of the hematopoietic cytokine, G-CSF and further relieving chemotherapy-induced bone marrow suppression. PROSPERO Registration: This review was registered with PROSPERO (International Prospective Register of Systematic Reviews: CRD42020185813).
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Affiliation(s)
- Ya Wen Shih
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Post-BaccalaureateProgram in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Mei Hua Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Karen A Monsen
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Ching Wen Chang
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yohanes Andy Rias
- Faculty of Health and Medicine, College of Nursing, InstitutIlmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
| | - Hsiu Ting Tsai
- Post-BaccalaureateProgram in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Kurniasari MD, Karwur FF, Rayanti RE, Shih YW, Yuliana S, Miao NF, Chou KR, Shen CJ, Tsai HT. Immersion in Water Between 20-30 oC Mediated Inflammations Marker to Reduced Pain Among Indonesian With Gout Arthritis: A Community-Based Randomized Controlled Trial. Biol Res Nurs 2023; 25:267-281. [PMID: 36207143 DOI: 10.1177/10998004221132843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Gout is triggered by high urate levels and causes inflammation, pain, and an impaired quality of life. Immersion in water at 20-30°C reduces inflammation and pain in arthritis. Yet, relationships of immersion in water at 20-30°C with urate levels and the nucleotide-binding domain (NOD)-like receptor protein 1 (NLRP1) inflammasome have never been clarified. OBJECTIVES We aimed to investigate the effects of immersion in water at 20-30°C on urate levels, the NLRP1 inflammasome, pain, and quality of life among acute gout patients. METHODS A community-based randomized control trial design was used with 2 parallel-intervention groups: immersion in water at 20-30°C (20 min/day for 4 weeks) group and a control group. In total, 76 eligible participants in Tomohon City, Indonesia, were assigned using block randomization. We analyze the results (coef. β) and 95% confidence intervals (CIs) using a generalized estimating equation model. We analyzed mediating effects using a path analysis. RESULTS Significant pain alleviation (β = -2.06 [95% CI = -2.67∼-1.45]; β = -2.42 [95% CI = -2.97∼-1.87]) and improved quality of life (β = 5.34 [95% CI = 3.12-7.57]; β = 9.93 [95% CI = 7.02-12.83]) were detected at 2 and 4 weeks of follow-up compared to the pre-test and control group. Urate levels (β = -0.34 [95% CI = -0.52∼-0.16]) were reduced at the 2-week follow-up, but there was no significant change in the NLRP1 inflammasome compared to the pre-test and control group after immersion in water at 20-30°C. Both the NLRP1 inflammasome (β = -0.48 [95% CI = -0.63∼-0.34]); water 0.01) and urate levels (β = -0.11 [95% CI = -0.24∼-0.03]; p < 0.01) had partial indirect (mediating) effects on the link between immersion in water at 20-30°C and pain at the 4-week follow-up. CONCLUSIONS Immersion in water at 20-30°C significantly decreased pain and increased the quality of life. Immersion in water at 20-30°C mediated NLRP1 and urate levels to decrease pain, although it had no significant effect on the NLRP1 inflammasome concentration after 4 weeks of follow-up and reduced urate levels only at 2 weeks after immersion in water at 20-30°C.
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Affiliation(s)
- Maria Dyah Kurniasari
- Faculty of Medicine and Health Science, 106208Universitas Kristen Satya Wacana, Salatiga, Indonesia
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
| | - Ferry Fredy Karwur
- Faculty of Medicine and Health Science, 106208Universitas Kristen Satya Wacana, Salatiga, Indonesia
| | - Rosiana Eva Rayanti
- Faculty of Medicine and Health Science, 106208Universitas Kristen Satya Wacana, Salatiga, Indonesia
| | - Ya Wen Shih
- School of Nursing, 38028National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Sri Yuliana
- Department of Nursing, Yahya Health Science Institute of Bima, West Nusa Tenggara, Indonesia
| | - Nae Fang Miao
- Post-Baccalaureate Program in Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
| | - Kuei Ru Chou
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
| | - Chia Jung Shen
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
| | - Hsiu Ting Tsai
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
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Handayani S, Rias YA, Kurniasari MD, Agustin R, Rosyad YS, Shih YW, Chang CW, Tsai HT. Relationship of spirituality, health engagement, health belief and attitudes toward acceptance and willingness to pay for a COVID-19 vaccine. PLoS One 2022; 17:e0274972. [PMID: 36223417 PMCID: PMC9555617 DOI: 10.1371/journal.pone.0274972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To explore the wider determinant factor of citizens' spirituality, health engagement, health belief model, and attitudes towards vaccines toward acceptance and willingness to pay for a Coronavirus disease 2019 (COVID-19) vaccination. METHODS A community-based cross-sectional online investigation with convenience sampling was utilized to recruit 1423 citizens from 18 districts across Indonesia between December 14, 2020 and January 17, 2021. Descriptive statistics, One-way analysis of variance, Pearson correlation, Independent t-tests, and multiple linear regression were examined. RESULTS Spirituality, health engagement and attitude toward vaccines, as well as health beliefs constructs (all scores of perceived benefits and barriers) were significant key factors of acceptance of vaccines. Interestingly, the spirituality, attitude toward vaccine, and health beliefs constructs including perceived susceptibility, and benefits indicated a significantly higher willingness. CONCLUSIONS Results demonstrated the utility of spirituality, health engagement, health belief model, and attitudes towards vaccines in understanding acceptance and willingness to pay for a vaccine. Specifically, a key obstacle to the acceptance of and willingness to pay COVID-19 vaccination included a high score of the perceived barrier construct. Moreover, the acceptance of and willingness to pay could be impaired by worries about the side-effects of a COVID-19 vaccination.
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Affiliation(s)
- Sri Handayani
- Faculty of Health and Medicine, College of Nursing, Sekolah Tinggi Ilmu Kesehatan Yogyakarta, Yogyakarta, Indonesia
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Yohanes Andy Rias
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, R.O.C
- Faculty of Health and Medicine, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata Kediri, Kediri, Indonesia
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Maria Dyah Kurniasari
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Ratna Agustin
- Faculty of Health and Medicine, College of Nursing, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia
| | - Yafi Sabila Rosyad
- Faculty of Health and Medicine, College of Nursing, Sekolah Tinggi Ilmu Kesehatan Yogyakarta, Yogyakarta, Indonesia
| | - Ya Wen Shih
- School of Nursing, National Taipei University of Nursing and Health Science, Taipei, Taiwan, R.O.C
| | - Ching Wen Chang
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan, R.O.C
| | - Hsiu Ting Tsai
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, R.O.C
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, R.O.C
- * E-mail: ,
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Shih YW, Su JY, Kung YS, Lin YH, To Anh DT, Ridwan ES, Tsai HT. Effectiveness of Acupuncture in Relieving Chemotherapy-induced Leukopenia in Patients With Breast Cancer: A Systematic Review With A Meta-Analysis and Trial Sequential Analysis. Integr Cancer Ther 2021; 20:15347354211063884. [PMID: 34930039 PMCID: PMC8728772 DOI: 10.1177/15347354211063884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Breast cancer is one of the most common cancers and a major cause of death in
women worldwide. Chemotherapy is mainly used to treat and control the
progression of breast cancer. Leukopenia is the most common side effect of
chemotherapy which may decrease immune function and further lead to serious
fatal infections. The purpose of this study was to evaluate the effect of
acupuncture on regulating hematopoietic function in chemotherapy-induced
leukopenia among patients with breast cancer. Methods: PubMed, Embase, Cochrane Library, CINAHL Plus, Web of Science, and Chinese
articles in the Airiti Library and China National Knowledge Infrastructure
(CNKI) databases were searched to August 2021 for papers to include in a
systematic review and meta-analysis. A random-effects model was applied. The
effect size was calculated by Hedges’ g. Heterogeneity was determined using
Cochran’s Q test. Moderator analyses were performed to examine potential
sources of heterogeneity. A trial sequential analysis (TSA) was conducted to
determine whether the current sample size was sufficient. Results: Ten randomized controlled trials involving 650 participants were eligible for
inclusion. Analysis by the random-effects model showed a significant effect
by acupuncture of ameliorating leukopenia during chemotherapy. Levels of
white blood cells (WBCs) were increased (Hedges’ g = 0.70,
P < .001, I2 = 34%),
neutrophil counts (Hedges’ g = 0.80, P < .001,
I2 = 0%) were significantly enhanced.
Moreover, regardless of the manner through which acupuncture was applied,
overall values of WBCs increased. Conclusions: The current meta-analysis supports acupuncture possibly ameliorating
chemotherapy-induced leukopenia, as WBC and neutrophil values significantly
increased after acupuncture in patients undergoing chemotherapy.
Additionally, regardless of the type of acupuncture, values of WBCs
increased. These findings are actionable and support both the clinical use
of acupuncture to relieve chemotherapy-induced leukopenia and further
research regarding the use of acupuncture in patients experiencing
immunosuppression when undergoing chemotherapy. Trial Registration: PROSPERO-CRD42020215759.
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Affiliation(s)
- Ya Wen Shih
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Jui Yuan Su
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu Shan Kung
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu Huei Lin
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Duong Thi To Anh
- Personnel Department, Thai Nguyen Medical College, Thai Nguyen, Viet Nam
| | - Edi Sampurno Ridwan
- Department of Nursing, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia
| | - Hsiu Ting Tsai
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,School of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
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