This study for the first time identifies the sex-specific roles of the alternative p38γ and p38δ MAPK isoforms in promoting doxorubicin (DOX) cardiotoxicity. We show that p38δ and p38γ/δ systemic deletion was cardioprotective in female but not in male mice. Cardiac structure and function were preserved in DOX-treated p38δ^−/− females, and autophagy marker was increased.

Citation analysis is commonly used to evaluate the impact of academic publications within an area of study. The purpose of this study is to review the publications with the highest Altmetric scores related to total hip arthroplasty (THA) and total knee arthroplasty (TKA) and assess the correlation with traditional bibliometrics. Altmetric scores were obtained for the top articles relating to THA and TKA and organized from highest to lowest scores. The Clarivate Analytics Web of Knowledge database was used to search the top articles by Altmetric score. Articles meeting inclusion criteria were reviewed for various metrics, including number of citations, journal impact factor at the time of publication, and study type and design. The top THA and TKA publications were cited 3042 times and 7523 times, respectively. The former were published in journals with an average impact factor of 17.861, and the latter in journals with an average impact factor of 15.564. For THA, Altmetric score demonstrated a significant, weakly positive correlation with the number of citations (P = .008). For TKA, Altmetric score was found to have a significant, weakly positive correlation with impact factor of journal (P = .04); however, it was nonsignificant for citation count (P = .11). When one outlier is removed, the correlation with citation count is statistically significant (P = .009). While alternative metrics cannot replace traditional bibliometrics, they may serve a complimentary role in describing the influence of research. Thus, the Altmetric score represents an additional tool to identify the most influential articles to guide learning and evidence-based practice.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Revision total knee arthroplasty (TKA) is an increasingly common procedure and is effective in treating knee osteoarthritis, but it has higher complication rates than primary TKA. Anesthetic choice poses perioperative risk that has been extensively studied in primary TKA, showing favorable results for regional anesthesia compared with general anesthesia. The impact of anesthetic choice in revision TKAs is not well studied. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent revision TKAs between 2014 and 2017 were divided into three anesthesia cohorts: (1) general anesthesia, (2) regional anesthesia, and (3) combined general-regional anesthesia. Univariate and multivariate analyses were used to analyze patient characteristics and 30-day postoperative outcomes. Bonferroni correction was applied for post hoc analysis. In total, 8,820 patients were identified. Of whom, 3,192 patients underwent general anesthesia, 3,474 patients underwent regional anesthesia, and 2,154 patients underwent combined anesthesia. After multivariate analyses, regional anesthesia was associated with decreased odds for any complication (p = 0.008), perioperative blood transfusion (p < 0.001), and extended length of stay (p < 0.001) compared with general anesthesia. In addition, regional anesthesia was associated with decreased odds for perioperative blood transfusion (p < 0.001) and extended length of stay (p = 0.006) compared with combined anesthesia. However, following multivariate analysis, regional anesthesia was not associated with decreased odds of wound, pulmonary, renal, urinary tract, thromboembolic, and cardiac complications, and was not associated with return to operating room, extended length of stay, minor and major complications, and mortality. Retrospective analysis of a large surgical database suggests that patients receiving general anesthesia have increased likelihood for developing adverse postoperative outcomes relative to patients receiving regional anesthesia. Prospective and controlled trials should be conducted to verify these findings. ^* The authors contributed equally to the work.