Economic considerations for health insurance coverage of emerging genetic tests

Public and private health insurance plans face the question of whether to cover emerging genetic tests for cancer and other diseases. This paper outlines issues in the economic evaluation of new genetic tests, illustrating key methodological issues and policy implications with findings from a comprehensive and systematic review of the 14 full economic evaluations published over the past 5 years that have addressed both the costs and consequences of molecular genetic tests. Key questions for framing an evaluation include: whose viewpoint matters, which costs and consequences are relevant, and to which clinical alternatives should new genetic tests be compared? While economic evaluation research can inform coverage decisions about genetic tests, the coverage decision-making process must also inform economic researchers about the aims, context, and value systems within which genetic tests will be covered and practised.     

Comparison of fast algorithms for estimating large-scale permeabilities of heterogeneous media

The problem of upscaling permeability data from the core to the reservoir grid block scale for input into flow simulators is addressed. Two fast, approximate algorithms which have been suggested for this purpose—one based on random walks and the other on real-space renormalisation group methods—are compared using the results of numerical tests performed on 30 different heterogeneous permeability realisations in 3-D. The results show that random walks outperform renormalisation for this problem, being computationally more efficient and demonstrating significantly better accuracy for particular cases.     

Modal Analysis of a Servo-Hydraulic High Speed Machine and its Application to Dynamic Tensile Testing at an Intermediate Strain Rate

This paper describes the experimental procedure to identify the predominant frequencies of the high speed testing machine by conducting modal analysis. The effects due to the predominant frequencies of the system and loading rate on the magnitude of system ringing and the flow stress were analyzed by using a single degree-of-freedom (SDOF) spring-mass-damper model. The system was then used to study the dynamic tensile behavior of two engineering materials, i.e., polyethylene (PE) fabric-cement composite and Alkaline Resistant (AR) glass fabrics at an intermediate strain rate. The stress oscillations in the response of these materials due to system ringing were addressed. The failure behavior of each material was studied by examining high speed digital camera images of specimens during the test. The validity of the dynamic tensile tests was investigated by examining the condition of dynamic stress equilibrium—a criterion used in split Hopkinson pressure bar (SHPB) tests. The results show that the quantitative criterion for a valid SHPB test is also applicable to dynamic tensile tests of these materials at the intermediate strain rate.     

Variational modelling of diffused and localized damage with applications to fiber-reinforced concretes

A variational model for the evolution of damage in elastic materials is proposed, which is based on incremental energy minimization. Analytical solutions are determined in the one-dimensional case of a tensile bar, and the issue of their stability is addressed. Analytical results have given insights into the properties that elastic and damage energies must have in order that specific evolution processes are captured, such as diffuse damaging, progressive damage localization or brutal failure. Accordingly, expressions of elastic and damage energies are proposed aimed at reproducing the evolution of damage observed in high-performance fiber-reinforced concretes, which typically exhibit initial micro-cracking and subsequent macro-crack opening. Tensile tests on bone-shaped samples and three-points bending tests are reproduced, by implementing the model in a finite element code, and numerical results are compared with experimental evidences.     

位移浅水内孤立波

研究两层浅水系统中的内孤立波,该系统由两层常密度不可压缩无黏性水组成。利用Lagrange坐标和Hamilton原理,推导了两层浅水系统的位移浅水内波方程,并进一步导出了两层浅水系统的位移内孤立波解。数值实验表明,位移内孤立波与经典的KdV内孤立波吻合很好,说明Lagrange坐标和Hamilton方法适用于内波分析,可以为构造内波分析的保辛方法提供一种途径。     

Identification of stiffness properties of composite tubes from dynamic tests

The identification of the stiffness properties of typical laminated composite tubes from dynamic tests is presented. Unknown coefficients are identified by a technique of model updating. The fomulation is based on the minimization of the eigensolution residuals (sensitivity method). Errors of generalized masses are considered. The technique allows for the simultaneous identification of several properties from a single test. Stiffness properties of extension, bending/twisting and transverse shear are identified. Important points of the model updating of tubes in dynamics are addressed: potential energy evaluation, placement of sensors and the problem of multiple eigenvalues. Results obtained by numerical simulation show the efficiency of the proposed method.     

Effect of geometric imperfections on non-linear stability of circular cylindrical shells conveying fluid

Circular cylindrical shells conveying incompressible flow are addressed in this study; they lose stability by divergence when the flow velocity reaches a critical value. The divergence is strongly subcritical, becoming supercritical for larger amplitudes. Therefore the shell, if perturbed from the initial configuration, has severe deformations causing failure much before the critical velocity predicted by the linear threshold. Both Donnell's non-linear theory retaining in-plane displacements and the Sanders-Koiter non-linear theory are used for the shell. The fluid is modelled by potential flow theory but the effect of steady viscous forces is taken into account. Geometric imperfections are introduced and fully studied. Non-classical boundary conditions are used to simulate the conditions of experimental tests in a water tunnel. Comparison of numerical and experimental results is performed.     

Characterizing Torsional Properties of Microwires Using an Automated Torsion Balance

In order to characterize the torsional behavior of microwires, an automated torsion tester is established based on the principle of torsion balance. The main challenges in developing a torsion tester at small scales are addressed. An in-situ torsional vibration method for precisely calibrating the torque meter is developed. The torsion tester permits the measurement of torque to nN m, as a function of surface shear strain to a sensitivity of sub-microstrain. Using this technique, we performed (monotonic and/or cyclic) torsion tests on polycrystalline copper and gold wires. It is found that (i) a size effect appears in both the initial yielding and the plastic flow of torsional response; (ii) a reverse plasticity occurs upon unloading in cyclic torsion response; and (iii) the Hall-Petch effect and the strain gradient effect are synergistic. We also performed cyclic torsion tests on human hairs and spider silk which are natural protein fibers with a different morphological structure to metallic wires. It is shown that the single hair exhibits torsional recovery, and that the spider silk displays torsionally superelastic behavior whereby it is able to withstand great shear strain.     

Experimental and numerical characterization of damage evolution in steels

This paper presents an experimental and numerical characterization of ductile damage evolution in steels subjected to large plastic deformations. To this end, a set of tensile tests combining load–unload tensile cycles is firstly carried out in order to evaluate the deterioration exhibited by the Young’s modulus for increasing levels of plastic deformation. This task allows, in turn, to derive the characteristic parameters involved in a well-established evolution equation for the isotropic damage variable. In this context, a new damage identification procedure is presented. Different aspects of it are particularly addressed. The obtained material parameters are the basic data to be considered in the simulations that are performed afterwards: the analysis of the tensile test mainly aimed at assessing the proposed characterization and, in addition, the modelling of the flattening process of a cylinder studied to discuss the performance of the constitutive model in the prediction of damage evolution.     

International cooperation and networking in genetic health care provision: issues arising from the genetic services plan for the Emilia-Romagna region, Italy

The aims of this report are to describe the genetic plan for Emilia-Romagna, a region in Italy, and to contribute to the international exchange of information on developing and applying policy frameworks to provide high-quality and comprehensive genetic health care in the publicly funded health systems. At the present time there is no national policy for genetic medicine in Italy, and only two regions, Emilia-Romagna and Liguria, have formally agreed to a strategic plan for health care in genetics. The current provision of genetic services in Emilia-Romagna is described focusing on the intra- and inter-organizational linkages to ensure a comprehensive system of coordinated activities. Strengths and implementation areas are highlighted. Points that must be solved within the regional or national context are the definition of the level of assistance required in genetic medicine, the formal professional recognition of the genetic counselor and the adjustment of the billing mechanisms to the complexities of clinical genetic services. Issues that need to be addressed at a wider level include full assessment of genetic tests before their introduction into clinical practice, networking to provide tests for the rarest genetic diseases, consensus on fundamental terminology and clinical and administrative data sets to promote a cohesive framework for the flow of information throughout the health care systems with respect to genetics.     

Development of an approach to constitutive modelling of concrete: Isotropic damage coupled with plasticity

The paper presents an approach to constitutive modelling of concrete using damage mechanics and plasticity theory. The thermodynamic formulation, and parameter identification of a non-local coupled damage-plasticity model are presented in this study. The particular focus is the calibration of model parameters. It is shown that both the local parameters and the parameters governing the non-local interaction can be determined from experimental data reliably and consistently. A novel procedure is developed for parameter identification, using the separation of total dissipation energy into additive parts corresponding to different dissipation mechanisms. The relationship between the local and non-local parameters is also addressed, helping to obtain model responses consistent with the fracture energy of the material. The application of the model and the calibration procedure proposed in this study to the numerical failure analysis of concrete structures is illustrated through a series of real structural tests, showing both the performance of the model and the consistency of the proposed calibration procedure.     

Damage of Optical Fibers Under Wet Environments

Besides signal transmission for telecommunications, fibers are used in an increasing number of devices. A number of applications relate to devices exposed to severe wet environment (hot water, chemical attacks…). It is the case for the sensors used in nuclear plants, high energy physics or plasmas devices. However, reliability issues must be addressed for optical fiber sensors operating under severe conditions such as harsh chemical solutions. The purpose of this work is to study the mechanical behavior and aging of fibers exposed to hot water action, to hydrofluoric acid vapours (HF) and to tetramethoxysilane (TMOS) for different durations. Dynamic fatigue tests were implemented using a two-point bending testing device or tensile test set-up. Standard fibers tested immediately after exposure show a broader distribution of fiber strength accompanied by the drastic decrease of the failure stress. In some particular cases, the gain compared to as received fibers can be positive. Polymer reacts with different wet environments, which induces viscosity changes. This is consistent with SEM observations.     

Influence of temperature and strain rate on the mechanical behavior of three amorphous polymers: Characterization and modeling of the compressive yield stress

Uniaxial compression stress–strain tests were carried out on three commercial amorphous polymers: polycarbonate (PC), polymethylmethacrylate (PMMA), and polyamideimide (PAI). The experiments were conducted under a wide range of temperatures (−40 °C to 180 °C) and strain rates (0.0001 s⁻¹ up to 5000 s⁻¹). A modified split-Hopkinson pressure bar was used for high strain rate tests. Temperature and strain rate greatly influence the mechanical response of the three polymers. In particular, the yield stress is found to increase with decreasing temperature and with increasing strain rate. The experimental data for the compressive yield stress were modeled for a wide range of strain rates and temperatures according to a new formulation of the cooperative model based on a strain rate/temperature superposition principle. The modeling results of the cooperative model provide evidence on the secondary transition by linking the yield behavior to the energy associated to the β mechanical loss peak. The effect of hydrostatic pressure is also addressed from a modeling perspective.     

Full-Field Strain Measurement and Identification of Composites Moduli at High Strain Rate with the Virtual Fields Method

The present paper deals with full-field strain measurement on glass/epoxy composite tensile specimens submitted to high strain rate loading through a split Hopkinson pressure bar (SHPB) device and with the identification of their mechanical properties. First, the adopted methodology is presented: the device, including an Ultra-High Speed camera, and the experimental procedure to obtain relevant displacement maps are described. The different full-field results including displacement, strain and acceleration maps for two mechanical tests are then addressed. The last part of the paper deals with an original procedure to identify stiffnesses on this dynamic case only using the actual strain and acceleration maps (without the applied force) by using the Virtual Fields Method. The results provide very promising values of Young’s modulus and Poisson’s ratio on a quasi-isotropic glass-epoxy laminate. The load reconstructed from the moduli and strains compares favourably with that from the readings.     

Dynamics of flexible mechanical systems with contact-impact and plastic deformations

A computer based formulation for the analysis of mechanical systems is investigated as a feasible method to predict the impact response of complex structural systems. A general methodology for the dynamic analysis of rigid-flexible multibody systems using a number of redundant Cartesian coordinates and the method of the Lagrange multipliers is presented. The component mode synthesis is then used to reduce the number of flexible degrees of freedom. In many impact situations, the individual structural members are overloaded giving rise to plastic deformations in highly localized regions, called plastic hinges. This concept is used by associating revolute nonlinear actuators with constitutive relations corresponding to the collapse behavior of the structural components. The contact of the system components is described using a continuous force model based on the Hertz contact law with hysteresis damping. The effect and importance of structural damping schemes in flexible bodies are also addressed here. Finally, the validity of this methodology is assessed by comparing the results of the proposed models with those obtained in different experimental tests where: a beam collides transversally with a rigid block; a torque box impacts a rigid barrier.     

Dynamic structural loading using a light gas gun

A light gas gun was used to dynamically load models of the wall sections typical of those used in the construction of buried structures. Scaling of the loading time history is addressed, and the appropriate nondimensional parameters for the loading and the model structural characteristics are defined. Scaling is simplified by use of structural materials for the models which have a yield strength and material moduli close to those found in prototype structures. Methods for producing the desired loading by using a light gun are investigated, and reasonable accuracy and flexibility in achieving the desired loading time history is demonstrated. Experimental results are given for the loading conditions and the failure mode that occurs when the model wall section is breached. The loading conditions to produce failure in the model are reduced to nondimensional form and compared to results from prototype field tests, also in nondimensional form. The resulting nondimensional data are used to evaluate the suitability of the light gun to dynamically simulate ground shock loading as well as to investigate failure criteria.     

The reinforcement of ancient timber-joints with carbon nano-composites

The paper describes an experimental research activity on the application of a polymeric resin reinforced with carbon nanotubes on an ancient timber structures belonging to cultural heritage (Bertolini Cestari et al. in Proc. of SAHC2008. VI International Conference, pp. 941–947, 2008; Marzi in Ph.D. Thesis, 2010; Bertolini Cestari et al. in Proc. of ICRACM-2010—3rd International Conference on Recent Advances in Composite Materials, 2011). The proposed approach aims at the conservation of a specific wooden joint belonging to traditional constructions. Therefore the research was addressed to the definition and assessment of a methodology of preparation and application of the nano-composite with the aim of verifying an increased mechanical resistance in comparison with traditional reinforcement methods. Different wood species have been considered and the experimentation has been carried out in view of a possible in-situ application of the technique. Laboratory tests were carried out at first on small wooden samples, and afterwards on wooden elements having real dimension. These last ones were taken from ancient and decayed wooden floors belonging to an important historical building that were dismantled during restoration works. A numerical analysis of the structural behavior of the joint is provided, in order to assess the different possible collapse mechanisms. The results obtained from the tests are promising for future developments of the application of these nano-composite materials.     

Numerical and experimental investigations of a rotating nonlinear energy sink

In this work, passive nonlinear targeted energy transfer (TET) is addressed by numerically and experimentally investigating a lightweight rotating nonlinear energy sink (NES) which is coupled to a primary two-degree-of-freedom linear oscillator through an essentially nonlinear (i.e., non-linearizable) inertial nonlinearity. It is found that the rotating NES passively absorbs and rapidly dissipates a considerable portion of impulse energy initially induced in the primary oscillator. The parameters of the rotating NES are optimized numerically for optimal performance under intermediate and strong loads. The fundamental mechanism for effective TET to the NES is the excitation of its rotational nonlinear mode, since its oscillatory mode dissipates far less energy. This involves a highly energetic and intense resonance capture of the transient nonlinear dynamics at the lowest modal frequency of the primary system; this is studied in detail by constructing an appropriate frequency–energy plot. A series of experimental tests is then performed to validate the theoretical predictions. Based on the obtained numerical and experimental results, the performance of the rotating NES is found to be comparable to other current translational NES designs; however, the proposed rotating device is less complicated and more compact than current types of NESs.     

Understanding a time reversal process in Lamb wave propagation

This study investigates the time reversal process (TRP) of Lamb wave signals which are transmitted and received by piezoelectric transducers bonded on plate-like structures. A number of previous studies have paid attention to spatial and temporal refocusing capability of an original excitation through the TRP in highly dispersive and complex media. However, when the TRP is applied to Lamb waves in a homogeneous regular waveguide, the refocusing capability is limited due to permanent residual side bands even if the duration of the time reversed signal increases. Based on the reciprocity of elastodynamics and linear piezoelectricity, theoretical interpretation is conducted for the main and residual side bands of the reconstructed signal in the time domain. In particular, the interpretation includes the temporal effect of velocity and amplitude dispersions, the existence of multimodes, and the reflections from boundaries during the TRP. Then, numerical and experimental tests are conducted to validate the theoretical findings of this paper. Practical issues for the successful implementation of the TRP of Lamb waves are briefly addressed as well.