Cost-effectiveness of voluntary HIV-1 counseling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania.

Background Access to HIV-1 voluntary counseling and testing (VCT) is severely limited in less-developed countries. We undertook a multisite trial of HIV-1 VCT to assess its impact, cost, and cost-effectiveness in less-developed country settings.\ud Methods\ud The cost-effectiveness of HIV-1 VCT was estimated for a hypothetical cohort of 10 000 people seeking VCT in urban east Africa. Outcomes were modelled based on results from a randomised controlled trial of HIV-1 VCT in Tanzania and Kenya. Our main outcome measures included programme cost, number of HIV-1 infections averted, cost per HIV-1 infection averted, and cost per disability-adjusted life-year (DALY) saved. We also modelled the impact of targeting VCT by HIV-1 prevalence of the client population, and the proportion of clients who receive VCT as a couple compared with as individuals. Sensitivity analysis was done on all model parameters.\ud Findings\ud HIV-1 VCT was estimated to avert 1104 HIV-1 infections in Kenya and 895 in Tanzania during the subsequent year. The cost per HIV-1 infection averted was US$249 and$346, respectively, and the cost per DALY saved was $12·77 and$17·78. The intervention was most cost-effective for HIV-1-infected people and those who received VCT as a couple. The cost-effectiveness of VCT was robust, with a range for the average cost per DALY saved of $5·16-27·36 in Kenya, and$6·58-45·03 in Tanzania. Analysis of targeting showed that increasing the proportion of couples to 70% reduces the cost per DALY saved to $10·71 in Kenya and$13·39 in Tanzania, and that targeting a population with HIV-1 prevalence of 45% decreased the cost per DALY saved to $8·36 in Kenya and$11·74 in Tanzania.\ud Interpretation\ud HIV-1 VCT is highly cost-effective in urban east African settings, but slightly less so than interventions such as improvement of sexually transmitted disease services and universal provision of nevirapine to pregnant women in high-prevalence settings. With the targeting of VCT to populations with high HIV-1 prevalence and couples the cost-effectiveness of VCT is improved significantly

The STACEE-32 Ground Based Gamma-ray Detector

We describe the design and performance of the Solar Tower Atmospheric Cherenkov Effect Experiment detector in its initial configuration (STACEE-32). STACEE is a new ground-based gamma ray detector using the atmospheric Cherenkov technique. In STACEE, the heliostats of a solar energy research array are used to collect and focus the Cherenkov photons produced in gamma-ray induced air showers. The large Cherenkov photon collection area of STACEE results in a gamma-ray energy threshold below that of previous detectors.Comment: 45 pages, 25 figures, Accepted for publication in Nuclear Instruments and Methods

Detection of Atmospheric Cherenkov Radiation Using Solar Heliostat Mirrors

The gamma-ray energy region between 20 and 250 GeV is largely unexplored. Ground-based atmospheric Cherenkov detectors offer a possible way to explore this region, but large Cherenkov photon collection areas are needed to achieve low energy thresholds. This paper discusses the development of a Cherenkov detector using the heliostat mirrors of a solar power plant as the primary collector. As part of this development, we built a prototype detector consisting of four heliostat mirrors and used it to record atmospheric Cherenkov radiation produced in extensive air showers created by cosmic ray particles.Comment: 16 latex pages, 8 postscript figures, uses psfig.sty, to be published in Astroparticle Physic

Gas chemical investigation of hafnium and zirconium complexes with hexafluoroacetylacetone using preseparated short-lived radioisotopes

Volatile metal complexes of the group 4 elements Zr and Hf with hexafluoroacetylacetonate (hfa) have been studied using short-lived radioisotopes of the metals. The new technique of physical preseparation has been employed where reaction products from heavy-ion induced fusion reactions are isolated in a physical recoil separator - the Berkeley Gas-filled Separator in our work - and made available for chemistry experiments. Formation and decomposition of M(hfa)4 (M=Zr, Hf) has been observed and the interaction strength with a fluorinated ethylene propylene (FEP) Teflon surface has been studied. From the results of isothermal chromatography experiments, an adsorption enthalpy of -ΔHa=(57±3)kJ/mol was deduced. In optimization experiments, the time for formation of the complex and its transport to a counting setup installed outside of the irradiation cave was minimized and values of roughly one minute have been reached. The half-life of 165Hf, for which conflicting values appear in the literature, was measured to be (73.9±0.8)s. Provided that samples suitable for α-spectroscopy can be prepared, the investigation of rutherfordium (Rf), the transactinide member of group 4, appears possible. In the future, based on the studies presented here, it appears possible to investigate short-lived single atoms produced with low rates ( e.g. , transactinide isotopes) in completely new chemical systems, e.g. , as metal complexes with organic ligands as used here or as organometallic compound

Search for the Production of Element 112 in the 48Ca + 238U Reaction

We have searched for the production of element 112 in the reaction of 231 MeV 48Ca with 238U. We have not observed any events with a "one event" upper limit cross section of 1.6 pb for EVR-fission events and 1.8 pb for EVR-alpha events.Comment: 6 pages, 3 figures, submitted to Phys. Rev.

Backward pion-nucleon scattering

A global analysis of the world data on differential cross sections and polarization asymmetries of backward pion-nucleon scattering for invariant collision energies above 3 GeV is performed in a Regge model. Including the $N_\alpha$, $N_\gamma$, $\Delta_\delta$ and $\Delta_\beta$ trajectories, we reproduce both angular distributions and polarization data for small values of the Mandelstam variable $u$, in contrast to previous analyses. The model amplitude is used to obtain evidence for baryon resonances with mass below 3 GeV. Our analysis suggests a $G_{39}$ resonance with a mass of 2.83 GeV as member of the $\Delta_{\beta}$ trajectory from the corresponding Chew-Frautschi plot.Comment: 12 pages, 16 figure