An Analysis of the Readability of Online Sarcoidosis Resources.

Introduction Sarcoidosis is an inflammatory disease characterized by the formation of noncaseating granulomas in multiple organ systems. The presentation can vary widely; although some patients with sarcoidosis can be asymptomatic, sarcoidosis can also present in others with symptomatic multiorgan system involvement. Considering the potential severity of the disease, patients need to be well-informed about sarcoidosis to better manage their health. This study aims to assess the readability levels of online resources about sarcoidosis. Methods We conducted a retrospective cross-sectional study. The term "sarcoidosis" was searched online using both Google and Bing to find websites written in English. Each website was categorized by type: academic, commercial, government, nonprofit, and physician. The readability scores for each website were calculated using six different readability tests: the Flesch-Kincaid reading ease (FKRE), Flesch-Kincaid grade level (FKGL), Gunning fog score (GFS), Simple Measure of Gobbledygook (SMOG), automated readability index (ARI), and Coleman-Liau index (CLI). FKRE gives a score that corresponds to the difficulty of the text, while the remaining tests give a score that corresponds to a grade level in terms of reading ability. A one-sample t-test was used to compare all test scores with the national recommended standard of a sixth-grade reading level. Our null hypothesis was that the readability scores of the websites searched would not differ statistically significantly from the sixth-grade reading level and that there would be no significant differences across website categories. To evaluate the difference between the categories of websites, ANOVA testing was used. Results Thirty-four websites were analyzed. Each of the six readability tests for the websites had an average score, which corresponded to being significantly harder to read than the nationally recommended sixth-grade reading level (p<0.001). None of the mean readability scores showed a statistically significant difference across the five different website categories. Conclusions This is the first study, to our knowledge, to examine the readability of online English resources on sarcoidosis and calculate standardized readability scores for them. It implies that the online English material for sarcoidosis is above the health literacy recommended reading levels for patients. There is a need to simplify the material to be easier to read for patients.

Association Between Twitter Mention and Open-Access Status on Article Citation Metrics in the Field of Ophthalmology.

INTRODUCTION: It is possible that social media use can boost not just articles' social impact but the number of citations and academic influence as well. If a positive correlation between Twitter usage and citation metrics exists in the ophthalmology literature, it is important to broadcast this information to the ophthalmology community so they can use Twitter to increase academic engagement with their research. There has also been an increase in the number of articles available as open access. Therefore, it is important to evaluate the presence of an open-access citation advantage in the field of ophthalmology. This study aims to evaluate the relationship between Twitter mention and open access status on citation metrics in the ophthalmology literature. METHODS: We conducted a retrospective cross-sectional study comparing article citation metrics to Twitter mentions and open access status. We gathered data on ophthalmology research articles from the six highest-ranked ophthalmology journals published as part of a January 2019 issue. Data were collected in April 2022, 38 months after online publication. Data on citations for each article was based on Google Scholar and Scopus websites. The Altmetric Bookmarklet extension was used to determine the amount of social engagement each article received. The open-access status of each article was based on the status listed in its corresponding journal. Two-tailed t-tests were used to compare social media engagement and open access status with the number of Google Scholar and Scopus citations. RESULTS: A total of 102 original research articles were analyzed. 89 (87.3%) articles received a Twitter mention. Articles tweeted at least once had a significantly higher Google Scholar score (27.2 +/- 4) compared to articles not tweeted (16.4 +/- 1.7; 1.7-fold increase, p<0.05). Likewise, the average Scopus score was significantly higher for tweeted articles (18.6 +/- 2.6) compared to articles not tweeted (11.8 +/- 1.6; 1.6-fold increase, p<0.05). Articles listed as open access had a significantly higher number of Twitter mentions (11.8 +/- 1.8) compared to articles that were not open access (5.6 +/- 0.7; 2.1-fold increase, p<0.05). Open-access articles also had higher citation scores compared to articles that are not open access, but this relationship was not statistically significant. CONCLUSION: This is the first study to evaluate the relationship between article Twitter mention and citation score in the field of ophthalmology. It demonstrates a significant positive correlation between the article Twitter mention and citation score and provides further evidence that social media engagement can be beneficial to the dissemination of academic information. Further studies on the relationship between social media engagement and article dissemination are warranted in the field of ophthalmology.

An Analysis of the Readability of Phacoemulsification Online Resources.

INTRODUCTION: Cataract is the leading cause of blindness worldwide. Phacoemulsification is now the gold standard for cataract extraction and is greatly needed in low socioeconomic status (SES) communities, rural and older patient populations, and patients with poor vision. This greatly increases the importance of high readability for online resources on this topic. This study aims to assess the readability of online information about phacoemulsification based on readability scores for each resource.  Methods: We conducted a retrospective cross-sectional study. The term "phacoemulsification" was searched online, and each website was categorized by type: academic, physician, non-physician, commercial, social media, and unspecified. The readability scores for each website were calculated using six different readability tests and a composite score that reflects reading grade level was obtained. To evaluate the difference between the categories of websites, analysis of variance (ANOVA) testing was used. All test scores were compared with the 6th grade standard recommendation using a one-sample t-test. RESULTS: A total of 20 websites were analyzed. Three websites (3/20; 15%) had a score which is correlated with a 6th grade reading level or below. Seventeen websites had a score correlated with a college reading level or above (17/20; 85%). None of the readability scores had a mean below a 6th grade reading level. No category had an average readability score at or below a 6th grade reading level. None of the mean readability scores resulted in a statistically significant difference across categories. All readability tests had an average score which was significantly different from a 6th grade reading level (p<0.001).  Conclusions: This is the first study to focus on the accessibility of online English resources on phacoemulsification and implement multiple standardized readability scores with regards to cataract surgery resources. It provides further overwhelming evidence that online resources on phacoemulsification are too complex for the average patient to understand. Interventions should be implemented to improve readability.

Autoimmune Progesterone Dermatitis.

The condition autoimmune progesterone dermatitis (APD) is an immune disorder, observed among women, primarily due to progesterone surge during menstrual cycle. Here, we present a case of a 29-year-old female with recurrent severe skin eruptions associated with her menstrual cycle that commenced a few years ago. She presented with blistered skin lesion of the body and also blisters in oropharyngeal mucosa leading to a variety of symptoms ranging from pruritus to difficulty in swallowing. Recognition of this process is important as it can result in significant debility among women. Our patient was treated with steroids and antihistamines to provide symptomatic relief and was encouraged to resume her oral contraceptive pill, which is a more definitive therapy.

p53 mutant-type in human prostate cancer cells determines the sensitivity to phenethyl isothiocyanate induced growth inhibition.

BACKGROUND: We reported previously that phenethyl isothiocyanate (PEITC), a dietary compound, can reactivate p53R175H mutant in vitro and in SK-BR-3 (p53R175H) breast xenograft model resulting in tumor inhibition. Because of the diversity of human cancers with p53 mutations, these findings raise important questions whether this mechanism operates in different cancer types with same or different p53 mutations. In this study, we investigated whether PEITC recuses mutant p53 in prostate cancer cells harboring different types of p53 mutants, structural and contact, in vitro and in vivo. METHODS: Cell proliferation, cell apoptosis and cell cycle arrest assays were performed to examine the effects of PEITC on prostate cancer cell lines with p53 mutation(s), wild-type p53, p53 null or normal prostate cells in vitro. Western blot analysis was used to monitor the expression levels of p53 protein, activation of ATM and upregulation of canonical p53 targets. Immunoprecipitation, subcellular protein fraction and qRT-PCR was performed to determine change in conformation and restoration of transactivation functions/ inhibition of gain-of-function (GOF) activities to p53 mutant(s). Mice xenograft models were established to evaluate the antitumor efficacy of PEITC and PEITC-induced reactivation of p53 mutant(s) in vivo. Immunohistochemistry of xenograft tumor tissues was performed to determine effects of PEITC on expression of Ki67 and mutant p53 in vivo. RESULTS: We demonstrated that PEITC inhibits the growth of prostate cancer cells with different "hotspot" p53 mutations (structural and contact), however, preferentially towards structural mutants. PEITC inhibits proliferation and induces apoptosis by rescuing mutant p53 in p53R248W contact (VCaP) and p53R175H structural (LAPC-4) mutant cells with differential potency. We further showed that PEITC inhibits the growth of DU145 cells that co-express p53P223L (structural) and p53V274F (contact) mutants by targeting p53P223L mutant selectively, but not p53V274F. The mutant p53 restored by PEITC induces apoptosis in DU145 cells by activating canonical p53 targets, delaying cells in G1 phase and phosphorylating ATM. Importantly, PEITC reactivated p53R175H and p53P223L/V274F mutants in LAPC-4 and DU145 prostate xenograft models, respectively, resulting in significant tumor inhibition. CONCLUSION: Our studies provide the first evidence that PEITC's anti-cancer activity is cancer cell type-independent, but p53 mutant-type dependent.

Counterintuitively Crossing a Critically Stenosed Aortic Valve is a Diastolic Phenomenon.

Crossing of a critically stenosed aortic valve is a pivotal step during diagnostic cardiac catheterization to measure the transvalvular gradient, especially in patients with discordant clinical and echocardiographic findings and also during transcatheter aortic valve replacement procedures. However, there are no data in the literature indicating whether aortic valve crossing typically occurs during systole or diastole. We hypothesize that aortic valve crossing is a diastolic phenomenon and describe our technique for crossing critically stenosed aortic valves.