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Robotic-assisted hip and knee arthroplasty represents significant advancements in orthopedic surgery. Artificial intelligence (AI)-driven chatbots, such as ChatGPT, could play a significant role in healthcare education. This study aims to evaluate the quality of responses provided by ChatGPT to the top 20 questions concerning robotic-assisted hip and knee arthroplasty. We have asked ChatGPT to select the top 20 questions on Google concerning robotic hip and knee arthroplasty and to provide a detailed answer to each of them. The accuracy and completeness of the information provided were examined by three orthopedic surgeons with scientific and clinical experience in hip- and knee-replacement surgery. The accuracy was assessed through a 5-point Likert scale (from 1—completely incorrect to 5—correct); the completeness through a 4-point Likert scale (from 0—comprehensiveness not assessable for completely incorrect answers to 3—exhaustive information) on two different occasions to ensure the consistency of the assessment. Our analysis reveals that ChatGPT provides a relatively high degree of accuracy; moreover, the explanations can be considered satisfying, especially for factual questions. The findings suggest that ChatGPT can serve as a valuable initial resource for general information on robotic hip and knee arthroplasty but the integration with human expertise remains essential.

Background and purpose: We aimed to determine sex differences for periprosthetic joint infections after primary arthroplasty of the hip, knee, ankle, and shoulder in osteoarthritis patients in an international perspective. Methods: This is a multinational combined arthroplasty registry study. Each arthroplasty registry performed Cox-regression analysis of their data and reported the crude and adjusted hazard ratios (HR) with an a priori designed data form. A random-effects model was used to pool these HRs to estimate an overall HR with 95% confidence interval (CI). Adjustment was undertaken for patient age, BMI, ASA grade, type of fixation, and type of implant. 9 arthroplasty registries participated. Patients who received primary total joint arthroplasty for primary osteoarthritis were considered: 2,134,313 hip arthroplasties, 2,658,237 knee arthroplasties, 57,889 shoulder arthroplasties, and 8,445 ankle arthroplasties. We calculated hazard ratios (HR) for the overall risk of complete revision due to infection for each implant type and follow-up. Results: The pooled HR for revision due to infection for men compared with women at 1-year follow-up was 1.60 (95% confidence interval [CI] 1.42–1.80) for hip arthroplasties; 2.06 (CI 1.90–2.46) for knee arthroplasties; 4.51 (CI 2.99–6.80) for shoulder arthroplasties; and 0.87 (CI 0.46–1.62) for ankle arthroplasties. These results remained consistent over time and were identified in both unadjusted and adjusted models. Conclusion: Men have a higher risk of revision due to infection than women after primary hip, knee, and shoulder arthroplasty. No evidence of difference was found for ankle arthroplasty. These elevated relative risks persist in the fully adjusted investigations and over the 10-year postoperative period studied.

Background and purpose: National joint replacement registries were developed for prospective monitoring of outcomes and post-market surveillance of implants. Increasingly registry data informs practice. However, analysis of a registry can only be as good as the data it captures on the population of interest. We aimed to analyze completeness of reporting of hip and knee replacement procedures for all national registries worldwide. Methods: We analyzed annual reports and data provided following written requests to all active national hip and knee replacement registries. Coverage was defined as the proportion of hospitals in the country that participate in the registry. Procedure completeness was defined as the proportion of procedures successfully captured by the registry. Results: 14 national registries were included, spanning years 2004 to 2022. Coverage was complete in 10. Median procedure completeness for primary hip and knee replacement across all years was 96.5% (interquartile range [IQR] 94.0–97.7%). Median procedure completeness for revisions was 88.5% (IQR 81.0–92.5%). The terminology used and method of calculation of completeness estimates in the registries were variable. Conclusion: National hip and knee replacement registry data generally reflects excellent coverage (full in 10 of 14 registries) and completeness (primary procedures 96.5% and revisions 88.5%) over the last 2 decades.

In recent years, there has been a significant increase in the use of structural health monitoring (SHM) technologies as systems for monitoring the integrity of aircraft’s structures. The use of compact and embeddable sensor networks, like the ones based on fibre optics (FO), is particularly attractive from the perspective of releasing an integrated structural system with intrinsic sensing capacity. Usually, an SHM system architecture is completed by a dedicated algorithm that processes the data gathered from the sensors to elaborate on the level of damage currently suffered by the structure, with the further possibility of providing information to the relevant specialists involved with its supervision. One of the main SHM applications that is attracting major interest is related to the inspection and detection of anomalies in bonded joints, which is extremely relevant in many composite realizations. Aeronautical regulations allow the use of bonded joints on an aircraft’s primary structure but require the implementation of a means to ensure their absolute safety, such as the introduction of further mechanical links aimed at stopping the propagation of a possible flaw or the availability of Non-Destructive Inspection (NDI) systems to prove the absence of relevant damaged areas. Generally, the main typical defects occurring during the manufacturing of bonded joints include adhesive curing, kissing bonds, poor porosity, and poor surface preparation. The current NDI systems more widely used and available to detect defects are still inaccurate due to the lack of standard procedures for the creation of representative defects in a controlled manner, which would allow for the development of reliable methodologies and tools able to ensure the safety of a bonded joint, as required by safety regulations. This paper shows the results relative to the implementation of an SHM system developed by the Italian Aerospace Research Centre (CIRA) aimed at monitoring the bonding lines between spar caps and panels of a typical composite wingbox section and detecting faults in location and length. The work was performed during typical ground static tests by using a fibre optical sensing network embedded within relevant adhesive paste layers during the manufacturing process of the structure. In the reported investigation, the SHM system assumed the function of an NDI system tool. The results show that the developed SHM system has good reliability for the detection of both the position and size of damage areas that were artificially inserted within the test article during the bonding phase, showing its potential as a candidate to be used as a tool to verify the conditions of a bonded joint, as required by aviation authorities’ regulations.

(1) Background: Vulvodynia is characterized by vulvar pain for at least three months and may have related variables, one of these being pelvic floor hypertonus. The purpose of this study was to compare the therapeutic effectiveness of two weekly sessions of pelvic floor rehabilitation and 5 mg of vaginal diazepam daily vs. pelvic floor rehabilitation alone in individuals with vulvodynia. (2) Methods: A single-center, not-blind, randomized study enrolled 20 vulvodynic patients: A total of 10 were treated with dual therapy (intravaginal diazepam and pelvic floor rehabilitation), and 10 were treated with only pelvic floor rehabilitation. All of them underwent a pelvic floor ultrasound examination and VAS pain and Marinoff scale assessments before the beginning of therapy as well as three and six months later. (3) Results: The elevator plate angle ranged from 8.2 to 9.55 (p = 0.0005), hiatal area diameter ranged from 1.277 to 1.482 (p = 0.0002), levator symphysis distance ranged from 3.88 to 4.098 (p = 0.006), anorectal angle ranged from 121.9 to 125.49 (p = 0.006), Marinoff scale ranged from 2.3 to 1.4 (p = 0.009), and VAS scale ranged from 5.8 to 2.8 (p < 0.001). (4) Conclusions: This pilot study demonstrates that the suggested treatment improves the hypertonicity of the pelvic floor, as measured by ultrasound parameters, correlating with a reduction in symptomatology.

Probability of detection (POD) is an acknowledged mean of evaluation for many investigations aiming at detecting some specific property of a subject of interest. For instance, it has had many applications for Non-Destructive Evaluation (NDE), aimed at identifying defects within structural architectures, and can easily be used for structural health monitoring (SHM) systems, meant as a compact and more integrated evolution of the former technology. In this paper, a probability of detection analysis is performed to estimate the reliability of an SHM system, applied to a wing box composite spar for bonding line quality assessment. Such a system is based on distributed fiber optics deployed on the reference component at specific locations for detecting strains; the attained data are then processed by a proprietary algorithm whose capability was already tested and reported in previous works, even at full-scale level. A finite element (FE) model, previously validated by experimental results, is used to simulate the presence of damage areas, whose effect is to modify strain transfer between adjacent parts. Numerical data are used to verify the capability of the SHM system in revealing the presence of the modeled physical discontinuities with respect to a specific set of loads, running along the beam up to cover its complete extension. The POD is then estimated through the analysis of the collected data sets, wide enough to assess the global SHM system performance. The results of this study eventually aim at improving the current strategies adopted for SHM for bonding analysis by identifying the intimate behavior of the system assessed at the date. The activities herein reported have been carried out within the RESUME project.

Abstract Background Surgery involving implantable devices is widely used to solve several health issues. National registries are essential tools for implantable device surveillance and vigilance. In 2017, the European Union encouraged Member States to establish “registries and databanks for specific types of devices” to evaluate device safety and performance and ensure their traceability. Spine-implantable devices significantly impact patient safety and public health; spine registries might help improve surgical outcomes. This study aimed to map existing national spine surgery registries and highlight their features and organisational standards to provide an essential reference for establishing other national registries. Methods A scoping search was performed using the Embase, PubMed/Medline, Scopus, and Web of Science databases for the terms “registry”, “register”, “implantable”, and all terms and synonyms related to spinal diseases and national registries in publications from January 2000 to December 2020. This search was later updated and finalised through a web search and an ad hoc survey to collect further detailed information. Results Sixty-two peer-reviewed articles were included, which were related to seven national spine registries, six of which were currently active. Three additional active national registries were found through the web search. The nine selected national registries were set up between 1998 and 2021. They collect data on the procedure and use patient-reported outcome measures (PROMs) for the follow-up. Conclusion Our study identified nine currently active national spine surgery registries. However, globally accepted standards for developing a national registry of spine surgery are yet to be established. Therefore, an international effort to increase result comparability across registries is highly advisable. We hope the recent initiative from the Orthopaedic Data Evaluation Panel (ODEP) to establish an international collaboration will meet these needs.

Abstract Background Compare all-suture anchors to traditional anchors through clinical and radiological evaluation at pre-established end-points. Materials and methods We performed a two-arms non-inferiority study on all-suture anchor (2.3 iconix™, Stryker) device with respect to traditional anchor (5.5 healix Advance™ BR, Depuy/Mitek) device under unpaired samples with size equal to 30 patients per group, all suffering from supraspinatus tendon rupture. We administrated DASH (Disabilities of the Arm, Shoulder and Hand); constant; and SST (Simple Shoulder Test) questionnaires in pre-operative, 3 ± 1 months post-intervention and 8 ± 1 months post-intervention. Questionnaires scores were the primary outcome. We also evaluated RMI at 3 and at 8 months after surgery to assess the presence of oedema or any loosening of the implant. Results All-suture anchor approach has been proven to have non-inferior performances with respect to traditional anchor approach, according to questionnaires scores at the 3-month endpoint. We observed 26 patients with oedema by MRI (18 in control group, 6 in experimental group). In the 8-month endpoint we found persistent edema in 12 patients (all treated with healix), 2 had mobilitazions (healix), 10 had partial retears (8 healix, 2 iconix) and 1 implant failure (healix). Conclusions All suture devices have clinical and functional results comparable to traditional devices, while they tend to give fewer complications in terms of bone edema, loosening and retear rate. The effectiveness of all-suture devices should be further investigated in rotator cuff suture arthroscopic revision surgery, given the advantages they offer.

Background: Proximal humeral fractures (PHFs) are common, especially in the elderly, and account for 4% to 10% of all fractures, with women more often affected than men. Treatments include conservative methods, internal fixation and arthroplasty, with surgical approaches increasingly being used due to technological advancements. This study analyzes the evolution of PHF treatments in Italy from 2001 to 2022, using data from the Italian Hospital Discharge Records (HDRs) Database, and includes a stratified analysis by age and sex. Methods: Using HDR data from 2001 to 2022, records with ICD9-CM codes for proximal humeral fractures (812.0 and 812.1) among diagnoses were selected and categorized into three treatment groups: arthroplasty, fixation and conservative. Time series were analyzed with stratification by sex and age. Results: The extracted data included 486,368 records of PHFs, with 223,742 cases treated surgically (arthroplasty or internal fixation) and 262,626 treated conservatively; the average patient age was 66.6 years, with a higher proportion of women, especially among arthroplasty patients. Over time, the use of fixation and arthroplasty increased from 20% of treatments in 2001 to over 60% in 2022, with fixation becoming the most common treatment method by 2014 and arthroplasty significantly increasing among women, particularly in the 65–74 and 75–84 age groups. Conclusions: The study shows that in Italy, over the past two decades, treatment for PHFs has shifted from conservative methods to a preference for internal fixation and increasingly for arthroplasty, particularly among women and patients aged 65–84, reflecting evolving trends and technological improvements. [ABSTRACT FROM AUTHOR]

This article discloses the activity developed in the framework of the research project “GRID” aiming at the feasibility demonstration of a fiber optic sensing system (FOS), based on fiber Bragg gratings (FGB), embedded in the ribs of a conical grid structure demonstrator in composite material (CFRP), manufactured by means of dry robotic winding, liquid resin infusion and oven curing. This structure represents an optimized and highly efficient conical adapter for satellite applications that was designed under the same requirements of a conventional CFRP benchmark solution in order to evaluate possible mass savings. Specific interfaces were conceived in order to facilitate the insertion of the fiber optics in the center of helical ribs—pausing the automated deposition phase of the dry preform—and secure them to the structure. Representative grid articles were produced and tested to select the materials and evaluate the preliminary feasibility of the integrated system in conjunction with the infusion process. The proper functioning and use of the sensing system were finally proven during the various phases of the mechanical testing campaign of the demonstrator. Such a campaign included stiffness and strength evaluations and culminated with the catastrophic failure of the structure. The significant amount of data collected from several sensors embedded in the ribs and from conventional sensors glued outside the ribs helped us to better understand the structural behavior and to validate the design and analysis models. The main steps of the design, manufacturing and tests of this project are here addressed.

In this work, the modeling of a demonstrator of a morphing system aimed at altering the twist of a rotorcraft blade is presented. The device was conceived for two different representative environments: the wind tunnel plant of the University of Bristol and the whirl tower facility of the DLR, for tests in fixed and wing rotary configurations, respectively. The concept, conceived and matured within the European Project of SABRE, is based on shape memory alloys, SMA. This technology was selected for its intrinsic compactness and solidity, which better meet the requirements of a typical blade structure, being extremely flexible and subjected to relevant inertial loads. A dedicated structural layout was conceived to favor the working modality of the SMA torsional system; this architecture was tailored both to absorb the typical actions occurring onto a blade and to assure a certain level of pre-twist necessary for the SMA strain recovery. The activation of the SMA was performed through an electrothermal helicoidal coil wrapped around it. A dedicated network of sensors was integrated within the structure to measure the impact of the different actions on the blade system. This subsystem, functional to shape reconstruction operations, is capable of splitting the contribution of the loads to pure twist and flapping. At first, the requirements imposed by the two test facilities were elaborated together to the operational needs, arriving at the issue of the most relevant specifications. Secondly, the conceptual and advanced design were considered, demonstrating, first, the feasibility of the concept and, then, its compliance with the test environment. The work ends with two different layouts, conceived respectively for the tests in fixed and rotary wing configurations. For both of them, a performance estimate was addressed, and a discussion on the advantages and disadvantages was presented.

The present work is framed inside a broader activity aimed at improving the accuracy of numerical models in predicting the crashworthiness behavior of flexible fuel tanks. This paper describes a comprehensive experimental and numerical study aimed at estimating the impact force of a test article, consisting of a soft nylon bag filled with water, subjected to crash impact tests. In order to understand and improve response predictions, the test article drops freely from different heights, and then strikes onto a rigid plate which is instrumented with different types of sensors. Strain gauges, piezoceramic sensors, and fiber optics are used to measure the strain induced by the impact force during the experiments. To tune the test matrix and the measurement chain parameters, numerical computations are carried out to predict the dynamics of drop impact through FE explicit analyses. Through analysis and comparison with experimental results, a relationship between strain and impact energy correlated with the drop height is established, and the overall accuracy of the entire measurement chain is assessed to determine the effectiveness of such a methodology in a full-scale test on a flexible fuel tank structure.

The final objective of the study herein reported is the preliminary evaluation of the capability of an original, real-time SHM system applied to a full-scale wing-box section as a significant aircraft component, during an experimental campaign carried out at the Piaggio Lab in Villanova D’Albenga, Italy. In previous works, the authors have shown that such a system could be applied to composite beams, to reveal damage along the bonding line between a longitudinal stiffening element and the cap. Utilizing a suitable scaling process, such work has then been exported to more complex components, in order to confirm the outcomes that were already achieved, and, possibly, expanding the considerations that should drive the project towards an actual implementation of the proposed architecture. Relevant topics dealt with in this publication concern the application of the structural health monitoring system to different temperature ranges, by taking advantage of a climatic room operating at the Piaggio sites, and the contemporary use of several algorithms for real-time elaborations. Besides the real-time characteristics already introduced and discussed previously, such further steps are essential for applying the proposed architecture on board an aircraft, and to increase reliability aspects by accessing the possibility of comparing different information derived from different sources. The activities herein reported have been carried out within the Italian segment of the RESUME project, a joint co-operation between the Ministry of Defense of Israel and the Ministry of Defense of Italy.

This study examined the connection between young children's social play, creativity, storytelling, and language abilities. Participants were 56 primarily European American preschool children. First, to assess creativity we asked children to draw several pictures. Children created stories about their pictures during the creative process. Second, children created an original story with access to multiple ethnic family doll sets to use as props. We analysed all storytelling episodes for mean length of utterance and parts of speech. Third, we observed children's social play behaviours over 10-minute intervals recording behaviour at 1-minute intervals. Finally, we administered the Test of Early Language Development 3 to assess children's receptive and expressive language skills. Our findings revealed positive relationships between storytelling abilities and language abilities, relationships between type of play, storytelling, and language abilities, and connections between play and creativity and language and creativity. Our findings provide avenues for future research.

In the aeronautical field, the damage that occurs to a carbon-fibre-reinforced polymer (CFRP) structure analysis is a crucial point for further improving its capability and performance. In the current the state of the art, in fact, many issues are linked to the certification process more than to technological aspects. For the sake of clarity, it should be added that regulations call for technological solutions that are invasive (in terms of weight and manufacturing costs) or exploit technologies that are not fully mature. Thus, the truth is in between the above statements. One of the possible solutions to bypass this issue is the assessment of a structural health monitoring system (SHM) that is sufficiently reliable to provide a full-state representation of the structure, automatically, perhaps in real-time, with a minimum intervention of specialized technicians, and that can raise an alert for safe maintenance whenever necessary. Among the different systems that have been proposed in the scientific and technological literature, SHM systems based on strain acquisitions seem very promising: they deduce the presence of flaws by analysing the variations of the intimate response of the structure. In this context, the SHM using fibre optics, supported by a dedicated algorithm, seems to be able to translate the effects of the damage reading the strain field. This means that is necessary to have a full comprehension of the flaws’ effects in terms of strain variation to better formulate a strategy aimed at highlighting these distortions. It should be remarked that each type of damage is distinct; imperfections of the bonding line are herein targeted since the quality of the latter is of paramount importance for ensuring the correct behaviour of the referred structure. This presents paper focuses on a deep investigation on the strain field peculiarities that arise after the imposition of irregularities in the adhesive region. The aim is to explore the damage dimension versus its effect on the strain map, especially when bonding connects different parts of a complex composite beam. By means of finite element method applied on a typical aeronautical beam, a parametric numerical simulation was performed in order to establish the influence of a debonding dimension on a reference strain map. This work provides evidence that these effects on strain flaw decrease the distancing itself of the damage. The knowledge of these effects can be highly helpful during the design of a preliminary phase of an SHM system in order to choose the most suitable sensor in terms of reading sensitivity error, the number to be used, and their location.

Probability of detection (POD) is an acknowledged mean of evaluation for many investigations aiming at detecting some specific property of a subject of interest. For instance, it has had many applications for Non-Destructive Evaluation (NDE), aimed at identifying defects within structural architectures, and can easily be used for structural health monitoring (SHM) systems, meant as a compact and more integrated evolution of the former technology. In this paper, a probability of detection analysis is performed to estimate the reliability of an SHM system, applied to a wing box composite spar for bonding line quality assessment. Such a system is based on distributed fiber optics deployed on the reference component at specific locations for detecting strains; the attained data are then processed by a proprietary algorithm whose capability was already tested and reported in previous works, even at full-scale level. A finite element (FE) model, previously validated by experimental results, is used to simulate the presence of damage areas, whose effect is to modify strain transfer between adjacent parts. Numerical data are used to verify the capability of the SHM system in revealing the presence of the modeled physical discontinuities with respect to a specific set of loads, running along the beam up to cover its complete extension. The POD is then estimated through the analysis of the collected data sets, wide enough to assess the global SHM system performance. The results of this study eventually aim at improving the current strategies adopted for SHM for bonding analysis by identifying the intimate behavior of the system assessed at the date. The activities herein reported have been carried out within the RESUME project. [ABSTRACT FROM AUTHOR]

Robotic-assisted hip and knee arthroplasty represents significant advancements in orthopedic surgery. Artificial intelligence (AI)-driven chatbots, such as ChatGPT, could play a significant role in healthcare education. This study aims to evaluate the quality of responses provided by ChatGPT to the top 20 questions concerning robotic-assisted hip and knee arthroplasty. We have asked ChatGPT to select the top 20 questions on Google concerning robotic hip and knee arthroplasty and to provide a detailed answer to each of them. The accuracy and completeness of the information provided were examined by three orthopedic surgeons with scientific and clinical experience in hip- and knee-replacement surgery. The accuracy was assessed through a 5-point Likert scale (from 1—completely incorrect to 5—correct); the completeness through a 4-point Likert scale (from 0—comprehensiveness not assessable for completely incorrect answers to 3—exhaustive information) on two different occasions to ensure the consistency of the assessment. Our analysis reveals that ChatGPT provides a relatively high degree of accuracy; moreover, the explanations can be considered satisfying, especially for factual questions. The findings suggest that ChatGPT can serve as a valuable initial resource for general information on robotic hip and knee arthroplasty but the integration with human expertise remains essential. [ABSTRACT FROM AUTHOR]

(1) Background: Vulvodynia is characterized by vulvar pain for at least three months and may have related variables, one of these being pelvic floor hypertonus. The purpose of this study was to compare the therapeutic effectiveness of two weekly sessions of pelvic floor rehabilitation and 5 mg of vaginal diazepam daily vs. pelvic floor rehabilitation alone in individuals with vulvodynia. (2) Methods: A single-center, not-blind, randomized study enrolled 20 vulvodynic patients: A total of 10 were treated with dual therapy (intravaginal diazepam and pelvic floor rehabilitation), and 10 were treated with only pelvic floor rehabilitation. All of them underwent a pelvic floor ultrasound examination and VAS pain and Marinoff scale assessments before the beginning of therapy as well as three and six months later. (3) Results: The elevator plate angle ranged from 8.2 to 9.55 (p = 0.0005), hiatal area diameter ranged from 1.277 to 1.482 (p = 0.0002), levator symphysis distance ranged from 3.88 to 4.098 (p = 0.006), anorectal angle ranged from 121.9 to 125.49 (p = 0.006), Marinoff scale ranged from 2.3 to 1.4 (p = 0.009), and VAS scale ranged from 5.8 to 2.8 (p < 0.001). (4) Conclusions: This pilot study demonstrates that the suggested treatment improves the hypertonicity of the pelvic floor, as measured by ultrasound parameters, correlating with a reduction in symptomatology. [ABSTRACT FROM AUTHOR]

Introduction Major haemorrhage after injury is the leading cause of preventable death for trauma patients. Recent advancements in trauma care suggest damage control resuscitation (DCR) should start in the prehospital phase following major trauma. In Italy, Helicopter Emergency Medical Services (HEMS) assist the most complex injuries and deliver the most advanced interventions including DCR. The effect size of DCR delivered prehospitally on survival remains however unclear.Methods and analysis This is an investigator-initiated, large, national, prospective, observational cohort study aiming to recruit >500 patients in haemorrhagic shock after major trauma. We aim at describing the current practice of hypotensive trauma management as well as propose the creation of a national registry of patients with haemorrhagic shock. Primary objective: the exploration of the effect size of the variation in clinical practice on the mortality of hypotensive trauma patients. The primary outcome measure will be 24 hours, 7-day and 30-day mortality. Secondary outcomes include: association of prehospital factors and survival from injury to hospital admission, hospital length of stay, prehospital and in-hospital complications, hospital outcomes; use of prehospital ultrasound; association of prehospital factors and volume of first 24-hours blood product administration and evaluation of the prevalence of use, appropriateness, haemodynamic, metabolic and effects on mortality of prehospital blood transfusions. Inclusion criteria: age >18 years, traumatic injury attended by a HEMS team including a physician, a systolic blood pressure

Objective: PAS is one of the most dangerous conditions associated with pregnancy and remains undiagnosed before delivery in from half to two-thirds of cases. Correct prenatal diagnosis is essential to reduce the burden of maternal and fetal morbidity. The purpose of our study is to evaluate the accuracy of US and MRI in the diagnosis of PAS. Study design: In this retrospective study, 104 patients with suspected placenta accreta were enrolled and had been investigated with US and MRI. They were divided into four groups: no PAS, accreta, increta, and percreta. Results: Compared to MRI, US results were higher in the diagnosis and in the identification of PAS severity (85% US vs. 80% MRI). For both methods, in the case of posterior placenta, there is greater difficulty in identifying the presence/absence of the disease (67% in both methods) and the severity level (61% US vs. 55% MRI). Conclusion: US, properly implemented with the application of defined and standardized scores, can be superior to MRI and absolutely sufficient for the diagnosis of PAS, limiting the use of MRI to a few doubtful cases and to cases in which surgical planning is necessary.

An optimal sensor placement methodology is implemented and herein proposed for SHM model-assisted design and analysis purposes. The kernel of this approach analysis is a genetic-based algorithm providing the sensor network layout by optimizing the probability of detection (PoD) function while, in this preliminary phase, a classic strain energy approach is adopted as well established damage detection criteria. The layout of the sensor network is assessed with respect to its own capability of detection, parameterized through the PoD. A distributed fiber optic strain sensor is adopted in order to get dense information of the structural strain field. The overall methodology includes an original user-friendly graphical interface (GUI) that reduces the time-to-design costs needs. The proposed methodology is preliminarily validated for isotropic and anisotropic elements.

This paper focuses on the development and demonstration of a novel blade morphing system within a whirl tower facility. The scope is to investigate the behavior of the proposed architecture under representative loads, demonstrating its capability to alter the blade original shape in operation under centrifugal, aerodynamic, and internal forces. The morphing concept was developed inside the European project “Shape Adaptive Blades for Rotorcraft Efficiency”, SABRE, and consists of a shape memory alloy system able to change the original twist law and, in this way, enhance rotor performance at certain specific regimes, such as hover and vertical flight. These phases, indeed, are generally penalized with respect to other more extended flight regimes (cruise). The work starts with an overview of the research in the field of morphing, with specific reference to the researches envisaging rotary wing demonstrations. Then, an overview of the morphing twist concept is provided, with particular attention paid to those features particularly suited for the whirl tower representative test environment. The laboratory characterization and commissioning operations are illustrated. Then, the task of the installation of the prototype on the whirl tower facility is described together with the testing modality adopted. Finally, the results of the test campaign are illustrated and critically discussed, providing the reader with insights and possible future steps to be taken in further research. The impact on the morphing capability of the following different parameters was investigated: the number of the prototype segments switched on, the speed and thus the centrifugal actions, and the angles of attack. The stiffening effect due to centrifugal actions was quantified through the measurement of the actual twist and the internal deformation. The link between speed, angle of attack at root, and twist and flap angles was also tracked, building a database useful for the comprehension of the phenomenon, and for the assessment of numerical predictive models. The achieved results highlighted the capability of the system to produce a twist angle matching the target of 8° per blade radius; this figure is related to a potential power saving of 10% in hover and vertical flight and an improvement of about 1% on the over-all efficiency of the rotorcraft.