Précis:
We assessed the readability of online glaucoma patient education materials using seven validated instruments. Overall, glaucoma materials were written at a 10th to 11th grade level, above the recommended seventh grade reading level.
Purpose:
Online health information is increasingly used by patients, yet previous studies show online patient education materials are often difficult to understand. As such, the American Medical Association recommends that patient education materials are written at or below a seventh grade reading level. This study aimed to assess the readability of online glaucoma patient education materials.
Methods:
Glaucoma was entered into the Google search engine, and the first 30 search results were assessed for readability using seven validated readability instruments. Scientific articles, forums, and dictionary entries were excluded. Single sample t tests were used to assess whether online glaucoma materials were written above the recommended seventh grade level.
Results:
Overall, glaucoma materials were written at a mean grade level of 10.33 (SD: 2.02). Across 6 grade level readability instruments, these patient education materials were written above the recommended seventh grade reading level (P<0.0001 for all). Glaucoma education materials only on the first page of Google search results were of a similar reading level: mean 10.56 (SD: 2.13). The readability instruments used in this study showed strong consistency.
Conclusions:
Glaucoma patient education materials are written above the recommended reading level to promote accessibility of education materials. This may contribute to lower patient engagement, worse clinical outcomes, and greater racial and ethnic disparities in glaucoma management. There is a need for reliable, simple glaucoma information to improve patient outcomes.
Non‐muscle myosin II (NMII) plays a role in many fundamental cellular processes including cell adhesion, migration, and cytokinesis. However, its role in mammalian vascular function is not well understood. Here, we investigated the function of NMII in the biomechanical and signalling properties of mouse aorta. We found that blebbistatin, an inhibitor of NMII, decreases agonist‐induced aortic stress and stiffness in a dose‐dependent manner. We also specifically demonstrate that in freshly isolated, contractile, aortic smooth muscle cells, the non‐muscle myosin IIA (NMIIA) isoform is associated with contractile filaments in the core of the cell as well as those in the non‐muscle cell cortex. However, the non‐muscle myosin IIB (NMIIB) isoform is excluded from the cell cortex and colocalizes only with contractile filaments. Furthermore, both siRNA knockdown of NMIIA and NMIIB isoforms in the differentiated A7r5 smooth muscle cell line and blebbistatin‐mediated inhibition of NM myosin II suppress agonist‐activated increases in phosphorylation of the focal adhesion proteins FAK Y925 and paxillin Y118. Thus, we show in the present study, for the first time that NMII regulates aortic stiffness and stress and that this regulation is mediated through the tension‐dependent phosphorylation of the focal adhesion proteins FAK and paxillin.
Chronic diseases of aging are increasingly common. Dementia, often due to multiple etiologies including Alzheimer disease (AD), is at the forefront. Previous studies have reported higher rates of dementia among persons with diabetes, yet less is known about how insulin resistance relates to cognition. This article reviews recently published data on the relationship of insulin resistance to cognition and AD, and remaining knowledge gaps in the field are discussed. A structured review of studies was conducted over a 5‐year period, investigating insulin and cognitive function in adults with a baseline mean age of ≥65 years. This search yielded 146 articles, of which 26 met the predetermined inclusion and exclusion criteria. Among the nine studies that specifically examined insulin resistance and cognitive dysfunction and/or decline, eight studies suggest an association, but some only in subanalyses. Results are mixed in studies relating insulin to structural and functional changes on brain imaging, and data on intranasal insulin for cognition remain unclear. Future avenues are proposed to elucidate the impact of insulin resistance on brain structure and function, including cognition, in persons with and without AD.
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