Can the UNAIDS 90-90-90 target be achieved? A systematic analysis of national HIV treatment cascades

Background In 2014, the Joint United Nations Programme on HIV and AIDS (UNAIDS) and partners set the ‘90-90-90 targets’; aiming to diagnose 90% of all HIV positive people, provide antiretroviral therapy (ART) for 90% of those diagnosed and achieve viral suppression for 90% of those treated, by 2020. This results in 81% of all HIV positive people on treatment and 73% of all HIV positive people achieving viral suppression. We aimed to analyse how effective national HIV treatment programmes are at meeting these targets, using HIV care continuums or cascades. Methods We searched for HIV treatment cascades for 196 countries in published papers, conference presentations, UNAIDS databases and national reports. Cascades were constructed using reliable, generalisable, recent data from national, cross-sectional and longitudinal study cohorts. Data were collected for four stages; total HIV positive people, diagnosed, on treatment and virally suppressed. The cascades were categorised as complete (four stages) or partial (3 stages), and analysed for ‘break points’ defined as a drop >10% in coverage between consecutive 90-90-90 targets. Results 69 country cascades were analysed (32 complete, 37 partial). Diagnosis (target one—90%) ranged from 87% (the Netherlands) to 11% (Yemen). Treatment coverage (target two—81% on ART) ranged from 71% (Switzerland) to 3% (Afghanistan). Viral suppression (target three—73% virally suppressed) was between 68% (Switzerland) and 7% (China). Conclusions No country analysed met the 90-90-90 targets. Diagnosis was the greatest break point globally, but the most frequent key break point for individual countries was providing ART to those diagnosed. Large disparities were identified between countries. Without commitment to standardised reporting methodologies, international comparisons are complex

Compositional characterisation of the Themis family

Context. It has recently been proposed that the surface composition of icy main-belt asteroids (B-,C-,Cb-,Cg-,P-,and D-types) may be consistent with that of chondritic porous interplanetary dust particles (CPIDPs). Aims. In the light of this new association, we re-examine the surface composition of a sample of asteroids belonging to the Themis family in order to place new constraints on the formation and evolution of its parent body. Methods. We acquired NIR spectral data for 15 members of the Themis family and complemented this dataset with existing spectra in the visible and mid-infrared ranges to perform a thorough analysis of the composition of the family. Assuming end-member minerals and particle sizes (<2\mum) similar to those found in CPIDPs, we used a radiative transfer code adapted for light scattering by small particles to model the spectral properties of these asteroids. Results. Our best-matching models indicate that most objects in our sample possess a surface composition that is consistent with the composition of CP IDPs.We find ultra-fine grained Fe-bearing olivine glasses to be among the dominant constituents. We further detect the presence of minor fractions of Mg-rich crystalline silicates. The few unsuccessfully matched asteroids may indicate the presence of interlopers in the family or objects sampling a distinct compositional layer of the parent body. Conclusions. The composition inferred for the Themis family members suggests that the parent body accreted from a mixture of ice and anhydrous silicates (mainly amorphous) and subsequently underwent limited heating. By comparison with existing thermal models that assume a 400km diameter progenitor, the accretion process of the Themis parent body must have occurred relatively late (>4Myr after CAIs) so that only moderate internal heating occurred in its interior, preventing aqueous alteration of the outer shell.Comment: 9 pages, 5 figures, accepted for publication in A&

An advanced multipole model of the (130) Elektra quadruple system

The Ch-type asteroid (130) Elektra is orbited by three moons, making it the first quadruple system in the main asteroid belt. We aim to characterise the irregular shape of Elektra and construct a complete orbital model of its unique moon system. We applied the All-Data Asteroid Modelling (ADAM) algorithm to 60 light curves of Elektra, including our new measurements, 46 adaptive-optics (AO) images obtained by the VLT/SPHERE and Keck/Nirc2 instruments, and two stellar occultation profiles. For the orbital model, we used an advanced $N$-body integrator, which includes a multipole expansion of the central body (with terms up to the order $\ell = 6$), mutual perturbations, internal tides, as well as the external tide of the Sun acting on the orbits. We fitted the astrometry measured with respect to the central body and also relatively, with respect to the moons themselves. We obtained a revised shape model of Elektra with the volume-equivalent diameter $(201\pm 2)\,{\rm km}$. Out of two pole solutions, $(\lambda, \beta) = (189; -88)\,{\rm deg}$ is preferred, because the other one leads to an incorrect orbital evolution of the moons. We also identified the true orbital period of the third moon S/2014 (130) 2 as $P_2 = (1.642112 \pm 0.000400)\,{\rm d}$, which is in between the other periods, $P_1 \simeq 1.212\,{\rm d}$, $P_3 \simeq 5.300\,{\rm d}$, of S/2014 (130) 1 and S/2003 (130) 1, respectively. The resulting mass of Elektra, $(6.606 \substack{+0.007 \\ -0.013}) \times 10^{18}\,{\rm kg}$, is precisely constrained by all three orbits. Its bulk density is then $(1.536 \pm 0.038)\,{\rm g\,cm}^{-3}$. The expansion with the assumption of homogeneous interior leads to the oblateness $J_2 = -C_{20} \simeq 0.16$. However, the best-fit precession rates indicate a slightly higher value, ${\simeq}\,0.18$.Comment: 19 pages, 23 figure

A protosolar nebula origin for the ices agglomerated by Comet 67P/Churyumov-Gerasimenko

The nature of the icy material accreted by comets during their formation in the outer regions of the protosolar nebula is a major open question in planetary science. Some scenarios of comet formation predict that these bodies agglomerated from crystalline ices condensed in the protosolar nebula. Concurrently, alternative scenarios suggest that comets accreted amorphous ice originating from the interstellar cloud or from the very distant regions of the protosolar nebula. On the basis of existing laboratory and modeling data, we find that the N$_2$/CO and Ar/CO ratios measured in the coma of the Jupiter family comet 67P/Churyumov-Gerasimenko by the ROSINA instrument aboard the European Space Agency's Rosetta spacecraft match those predicted for gases trapped in clathrates. If these measurements are representative of the bulk N$_2$/CO and Ar/CO ratios in 67P/Churyumov-Gerasimenko, it implies that the ices accreted by the comet formed in the nebula and do not originate from the interstellar medium, supporting the idea that the building blocks of outer solar system bodies have been formed from clathrates and possibly from pure crystalline ices. Moreover, because 67P/Churyumov-Gerasimenko is impoverished in Ar and N$_2$, the volatile enrichments observed in Jupiter's atmosphere cannot be explained solely via the accretion of building blocks with similar compositions and require an additional delivery source. A potential source may be the accretion of gas from the nebula that has been progressively enriched in heavy elements due to photoevaporation.Comment: The Astrophysical Journal Letters, in pres

Characterization of the Subsurface of 67P/Churyumov-Gerasimenko's Abydos Site

We investigate the structure of the subsurface of the Abydos site using a cometary nucleus model with parameters adapted to comet 67P/Churyumov-Gerasimenko and the Abydos landing site. We aim to compare the production rates derived from our model with those of the main molecules measured by Ptolemy. This will allow us to retrieve the depths at which the different molecules still exist in solid form

Interferon alpha-2a Plus Ribavirin 1,000/1,200 mg versus Interferon alpha-2a Plus Ribavirin 600 mg for Chronic Hepatitis C Infection in Patients on Opiate Maintenance Treatment: An Open-Label Randomized Multicenter Trial

Abstract : Background: : Many intravenous opiate users are infected with hepatitis C virus (HCV) but few are treated. Although this complies with various guidelines, virtually no published evidence supports such a recommendation. Patients and Methods: : In a multicenter study, HCV-infected patients in opiate maintenance treatment programs received interferon plus high- or low-dose ribavirin (1,000/1,200 mg or 600 mg). HIV-coinfected patients were not included. Endpoints were feasibility, efficacy, side effects, and reasons for dropout. Results: : Of the 420 patients who tested positive for HCV, 27 (6%) were enrolled; 393 (94%) either failed to meet the inclusion criteria or refused treatment. Virologic end-of-treatment response was achieved in 12/27 patients, and sustained response in 13/27 (48%). Response depended on viral genotype, not ribavirin dose. The two doses of ribavirin did not differ in their side effects. Conclusion: : In a small fraction of HCV-infected intravenous drug users in an opiate maintenance treatment program, antiviral therapy was feasible, safe, and effective. The success rate was comparable to that achieved in controlled studies that excluded drug user

E-type asteroid (2867) Steins: flyby target for Rosetta

Reproduced with permission. Copyright ESO. Article published by EDP Sciences and available at http://www.aanda.org.International audienceAims. The mineralogy of the asteroid (2867) Steins was investigated in the framework of a ground-based science campaign dedicated to the future encounter with Rosetta spacecraft. Methods. Near-infrared (NIR) spectra of the asteroid in the 0.8−2.5 μm spectral range have been obtained with SpeX/IRTF in remoteobserving mode from Meudon, France, and Cambridge, MA, in December 2006 and in January and March 2007. A spectrum with a combined wavelength coverage from 0.4 to 2.5 μm was constructed using previously obtained visible data. To constrain the possible composition of the surface, we constructed a simple mixing model using a linear (areal) mix of three components obtained from the RELAB database. A space-weathering model was applied to the aubrite ALH-78113 spectrum. Results. The four new NIR spectra reveal no major absorption features. The best-fit model for the constructed visible-plus-NIR spectrum is represented by a mixture of 57% enstatite, 42% oldhamite, and 1% orthopyroxene. These results place Steins in a subdivision of the E-type class with objects like Angelina, Eger, and Nereus. This group is not sampled by the current collection of aubrite meteorites. Interestingly, the reddened aubrite spectrum also provides a good match to the Steins VNIR spectrum

Relationship between non-thermal electron energy spectra and GOES classes

We investigate the influence of the variations of energy spectrum of non-thermal electrons on the resulting GOES classes of solar flares. Twelve observed flares with various soft to hard X-ray emission ratios were modelled using different non-thermal electron energy distributions. Initial values of the flare physical parameters including geometrical properties were estimated using observations. We found that, for a fixed total energy of non-thermal electrons in a flare, the resulting GOES class of the flare can be changed significantly by varying the spectral index and low energy cut-off of the non-thermal electron distribution. Thus, the GOES class of a flare depends not only on the total non-thermal electrons energy but also on the electron beam parameters. For example, we were able to convert a M2.7 class solar flare into a merely C1.4 class one and a B8.1 class event into a C2.6 class flare. The results of our work also suggest that the level of correlation between the cumulative time integral of HXR and SXR fluxes can depend on the considered HXR energy range.Comment: 8 pages, 5 figures, Astronomy and Astrophysics (accepted, March 2009

Ultraviolet and visible photometry of asteroid (21) Lutetia using the Hubble Space Telescope

The asteroid (21) Lutetia is the target of a planned close encounter by the Rosetta spacecraft in July 2010. To prepare for that flyby, Lutetia has been extensively observed by a variety of astronomical facilities. We used the Hubble Space Telescope (HST) to determine the albedo of Lutetia over a wide wavelength range, extending from ~150 nm to ~700 nm. Using data from a variety of HST filters and a ground-based visible light spectrum, we employed synthetic photometry techniques to derive absolute fluxes for Lutetia. New results from ground-based measurements of Lutetia's size and shape were used to convert the absolute fluxes into albedos. We present our best model for the spectral energy distribution of Lutetia over the wavelength range 120-800 nm. There appears to be a steep drop in the albedo (by a factor of ~2) for wavelengths shorter than ~300 nm. Nevertheless, the far ultraviolet albedo of Lutetia (~10%) is considerably larger than that of typical C-chondrite material (~4%). The geometric albedo at 550 nm is 16.5 +/- 1%. Lutetia's reflectivity is not consistent with a metal-dominated surface at infrared or radar wavelengths, and its albedo at all wavelengths (UV-visibile-IR-radar) is larger than observed for typical primitive, chondritic material. We derive a relatively high FUV albedo of ~10%, a result that will be tested by observations with the Alice spectrograph during the Rosetta flyby of Lutetia in July 2010.Comment: 14 pages, 2 tables, 8 figure