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Achilles tendon ruptures are common injuries typically sustained during sport with higher incidence in men, though little is understood regarding sex-specific risk factors or outcomes following injury management. This cross-sectional clinical study and systematic review aimed to examine sex-specific Achilles tendon rupture incidence and outcomes following intervention. This study included patients who sustained a rupture between 2011-2021, were ≥18 years old, and who had a minimum follow-up of at least six months, and evaluated age, sex, sport involvement, mechanism of injury, and postoperative complications and revision. Separately, a systematic literature review in the PubMed, EMBASE, and Cochrane databases was performed. A total of 705 male and 158 female patients were included in this retrospective study. 71.1% of men and 52.5% of women sustained a sports-related rupture (p <.001), with sport involvement demonstrating a positive correlation with revision rate (coefficient = 0.09, p =.02). A total of 21 studies with 250,907 patients (87,514 male, 35,792 female) were included in the systematic review. All studies revealed an increased incidence of ATR in men. Functional outcomes were worse in women, and female sex was an independent risk factor for postoperative complications and need for revision surgery. This study demonstrated a higher incidence of sports-related ATR in men than women, likely related to their higher ball sport participation. Although the retrospective analysis did not find a significant difference in complication or revision rates, the systematic review demonstrates poorer functional outcomes, with increased likelihood for postoperative complication and revision surgery in women as compared to men. [ABSTRACT FROM AUTHOR]

Difficulty scoring systems are important for the safe, stepwise implementation of new procedures. We designed a retrospective observational study for building a difficulty score for robotic pancreatoduodenectomy. The difficulty score (PD-ROBOSCORE) aims at predicting severe postoperative complications after robotic pancreatoduodenectomy. The PD-ROBOSCORE was developed in a training cohort of 198 robotic pancreatoduodenectomies and was validated in an international multicenter cohort of 686 robotic pancreatoduodenectomies. Finally, all centers tested the model during the early learning curve (n = 300). Growing difficulty levels (low, intermediate, high) were defined using cut-off values set at the 33rd and 66th percentile (NCT04662346). Factors included in the final multivariate model were a body mass index of ≥25 kg/m2 for males and ≥30 kg/m2 for females (odds ratio:2.39; P <.0001), borderline resectable tumor (odd ratio:1.98; P <.0001), uncinate process tumor (odds ratio:1.69; P <.0001), pancreatic duct size <4 mm (odds ratio:1.59; P <.0001), American Society of Anesthesiologists class ≥3 (odds ratio:1.59; P <.0001), and hepatic artery originating from the superior mesenteric artery (odds ratio:1.43; P <.0001). In the training cohort, the absolute score value (odds ratio = 1.13; P =.0089) and difficulty groups (odds ratio = 2.35; P =.041) predicted severe postoperative complications. In the multicenter validation cohort, the absolute score value predicted severe postoperative complications (odds ratio = 1.16, P <.001), whereas the difficulty groups did not (odds ratio = 1.94, P =.082). In the learning curve cohort, both absolute score value (odds ratio:1.078, P =.04) and difficulty groups (odds ratio: 2.25, P =.017) predicted severe postoperative complications. Across all cohorts, a PD-ROBOSCORE of ≥12.51 doubled the risk of severe postoperative complications. The PD-ROBOSCORE score also predicted operative time, estimated blood loss, and vein resection. The PD-ROBOSCORE predicted postoperative pancreatic fistula, delayed gastric emptying, postpancreatectomy hemorrhage, and postoperative mortality in the learning curve cohort. The PD-ROBOSCORE predicts severe postoperative complications after robotic pancreatoduodenectomy. The score is readily available via www.pancreascalculator.com [ABSTRACT FROM AUTHOR]

• Risk assessment was estimated starting from environmental hazard data and vulnerability and • exposure information of architectural buildings. • Three different risk levels can be assessed starting from air pollution and meteorological data measured by national monitoring station network. • Vulnerability and exposure describe the conservation condition based on damage intensity. • Risk assessment as a tool to plan maintenance and restoration activities according a priority scale. Limestone monuments are generally subjected to natural and anthropogenic environmental threats. This paper describes a methodology to assess the risk of surface recession damage, due to air pollution and meteorological factors, to architectural buildings in Italy. Through the elaboration of environmental data and information on conservation conditions of cultural heritage, three different risk models were identified: i) the territorial risk, obtained combining territorial hazard information with the density of historic buildings defined at municipal scale; ii) the individual risk, attained by overlapping territorial hazard data at municipal scale, with surface vulnerability and exposure information of a single monument; iii) the local risk, defined starting from the combination of territorial hazard at sub-municipal scale, with vulnerability and exposure information of a single monument. The first model refers to the risk of an aggregate of cultural assets located in a municipality, while the other two indicators identify the damage risk of a single monument at municipal and sub-municipal spatial scales. The proposed method was applied, using GIS (Geographical Information System) application, to identify the three risk models for Italian architectural buildings using environmental and monument conservation data updated to 2018. The territorial hazard was defined by assessing the material loss damage expressed as surface recession and quantified starting from air pollutant concentrations and meteorological data measured by the monitoring station network of Italy in 2018. The vulnerability and exposure information were extracted from the Italian Risk Map of Cultural Heritage system. The obtained results allowed to identify the potentially most aggressive areas from climatic and environmental point of view and the architectural buildings most exposed to surface recession risk. The methodology described in this paper can be therefore considered as a tool that can be used, by policy makers, to plan priority maintenance and conservation activities in order to reduce the progress and the intensity of decay on outdoor cultural properties. [Display omitted] [ABSTRACT FROM AUTHOR]

The growing interest in process intensification and continuous processing has led to concerns regarding the performance of virus removal filters at low permeate fluxes. This paper presents a quantitative analysis of virus retention by the Viresolve® Pro membrane during constant permeate flux filtration and in response to process disruptions using ΦX-174, a bacteriophage, as a model for a mammalian parvovirus. Virus retention by a single layer of Viresolve® Pro membrane was reduced at lower permeate fluxes due to the greater diffusive mobility of phage, although the expected retention for a commercial device employing two layers of membrane remained above 4-logs. The retention data were well correlated with the ΦX-174 Péclet number for filtrate flux from 5 to 100 L/m2/h. Process disruptions caused an immediate transient increase in phage transmission, although this effect was much less pronounced at low permeate flux. The experimental data for phage retention, both with and without process disruptions, were well-described using an internal polarization model with the fraction of virus remaining mobile within the filter scaling as 1/ Pe 2. In contrast, the fraction of previously captured virus that were re-mobilized after a process interruption was independent of the flow rate. Model equations were developed for rapid estimation of virus performance behavior with the Viresolve® Pro membrane, facilitating the design and implementation of virus filtration processes operating at constant filtrate flux. [Display omitted] • Virus retention by the Viresolve® Pro filter reduced at low filtrate flux due to virus diffusion. • Log reduction value (LRV) well-correlated with the virus Péclet number. • Virus transmission increases immediately after process disruption. • LRV data well described using internal polarization model. • Fraction of previously captured virus re-mobilized after disruption independent of filtrate flux. [ABSTRACT FROM AUTHOR]