Offering the Choice of Self-Administered Oral HIV Testing (CHIVST) among Long-distance Truck Drivers in Kenya: A Trial-based Cost-effectiveness Analysis

Background: Long distance truck drivers (LDTD) are a high-HIV-risk population facing unique healthcare barriers due to continuous travel and irregular schedules, and may require targeted, resource-intensive strategies for HIV-test uptake. We conducted a trial-based cost-effectiveness of CHIVST among LDTD in Kenya. Methods: Effectiveness data came from a randomized-controlled trial of CHIVST (n=150) versus provider-administered testing (n=155). Economic cost data came from the literature and reflected a societal perspective. Generalized Poisson and linear-gamma regression models estimated the effectiveness (relative-risk) and incremental costs (2017 I$), respectively, with incremental effectiveness calculated as the reciprocal of the absolute risk difference and reported as the number needing to receive CHIVST for an additional HIV-test uptake. We reported incremental cost-effectiveness ratios (ICERs), with 95$9,774). Results: HIV-test uptake was 23% more likely for CHIVST versus provider-administered HIVtesting, with six individuals needing to be offered CHIVST for an additional HIV-test uptake (6.25, 95%CI 5.00-8.33). The mean cost per patient was more than double for CHIVST (I$26.56 vs I$10.47). The incremental cost-effectiveness of CHIVST was I$97.21 [95$140. Conclusion: CHIVST is an efficient use of resources compared to provider-administered testing.https://scholarscompass.vcu.edu/gradposters/1114/thumbnail.jp

Phase change indicators for subambient temperatures

Evaluation of organic compounds for temperature indicators for subambient temperature

Improving the Functional Control of Aged Ferroelectrics using Insights from Atomistic Modelling

We provide a fundamental insight into the microscopic mechanisms of the ageing processes. Using large scale molecular dynamics simulations of the prototypical ferroelectric material PbTiO3, we demonstrate that the experimentally observed ageing phenomena can be reproduced from intrinsic interactions of defect-dipoles related to dopant-vacancy associates, even in the absence of extrinsic effects. We show that variation of the dopant concentration modifies the material's hysteretic response. We identify a universal method to reduce loss and tune the electromechanical properties of inexpensive ceramics for efficient technologies.Comment: 6 pages, 3 figure

Evaluating racial and ethnic disparities in access to primary care among gay and bisexual men in the US, a population at high-risk of HIV infection

BACKGROUND: 69% of new HIV diagnoses in the US are among gay and bisexual men, with disparities by race and ethnicity. Primary care providers increasingly provide HIV prevention. Racial and ethnic disparities in primary care access are well-documented, but their persistence among gay and bisexual men is unknown. We examined racial and ethnic disparities in access to primary care among this population. METHODS: We used nationally representative person-level sociodemographic, health status and utilization data, and data on organizational- and socially determinant barriers to care, from the National Health Interview Survey, 2013-2018. Outcomes were: 1) general physician visit RESULTS: The sample included 1,867 gay and bisexual men (unweighted), 18-64 years with 28% NHB or Hispanic. NHB and Hispanic men were less likely have seen a general provider within the past 12 months (aOR=0.76, p=0.10) but the result was not significant with no difference in having a usual place of care (aOR=1.11, p=0.616). Findings were sensitive to the specification of primary care site as usual place of care. CONCLUSIONS: Significant racial and ethnic disparities were observed when specifying a primary care specific site as place of care. Primary care engagement should be immediately prioritized to promote access and equity of HIV prevention.https://scholarscompass.vcu.edu/gradposters/1140/thumbnail.jp

Sweating the small stuff: simulating dwarf galaxies, ultra-faint dwarf galaxies, and their own tiny satellites

We present FIRE/Gizmo hydrodynamic zoom-in simulations of isolated dark matter halos, two each at the mass of classical dwarf galaxies ($M_{\rm vir} \simeq 10^{10} M_{\odot}$) and ultra-faint galaxies ($M_{\rm vir} \simeq 10^9 M_{\odot}$), and with two feedback implementations. The resultant central galaxies lie on an extrapolated abundance matching relation from $M_{\star} \simeq 10^6$ to $10^4 M_{\odot}$ without a break. Every host is filled with subhalos, many of which form stars. Our dwarfs with $M_{\star} \simeq 10^6 M_{\odot}$ each have 1-2 well-resolved satellites with $M_{\star} = 3-200 \times 10^3 M_{\odot}$. Even our isolated ultra-faint galaxies have star-forming subhalos. If this is representative, dwarf galaxies throughout the universe should commonly host tiny satellite galaxies of their own. We combine our results with the ELVIS simulations to show that targeting $\sim 50~ \rm kpc$ regions around nearby isolated dwarfs could increase the chances of discovering ultra-faint galaxies by $\sim 35\%$ compared to random halo pointings, and specifically identify the region around the Phoenix dwarf galaxy as a good potential target. The well-resolved ultra-faint galaxies in our simulations ($M_{\star} \simeq 3 - 30 \times 10^3 M_{\odot}$) form within $M_{\rm peak} \simeq 0.5 - 3 \times 10^9 M_{\odot}$ halos. Each has a uniformly ancient stellar population ($> 10~ \rm Gyr$) owing to reionization-related quenching. More massive systems, in contrast, all have late-time star formation. Our results suggest that $M_{\rm halo} \simeq 5 \times 10^9 M_{\odot}$ is a probable dividing line between halos hosting reionization "fossils" and those hosting dwarfs that can continue to form stars in isolation after reionization.Comment: 12 pages, 6 figures, 1 table, submitted to MNRA