What is the optimum time to start antiretroviral therapy in people with HIV and tuberculosis coinfection? A systematic review and meta-analysis

Background: HIV and tuberculosis are frequently diagnosed concurrently. In March 2021, World Health Organization recommended that antiretroviral therapy (ART) should be started within two weeks of tuberculosis treatment start, at any CD4 count. We aimed to assess whether earlier ART improved outcomes in people with newly diagnosed HIV and tuberculosis. Methods: We did a systematic review by searching nine database for for trials that compared earlier ART to later ART initiation in people with HIV and tuberculosis. We included studied published from database inception to 12 March 2021. We compared ART within four weeks vs. ART more than four weeks after TB treatment, and ART within two weeks vs. ART between two and eight weeks, and stratified analysis by CD4 count. The main outcome was death; secondary outcomes included IRIS and AIDS-defining events. We used random effects meta-analysis to pool effect estimates. Results: 2468 abstracts were screened, from which we identified nine trials. Among people with all CD4 counts, there was no difference in mortality by earlier ART (≤ 4 week) vs. later ART (> 4 week) (risk difference [RD] 0%; 95% confidence interval [CI] -2% to +1%). Among people with CD4 count ≤50 cells/mm3, earlier ART (≤4 weeks) reduced risk of death (RD -6%; -10% to -1%). Among people with all CD4 counts earlier ART (≤4 weeks) increased the risk of IRIS (RD +6%, 95% CI +2% to +10%) and reduced the incidence of AIDS defining events (RD -2%, 95% CI -4% to 0%). Results were similar when trials were restricted to the five trials which permitted comparison of ART within two weeks to ART between two and eight weeks. Discussion: Earlier ART did not alter risk of death overall among people living with HIV who had TB disease. Trials were conducted between 2004 and 2014, before recommendations to treat HIV at any CD4 count or to rapidly start ART in people without TB. No trials included children or pregnant women. No trials included integrase inhibitors in ART regimens. For logistical and patient preference reasons, earlier ART initiation for everyone with TB and HIV may be preferred to later ART

Regional surface morphology of comet 67P/Churyumov-Gerasimenko from Rosetta/OSIRIS images: The southern hemisphere

Aims. The OSIRIS camera on board the Rosetta spacecraft has been acquiring images of the comet 67P/Churyumov-Gerasimenko (67P)'s nucleus since August 2014. Starting in May 2015, the southern hemisphere gradually became illuminated and was imaged for the first time. Here we present the regional morphology of the southern hemisphere, which serves as a companion to an earlier paper that presented the regional morphology of the northern hemisphere. Methods. We used OSIRIS images that were acquired at orbits ~45-125 km from the center of the comet (corresponding to spatial resolutions of ~0.8 to 2.3 m/pixel) coupled with the use of digital terrain models to define the different regions on the surface, and identify structural boundaries accurately. Results. Seven regions have been defined in the southern hemisphere bringing the total number of defined regions on the surface of the nucleus to 26. These classifications are mainly based on morphological and/or topographic boundaries. The southern hemisphere shows a remarkable dichotomy with its northern counterpart mainly because of the absence of wide-scale smooth terrains, dust coatings and large unambiguous depressions. As a result, the southern hemisphere closely resembles previously identified consolidated regions. An assessment of the overall morphology of comet 67P suggests that the comet's two lobes show surface heterogeneities manifested in different physical/mechanical characteristics, possibly extending to local (i.e., within a single region) scales.© 2016 ESO.The support of the national funding agencies of Germany (DLR), France (CNES), Italy (ASI), Spain (MEC), Sweden (SNSB), and the ESA Technical Directorate is gratefully acknowledged.Peer Reviewe

Comet 67P/Churyumov-Gerasimenko: Constraints on its origin from OSIRIS observations

Context. One of the main aims of the ESA Rosetta mission is to study the origin of the solar system by exploring comet 67P/Churyumov-Gerasimenko at close range. Aims. In this paper we discuss the origin and evolution of comet 67P/Churyumov-Gerasimenko in relation to that of comets in general and in the framework of current solar system formation models. Methods. We use data from the OSIRIS scientific cameras as basic constraints. In particular, we discuss the overall bi-lobate shape and the presence of key geological features, such as layers and fractures. We also treat the problem of collisional evolution of comet nuclei by a particle-in-a-box calculation for an estimate of the probability of survival for 67P/Churyumov-Gerasimenko during the early epochs of the solar system. Results. We argue that the two lobes of the 67P/Churyumov-Gerasimenko nucleus are derived from two distinct objects that have formed a contact binary via a gentle merger. The lobes are separate bodies, though sufficiently similar to have formed in the same environment. An estimate of the collisional rate in the primordial, trans-planetary disk shows that most comets of similar size to 67P/Churyumov-Gerasimenko are likely collisional fragments, although survival of primordial planetesimals cannot be excluded. Conclusions. A collisional origin of the contact binary is suggested, and the low bulk density of the aggregate and abundance of volatile species show that a very gentle merger must have occurred. We thus consider two main scenarios: the primordial accretion of planetesimals, and the re-accretion of fragments after an energetic impact onto a larger parent body. We point to the primordial signatures exhibited by 67P/Churyumov-Gerasimenko and other comet nuclei as critical tests of the collisional evolution

Multivariate statistical analysis of OSIRIS/Rosetta spectrophotometric data of comet 67P/Churyumov-Gerasimenko

Context. The ESA Rosetta mission explored comet 67P/Churyumov-Gerasimenko in 2014-2016, following its target before and after the perihelion passage on 13 August 2015. The NAC camera of the OSIRIS imaging system allowed to map the nucleus surface acquiring images with different filters in the visible wavelength range. Aims. Here we study the spectrophotometric behaviour of the nucleus by a multivariate statistical analysis, aiming to distinguish homogeneous groups and to constrain the bulk composition. Methods. We applied the G-mode clustering algorithm to 16 OSIRIS data cubes acquired on 5-6 August 2014 (mostly covering the northern hemisphere) and 2 May 2015 (mostly covering the southern hemisphere), selected to have complete coverage of the comet's surface with similar observing conditions. Results. We found four similar homogeneous groups for each of the analysed cubes. The first group corresponds to the average spectrophotometric behaviour of the nucleus. The second (spectrally redder) and the third (spectrally bluer) groups are found in regions that were already found to deviate from the average terrain of the comet by previous studies. A fourth group (characterised by enhancements of the flux at 700-750 nm and 989 nm, possibly due to H2O+ and/or NH2 emissions) seems connected with the cometary activity rather than with the bulk composition. Conclusions. While our aim in this work was to study the spectrophotometric behaviour of the nucleus of 67P/Churyumov-Gerasimenko as a whole, we found that a follow-up application of the G-mode to smaller regions of the surface could be useful in particular to identify and study the temporal evolution of ice patches, as well as to constrain the composition and physical processes behind the emission of dust jets

Sunset jets observed on comet 67P/Churyumov-Gerasimenko sustained by subsurface thermal lag

We present observations of sunset jets on comet 67P/Churyumov-Gerasimenko by Rosetta/OSIRIS camera. In late April 2015, when the comet was at a heliocentric distance of ∼1.8AU, clusters of dust jets that originated in the Ma'at region on the comet's small lobe were identified from multipleimages and were apparently sustained for about an hour beyond local sunset. Emanating from the shadowed nucleus, these jets became visible by solar illumination at their apparent sources up to only a few tens of meters above the nucleus surface. We investigate the plausibility of these jets as having been triggered by water ice sublimation and sustained by thermal lag in the subsurface beyond sunset. A general thermo-physical model was parameterized such that the thermal lag in the subsurface is consistent with the elapsed time of observation after sunset. It is found that the sublimation of water ice from a depth of 6 mm and with a low thermal inertia of 50 W m-2 K-1 s1/2 could explain the spatial pattern and evolution of the apparent sources, particularly their disappearance due to the eventual cooling of the subsurface. Our analysis suggests that these sunset jets were essentially day-side dust activities that continued after sunset. Specific observational conditions for the sunset jets constrain their possible sources to mostly within the less abrupt, dusty terrains. The uneven distribution of these jets is possibly related to subsurface inhomogeneities in the dusty area

Gravitational slopes, geomorphology, and material strengths of the nucleus of comet 67P/Churyumov-Gerasimenko from OSIRIS observations

We study the link between gravitational slopes and the surface morphology on the nucleus of comet 67P/Churyumov-Gerasimenko and provide constraints on the mechanical properties of the cometary material (tensile, shear, and compressive strengths). Methods. We computed the gravitational slopes for five regions on the nucleus that are representative of the different morphologies observed on the surface (Imhotep, Ash, Seth, Hathor, and Agilkia), using two shape models computed from OSIRIS images by the stereo-photoclinometry (SPC) and stereo-photogrammetry (SPG) techniques. We estimated the tensile, shear, and compressive strengths using different surface morphologies (overhangs, collapsed structures, boulders, cliffs, and Philae's footprint) and mechanical considerations. Results. The different regions show a similar general pattern in terms of the relation between gravitational slopes and terrain morphology: i) low-slope terrains (0-20°) are covered by a fine material and contain a few large (>10 m) and isolated boulders; ii) intermediate-slope terrains (20-45°) are mainly fallen consolidated materials and debris fields, with numerous intermediate-size boulders from <1 m to 10 m for the majority of them; and iii) high-slope terrains (45-90°) are cliffs that expose a consolidated material and do not show boulders or fine materials. The best range for the tensile strength of overhangs is 3-15 Pa (upper limit of 150 Pa), 4-30 Pa for the shear strength of fine surface materials and boulders, and 30-150 Pa for the compressive strength of overhangs (upper limit of 1500 Pa). The strength-to-gravity ratio is similar for 67P and weak rocks on Earth. As a result of the low compressive strength, the interior of the nucleus may have been compressed sufficiently to initiate diagenesis, which could have contributed to the formation of layers. Our value for the tensile strength is comparable to that of dust aggregates formed by gravitational instability and tends to favor a formation of comets by the accrection of pebbles at low velocities

Temporal morphological changes in the Imhotep region of comet 67P/Churyumov-Gerasimenko

Aims. We report on the first major temporal morphological changes observed on the surface of the nucleus of comet 67P/Churyumov-Gerasimenko in the smooth terrains of the Imhotep region. Methods. We used images of the OSIRIS cameras onboard Rosetta to follow the temporal changes from 24 May 2015 to 11 July 2015. Results. The morphological changes observed on the surface are visible in the form of roundish features that are growing in size from a given location in a preferential direction at a rate of 5.6-8.1 × 10-5 m s-1 during the observational period. The location where the changes started and the contours of the expanding features are bluer than the surroundings, which suggests that ices (H2O and/or CO2) are exposed on the surface. However, sublimation of ices alone is not sufficient to explain the observed expanding features. No significant variations in the dust activity pattern are observed during the period of changes

The primordial nucleus of comet 67P/Churyumov-Gerasimenko

Context. We investigate the formation and evolution of comet nuclei and other trans-Neptunian objects (TNOs) in the solar nebula and primordial disk prior to the giant planet orbit instability foreseen by the Nice model. Aims. Our goal is to determine whether most observed comet nuclei are primordial rubble-pile survivors that formed in the solar nebula and young primordial disk or collisional rubble piles formed later in the aftermath of catastrophic disruptions of larger parent bodies. We also propose a concurrent comet and TNO formation scenario that is consistent with observations. Methods. We used observations of comet 67P/Churyumov-Gerasimenko by the ESA Rosetta spacecraft, particularly by the OSIRIS camera system, combined with data from the NASA Stardust sample-return mission to comet 81P/Wild 2 and from meteoritics; we also used existing observations from ground or from spacecraft of irregular satellites of the giant planets, Centaurs, and TNOs. We performed modeling of thermophysics, hydrostatics, orbit evolution, and collision physics. Results. We find that thermal processing due to short-lived radionuclides, combined with collisional processing during accretion in the primordial disk, creates a population of medium-sized bodies that are comparably dense, compacted, strong, heavily depleted in supervolatiles like CO and CO2; they contain little to no amorphous water ice, and have experienced extensive metasomatism and aqueous alteration due to liquid water. Irregular satellites Phoebe and Himalia are potential representatives of this population. Collisional rubble piles inherit these properties from their parents. Contrarily, comet nuclei have low density, high porosity, weak strength, are rich in supervolatiles, may contain amorphous water ice, and do not display convincing evidence of in situ metasomatism or aqueous alteration. We outline a comet formation scenario that starts in the solar nebula and ends in the primordial disk, that reproduces these observed properties, and additionally explains the presence of extensive layering on 67P/Churyumov-Gerasimenko (and on 9P/Tempel 1 observed by Deep Impact), its bi-lobed shape, the extremely slow growth of comet nuclei as evidenced by recent radiometric dating, and the low collision probability that allows primordial nuclei to survive the age of the solar system. Conclusions. We conclude that observed comet nuclei are primordial rubble piles, and not collisional rubble piles. We argue that TNOs formed as a result of streaming instabilities at sizes below ∼400 km and that ∼350 of these grew slowly in a low-mass primordial disk to the size of Triton, Pluto, and Eris, causing little viscous stirring during growth. We thus propose a dynamically cold primordial disk, which prevented medium-sized TNOs from breaking into collisional rubble piles and allowed the survival of primordial rubble-pile comets. We argue that comets formed by hierarchical agglomeration out of material that remained after TNO formation, and that this slow growth was a necessity to avoid thermal processing by short-lived radionuclides that would lead to loss of supervolatiles, and that allowed comet nuclei to incorporate ∼3 Myr old material from the inner solar system

Spectrophotometry of the Khonsu region on the comet 67P/Churyumov-Gerasimenko using OSIRIS instrument images

Our work focuses on the spectrophotometric analysis of selected terrain and bright patches in the Khonsu region on the comet 67P/Churyumov-Gerasimenko. Despite the variety of geological features, their spectrophotometric properties appear to indicate a similar composition. It is noticeable that the smooth areas in Khonsu possess similar spectrophotometric behaviour to some other regions of the comet. We observed bright patches on Khonsu with an estimation of > 40 per cent of normal albedo and suggest that they are associated with H2O ice. One of the studied bright patches has been observed to exist on the surface for more than 5 months without a major decay of its size, implying the existence of potential sub-surface icy layers. Its location may be correlated with a cometary outburst during the perihelion passage of the comet in 2015 August, and we interpret it to have triggered the surface modifications necessary to unearth the stratified icy layers beneath the surface. A boulder analysis on Khonsu leads to a power-law index of -3.1 +0.2/-0.3 suggesting a boulder formation, shaped by varying geological processes for different morphological units

Long-term monitoring of comet 67P/Churyumov-Gerasimenko's jets with OSIRIS onboard Rosetta

We used the OSIRIS camera system onboard the Rosetta spacecraft to monitor jet activity of comet 67P/Churyumov-Gerasimenko. With a monthly cadence, we covered an epoch from 2014 December to 2015 October, thereby including the first equinox and the perihelion passage. Jet features were measured in individual images, which were used to perform a statistical inversion. The study provides maps for the locations of likeliest sources of jet activity on the comet's surface as a function of time. The sources follow the subsolar latitude, show clustering and a broadening of the activity band with time in the Northern hemisphere. In the Southern hemisphere, they are not clustered but show a broader spread over all longitudes which is either related to the north-south dichotomy of the comet's topography or due to a higher insolation during southern summer