BACKGROUND/OBJECTIVES An increasing number of patients are using the internet to supplement information provided by medical professionals. Online geriatric patient education materials (PEMs) should be written at or below a 6th grade reading level (GRL) that takes into account barriers unique to the geriatric population. The objectives of the study are to assess PEMs of geriatric associations' websites and determine whether they are above the GRL recommended by the Centers for Disease Control and National Institutes of Health. DESIGN Descriptive and correlational methodology. PEMs from 10 major geriatric associations were assessed for their GRL using 10 scales. Eight of the scales provide a numerical GRL while two of the scales provide a visual representation of the GRLs. Analysis was conducted using Readability Studio 2019.3. SETTING Analysis was conducted February 2020. PARTICIPANTS Identified 10 geriatric associations and 884 PEMs. MEASUREMENTS GRLs were measured by 10 validated readability indices: the Degrees of Reading Power and Grade Equivalent test, Flesch–Kincaid grade level, Simple Measure of Gobbledygook test, Coleman‐Liau Index, Gunning Fog Index, New Fog Count, New Dale‐Chall readability formula, Ford, Caylor, Sticht scale, Raygor readability estimate graph, and Fry readability graph. RESULTS The mean of all PEMs using the numerical scales was 11.1 ± 2.4. Ninety‐nine percent of PEMs are above the 6th GRL. PEMs ranged from a grade 3.0 to 19.0 reading level. Analysis of variance demonstrated a significant difference between associations (P < .0001), and multiple comparison analysis identified the National Institute on Aging as the content easiest to read (9.5 ± 1.6). CONCLUSION PEMs from geriatric association websites are written above the recommended 6th GRL. As patients increasingly look toward online supplementary health information during COVID‐19, there is an opportunity for improving PEMs to enable greater comprehension by the target population.

The synthesis of Zein nanoparticles (NPs) using conventional methods, such as emulsion solvent diffusion and emulsion solvent evaporation, is often unreliable in replicating particle size and polydispersity between batch-to-batch syntheses. We have systematically examined the parameters for reproducibly synthesizing Zein NPs using a Y-junction microfluidics chip with staggered herringbone micromixers. Our results indicate that the total flow rate of the fluidics system, relative flow rate of the aqueous and organic phase, concentration of the base material and solvent, and properties of the solvent influence the polydispersity and size of the NPs. Trends such as increasing the total flow rate and relative flow rate lead to a decrease in Zein NP size, while increasing the ethanol and Zein concentration lead to an increase in Zein NP size. The solvent property that was found to impact the size of the Zein NPs formed the most was their hydropathy. Solvents that had a hydropathy index most similar to that of Zein formed the smallest Zein NPs. Synthesis consistency was confirmed within and between sample batches. Stabilizing agents, such as sodium caseinate, Tween 80, and Pluronic F-68, were incorporated using the microfluidics system, necessary for in vitro and in vivo use, into Zein-based NPs.

This review explores the use of energy sources, including ultrasound, magnetic fields, and external beam radiation, to trigger the delivery of drugs from liposomes in a tumor in a spatially-specific manner. Each section explores the mechanism(s) of drug release that can be achieved using liposomes in conjunction with the external trigger. Subsequently, the treatment’s formulation factors are discussed, highlighting the parameters of both the therapy and the medical device. Additionally, the pre-clinical and clinical trials of each triggered release method are explored. Lastly, the advantages and disadvantages, as well as the feasibility and future outlook of each triggered release method, are discussed.

Mercury is a highly toxic heavy metal and many DNA-based biosensors have been recently developed for Hg 2+ detection in water. Among them, thymine-rich DNA is the most commonly used for designing Hg 2+ sensors. However, the thymine-Hg 2+ interaction is strongly affected by buffer conditions. We recently reported a molecular beacon containing phosphorothioate (PS)-modified RNA linkages that can be cleaved by Hg 2+ . In this work, the fluorescence quenching and DNA adsorption properties of nano-sized graphene oxide (NGO) were used to develop a new sensor using the PS-RNA chemistry. Three DNA probes were tested, containing one, three and five PS-RNA linkages, respectively. Finally, a fluorophore-labeled poly-A DNA with five PS-RNA linkages was selected and adsorbed by NGO. In the presence of Hg 2+ , the fluorophore was release from NGO due to the cleavage reaction, resulting in fluorescence enhancement. This sensor is highly selective for Hg 2+ with a detection limit of 8.5 nM Hg 2+ . For comparison, a fluorophore-labeled poly-T DNA was also tested, which responded to Hg 2+ slower and was inhibited by high NaCl concentrations, while the PS-RNA probe was more tolerable to different buffer conditions. This work indicates a new way of interfacing DNA with NGO for Hg 2+ detection.3

Introduction Health literacy is an individual’s ability to access, understand, and utilize information in order to create an informed decision regarding their health. Readability plays an integral role in health literacy as complex health information may be inaccessible to those with low health literacy. The aim of this study is to determine the readability of Canadian patient education material (PEM) for oncology related pharmaceutics. Methods Eighty PEMs from Cancer Care Ontario (CCO) and BC Cancer (BCC) were evaluated for their reading level using a Ford, Caylor, Sticht (FORCAST) analysis. Twenty therapies were then randomly selected and converted to plain text to be analyzed further using the Flesch-Kincaid Grade Level (FKGL), the Simple Measure of Gobbledygook (SMOG) Index, the Coleman-Liau Index (CLI), and the Gunning Fog Index (GFI). Results Both PEMs from CCO and BCC were above the recommended reading level with PEMs from CCO, on average, requiring a higher reading level. Within the text, the section which describes side effects was found to be the most complex section of the representative PEMs from BCC. PEMs from BCC which described antibody-based therapies were, on average, more difficult to read than small molecule-based therapies regardless from which section the PEM was being analyzed. These observations were not seen in CCO PEMs. Conclusions Overall, online PEMs from major Canadian cancers associations were written above the recommended reading level. Consideration should be given to revision of these materials, with emphasis on the therapies’ side effects, to allow for greater comprehension amongst a wider target audience.

Background Web-based patient education materials (PEMs) are frequently written above the recommended reading level in North America. Poor PEM readability limits the accessibility of medical information for individuals with average literacy levels or lower. Pediatric hospital and association websites have not only been shown to be a preferred source of information among caregivers but have also become a necessity during the COVID-19 pandemic. The readability of Canadian pediatric association websites has not yet been assessed. Objective The aim of this study is to determine if the content of PEMs from Canadian pediatric associations is written at a reading level that the majority of Canadians can understand. Methods A total of 258 PEMs were extracted from 10 Canadian pediatric associations and evaluated for their reading level using 10 validated readability scales. The PEMs underwent a difficult word analysis and comparisons between PEMs from different associations were conducted. Results Web-based PEMs were identified from 3 pediatric association websites, where the reading level (calculated as a grade level) was found to be an average of 8.8 (SD 1.8) for the Caring for Kids website, 9.5 (SD 2.2) for the Pediatric Endocrine Group website, and 13.1 (SD 2.1) for the Atlantic Pediatric Society website. The difficult word analysis identified that 19.9% (SD 6.6%) of words were unfamiliar, with 13.3% (SD 5.3%) and 31.9% (SD 6.1%) of words being considered complex (≥3 syllables) and long (≥6 letters), respectively. Conclusions The web-based PEMs were found to be written above the recommended seventh-grade reading level for Canadians. Consideration should be made to create PEMs at an appropriate reading level for both patients and their caregivers to encourage health literacy and ultimately promote preventative health behaviors and improve child health outcomes.

The 2019 novel coronavirus (COVID-19) pandemic has prompted the reorganization in the scheduling and method of care for many patients, including patients diagnosed with cancer. Cancer patients, who have an immunocompromised status, may be at a higher risk of severe symptoms from infection with COVID-19. While information is rapidly evolving regarding COVID-19, Canada, both nationally and provincially, has been conveying new information to patients online. We assessed the content and readability of COVID-19-related online Canadian patient education material (PEM) for cancer patients to determine if the content of the material was written at a grade reading level that the majority of Canadians can understand. PEMs were extracted from provincial cancer agencies and the national Canadian Cancer Society, evaluated using 10 readability scales, qualitatively analyzed to identify their themes and difficult word content. Thirty-eight PEMs from both national and provincial cancers associations were, on average, written above the recommended 7th grade level. Each of the associations’ average grade levels were: BC Cancer (11.00 95% confidence interval [CI] 8.27-13.38), CancerControl Alberta (10.46 95% CI 8.29-12.62), Saskatchewan Cancer Agency (11.08 95% CI 9.37-12.80), Cancer Care Manitoba (9.55 95% CI 6.02-13.01), Cancer Care Ontario (9.35 95% CI 6.80-11.90), Cancer Care Nova Scotia (10.95 95% CI 9.86-12.04), Cancer Care Eastern Health Newfoundland and Labrador (10.14 95% CI 6.87-13.41), and the Canadian Cancer Society (10.06 95% CI 8.07-12.05). Thematic analysis identified 4 themes: public health strategy, information about COVID-19, patient instructions during COVID-19, and resources. Fifty-three percent of the complex words identified were medical jargon. This represents an opportunity to improve PEM readability, to allow for greater comprehension amongst a wider target audience.

Patient education materials (PEM)s were extracted from provincial cancer agencies to determine their organizational health literacy by evaluating the quality, actionability, and functional accessibility (e.g., readability and understandability) of their PEMs. PEMs from 10 provincial agencies were assessed for their grade reading level (GRL), using eight numerical and two graphical readability scales, and underwent a difficult word analysis. The agencies were assessed for PEM quality using two methods (JAMA benchmarks and DISCERN), while actionability and understandability were assessed using the Patient Education Materials Assessment Tool (PEMAT). Seven hundred and eighty-six PEMs were analyzed. The overall average GRL was 9.3 ± 2.1, which is above the recommended 7th GRL for health information. The difficult word analysis showed that 15.4% ± 5.1% of texts contained complex words, 35.8% ± 6.8% of texts contained long words, and 24.2% ± 6.6% of texts contained unfamiliar words. Additionally, there was high overlap between the most frequently identified difficult words in the PEMs and the most frequently misunderstood words by cancer patients identified in the literature. Regarding quality indicators, no agency displayed all four indicators according to the JAMA benchmarks and DISCERN scores ranged between 38 (poor) to 66 (excellent). PEMAT scores ranged between 68% to 88% for understandability and 57% to 88% for actionability. PEMs continue to be written at a level above the recommended GRL across all provinces, and there was overall high variability in the quality, understandability, and actionability of PEMs among provincial agencies. This represents an opportunity to optimize materials, thus ensuring understanding by a wider audience and improving health literacy among Canadian cancer patients.