Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
-
Pin-Tzu Chen
und
Yu-Hsiang Kuan
Abstract
Background
Investigated the relationship between health literacy and treatment adherence and compliance due to incorrect medication use resulting from low health literacy in southern Taiwan.
Methods
A cross-sectional study in Chiayi, Taiwan (Sep–Nov 2013) used randomized sampling to survey 300 adults. Health literacy was assessed via the test of functional health literacy in adults, and medication knowledge/behavior was assessed via a validated questionnaire (KR-20 = 0.83). Data were analyzed using SPSS (chi-square, t-tests, ANOVA, Pearson’s correlation, P < 0.05).
Results
It was found that 97.9% of the respondents had adequate health literacy. Age negatively correlated with health literacy (r = –0.395; P < 0.0001) and positively with medication knowledge (r = 0.121; P = 0.038). Women exhibited higher health literacy and medication knowledge than men. Higher education levels and living with health professionals were associated with better health literacy. Patients with chronic diseases had lower health literacy than those without (mean scores: 31.5 vs 32.7). Significant correlations were observed between health literacy and treatment adherence and compliance and use.
Conclusions
Targeted health literacy interventions are required across different ages, genders, and education levels to improve medication use and health outcomes. Future research should examine the long-term effects of these interventions.
1 Introduction
Health is the most valuable asset in life. Health literacy – an individual’s ability to obtain, comprehend, and use basic health information and services to make informed health decisions – strongly influences health outcomes [1,2,3,4]. Limited health literacy leads to suboptimal healthcare results, including poor adherence to prescribed medical regimens [2,3,4,5]. Inadequate health literacy can lead to difficulty in understanding written medical instructions, particularly those related to medication administration. An individual’s lack of comprehension may lead them to take medications at incorrect dosages, have reduced access to health care, and exhibit noncompliance with prescribed treatments [1,2,6,7].
A higher level of health literacy is associated with better health outcomes and treatment adherence [2,8,9]. Inadequate health literacy often results in suboptimal treatment decision-making, limited understanding of medications, and nonadherence to medical instructions, which can exacerbate health problems [10]. A survey conducted using the short form of the test of functional health literacy in adults (TOFHLA) questionnaire revealed that patients with a low health literacy level and high blood pressure could not identify their blood pressure medications, whereas those with adequate health literacy could identify these medications [8,11,12].
Taiwan’s National Health Insurance data pertaining to the year 2011 indicated that the total healthcare expenditure, including copayments, reached 558.5 billion points. The expenditure for outpatient services reached 384.9 billion points (70%), and it mostly included medical services and material costs, followed by drug expenses. The expenditure for inpatient services was 173.6 billion points (30%), and it predominantly included ward services and subsequent drug expenses. Furthermore, the expenditure for outpatient services at medical centers alone was 81.4 billion points, and it primarily included drug expenses. For outpatient services at regional and local hospitals, the expenditure was 83 and 40 billion points, respectively, and it mainly included medical service and material costs, followed by drug expenses. Regarding inpatient care, the expenditure was primarily for ward services, followed by drug expenses.
Chronic renal failure (uremia), the most common condition in Taiwan, accounts for approximately 47.5% of all outpatient service-related claims. Data from Taiwan’s National Health Insurance Administration of the Ministry of Health and Welfare suggest that Yunlin and Chiayi counties have the highest rates of dialysis worldwide. This trend may be attributable to misleading advertisements that overstate the efficacy of unverified drugs, the public’s susceptibility to such claims, and a high rate of drug misuse. These figures indicate the substantial healthcare burden on the Taiwanese populace. To improve health outcomes and reduce healthcare costs, effective interventions must be developed that improve the public’s understanding and use of medications.
Evidence suggests an association between health literacy and overall health [1,2,3,4]. In consideration of this, the current study investigated how well the residents of southern Taiwan understand and use their medications and how this relates to their health literacy levels.
2 Methods
2.1 Study design
This study utilized a cross-sectional correlational analysis to examine the relationship between health literacy and individuals’ comprehension and utilization of medications in southern Taiwan. The population using the criteria for inclusion in the study were established as follows: (1) participants must be 20 years of age or older, (2) they must have resided in Chiayi County or City for a minimum duration of 6 months, (3) they should possess the ability to communicate in either Mandarin or Taiwanese, whether verbally or in written form, and (4) they must demonstrate a willingness to participate in the study after receiving a comprehensive explanation of its objectives. The criteria for exclusion included the following: (1) individuals exhibiting impaired consciousness or psychiatric conditions, (2) those with substantial visual or auditory impairments, (3) individuals who opted not to participate, and (4) newly immigrated residents who had resided in Taiwan for less than 6 months. The sample size was determined using G*Power (version 2.1.2), with an effect size of 0.3, an alpha level of 0.05, and a power of 0.8. A total of 102 participants were required to achieve statistical power. To account for potential incomplete responses, 306 individuals were approached, resulting in 300 valid questionnaires (effective response rate: 98%).
2.2 Research tools and measurements
This study utilized a structured questionnaire to systematically assess health literacy, medication knowledge, and medication-related behaviors among residents of Chiayi County and Chiayi City. Data collection was conducted from September to November 2013, employing a randomized sampling methodology. Participants were recruited from Chiayi Country and Chiayi City at diverse community events, including temple fairs, local gatherings, public parks, educational institutions, and workplaces. Prior to enrollment, all eligible individuals were thoroughly informed of the study’s objectives, and written consent was obtained to ensure that participation was voluntary and ethically sound.
To evaluate health literacy, the study employed the TOFHLA, a reputable instrument designed to assess both reading comprehension and numerical proficiency. The Taiwanese adaptation of the TOFHLA underwent a comprehensive validation process to establish its reliability and relevance in the target population. A panel of experts meticulously reviewed the questionnaire, resulting in each item receiving a content validity score of 3 points or higher. The content validity index was calculated as 0.85, indicating that 85% of the items were regarded as appropriate for use without requiring any modifications. Concurrent criterion validity was assessed through the utilization of the Chinese version of the Rapid Estimate of Adult Literacy in Medicine [13], which revealed a correlation coefficient of 0.70 (P < 0.01). This finding demonstrates a substantial association between the two measurement instruments. The TOFHLA is composed of multiple-choice questions, each with a singular correct answer, and requires approximately 22 min to complete. The scoring range for the TOFHLA extends from 0 to 36, with higher scores indicative of elevated levels of health literacy. Participants were categorized into three distinct levels of health literacy: inadequate (≤16), marginal (17–22), and adequate (≥23).
In addition to assessing health literacy, medication-related knowledge and behaviors were evaluated using the Proper Medication Cognition and Behavior Questionnaire, a newly developed instrument that has undergone rigorous validation. The questionnaire was reviewed by a panel consisting of two senior clinical pharmacists and one senior associate professor, who provided expert feedback for its refinement. The instrument demonstrated high reliability, evidenced by a Kuder–Richardson Formula 20 coefficient (KR-20) of 0.83, indicating strong internal consistency. It evaluates the participants’ understanding of medication indications, proper usage, potential side effects, and adherence to regimens. The questionnaire comprises two subscales: medication cognition (19 items, total score range: 0–19) and medication behavior (15 items, total score range: 0–15). Higher scores indicate a greater accuracy in medication-related knowledge and improved adherence to medication regimens.
Sociodemographic variables were gathered to explore the potential factors that influence health literacy and medication-related behaviors. These variables included age, gender, education level, occupation, the presence of chronic diseases, and whether participants lived with family members employed in healthcare-related professions. Participants were categorized into four age ranges: 20–30, 31–50, 51–64, and 65 years or older. Education levels were classified as illiterate/primary school, high school, and university/graduate school. Occupational data covered various sectors, including agriculture, industry, business, civil service, and service-related professions. Data collection was performed through both face-to-face interviews and self-administered questionnaires, offering flexibility based on the literacy levels and preferences of the participants. Interviewers underwent training to ensure the standardized administration of the survey instruments, thereby reducing the potential for bias in data collection.
2.3 Data processing and statistical analysis
All data were meticulously coded and analyzed using SPSS 18.0. Descriptive statistics were employed to summarize the sociodemographic characteristics, health literacy levels, and aspects of medication cognition and behavior. For the inferential statistics, chi-square tests, independent t-tests, and one-way ANOVA were utilized to investigate differences across demographic variables. Pearson’s correlation analysis was conducted to explore the relationships between health literacy, medication cognition, and behavior. A p-value of less than 0.05 was deemed statistically significant.
-
Ethical considerations: This study was conducted in accordance with the ethical principles of the Declaration of Helsinki. All participants provided informed consent. The study protocol was approved by the Institutional Review Board of Chang Gung Memorial Hospital in Southern Taiwan (permit number 1021637B).
3 Results
3.1 Sociodemographic characteristics and health literacy levels
The cohort’s demographic and health literacy profiles are presented in Table 1. A total of 300 valid responses were obtained (effective response rate: 98%). Regarding sex distribution, the cohort included 118 men (39.3%) and 182 women (60.6%). Regarding age distribution, 17.0, 50.0, 23.3, and 9.7% of the respondents were aged 20–30, 31–50, 51–64, and 65–80 years, respectively, with significant variations across age categories (P < 0.0001). Regarding employment status, 51.3, 22.0, 11.3, 8.3, 4.3, and 2.7% of the respondents were engaged in service industry work, other occupations, business, industrial work, civil service, and agricultural work, respectively, exhibiting significant variations (P = 0.0130). Regarding education, 52.3, 32.4, and 13.5% received university or graduate education, high school education, and secondary education or no formal education, respectively (P = 0.1854). Furthermore, regarding living with family members having health-related occupations, 69.6% did not reside with such family members, whereas 29% did; approximately 1.3% of the individuals were uncertain of whether they did.
Sociodemographic attributes and health literacy level of adults in Southern Taiwan
| Characteristics | All (%) | Men (%) | Women (%) | P value |
|---|---|---|---|---|
| Gender | 300 (100) | 118 (39.3) | 182 (60.6) | — |
| Age (years) | ||||
| 20–30 | 51 (17.0) | 15 (12.7) | 36 (19.8) | <0.0001 |
| 31–50 | 150 (50.00) | 48 (40.68) | 102 (56.04) | |
| 51–64 | 70 (23.33) | 34 (28.81) | 36 (19.78) | |
| 65–80 | 29 (9.67) | 21 (17.80) | 8 (4.40) | |
| Job occupation | ||||
| Agriculture | 8 (2.7) | 2 (1.7) | 6 (3.3) | 0.0130 |
| Industry | 25 (8.3) | 18 (15.3) | 7 (3.9) | |
| Business | 34 (11.3) | 15 (12.7) | 19 (10.4) | |
| Civil servants | 13 (4.3) | 3 (2.5) | 10 (5.5) | |
| Service industry | 154 (51.3) | 58 (49.2) | 96 (52.8) | |
| Others | 66 (22.0) | 22 (18.6) | 44 (24.2) | |
| Education | ||||
| Illiterate–secondary | 41 (13.5) | 16 (13.6) | 25 (13.7) | 0.1854 |
| High school | 99 (32.4) | 46 (39.0) | 53 (29.1) | |
| University–Graduate school | 160 (52.3) | 56 (47.5) | 104 (57.1) | |
| Living with family health-related industries | ||||
| Exist | 87 (28.4) | 33 (28.0) | 54 (29.7) | 0.4228 |
| Does not exist | 209 (68.3) | 82 (69.5) | 127 (69.8) | |
| Do not know | 4 (1.3) | 3 (2.5) | 1 (0.6) | |
| Health literacy level | ||||
| Insufficient (16↓) | 2 (0.7) | 1 (0.9) | 1 (0.6) | 0.0415 |
| Edge (17–22) | 4 (1.3) | 4 (3.4) | 0 (0.0) | |
| Adequate (23↑) | 294 (98.0) | 113 (95.8) | 181 (99.5) | |
Baker et al. used the short-form TOFHLA questionnaire to evaluate health literacy [14]. The respondents’ mean score was 32.24. Inadequate, marginal, and adequate levels of health literacy were noted in 2 (0.7%), 4 (1.3%), and 294 (97.9%) respondents, respectively. Notably, sex significantly influenced the level of health literacy (P = 0.0415). The prevalence of chronic diseases was considerably high; the predominant conditions were cardiovascular diseases, such as hypertension, heart disease, and stroke, followed by diabetes and cancer. Similar trends were observed in the participants’ cohabiting family members. Pearson correlation analysis revealed a significant negative correlation between health literacy and age (r = −0.395; P < 0.0001), indicating that older adults had lower levels of health literacy. Conversely, a positive correlation was noted between age and medication knowledge (r = 0.121; P < 0.038), suggesting that older adults possessed higher levels of medication knowledge. However, no significant correlation was observed between age and medication use (r = 0.024; P = 0.678).
3.2 Correlation of health literacy with correct medication cognition (CMC) and behavior
A higher level of education was associated with a higher level of health literacy. However, employment exerted no significant effect on health literacy. Living with family members having health-related occupations strongly influenced health literacy. Table 2 presents the correlations of health literacy with correct understanding of and adherence to medications. The level of health literacy was significantly higher in participants adhering to medical instructions than in those not adhering to such instructions (mean score: 32.94 ± 2.45 vs 32.08 ± 3.67; P = 0.0034). However, no significant sex-based difference in health literacy was observed between participants adhering to medical instructions and those not adhering to such instructions.
Analysis of the health literacy correlation between CMC and CMB
| Item | All (N = 300) | Men (N = 118) | Women (N = 182) | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Case (%) | Mean ± SD | P value | Case (%) | Mean ± SD | P value | Case (%) | Mean ± SD | P value | |
| Health level | |||||||||
| Obey orders | 56 (18.67) | 32.94 ± 2.45 | 0.0034 | 18 (15.25) | 32.06 ± 2.36 | 0.2219 | 38 (20.88) | 33.37 ± 2.41 | 0.2086 |
| Does not obey orders | 244 (81.33) | 32.08 ± 3.67 | 100 (84.75) | 31.18 ± 4.38 | 144 (79.12) | 32.71 ± 2.98 | |||
| CMC | |||||||||
| Obey orders | 56 (18.67) | 17.66 ± 1.18 | 0.7645 | 18 (15.25) | 17.72 ± 1.45 | 0.2597 | 38 (20.88) | 17.63 ± 1.05 | 0.1637 |
| Does not obey orders | 244 (81.33) | 17.60 ± 1.77 | 100 (84.75) | 17.14 ± 2.09 | 144 (79.12) | 17.92 ± 1.42 | |||
A t-test revealed significant effects of sex on health literacy (P < 0.0001); the level of health literacy was higher in women than in men. Moreover, chronic diseases significantly influenced health literacy (P < 0.0001). However, no significant difference in health literacy was observed between respondents whose family members had chronic diseases and those whose family members did not have such diseases (P = 0.155). A significant sex-based difference was noted in medication knowledge (P < 0.003), with women outperforming men. Furthermore, a significant difference in the understanding of medication was noted between individuals with chronic diseases and those without such diseases (P < 0.0001). No significant difference was observed between respondents whose family members had chronic diseases and those whose family members did not (P = 0.317). Univariate analysis revealed a significant positive correlation between health literacy and proper medication knowledge (r = 0.520; P < 0.0001), indicating that a higher level of health literacy was associated with a higher level of medication knowledge. However, no significant correlation was observed between health literacy and proper medication use (r = −0.014; P = 0.804). Furthermore, no significant correlation was noted between medication knowledge and medication use (r = 0.093; P = 0.109).
3.3 Correct health behaviors, medication cognition, and health literacy
The average health literacy score was significantly higher in participants adhering to medical instructions than in those not adhering to instructions (32.9 vs 32.08; P ≤ 0.05). However, no significant difference in medication knowledge was observed between compliant and noncompliant participants (17.66 vs 17.60; P = 0.123). Table 3 presents the correct health behaviors, medication cognition, and health literacy levels in the patients stratified by demographic characteristics. Health literacy was significantly influenced by age (F = 21.873; P < 0.01) and education level (F = 27.963; P < 0.01). The level of health literacy was the highest in participants with a university or graduate education level (mean score: 33.23) and the lowest in those with a secondary education level or no formal education (mean score: 29.07).
Correct health behaviors, CMC, and health literacy for residents in Southern Taiwan
| Characteristics | Health literacy level | CMC | CMB | |||
|---|---|---|---|---|---|---|
| Average score | F value | Average score | F value | Average score | F value | |
| Age (years) | 32.24 | 21.873(**) | 17.61 | 4.548(*) | 11.98 | 1.781 |
| 20–30 | 33.04 | 17.82 | 11.86 | |||
| 31–50 | 33.21 | 17.85 | 11.77 | |||
| 51–64 | 31.14 | 17.30 | 12.29 | |||
| 65–80 | 28.52 | 16.79 | 12.55 | |||
| Job occupation | 32.24 | 1.483 | 17.61 | 0.748 | 11.98 | 0.603 |
| Agriculture | 31.26 | 17.39 | 12.24 | |||
| Industry | 33.43 | 18.00 | 12.43 | |||
| Business | 32.28 | 17.28 | 11.88 | |||
| Civil servants | 32.56 | 17.79 | 12.21 | |||
| Service industry | 32.69 | 18.00 | 11.46 | |||
| Others | 32.49 | 17.67 | 11.86 | |||
| Education | 32.23 | 27.963(**) | 17.61 | 12.989(**) | 11.98 | 3.033(*) |
| Illiterate–secondary | 29.07 | 16.56 | 12.37 | |||
| High school | 31.94 | 17.47 | 12.26 | |||
| University–graduate school | 33.23 | 17.97 | 11.70 | |||
| Living with family health-related industries | 32.24 | 5.841(**) | 17.61 | 1.254 | 11.98 | 1.223 |
| Exist | 32.25 | 17.55 | 12.05 | |||
| Does not exist | 32.49 | 17.80 | 11.87 | |||
| Do not know | 26.50 | 16.75 | 10.50 | |||
*P < 0.05, **P < 0.01.
3.4 Correlation between CMC and correct medication behavior (CMB)
Individuals’ medication purchase behaviors are influenced by recommendations from family members and friends and information from sources such as television commercials, radio advertisements, the Internet, public parks, and traditional markets. In the current study, a significant positive correlation was observed between proper medication knowledge and correct medication use (r = 0.378; P < 0.0001), indicating that a higher level of medication knowledge was associated with better use of medications. A positive correlation was noted between CMC and CMB (r = 0.09; Table 4). This correlation was slightly stronger in women than in men (r = 0.13 vs 0.09).
Analysis of the correlation between CMC and CMB
| Item | All (N = 300) | Men (N = 118) | Women (N = 182) | |||
|---|---|---|---|---|---|---|
| CMC | CMB | CMC | CMB | CMC | CMB | |
| CMC | 1 | 0.09 | 1 | 0.09 | 1 | 0.13 |
| CMB | 0.09 | 1 | 0.09 | 1 | 0.13 | 1 |
CMC: correct medication cognition.
CMB: correct medication behavior.
4 Discussion
We investigated the associations of health literacy with individuals’ understanding and use of medications. Our findings revealed a negative association between age and health literacy (r = −0.395; P < 0.0001) and a positive correlation between age and medication knowledge (r = 0.121; P = 0.038). However, no significant association was noted between age and medication behavior (r = 0.024; P = 0.678). Furthermore, health literacy was significantly and positively correlated with CMC (r = 0.520; P < 0.0001) but not medication behavior (r = −0.014; P = 0.804).
Our findings are consistent with those of other studies indicating significant effects of health literacy on health behaviors and outcomes [5,15,16]. Evidence suggests that individuals with low health literacy levels often struggle to comprehend medical instructions, leading to improper medication use and poor health outcomes [3,7,17]. The present study adds to the current literature by unveiling the intricate associations between health literacy, medication knowledge, and medication behavior across age groups. These findings underscore the urgent need for tailored interventions to address health literacy issues.
Although we identified a negative correlation between age and health literacy, a positive correlation was noted between age and medication knowledge. Older adults may acquire medication knowledge through interactions with healthcare systems and providers over time. The low level of health literacy in the older population may be attributable to generational disparities in education and access to health information [18,19]. This disparity suggests that although older adults possess medication knowledge, they lack the broader health literacy required for effective health management. This finding highlights the need for age-specific health literacy interventions.
Our findings revealed sex disparities, indicating that women outperform men in terms of health literacy and medication knowledge. This may be attributable to traditional gender roles, with women often shouldering the responsibility of overseeing family health. Thus, women proactively seek and comprehend health information, which ultimately increases their health literacy and medication knowledge [20,21]. Acknowledging sex-based differences is essential in developing health literacy interventions tailored to the unique requirements and strengths of each sex. This underscores the importance of addressing gender disparities in health literacy through sex-specific interventions.
Our findings highlight the significant role of family influence in health literacy. Living with family members having health-related occupations increased the level of health literacy, indicating that exposure to health information and practices within the family unit can markedly improve an individual’s health literacy [22,23]. This suggests a potential for positive change through family-based health literacy interventions, which could leverage the influence of health-literate family members and create a supportive learning environment.
Education level significantly influenced health literacy: a higher level of education was correlated with a higher level of health literacy. This correlation aligns with the premise that education nurtures critical thinking and information-processing skills, which are pivotal for understanding and using health information [9,24,25,26,27,28]. Thus, educational interventions may help improve health literacy, particularly in individuals with low educational achievements. Educational interventions aimed at enhancing health literacy should be incorporated into school curricula and adult education programs. These interventions should focus on cultivating the skills required to navigate the healthcare system and to understand health information. Furthermore, health-literate family members should be involved in these interventions to create a supportive environment for acquiring and applying health-related knowledge.
5 Limitations
This study has some limitations. The applicability of our findings, which were derived from a sample from southern Taiwan to other regions or populations may be low. Future studies should validate our findings in different contexts by including a diverse sample. Furthermore, the cross-sectional design of this study precluded the establishment of causal relationships. Thus, longitudinal studies are required to clarify the dynamic interplay between health literacy, medication knowledge, and medication behavior over time. Future studies should measure the effects of targeted health literacy interventions on medication behavior and health outcomes; findings from such studies may provide substantial evidence for effective practices. Furthermore, in the current era of telehealth and online health information, researchers should investigate the benefits of digital health literacy to guide the development of novel strategies for enhancing health literacy.
6 Conclusions
This study highlights the importance of health literacy in understanding and adhering to medication regimens. It further highlights the need for targeted health education and interventions to cater to the unique requirements of various demographic groups, thereby achieving the goal of enhancing health literacy and thus improving health outcomes for all.
7 Implications
This study has several practical implications. First, interventions to enhance health literacy should be tailored to the specific needs of older adults, who may require extensive support to bridge the gap between medication knowledge and health literacy. Second, sex-specific interventions should be developed to accommodate men's and women’s distinct approaches to processing health information. Finally, healthcare practitioners should recognize their patients’ diverse levels of health literacy and adopt strategies to ensure the accessibility and comprehensibility of health information for all, irrespective of age, sex, or education level. Such strategies may involve the use of plain language and visual aids and reinforcement of comprehension through teach-back techniques.
Acknowledgments
The authors would like to acknowledge the support of Dr. Tsung-Hsien Chen in the preparation of this manuscript.
-
Funding information: The authors would like to thank the National Science and Technology Council, Taiwan, for financially supporting this research under Contract No. 113-2320-B-040-014-MY3.
-
Author contributions: Conceptualization: Pin-Tzu Chen, Min-Li Chen, Li-Chun Chang, Chin-Ho Kuo, and Yu-Hsiang Kuan; data curation: Pin-Tzu Chen; funding acquisition: Yu-Hsiang Kuan; investigation: Min-Li Chen, Li-Chun Chang, Chin-Ho Kuo, and Yu-Hsiang Kuan; methodology: Pin-Tzu Chen, Min-Li Chen, and Chin-Ho Kuo; software: Li-Chun Chang; validation: Li-Chun Chang; writing – original draft: Pin-Tzu Chen and Min-Li Chen; writing – review & editing: Yu-Hsiang Kuan.
-
Conflict of interest: The authors state no conflict of interest.
-
Data availability statement: The datasets generated during and/or analyzed during the current study are available from Pin-Tzu Chen and the corresponding author on reasonable request.
References
[1] Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant of health. Annu Rev Public Health. 2021;42:159–73.10.1146/annurev-publhealth-090419-102529Suche in Google Scholar PubMed
[2] Svendsen MT, Bak CK, Sørensen K, Pelikan J, Riddersholm SJ, Skals RK, et al. Associations of health literacy with socioeconomic position, health risk behavior, and health status: a large national population-based survey among Danish adults. BMC Public Health. 2020;20:565.10.1186/s12889-020-08498-8Suche in Google Scholar PubMed PubMed Central
[3] Schillinger D. Social determinants, health literacy, and disparities: intersections and controversies. Health Lit Res Pract. 2021;5(3):e234–43.10.3928/24748307-20210712-01Suche in Google Scholar PubMed PubMed Central
[4] Meherali S, Punjani NS, Mevawala A. Health literacy interventions to improve health outcomes in low- and middle-income countries. Health Lit Res Pract. 2020;4(4):e251–66.10.3928/24748307-20201118-01Suche in Google Scholar PubMed PubMed Central
[5] Paasche-Orlow M. Caring for patients with limited health literacy: a 76-year-old man with multiple medical problems. JAMA. 2011;306:1122–9.10.1001/jama.2011.1203Suche in Google Scholar PubMed
[6] Li X, Krumholz HM, Yip W, Cheng KK, De Maeseneer J, Meng Q, et al. Quality of primary health care in China: challenges and recommendations. Lancet. 2020;395(10239):1802–12.10.1016/S0140-6736(20)30122-7Suche in Google Scholar PubMed PubMed Central
[7] Liechty JM. Health literacy: critical opportunities for social work leadership in health care and research. Health Soc Work. 2011;36:99–107.10.1093/hsw/36.2.99Suche in Google Scholar PubMed
[8] Walters R, Leslie SJ, Polson R, Cusack T, Gorely T. Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review. BMC Public Health. 2020;20(1):1040.10.1186/s12889-020-08991-0Suche in Google Scholar PubMed PubMed Central
[9] Cho YI, Lee SD, Arozullah AM, Crittenden KS. Effect of health literacy on health status and health service utilization amongst the elderly. Soc Sci Med. 2008;66:1809–16.10.1016/j.socscimed.2008.01.003Suche in Google Scholar PubMed
[10] Fitzpatrick PJ. Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. Front Digit Health. 2023;5:1264780.10.3389/fdgth.2023.1264780Suche in Google Scholar PubMed PubMed Central
[11] Tavakoly Sany SB, Behzhad F, Ferns G, Peyman N. Communication skills training for physicians improves health literacy and medical outcomes among patients with hypertension: a randomized controlled trial. BMC Health Serv Res. 2020;20(1):60.10.1186/s12913-020-4901-8Suche in Google Scholar PubMed PubMed Central
[12] Persell SD, Osborn CY, Richard R, Skripkauskass S, Wolf MS. Limited health literacy is a barrier to medication reconciliation in ambulatory care. J Gen Intern Med. 2007;22:1523–6.10.1007/s11606-007-0334-xSuche in Google Scholar PubMed PubMed Central
[13] Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995;10(10):537–41.10.1007/BF02640361Suche in Google Scholar PubMed
[14] Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss JR. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38:33–42.10.1016/S0738-3991(98)00116-5Suche in Google Scholar PubMed
[15] Fleary SA, Joseph P, Pappagianopoulos JE. Adolescent health literacy and health behaviors: A systematic review. J Adolesc. 2018;62:116–27.10.1016/j.adolescence.2017.11.010Suche in Google Scholar PubMed
[16] McAnally K, Hagger MS. Health literacy, social cognition constructs, and health behaviors and outcomes: A meta-analysis. Health Psychol. 2023;42:213–34.10.1037/hea0001266Suche in Google Scholar PubMed
[17] van der Gaag M, Heijmans M, Spoiala C, Rademakers J. The importance of health literacy for self-management: A scoping review of reviews. Chronic Illn. 2022;18(2):234–54.10.1177/17423953211035472Suche in Google Scholar PubMed
[18] Sears K, Woo KY, Almost J, Wilson R, Frymire E, Whitehead M, et al. Medication knowledge among older adults admitted to home care in Ontario during 2012–2013. J Healthc Qual. 2018;40(3):e33–45.10.1097/JHQ.0000000000000055Suche in Google Scholar PubMed
[19] Meyers S, Gant K, Burmeister M. Assessment of education in a community hospital on healthcare providers’ knowledge of and attitudes toward medical marijuana. Curr Pharm Teach Learn. 2024;16(6):396–403.10.1016/j.cptl.2024.03.007Suche in Google Scholar PubMed
[20] Corrarino JE. Health literacy and women’s health: challenges and opportunities. J Midwifery Womens Health. 2013;58(3):257–64.10.1111/jmwh.12018Suche in Google Scholar PubMed
[21] Harsch S, Jawid A, Jawid E, Saboga-Nunes L, Sørensen K, Sahrai D, et al. Health literacy and health behavior among women in Ghazni, Afghanistan. Front Public Health. 2021;9:629334.10.3389/fpubh.2021.629334Suche in Google Scholar PubMed PubMed Central
[22] Ishikawa H, Kiuchi T. Association of health literacy levels between family members. Front Public Health. 2019;7:169.10.3389/fpubh.2019.00169Suche in Google Scholar PubMed PubMed Central
[23] de Buhr E, Tannen A. Parental health literacy and health knowledge, behaviours and outcomes in children: a cross-sectional survey. BMC Public Health. 2020;20(1):1096.10.1186/s12889-020-08881-5Suche in Google Scholar PubMed PubMed Central
[24] Palumbo R. Leveraging organizational health literacy to enhance health promotion and risk prevention: a narrative and interpretive literature review. Yale J Biol Med. 2021;94(1):115–28.Suche in Google Scholar
[25] Auld ME, Allen MP, Hampton C, Montes JH, Sherry C, Mickalide AD, et al. Health literacy and health education in schools: collaboration for action. NAM Perspect. 2020;2020. 10.31478/202007b.Suche in Google Scholar PubMed PubMed Central
[26] Aljassim N, Ostini R. Health literacy in rural and urban populations: A systematic review. Patient Educ Couns. 2020;103(10):2142–54.10.1016/j.pec.2020.06.007Suche in Google Scholar PubMed
[27] Sudhakar S, Aebi ME, Burant CJ, Wilson B, Wenk J, Briggs FBS, et al. Health literacy and education level correlates of participation and outcome in a remotely delivered epilepsy self-management program. Epilepsy Behav. 2020;107:107026.10.1016/j.yebeh.2020.107026Suche in Google Scholar PubMed PubMed Central
[28] Coman MA, Marcu A, Chereches RM, Leppälä J, Van Den Broucke S. Educational interventions to improve safety and health literacy among agricultural workers: a systematic review. Int J Environ Res Public Health. 2020;17(3):1114.10.3390/ijerph17031114Suche in Google Scholar PubMed PubMed Central
© 2025 the author(s), published by De Gruyter
This work is licensed under the Creative Commons Attribution 4.0 International License.
Artikel in diesem Heft
- Research Articles
- Network pharmacological analysis and in vitro testing of the rutin effects on triple-negative breast cancer
- Impact of diabetes on long-term survival in elderly liver cancer patients: A retrospective study
- Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
- Risk factors for severe adverse drug reactions in hospitalized patients
- Analysis of the effect of ALA-PDT on macrophages in footpad model of mice infected with Fonsecaea monophora based on single-cell sequencing
- Development and validation of headspace gas chromatography with a flame ionization detector method for the determination of ethanol in the vitreous humor
- CMSP exerts anti-tumor effects on small cell lung cancer cells by inducing mitochondrial dysfunction and ferroptosis
- Predictive value of plasma sB7-H3 and YKL-40 in pediatric refractory Mycoplasma pneumoniae pneumonia
- Antiangiogenic potential of Elaeagnus umbellata extracts and molecular docking study by targeting VEGFR-2 pathway
- Comparison of the effectiveness of nurse-led preoperative counseling and postoperative follow-up care vs standard care for patients with gastric cancer
- Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis
- Adhered macrophages as an additional marker of cardiomyocyte injury in biopsies of patients with dilated cardiomyopathy
- Association between statin administration and outcome in patients with sepsis: A retrospective study
- Exploration of the association between estimated glucose disposal rate and osteoarthritis in middle-aged and older adults: An analysis of NHANES data from 2011 to 2018
- A comparative analysis of the binary and multiclass classified chest X-ray images of pneumonia and COVID-19 with ML and DL models
- Lysophosphatidic acid 2 alleviates deep vein thrombosis via protective endothelial barrier function
- Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
- Serum PM20D1 levels are associated with nutritional status and inflammatory factors in gastric cancer patients undergoing early enteral nutrition
- Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study
- Vitamin D replacement therapy may regulate sleep habits in patients with restless leg syndrome
- The first-line antihypertensive nitrendipine potentiated the therapeutic effect of oxaliplatin by downregulating CACNA1D in colorectal cancer
- Health literacy and health-related quality of life: The mediating role of irrational happiness
- Modulatory effects of Lycium barbarum polysaccharide on bone cell dynamics in osteoporosis
- Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
- Examination of the causal role of immune cells in non-alcoholic fatty liver disease by a bidirectional Mendelian randomization study
- Clinical analysis of ten cases of HIV infection combined with acute leukemia
- Investigating the cardioprotective potential of quercetin against tacrolimus-induced cardiotoxicity in Wistar rats: A mechanistic insights
- Clinical observation of probiotics combined with mesalazine and Yiyi Baitouweng Decoction retention enema in treating mild-to-moderate ulcerative colitis
- Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection
- Sex-specific associations of sex hormone binding globulin and risk of bladder cancer
- Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women
- The ERAS nursing care strategy for patients undergoing transsphenoidal endoscopic pituitary tumor resection: A randomized blinded controlled trial
- The serum IL-17A levels in patients with traumatic bowel rupture post-surgery and its predictive value for patient prognosis
- Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients
- Analysis of serum NLR combined with intraoperative margin condition to predict the prognosis of cervical HSIL patients undergoing LEEP surgery
- Commiphora gileadensis ameliorate infertility and erectile dysfunction in diabetic male mice
- The correlation between epithelial–mesenchymal transition classification and MMP2 expression of circulating tumor cells and prognosis of advanced or metastatic nasopharyngeal carcinoma
- Tetrahydropalmatine improves mitochondrial function in vascular smooth muscle cells of atherosclerosis in vitro by inhibiting Ras homolog gene family A/Rho-associated protein kinase-1 signaling pathway
- A cross-sectional study: Relationship between serum oxidative stress levels and arteriovenous fistula maturation in maintenance dialysis patients
- A comparative analysis of the impact of repeated administration of flavan 3-ol on brown, subcutaneous, and visceral adipose tissue
- Identifying early screening factors for depression in middle-aged and older adults: A cohort study
- Perform tumor-specific survival analysis for Merkel cell carcinoma patients undergoing surgical resection based on the SEER database by constructing a nomogram chart
- Unveiling the role of CXCL10 in pancreatic cancer progression: A novel prognostic indicator
- High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries
- RAB39B: A novel biomarker for acute myeloid leukemia identified via multi-omics and functional validation
- Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
- Clinical efficacy of azacitidine in the treatment of middle- and high-risk myelodysplastic syndrome in middle-aged and elderly patients: A retrospective study
- The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients
- Expression and clinical significance of ITGA3 in breast cancer
- Single-nucleus RNA sequencing reveals ARHGAP28 expression of podocytes as a biomarker in human diabetic nephropathy
- rSIG combined with NLR in the prognostic assessment of patients with multiple injuries
- Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake
- Exploring causal relationship between 41 inflammatory cytokines and marginal zone lymphoma: A bidirectional Mendelian randomization study
- Gender beliefs and legitimization of dating violence in adolescents
- Effect of serum IL-6, CRP, and MMP-9 levels on the efficacy of modified preperitoneal Kugel repair in patients with inguinal hernia
- Effect of smoking and smoking cessation on hematological parameters in polycythemic patients
- Pathogen surveillance and risk factors for pulmonary infection in patients with lung cancer: A retrospective single-center study
- Necroptosis of hippocampal neurons in paclitaxel chemotherapy-induced cognitive impairment mediates microglial activation via TLR4/MyD88 signaling pathway
- Celastrol suppresses neovascularization in rat aortic vascular endothelial cells stimulated by inflammatory tenocytes via modulating the NLRP3 pathway
- Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
- GATA1: A key biomarker for predicting the prognosis of patients with diffuse large B-cell lymphoma
- Influencing factors of false lumen thrombosis in type B aortic dissection: A single-center retrospective study
- MZB1 regulates the immune microenvironment and inhibits ovarian cancer cell migration
- Integrating experimental and network pharmacology to explore the pharmacological mechanisms of Dioscin against glioblastoma
- Trends in research on preterm birth in twin pregnancy based on bibliometrics
- Four-week IgE/baseline IgE ratio combined with tryptase predicts clinical outcome in omalizumab-treated children with moderate-to-severe asthma
- Single-cell transcriptomic analysis identifies a stress response Schwann cell subtype
- Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus
- Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients
- Interleukin-37 mediates the anti-oral tumor activity in oral cancer through STAT3
- CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
- Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study
- Comprehensive biomedicine assessment of Apteranthes tuberculata extracts: Phytochemical analysis and multifaceted pharmacological evaluation in animal models
- Relation of time in range to severity of coronary artery disease in patients with type 2 diabetes: A cross-sectional study
- Dopamine attenuates ethanol-induced neuronal apoptosis by stimulating electrical activity in the developing rat retina
- Correlation between albumin levels during the third trimester and the risk of postpartum levator ani muscle rupture
- Factors associated with maternal attention and distraction during breastfeeding and childcare: A cross-sectional study in the west of Iran
- Mechanisms of hesperetin in treating metabolic dysfunction-associated steatosis liver disease via network pharmacology and in vitro experiments
- The law on oncological oblivion in the Italian and European context: How to best uphold the cancer patients’ rights to privacy and self-determination?
- The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer
- Factors affecting the measurements of peripheral oxygen saturation values in healthy young adults
- Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
- The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
- Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
- Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
- Correlation of serum calprotectin with outcome of acute cerebral infarction
- Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
- Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
- The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
- Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
- Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
- Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
- Analysis of serum metabolomics in patients with different types of chronic heart failure
- Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
- Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
- Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
- METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
- The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
- Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
- Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
- Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
- Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
- Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
- Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
- Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
- Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
- Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
- Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
- Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
- HALP score in Demodex blepharitis: A case–control study
- Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
- Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
- Comparison of the two intestinal anastomosis methods in pediatric patients
- Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
- Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
- Review Articles
- The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
- Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
- Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
- Review of mechanisms and frontier applications in IL-17A-induced hypertension
- Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
- The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
- The application of augmented reality in robotic general surgery: A mini-review
- The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
- Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
- Plant polyphenols, terpenes, and terpenoids in oral health
- Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
- End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
- The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
- Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
- PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
- Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
- Giant borderline ovarian tumours – review of the literature
- Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
- Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
- Case Reports
- Delayed graft function after renal transplantation
- Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
- Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
- Giant right atrial hemangioma presenting with ascites: A case report
- Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
- Rapid Communication
- Biological properties of valve materials using RGD and EC
- Letter to the Editor
- Role of enhanced external counterpulsation in long COVID
- Expression of Concern
- Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
- Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
- Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
- Corrigendum
- Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
- Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
- Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
- Retraction
- Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
- Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
- Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
- Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
- The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
- Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
- Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
- Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
- Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
- Special Issue The evolving saga of RNAs from bench to bedside - Part III
- Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
- Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
- Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
- A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
- Special Issue Diabetes
- Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
- Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
- Special Issue Biomarker Discovery and Precision Medicine
- CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
Artikel in diesem Heft
- Research Articles
- Network pharmacological analysis and in vitro testing of the rutin effects on triple-negative breast cancer
- Impact of diabetes on long-term survival in elderly liver cancer patients: A retrospective study
- Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
- Risk factors for severe adverse drug reactions in hospitalized patients
- Analysis of the effect of ALA-PDT on macrophages in footpad model of mice infected with Fonsecaea monophora based on single-cell sequencing
- Development and validation of headspace gas chromatography with a flame ionization detector method for the determination of ethanol in the vitreous humor
- CMSP exerts anti-tumor effects on small cell lung cancer cells by inducing mitochondrial dysfunction and ferroptosis
- Predictive value of plasma sB7-H3 and YKL-40 in pediatric refractory Mycoplasma pneumoniae pneumonia
- Antiangiogenic potential of Elaeagnus umbellata extracts and molecular docking study by targeting VEGFR-2 pathway
- Comparison of the effectiveness of nurse-led preoperative counseling and postoperative follow-up care vs standard care for patients with gastric cancer
- Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis
- Adhered macrophages as an additional marker of cardiomyocyte injury in biopsies of patients with dilated cardiomyopathy
- Association between statin administration and outcome in patients with sepsis: A retrospective study
- Exploration of the association between estimated glucose disposal rate and osteoarthritis in middle-aged and older adults: An analysis of NHANES data from 2011 to 2018
- A comparative analysis of the binary and multiclass classified chest X-ray images of pneumonia and COVID-19 with ML and DL models
- Lysophosphatidic acid 2 alleviates deep vein thrombosis via protective endothelial barrier function
- Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
- Serum PM20D1 levels are associated with nutritional status and inflammatory factors in gastric cancer patients undergoing early enteral nutrition
- Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study
- Vitamin D replacement therapy may regulate sleep habits in patients with restless leg syndrome
- The first-line antihypertensive nitrendipine potentiated the therapeutic effect of oxaliplatin by downregulating CACNA1D in colorectal cancer
- Health literacy and health-related quality of life: The mediating role of irrational happiness
- Modulatory effects of Lycium barbarum polysaccharide on bone cell dynamics in osteoporosis
- Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
- Examination of the causal role of immune cells in non-alcoholic fatty liver disease by a bidirectional Mendelian randomization study
- Clinical analysis of ten cases of HIV infection combined with acute leukemia
- Investigating the cardioprotective potential of quercetin against tacrolimus-induced cardiotoxicity in Wistar rats: A mechanistic insights
- Clinical observation of probiotics combined with mesalazine and Yiyi Baitouweng Decoction retention enema in treating mild-to-moderate ulcerative colitis
- Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection
- Sex-specific associations of sex hormone binding globulin and risk of bladder cancer
- Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women
- The ERAS nursing care strategy for patients undergoing transsphenoidal endoscopic pituitary tumor resection: A randomized blinded controlled trial
- The serum IL-17A levels in patients with traumatic bowel rupture post-surgery and its predictive value for patient prognosis
- Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients
- Analysis of serum NLR combined with intraoperative margin condition to predict the prognosis of cervical HSIL patients undergoing LEEP surgery
- Commiphora gileadensis ameliorate infertility and erectile dysfunction in diabetic male mice
- The correlation between epithelial–mesenchymal transition classification and MMP2 expression of circulating tumor cells and prognosis of advanced or metastatic nasopharyngeal carcinoma
- Tetrahydropalmatine improves mitochondrial function in vascular smooth muscle cells of atherosclerosis in vitro by inhibiting Ras homolog gene family A/Rho-associated protein kinase-1 signaling pathway
- A cross-sectional study: Relationship between serum oxidative stress levels and arteriovenous fistula maturation in maintenance dialysis patients
- A comparative analysis of the impact of repeated administration of flavan 3-ol on brown, subcutaneous, and visceral adipose tissue
- Identifying early screening factors for depression in middle-aged and older adults: A cohort study
- Perform tumor-specific survival analysis for Merkel cell carcinoma patients undergoing surgical resection based on the SEER database by constructing a nomogram chart
- Unveiling the role of CXCL10 in pancreatic cancer progression: A novel prognostic indicator
- High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries
- RAB39B: A novel biomarker for acute myeloid leukemia identified via multi-omics and functional validation
- Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
- Clinical efficacy of azacitidine in the treatment of middle- and high-risk myelodysplastic syndrome in middle-aged and elderly patients: A retrospective study
- The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients
- Expression and clinical significance of ITGA3 in breast cancer
- Single-nucleus RNA sequencing reveals ARHGAP28 expression of podocytes as a biomarker in human diabetic nephropathy
- rSIG combined with NLR in the prognostic assessment of patients with multiple injuries
- Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake
- Exploring causal relationship between 41 inflammatory cytokines and marginal zone lymphoma: A bidirectional Mendelian randomization study
- Gender beliefs and legitimization of dating violence in adolescents
- Effect of serum IL-6, CRP, and MMP-9 levels on the efficacy of modified preperitoneal Kugel repair in patients with inguinal hernia
- Effect of smoking and smoking cessation on hematological parameters in polycythemic patients
- Pathogen surveillance and risk factors for pulmonary infection in patients with lung cancer: A retrospective single-center study
- Necroptosis of hippocampal neurons in paclitaxel chemotherapy-induced cognitive impairment mediates microglial activation via TLR4/MyD88 signaling pathway
- Celastrol suppresses neovascularization in rat aortic vascular endothelial cells stimulated by inflammatory tenocytes via modulating the NLRP3 pathway
- Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
- GATA1: A key biomarker for predicting the prognosis of patients with diffuse large B-cell lymphoma
- Influencing factors of false lumen thrombosis in type B aortic dissection: A single-center retrospective study
- MZB1 regulates the immune microenvironment and inhibits ovarian cancer cell migration
- Integrating experimental and network pharmacology to explore the pharmacological mechanisms of Dioscin against glioblastoma
- Trends in research on preterm birth in twin pregnancy based on bibliometrics
- Four-week IgE/baseline IgE ratio combined with tryptase predicts clinical outcome in omalizumab-treated children with moderate-to-severe asthma
- Single-cell transcriptomic analysis identifies a stress response Schwann cell subtype
- Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus
- Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients
- Interleukin-37 mediates the anti-oral tumor activity in oral cancer through STAT3
- CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
- Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study
- Comprehensive biomedicine assessment of Apteranthes tuberculata extracts: Phytochemical analysis and multifaceted pharmacological evaluation in animal models
- Relation of time in range to severity of coronary artery disease in patients with type 2 diabetes: A cross-sectional study
- Dopamine attenuates ethanol-induced neuronal apoptosis by stimulating electrical activity in the developing rat retina
- Correlation between albumin levels during the third trimester and the risk of postpartum levator ani muscle rupture
- Factors associated with maternal attention and distraction during breastfeeding and childcare: A cross-sectional study in the west of Iran
- Mechanisms of hesperetin in treating metabolic dysfunction-associated steatosis liver disease via network pharmacology and in vitro experiments
- The law on oncological oblivion in the Italian and European context: How to best uphold the cancer patients’ rights to privacy and self-determination?
- The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer
- Factors affecting the measurements of peripheral oxygen saturation values in healthy young adults
- Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
- The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
- Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
- Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
- Correlation of serum calprotectin with outcome of acute cerebral infarction
- Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
- Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
- The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
- Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
- Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
- Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
- Analysis of serum metabolomics in patients with different types of chronic heart failure
- Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
- Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
- Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
- METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
- The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
- Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
- Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
- Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
- Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
- Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
- Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
- Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
- Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
- Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
- Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
- Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
- HALP score in Demodex blepharitis: A case–control study
- Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
- Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
- Comparison of the two intestinal anastomosis methods in pediatric patients
- Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
- Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
- Review Articles
- The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
- Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
- Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
- Review of mechanisms and frontier applications in IL-17A-induced hypertension
- Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
- The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
- The application of augmented reality in robotic general surgery: A mini-review
- The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
- Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
- Plant polyphenols, terpenes, and terpenoids in oral health
- Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
- End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
- The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
- Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
- PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
- Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
- Giant borderline ovarian tumours – review of the literature
- Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
- Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
- Case Reports
- Delayed graft function after renal transplantation
- Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
- Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
- Giant right atrial hemangioma presenting with ascites: A case report
- Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
- Rapid Communication
- Biological properties of valve materials using RGD and EC
- Letter to the Editor
- Role of enhanced external counterpulsation in long COVID
- Expression of Concern
- Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
- Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
- Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
- Corrigendum
- Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
- Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
- Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
- Retraction
- Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
- Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
- Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
- Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
- The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
- Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
- Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
- Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
- Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
- Special Issue The evolving saga of RNAs from bench to bedside - Part III
- Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
- Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
- Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
- A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
- Special Issue Diabetes
- Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
- Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
- Special Issue Biomarker Discovery and Precision Medicine
- CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
