Donna M. Edwards

A Dynamic HIV-Transmission Model for Evaluating the Costs and Benefits of Vaccine Programs

We developed a dynamic model of HIV transmission to evaluate the costs and benefits of HIV-vaccine programs in a population of homosexual men. We examined how changes in high-risk sexual behavior and the growth pattern of the epidemic influence the cost-effectiveness of preventive vaccines and of therapeutic vaccines. We found that the effect of reductions in condom use is more important for therapeutic vaccines than for preventive vaccines. Therapeutic vaccines may increase HIV seroprevalence in the population, unless the vaccine program is accompanied by increased condom use. Epidemic growth patterns also influence the cost-effectiveness of both vaccines, but the effects are more pronounced for preventive vaccines, which are more cost-effective in an early-stage epidemic than in a late-stage epidemic.

A Systematic Methodology for Selecting Decontamination Strategies Following a Biocontamination Event

Decontamination and recovery of a facility or outdoor area after a wide-area biological incident involving a highly persistent agent (eg, Bacillus anthracis spores) is a complex process that requires extensive information and significant resources, which are likely to be limited, particularly if multiple facilities or areas are affected. This article proposes a systematic methodology for evaluating information to select the decontamination or alternative treatments that optimize use of resources if decontamination is required for the facility or area. The methodology covers a wide range of approaches, including volumetric and surface decontamination, monitored natural attenuation, and seal and abandon strategies. A proposed trade-off analysis can help decision makers understand the relative appropriateness, efficacy, and labor, skill, and cost requirements of the various decontamination methods for the particular facility or area needing treatment--whether alone or as part of a larger decontamination effort. Because the state of decontamination knowledge and technology continues to evolve rapidly, the methodology presented here is designed to accommodate new strategies and materials and changing information.

The Cost Effectiveness of Partially Effective HIV Vaccines

Development of a vaccine remains the best hope for curtailing the worldwide pandemic caused by human immunodeficiency virus (HIV) infection. Due to the complex biology of HIV infection, there is increasing concern that an HIV vaccine may provide incomplete protection from infection. In addition to reducing susceptibility to disease, an HIV vaccine may also prolong life in people who acquire HIV despite vaccination, and may reduce HIV transmission. We evaluated how varying degrees of vaccine efficacy for susceptibility, progression of disease, and infectivity influence the costs and benefits of a vaccine program in a population of men who have sex with men, We found that the health benefits, and thus cost effectiveness, of HIV vaccines were strikingly dependent on each of the types of vaccine efficacy. We also found that vaccines with even modest efficacy provided substantial health benefits and were cost effective or cost saving. Although development of an HIV vaccine has been extremely difficult, even a partially effective HIV vaccine could dramatically change the course of the HIV epidemic.

Realtime data fusion for climate monitoring, via process trellis

Climate monitoring projects, typically intended to gather and validate meteorological data and to serve as information frameworks for experiments, often have massive data‐gathering and data‐management requirements. The process trellis is a software architecture that meets these requirements. The trellis imposes a simple and regular organization on a complex, diverse set of parallel processes. The architecture is based on a hierarchical graph of decision processes, reflecting the conceptual hierarchy of the problem domain; all processes in the graph execute continuously and concurrently. The trellis has been implemented in the form of a domain‐independent shell (using the portable coordination language Linda). We describe the trellis structure and address trellis issues that seem particularly relevant to climate monitoring.

Guidelines to improve airport preparedness against chemical and biological terrorism.

This unlimited release document is an extraction from the original Official Use Only report, Sandia National Laboratories report number SAND2005-1045 and Lawrence Berkeley Lab report number 54973/Rev 2.1. The purpose of the original document is to aid airport planners in defending their facilities against chemical and biological (chem-bio) attack, given the technologies and capabilities available today. With this document, airport planners should gain an understanding of the important issues for chem-bio defense, and should be able to assess the preparedness of their airport, to determine whether to bring in consultant expertise, and to target the most effective upgrades for their facilities. The defenses outlined in this document are intended to accomplish two objectives: (1) to deter some high-consequence attacks through HVAC system physical security, and (2) to mitigate the consequences of an attack through passive protection and active response measures.