Inclusion of marginalized populations in HPV vaccine modeling: A systematic review.

OBJECTIVE: Models simulating the potential impacts of Human Papillomavirus (HPV) vaccine have been used globally to guide vaccination policies and programs. We sought to understand how and why marginalized populations have been incorporated into HPV vaccine simulation models. METHODS: We conducted a systematic search of PubMed, CINAHL, Scopus, and Embase to identify studies using simulation models of HPV vaccination incorporating one or more marginalized population through stratification or subgroup analysis. We extracted data on study characteristics and described these overall and by included marginalized groups. RESULTS: We identified 36 studies that met inclusion criteria, which modeled vaccination in 21 countries. Models included men who have sex with men (MSM; k = 16), stratification by HIV status (k = 9), race/ethnicity (k = 6), poverty (k = 5), rurality (k = 4), and female sex workers (k = 1). When evaluating for a marginalized group (k = 10), HPV vaccination was generally found to be cost-effective, including for MSM, individuals living with HIV, and rural populations. In studies evaluating equity in cancer prevention (k = 9), HPV vaccination generally advanced equity, but this was sensitive to differences in HPV vaccine uptake and use of absolute or relative measures of inequities. Only one study assessed the impact of an intervention promoting HPV vaccine uptake. DISCUSSION: Incorporating marginalized populations into decision models can provide valuable insights to guide decision making and improve equity in cancer prevention. More research is needed to understand the equity impact of HPV vaccination on cancer outcomes among marginalized groups. Research should emphasize implementation - including identifying and evaluating specific interventions to increase HPV vaccine uptake.

Mechanism of PVDF Membrane Formation by NIPS Revisited: Effect of Precipitation Bath Nature and Polymer-Solvent Affinity.

A new interpretation of the mechanism of the polyvinylidene fluoride (PVDF) membrane formation using the nonsolvent-induced phase separation (NIPS) method based on an analysis of the complete experimental phase diagram for the three-component mixture PVDF-dimethyl acetamide (DMAc)-water is proposed. The effects of the precipitation bath's harshness and thermodynamic affinity of the polymer's solvent on the morphology, crystalline structure, transport and physical-mechanical properties of the membranes are investigated. These characteristics were studied via scanning electron microscopy, wide-angle X-ray scattering, liquid-liquid porosimetry and standard methods of physico-mechanical analysis. It is established that an increase in DMAc concentration in the precipitation bath results in the growth of mean pore size from ~60 to ~150 nm and an increase in permeance from ~2.8 to ~8 L m-2 h-1 bar-1. It was observed that pore size transformations are accompanied by changes in the tensile strength of membranes from ~9 to ~11 and to 6 MPa, which were explained by the degeneration of finger-like pores and appearance of spherulitic structures in the samples. The addition of water to the dope solution decreased both the transport (mean pore size changed from ~55 to ~25 nm and permeance reduced from ~2.8 to ~0.5 L m-2 h-1 bar-1) and mechanical properties of the membranes (tensile strength decreased from ~9 to ~6 MPa). It is possible to conclude that the best membrane quality may be reached using pure DMAc as a solvent and a precipitation bath containing 10-30% wt. of DMAc, in addition to water.

Phase Equilibria and Structure Formation in the Polylactic-co-Glycolic Acid/Tetraglycol/Water Ternary System.

This paper concerns a detailed study of the phase separation and structure formation processes that occur in solutions of highly hydrophobic polylactic-co-glycolic acid (PLGA) in highly hydrophilic tetraglycol (TG) upon their contact with aqueous media. In the present work, cloud point methodology, high-speed video recording, differential scanning calorimetry, and both optical and scanning electron microscopy were used to analyze the behavior of PLGA/TG mixtures differing in composition when they are immersed in water (the so-called "harsh" antisolvent) or in a nonsolvent consisting of equal amounts of water and TG (a "soft" antisolvent). The phase diagram of the ternary PLGA/TG/water system was designed and constructed for the first time. The PLGA/TG mixture composition with which the polymer undergoes glass transition at room temperature was determined. Our data enabled us to analyze in detail the structure evolution process taking place in various mixtures upon their immersion in "harsh" and "soft" antisolvent baths and gain an insight into the peculiarities of the structure formation mechanism active in the course of antisolvent-induced phase separation in PLGA/TG/water mixtures. This provides intriguing opportunities for the controlled fabrication of a wide variety of bioresorbable structures-from polyester microparticles, fibers, and membranes to scaffolds for tissue engineering.

A New Look at the Structure and Thermal Behavior of Polyvinylidene Fluoride-Camphor Mixtures.

An experimental quasi-equilibrium phase diagram of the polyvinylidene fluoride (PVDF)-camphor mixture is constructed using an original optical method. For the first time, it contains a boundary curve that describes the dependence of camphor solubility in the amorphous regions of PVDF on temperature. It is argued that this diagram cannot be considered a full analogue of the eutectic phase diagrams of two low-molar-mass crystalline substances. The phase diagram is used to interpret the polarized light hot-stage microscopy data on cooling the above mixtures from a homogeneous state to room temperature and scanning electron microscopy data on the morphology of capillary-porous bodies formed upon camphor removal. Based on our calorimetry and X-ray studies, we put in doubt the possibility of incongruent crystalline complex formation between PVDF and camphor previously suggested by Dasgupta et al. (Macromolecules 2005, 38, 5602-5608). We also describe and discuss the high-temperature crystalline structure of racemic camphor, which is not available in the modern literature.

Effect of Acetone as Co-Solvent on Fabrication of Polyacrylonitrile Ultrafiltration Membranes by Non-Solvent Induced Phase Separation.

For the first time, the presence of acetone in the casting solutions of polyacrylonitrile (PAN) in dimethylsulfoxide or N-methyl-2-pyrrolidone was studied with regards to thermodynamical aspects of phase separation of polymeric solutions induced by contact with non-solvent (water), formation and performance of porous membranes of ultrafiltration range. The positions of the liquid equilibrium binodals on the phase diagrams of these three-component and pseudo-three-component mixtures were determined. For PAN-N-methyl-2-pyrrolidone-water glass transition curve on a ternary phase diagram was plotted experimentally for the first time. The real-time evolution of the structure of mixtures of PAN with solvents (co-solvents) upon contact with a non-solvent (water) has been studied. The thermodynamic analysis of the phase diagrams of these mixtures, together with optical data, made it possible to propose a mechanism of structure formation during non-solvent induced phase separation of different mixtures. The addition of acetone promotes the formation of a spongy layer on the membrane surface, which decreases the probability of defect formation on the membrane surface and keeps finger-like macrovoids from the underlying layers of the membrane. It was shown that the molecular weight cut-off (MWCO) of the membranes can be improved from 58 down to 1.8 kg/mol by changing the acetone content, while polymer concentration remained the same.

Analysis of the Thermal Behavior of Polypropylene-Camphor Mixtures for Understanding the Pathways to Polymeric Membranes via Thermally Induced Phase Separation.

An experimental phase diagram of the isotactic polypropylene-camphor system is constructed using an original optical method. It considerably deviates from the dynamic diagram, which can be obtained using conventional differential scanning calorimetry (DSC), and contains an additional boundary line that describes camphor solubility in the polymer. An accurate phase diagram makes it possible to perform a detailed and consistent thermodynamic analysis of the DSC, optical, and scanning electron microscopy data on the cooling of prehomogenized mixtures of different compositions, which leads to the formation of capillary-porous bodies via thermally induced phase separation. The removal of camphor results in the formation of polypropylene membranes, the morphology and functional properties of which, such as the total pore volume, mean pore size, permeability coefficient, and breaking stress, appear to be highly dependent on the composition of the initial binary system. It is shown that thermally induced phase separation induces the formation of microscopic cracks in the studied membranes. The crack density decreases with the polymer content in the initial system, but at 53 wt % of polypropylene, the membrane becomes completely impermeable to isopropanol despite the presence of large ∼4 µm pores, thus questioning the perspectives of its practical use. In general, the study makes it possible to achieve a deeper understanding of the membrane formation process via thermally induced phase separation in the mixtures of semicrystalline polymers with low molar mass substances.