Digital Commons Network^™

Turnover Time In Neuroangiography Suites: Comparison Between Cases Performed At An Ambulatory Neurosurgery Center Versus A Tertiary Hospital, Pui Man Rosalind Lai, Vinay Jaikumar, Erika L. Leasher, Varun Sridhar, Gustavo M. Cortez, Aimee C. Degaetano, Elad I. Levy

EVMS School of Health Professions Faculty Publications

Background:

Efficient turnover time (TOT) and adherence to first-start time (FST) in operating and angiography suites are critical for optimizing workflow, reducing costs, and maximizing patient satisfaction. Hospitals face challenges in maintaining these metrics due to operational constraints and unexpected emergent cases. Our goal was to compare TOT, FST, and total admission time for elective cases performed in angiography suites at an ambulatory neurosurgery center (ANSC) versus a tertiary hospital (TH).

Methods:

We conducted a retrospective analysis of data for patients who underwent elective diagnostic or interventional neuroendovascular procedures at the TH or ANSC from January 2024 through October 2024. …

Implementation And Clinical Utility Of Ultra-Low-Field Portable Magnetic Resonance Imaging For Postprocedural Neurological Evaluation In Ambulatory Neurosurgery: Illustrative Cases, Devan Patel, Vinay Jaikumar, Taysia P. T. Morioka, Laz Rifkin, Kenneth S. Jacoby, Jaims Lim, Anais Andrade, Aimee C. Degaetano, Pui Man Rosalind Lai, Elad I. Levy

EVMS School of Health Professions Faculty Publications

BACKGROUND

Elective endovascular neurosurgical procedures are increasingly performed in ambulatory neurosurgery centers, enabled by advances in catheter technology, safety of conscious sedation, and refined patient selection. Although complication rates are low, rapid evaluation of postprocedural neurological deficits remains critical. Conventional MRI is often impractical in outpatient or procedural settings, whereas ultra-low-field portable MRI (ULF-pMRI) systems (such as Swoop) allow bedside imaging with favorable diagnostic performance.

OBSERVATIONS

Two women in their 60s developed acute neurological deficits at an ambulatory neurosurgery center (ANSC) after diagnostic cerebral angiography in one case and elective internal carotid artery flow diversion in the other. In both …

Bovine Lactoferrin Maintains Antibacterial Effect Against Neonatal Escherichia Coli Septicaemia Isolates Despite The Presence Of Iron Acquisition Genes, Matthew Mayorga, Joshua L. Wheatley, Brianna N. Maldonado, Susana Chavez-Bueno

Student Publications

Introduction. Escherichia coli is a dominant cause of neonatal sepsis for which no prevention measures currently exist. Lactoferrin (LF) is an iron-sequestering antibacterial protein that has been noticed to decrease neonatal late-onset sepsis.

Hypothesis/Gap Statement. LF’s effect on in vitro growth of neonatal E. coli clinical isolates causing septicaemia is unknown. The prevalence of iron acquisition virulence genes which contribute to pathogenicity outcomes in these strains has also not been described in detail.

Aim. To evaluate bovine lactoferrin’s (bLF) effects on the in vitro growth of neonatal septicaemia E. coli isolates, and to determine the presence of iron acquisition …

First-Generation Medical School Applicants: A Quantitative Study Designed To Identify Areas Of Educational Support, Bethsabe Romero, Amanda K. Burbage

EVMS School of Health Professions Faculty Publications

First-generation (First Gen) students are unique medical school applicants. Due to their lived experience, they approach patient care by prioritizing trust, comfort and understanding. They have proven ability to overcome obstacles and were found to be more resilient than their continuing generation (Cont Gen) peers. Despite these notable attributes, they face unique challenges in gaining medical school acceptance. There are very few quantitative studies examining this student subpopulation, and our study identifies characteristics of first-generation medical school applicants while highlighting areas of needed support. This cross-sectional study used deidentified Application and Matriculating Student Questionnaire survey data that was obtained from …

Determinants Of Patient Satisfaction In An Academic Primary Care Setting: A Cross-Sectional Study Of The Postpandemic Era, Alvin Maliakal, Rajita Kanapareddy, Zooha Altaf, Janani Anbazhagan, Kristin Olson, Cynthia Avila, Rehan Qayyum

Department of Medicine Faculty Publications

Background

Patient satisfaction, a key indicator of healthcare quality, is associated with improved adherence, continuity, and outcomes. However, limited evidence describes determinants of patient satisfaction in contemporary primary care settings reflecting the postpandemic era, when care delivery models and patient expectations have evolved substantially.

Objective

To evaluate the sociodemographic and clinical factors associated with patient satisfaction in an academic primary care setting following the postpandemic era.

Methods

We conducted a cross-sectional survey of adult patients (≥18 years) attending a primary care clinic. Participants completed a self-administered questionnaire including the Visit-Specific Satisfaction Questionnaire (VSQ-9) and measures of sociodemographic and clinical characteristics. …

Crossing The Theory Threshold: The Pedagogical Potential Of Generative Artificial Intelligence In Educational Research, Amanda Burbage, Jennifer L. Styron

EVMS School of Health Professions Faculty Publications

Purpose

This paper presents findings from an educational research graduate course in which generative artificial intelligence (AI) was incorporated to strengthen learners' understanding of threshold concepts related to theoretical frameworks. Medical and health professionals often struggle with the transition from a clinical role into the educational research role.

Methods

The study posits that the use of generative AI will help learners understand and apply theoretical frameworks beyond a superficial level, furthering their understanding, constructing new knowledge, and strengthening their ability to develop sound educational research studies. Journal and AI transcripts were analyzed for 37 participants.

Results

Open-ended codes were grouped …

Measurement Invariance Of Transtheoretical Model-Based Measures For Covid-19 Vaccination Readiness, Allegra Opiela

Open Access Dissertations

Purpose. To assess the measurement invariance of four novel Transtheoretical Model (TTM)-based measures for readiness to get vaccinated for COVID-19. Design. Cross-sectional.

Setting. Online survey study in the United States (US).

Participants. 1169 US-based adults aged 18-85.

Measures. Demographics, Stage of Change, Vaccination History, Decisional Balance, Self-efficacy, Myths, and Barriers to COVID-19 vaccination.

Analyses. Multigroup confirmatory factor analyses with increased restraints on model parameters to assess configural (no constraints), metric (factor loadings constrained), and scalar invariance (factor loadings and item intercepts constrained) in a sequential manner.

Results. Decisional Balance, Myths, and Barriers demonstrated scalar …

Estimating The Average Treatment Effect In Randomized Controlled Trials With Incomplete Covariates, Elizabeth M. Pauley

Open Access Dissertations

Randomized controlled trials (RCTs) are commonly used to estimate average treatment effects (ATEs), with baseline covariates often included to improve precision and statistical power for detecting those effects. In applied settings, covariates can be incomplete, and some may moderate treatment effects, leading to heterogeneous treatment effects (HTE). Literature lacks clear direction regarding whether incomplete covariates should be included when estimating the ATE and how different missing data handling methods perform in such conditions. This study aimed to evaluate the performance of four missing data handling methods in RCTs via Monte Carlo simulations, namely listwise deletion (LD), inverse probability weighting (IPW), …

Coarse-Grained Models For Microbial Metabolisms And Biological Interactions, Meng Gao

Open Access Dissertations

Microorganisms are microscopic, typically unicellular organisms widely distributed across the world’s environments.  In the global ocean, they account for the majority of primary production and decompose organic matter to drive nutrient cycles. Through their metabolic processes, including photosynthesis, dinitrogen (N₂) fixation, sulfur oxidation, and methanogenesis, microbes contribute to global biogeochemical processes, and establish their ecological niches in suitable habitats. Their biological interactions, including competition, symbiosis, and grazing, are important links among different functional groups in marine communities. Consequently, quantifying microbial metabolisms and their biological interactions is important to investigate their ecological functions in marine ecosystems and the global …

Unified Bayesian And Machine Learning-Based State Of Charge Estimation In A Pv Battery System, Showrov Rahman

Open Access Dissertations

The state of charge (SOC) of a battery indicates the remaining charge in the battery relative to its nominal maximum charge capacity. The accurate estimation of SOC is of utmost importance for efficient energy management as it indicates the level of energy stored in the battery.

Bayesian and machine learning (ML) approaches represent two distinct estimation strategies for battery state estimation. Bayesian filters, such as the Kalman filter (KF) and particle filter (PF), operate sequentially by incorporating physical models of battery dynamics. In contrast, ML-based methods are data-driven, and their performance largely depends on the quantity and quality of training …

Points Of Interest: Implementing Simulation-Based Storm Hazard Consequence Prediction, Samuel W. Adams

Open Access Dissertations

During major ocean storms (hurricanes, tropical storms, nor’easters), coastal communities often experience negative outcomes that local emergency managers (EMs) did not anticipate or sufficiently prepare for. Local EMs often have difficulty obtaining specific, local forecast data and consequence predictions they can act on to prevent losses and minimize avoidable consequences. Despite tremendous advances in forecasting science, uncertainty remains a constant in storm decision making, requiring local EMs to make critical response choices under pressure of limited time and incomplete information. Rising sea levels, more frequent and intense storm events, growing coastal populations, and increasing societal dependence on complex infrastructure are …

Optimizing Poultry Production And Enhancing Egg Nutrient Composition Through Kelp Supplementation In Laying Hens, Meghan Clifford

Open Access Dissertations

The development of sustainable feed supplements is a crucial component in addressing the current global need for resilient and environmentally responsible food systems. This dissertation has explored the potential of brown algae (Saccharina latissima) as a sustainable feed supplement for poultry with the potential to benefit production efficiency, product quality, and the global food supply. With both controlled feeding trials and a producer-based survey, the work in this dissertation investigates the nutritional, biological and practical implications of adopting kelp into poultry diets.

Chapter one provides a comprehensive overview of the current literature surrounding the use of marine sources …

The Actor, The Character, And The Audience: The Impact Of Racial Alignment On Theater Audiences, Conwell Worthington Iii

Open Access Dissertations

Broadway represents the pinnacle of live theater in the USA, generating billions of dollars in revenue and serving as an international cultural icon. Despite Broadway’s prominence, it faces challenges stemming from its reliance on a relatively homogeneous audience base and a changing market. One determinant of both financial and critical success is casting. Casting also significantly impacts audience perceptions and acceptance. The recent success of Hamilton: An American Musical and Six: The Musical juxtaposed with the failure of 1776 have sparked discussion and interest into how to best utilize non-traditional casting as a strategy to broaden Broadway Audiences. This dissertation …

Computational Modeling And Machine Learning For The Design Of Polymer-Based Protective Systems Under Dynamic Loading, Jonathan Tate Villada

Open Access Dissertations

Computational modeling and machine learning offer powerful pathways for designing polymer-based protective systems subjected to dynamic loading, particularly for mitigating the early shock-dominated response generated by near-field underwater explosions (UNDEX). As naval, offshore, and submerged infrastructure systems continue to grow in strategic importance, there is an increasing need for lightweight, damage-tolerant protective solutions capable of reducing transmitted pressure, deformation, and energy transfer under extreme impulsive environments. Since large-scale experimental testing under such conditions are costly and limited, validated numerical frameworks provide an efficient means to evaluate polymeric coatings, architected metastructures, and data-driven predictive tools across broad design spaces. The first …

Ecce Leadership Development: Supports, Barriers, And Identity Formation, Andrea Weidele

Open Access Dissertations

Early childhood care and education (ECCE) leadership development is not given the attention it deserves. Despite the proven link between high-quality ECCE programs and positive societal outcomes, leadership development within the sector is significantly under-resourced. Because program quality is inherently tied to leadership efficacy, there is an urgent need to investigate the supports and structures that foster effective ECCE leadership. This study addressed that gap by using a qualitative multiple case study to explore how six ECCE program leaders of licensed ECCE programs from a New England state describe their leadership development, including supports and barriers they encountered and how …

Protective Behavioral Strategies On Alcohol And Cannabis Co-Use Occasions, Sabrina Todaro

Open Access Dissertations

Simultaneous use of alcohol and cannabis, or co-use (i.e., the use of both substances so that effects overlap), is an increasingly significant public health concern among young adults between the ages of 18 and 25 in the U.S. (SAMHSA 2025; Terry-McElrath & Patrick, 2018). Protective behavioral strategies (PBS; i.e., tactics used to modify or limit substance use related harm; Pearson, 2013) have been robustly linked to fewer negative outcomes (e.g., lower use quantity, frequency, and consequences) for alcohol- and cannabis-only occasions (Bravo et al., 2016; Bravo et al., 2017; Bravo et al., 2019; Pearson, 2013; Pedersen et al., 2016; Pedersen …

Generating Template Banks For Intermediate Duration Gravitational Waves, Michael St. Pierre

Open Access Dissertations

There are a multitude of astrophysical sources which carry the potential to produce perturbations in spacetime, known as gravitational waves, across a wide spectrum of frequencies. Over the brief history of gravitational wave astronomy, short-duration “chirp” signals emitted from black hole mergers, highly energetic “burst” signals emitted from supernovae and Gamma-Ray Bursts (GRBs), and long duration “continuous” signals emitted from galactic neutron stars and the stochastic gravitational wave background have traditionally been at the forefront of search development, leaving a class of intermediate duration  ($10² - 10⁴ seconds) gravitational wave signals poorly suited for detection. The conventional way …

Linking Phytoplankton Physiology And Ecology To Global Biogeochemical Cycles: A Modeling Approach, Margaret Bernish

Open Access Dissertations

Phytoplankton, or microscopic primary producers, contribute to carbon export through the biological transformation of carbon dioxide into organic molecules. Phytoplankton are responsible for approximately half of global net primary production, while only contributing minimally to total photosynthetic biomass. Despite their important role in the global cycling of nutrients, phytoplankton physiology and ecology are often highly simplified in global biogeochemical models. This dissertation elucidates the role of phytoplankton physiology and ecology within biogeochemical cycles, allowing for better characterization of marine microbial distribution and better representation of nutrient cycling for interpretive and predictive models. The development of formulations that link physiological responses …

Attract Or Repel: Ceo Activism & Gen Z Pursuits, William Thomas Garrett

Open Access Dissertations

This study examines the effect of CEO sociopolitical activism on Gen Z job seekers by conceptualizing the former as an identity-implicating experience that poses either an identity opportunity or identity threat. As part of a 3 x 3 experimental study, participants reviewed comments about a proposed transgender bathroom bill made by the CEO of a fictional potential employer. The experiment introduced features of organizational policies governing internal discussions of political and social issues in the workplace and measured the ability of the policies to influence the potential applicant’s perception of an opportunity or threat. Results examined the relationship between the …

Investigating The Effects Of Nucleopore Defects On The Cellular Response To Stress In Als/Ftd Ipsc-Derived Neurons, Alicia Christine Collins

Open Access Dissertations

Amyotrophic lateral sclerosis/frontotemporal dementia (ALS/FTD) is a progressive neurodegenerative disease spectrum characterized by motor dysfunction, cognitive decline, and death within a few years of clinical onset. Hallmark features of ALS/FTD include defects in nucleocytoplasmic transport (NCT) and abnormal cytoplasmic mislocalization and aggregation of the RNA-binding protein TDP-43, both of which have been shown to be exasperated by oxidative stress (OS). It remains unclear how these processes are connected and how they collectively contribute to neurodegeneration. To fill this gap of knowledge, we used human embryonic kidney cells, neuroblastoma cells, and induced pluripotent stem cell-derived cortical neurons harboring the ALS/FTD C9ORF72 …

Submesoscale Dynamics Of Phytoplankton And Carbon Export Revealed By High-Resolution Airborne And Satellite Remote Sensing Of Currents And Ocean Color, Sarah E. Lang

Open Access Dissertations

Satellites and airborne sensors reveal submesoscale (1 - 10 km) variability in ocean color in the form of filaments, eddies, and patches. The variability in ocean color is closely tied to the physical dynamics that restructure phytoplankton distributions and drive active biological responses like changes in primary productivity and community structure. As the base of the marine food web and a key component of the biological carbon pump, phytoplankton are crucial to the overall health of marine ecosystems and to the ocean's role in climate. This dissertation focuses on the use of airborne and satellite remote sensing to study the …

Information Asymmetry: A Configurational Perspective In Buyer-Supplier Relationships, Soode Vaezinejad

Open Access Dissertations

Information asymmetry in buyer-supplier relationships has been linked to several influencing factors. However, these factors are often examined in isolation, limiting understanding of their synergistic effects. Grounded in agency theory, signaling theory, and transaction cost economics, this study adopts a configurational perspective to examine which combinations of factors lead to high information asymmetry. Using a three-part study design, we first conduct a systematic literature review to identify relevant factors, which are then refined and prioritized through a Delphi study. Building on this foundation, fuzzy-set Qualitative Comparative Analysis (fsQCA) is applied to survey data from 385 buyer managers to uncover equifinal …

Deep Learning-Based Structural Displacement Identification And Quantification Under Target Feature Loss, Lishuai Zhu, Guangcai Zhang, Qun Xie, Zhen Peng

Civil Engineering Faculty Publications

Structural displacement monitoring faces significant challenges under complex environmental conditions due to the loss or degradation of target features, making it difficult for traditional methods to ensure high accuracy and robustness. Therefore, this study proposes a structural displacement identification and quantification method that integrates YOLOv8n with an improved edge-orientation gradient-based template matching algorithm. By combining deep learning techniques with traditional template matching methods, the accuracy and robustness of monitoring are enhanced under adverse conditions such as noise and extremely low illumination. Specifically, in the edge-orientation gradient matching stage, the Canny-Devernay sub-pixel edge detection technique and an improved ellipse-fitting method are …

Lorawan-Based Asset Tracking System Development And Performance Analysis Within Stem-Pbl Framework: A Mixed-Method Study, Yousef Alfarraj, Ghada Abdelhady, Abdelrahman Ahmed, Mahmoud Elaasar, Jair J. Aguilar

Teaching and Learning Faculty Publications

This study examines the integration of project-based learning (PBL) within the integrative STEM framework to advance practical problem-solving skills and investigate students' perceptions of the STEM-PBL approach through developing an IoT-enabled asset tracking system using Long-Range Wide Area Network (LoRaWAN) technology to tackle real-world logistical challenges. Adopting a mixed-methods approach, the study combines an experimental approach utilizing quantitative system performance analysis with qualitative insights gathered through participant interviews with ten graduate students. Results reveal that the LoRaWAN system demonstrated high reliability with only 0.437% downtime, validating the technical feasibility of the educational project. Furthermore, participants perceived the STEM-PBL approach positively, …

Development Of A Semi-Mechanistic Population Pharmacokinetic Model For Predicting Tenofovir Disoproxil Fumarate And Tenofovir Alafenamide Exposure In Plasma And Cellular Matrices During Pregnancy And Postpartum, Yifan Yu, Kristina M. Brooks, Gustavo F. Doncel, Brookie M. Best, Mark A. Marzinke, Mark Mirochnick, Peter Anderson, Landon Myer, Connie Celum, Renee Heffron, Jenell Coleman, Dvora Joseph Davey, Craig W. Hendrix, Jeremiah D. Momper, Robert Bies, Rachel K. Scott

CONRAD Publications

Background and Objective

Tenofovir (TFV)-based regimens are backbones of both HIV treatment and pre-exposure prophylaxis during pregnancy. Multiple studies have shown up to one-third decreases in dried blood spot tenofovir-diphosphate concentrations during pregnancy among participants taking tenofovir disoproxil fumarate (TDF). Currently, there are no mechanism-based models describing the pharmacokinetics of tenofovir diphosphate (the active anabolite) in peripheral blood mononuclear cells (PBMCs) of pregnant individuals receiving TDF or tenofovir alafenamide (TAF), and the mechanisms behind observed differences between dried blood spots and PBMCs remain unclear.

Methods

To address this gap, we developed a semi-mechanistic model to simultaneously describe the pharmacokinetics of …

A Comparison Of F/Taf And F/Tdf As Hiv Pre-Exposure Prophylaxis In A Predominantly Cisgender Women Population In East And South Africa: A Randomised, Factorial, Non-Inferiority Trial, Sheena Mccormack, David Dunn, Sylvia Kusemererwa, Patricia Munseri, Nishanta Singh, Wiston William, Gertrude Mutonyi, Henry Bern, Lauriane Goldwirt, Cherry Kingsley, Arne Kkroidl, Christian Holm Hansen, Song Ding, Rachel Kawuma, Mary Amondi, Ubaldo Bahemuka, Deus Buma, Daniel Clutterbuck, Zakir Gaffoor, Angus Jennings, Agricola Joachim, Ayoub Kakande, Berna Kalanzi, Abisai Kisinda, Mabela Matsoso, Thomas Miller, Neetha Mmedsci Morar, Jacqueline Musau, Jane Nabbuto, Ayanda Nzuza, Doreen Pamba, Simona Salomone, Thandiwe Sithole, Edith Tarimo, Kubashni Woeber, Kundai Chinyenze, Glenda Gray, Eligius Lyamuya, Muhammad Bakari, Said Aboud, Lucas Maganga, Gustavo Doncel, Janet Seeley, Jonathan Weber, Pontiano Kaleebu, Julie Fox, Eugene Ruzagira, On Behalf Of The Prepvacc Study Group

CONRAD Publications

Background:

F/TAF was shown to be non-inferior to F/TDF as pre-exposure prophylaxis (PrEP) in men, but approval was not extended to cisgender women. We report the results of PrEPVacc, in which a predominantly female population was randomly allocated to receive daily oral F/TDF or F/TAF for ∼6 months within a HIV-1 prophylactic vaccine trial.

Setting:

Five study sites in three African countries (Uganda, Tanzania, South Africa).

Methods:

The two regimens were compared by the averted infections ratio (AIR) - the proportion of infections averted by F/TAF relative to F/TDF. The counterfactual HIV incidence, an essential component of this metric, was …

Longitudinal Changes In Plasma Biomarkers Of Immune Activation, Neuronal Inflammation And Injury In Persons With Hiv Initiating Art, Merle Henderson, Peter Dutey-Magni, Carolina Herrera, Wolfgang Stöhr, Alejandro Arenas-Pinto, Owen Swann, Amanda Heslegrave, Henrik Zetterberg, John Tregoning, Sarah Fidler, François Raffi, Andrea Calcagno, Ab Babiker, Alan Winston

CONRAD Publications

Background

Data on changes in biomarkers of brain health, and their associations with cognitive function in adults commencing either dual- or triple-antiretroviral therapy (ART) are sparse.

Methods

Plasma biomarkers (neurofilament light [NfL], glial fibrillary acidic protein [GFAP], sCD14, CXCL10, neopterin and IL-6) were measured at baseline and after 96 weeks on ART in individuals randomized to darunavir/ritonavir and either tenofovir-DF/emtricitabine (triple-ART, n = 119) or raltegravir (dual-ART, n = 119) in NEAT-001/ANRS143. Regression models examined associations of baseline and week-96 biomarker concentrations with HIV clinical parameters, composite cognitive test scores (Standardized neuropsychological test [NPZ], 7-domains) and treatment arm.

Results

In …

Formulation Development Of Topical Inserts Containing Doxycycline And Doxycycline Combined With Tenofovir Alafenamide And Elvitegravir For The Prevention Of Sexually Transmitted Infections, Vivek Agrahari, M. Melissa Peet, Jasmin Monpara, Rijo John, Sriramakamal Jonnalagadda, Pardeep K. Gupta, Meredith R. Clark, Gustavo F. Doncel

CONRAD Publications

Despite advances in oral and injectable HIV prevention options and oral prophylaxis for sexually transmitted infections (STIs) of bacterial origin, there remains a critical need for effective on-demand topical (vaginal and rectal) products for pre- and post-exposure prophylaxis (PrEP and PEP). To fill this gap, we have developed single and first-in-kind multi-active topical inserts for bacterial STIs and HIV/STIs prevention. We have formulated two different inserts, one containing doxycycline (DOX) at 10, 50, and 100 mg doses for bacterial STI prevention, and a multipurpose prevention product (TED insert) that combines DOX (10 mg) with the antiretrovirals tenofovir alafenamide (TAF; 20 …

Artificial Intelligence And Machine Learning In Smart Vaginal Formulation Development, Deborah A. Ogundemuren, Vivek Agrahari, Andrew P. Wong, Carolina Herrera, Margaret O. Ilomuanya, Gustavo F. Doncel

CONRAD Publications

Vaginal drug delivery in women's health remains underutilized and insufficiently studied, largely due to the complexity and dynamic nature of the vaginal microenvironment. Variations in vaginal pH, hormonal levels, and microbiota composition introduce significant biological variability, complicating formulation design and contributing to inconsistent therapeutic outcomes and poor patient adherence. Conventional vaginal formulations often fail to account for these individual differences, highlighting the need for more adaptive and predictive approaches. Emerging advances in artificial intelligence (AI) and machine learning (ML) offer promising strategies to address these challenges by enabling multi-parameter, data-driven formulation development that explicitly considers biological variability. Despite their transformative …

Partial Post-Exposure Protection By Topical Inserts Containing Tenofovir Alafenamide Fumarate/Elvitegravir In A Macaque Model Of Rectal Simian Hiv (Shiv) Infection, Natalia Makarova, Tyana Singletary, M. Melissa Peet, Kristen Kelley, Ryan Johnson, Vivek Agrahari, Maria Mendoza, Yi Pan, Walid Heneine, Meredith R. Clark, J. Gerardo García Lerma, Gustavo F. Doncel, James W. Smith

CONRAD Publications

On-demand topical inserts for HIV prevention may be a good option for people who have a low frequency of sexual activity. We recently demonstrated in a preclinical macaque model that rectal application of inserts containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) conferred protection against SHIV infection (93% efficacy) when applied as pre-exposure prophylaxis 4 hours before SHIV exposure. Here, we show that the same inserts provide significant postexposure protection (82.9% efficacy) when applied 4 hours after SHIV exposure. Our findings further support the ongoing clinical development of TAF/EVG inserts for on-demand HIV prevention.