Assessing the readability and quality of online information about benign prostatic hyperplasia.

PURPOSE: Benign prostatic hyperplasia (BPH) affects nearly half of men in their fifties. Patients often search the Internet to better understand their diagnosis, but online health information is not well regulated and can be difficult for patients to comprehend. This study aims to evaluate not only readability, but also the quality of online information about BPH, as well as the effect of commercial bias on readability and quality. METHODS: Three search engines (Google, Bing, and DuckDuckGo) were used with broad search terms including "BPH," "BPH treatment," and "BPH surgery," to mimic a patient diagnosed with BPH seeking further information. 204 total websites were identified, of which 62 were unique websites. Among those unique websites, 23 were advertisements. Three readability formulas (Flesch-Kincaid Grade Level, Flesch-Kincaid Reading Ease, SMOG) were used to generate readability scores. DISCERN standardized questionnaire was used to evaluate website quality. RESULTS: Average reading level of online information about BPH was significantly higher than the recommended level by the American Medical Association (AMA) and United States Department of Health and Human Services (USDHHS). Advertisements had significantly easier readability than nonadvertisements. Average website quality was "excellent" for nonadvertisements, but only "fair" for advertisements. CONCLUSION: Although advertisements may hold optimal search result positions and have better readability than nonadvertisements, they have biased and lower quality information. It is important to guide patients to high quality online information of appropriate reading level. Continued efforts should be made to create and share with patients high quality resources with improved readability to facilitate comprehension and minimize misinformation.

A Case of Posterior Cortical Atrophy Presenting with Mood and Psychotic Symptoms.

Posterior cortical atrophy (PCA) is a rare neurodegenerative disorder characterized by predominant visual deficits due to its atrophy of the occipital lobes. Patients typically have preserved cognitive function during the early stages, making diagnosis more difficult when compared to other neurocognitive disorders. In this case, the patient presented predominantly with mood symptoms, delusions, and visual hallucinations. The disease course began 5 years ago with anxiety and insomnia. It developed into depressive symptoms including two suicide attempts (SAs), paranoia, and hallucinations. The diagnosis was eventually reached utilizing a thorough clinical exam, neuropsychological testing, MRI, positron emission tomography (PET), and dopamine transporter (DAT) scans. We conclude that mood or psychotic symptoms that emerge, escalate, or change dramatically at later ages merit further workup to evaluate for underlying neurodegenerative disorders.

Anomalous uptake and circulatory characteristics of the plant-based small RNA MIR2911.

Inconsistent detection of plant-based dietary small RNAs in circulation has thwarted the use of dietary RNA therapeutics. Here we demonstrate mice consuming diets rich in vegetables displayed enhanced serum levels of the plant specific small RNA MIR2911. Differential centrifugation, size-exclusion chromatography, and proteinase K treatment of plant extracts suggest this RNA resides within a proteinase K-sensitive complex. Plant derived MIR2911 was more bioavailable than the synthetic RNA. Furthermore, MIR2911 exhibited unusual digestive stability compared with other synthetic plant microRNAs. The characteristics of circulating MIR2911 were also unusual as it was not associated with exosomes and fractionated as a soluble complex that was insensitive to proteinase K treatment, consistent with MIR2911 being stabilized by modifications conferred by the host. These results indicate that intrinsic stability and plant-based modifications orchestrate consumer uptake of this anomalous plant based small RNA and invite revisiting plant-based microRNA therapeutic approaches.