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Author(s): Brazier, Ellen; Maruri, Fernanda; Duda, Stephany N; Tymejczyk, Olga; Wester, C William; Somi, Geoffrey; Ross, Jeremy; Freeman, Aimee; Cornell, Morna; Poda, Armel; Musick, Beverly S; Zhang, Fujie; Althoff, Keri N; Mugglin, Catrina; Kimmel, April D; Yotebieng, Marcel; Nash, Denis; IeDEA Consortium | Abstract: IntroductionSince 2015, the World Health Organization (WHO) has recommended that all people living with HIV (PLHIV) initiate antiretroviral treatment (ART), irrespective of CD4+ count or clinical stage. National adoption of universal treatment has accelerated since WHO's 2015 "Treat All" recommendation; however, little is known about the translation of this guidance into practice. This study aimed to assess the status of Treat All implementation across regions, countries, and levels of the health care delivery system.MethodsBetween June and December 2017, 201/221 (91%) adult HIV treatment sites that participate in the global IeDEA research consortium completed a survey on capacity and practices related to HIV care. Located in 41 countries across seven geographic regions, sites provided information on the status and timing of site-level introduction of Treat All, as well as site-level practices related to ART initiation.ResultsAlmost all sites (93%) reported that they had begun implementing Treat All, and there were no statistically significant differences in site-level Treat All introduction by health facility type, urban/rural location, sector (public/private) or country income level. The median time between national policy adoption and site-level introduction was one month. In countries where Treat All was not yet adopted in national guidelines, 69% of sites reported initiating all patients on ART, regardless of clinical criteria, and these sites had been implementing Treat All for a median period of seven months at the time of the survey. The majority of sites (77%) reported typically initiating patients on ART within 14ndays of confirming diagnosis, with 60% to 62% of sites implementing Treat All in East, Southern and West Africa reporting same-day ART initiation for most patients.ConclusionsBy mid- to late-2017, the Treat All strategy was the standard of care at almost all IeDEA sites, including rural, primary-level health facilities in low-resource settings. While further assessments of site-level capacity to provide high-quality HIV care under Treat All and to support sustained viral suppression after ART initiation are needed, the widespread introduction of Treat All at the service delivery level is a critical step towards global targets for ending the HIV epidemic as a public health threat.

Background Individuals with two copies of the apolipoprotein-1 (APOL1) gene risk variants are at high risk (HR) for non-diabetic kidney disease. The presence of these risk variants is highest in West Africa, specifically in Nigeria. However, there is limited availability of dialysis and kidney transplantation in Nigeria, and most individuals will die soon after developing end-stage renal disease. Blocking the renin angiotensin aldosterone system with angiotensin-converting enzyme inhibitors (ACEi) is a well-recognized strategy to slow renal disease progression in patients with diabetes mellitus with chronic kidney disease (CKD) and in patients with HIV-associated nephropathy. We propose to determine whether presence of the APOL1 HR genotype alters or predicts responsiveness to conventional therapy to treat or prevent CKD and if addition of an ACEi to standard combination antiretroviral therapy (ART) reduces the risk of kidney complications among non-diabetic Nigerian adults. Methods/design We will screen 2600 HIV-positive adults who have received ART to (1) determine the prevalence of APOL1 risk variants and assess whether APOL1 HR status correlates with prevalent albuminuria, estimated glomerular filtration rate (eGFR), and/or prevalent CKD; (2) assess, via a randomized, placebo-controlled trial (RCT) in a subset of these participants with microalbuminura (n = 280) whether addition of the ACEi, lisinopril, compared to standard of care, significantly reduces the incidence or progression of albuminuria; and (3) determine whether the APOL1 HR genotype is associated with worse kidney outcomes (i.e. eGFR slope or regression of albuminuria) among participants in the RCT. Conclusions This study will examine the increasing prevalence of kidney diseases in HIV-positive adults in a West African population, and the relationship between these diseases and the APOL1 high-risk genotype. By evaluating the addition of an ACEi to the care of individuals with HIV infection who have albuminuria, our trial will provide definitive evidence to guide strategies for management and clinical care in this population, with the goal of reducing HIV-related kidney complications. Trial registration ClinicalTrials.gov, NCT03201939. Registered on 26 August 2016. Electronic supplementary material The online version of this article (10.1186/s13063-019-3436-y) contains supplementary material, which is available to authorized users.

We present the design for the first narrowband filter NB964 for the Dark Energy Camera (DECam), which is operated on the 4m Blanco Telescope at the Cerro Tololo Inter-American Observatory. The NB964 filter profile is essentially defined by maximizing the power of searching for Lyman alpha emitting galaxies (LAEs) in the epoch of reionization, with the consideration of the night sky background in the near-infrared and the DECam quantum efficiency. The NB964 filter was manufactured by Materion in 2015. It has a central wavelength of 964.2 nm and a full width at half maximum (FWHM) of 9.2 nm. An NB964 survey named LAGER (Lyman Alpha Galaxies in the Epoch of Reionization) has been ongoing since December 2015. Here we report results of lab tests, on-site tests and observations with the NB964 filter. The excellent performances of this filter ensure that the LAGER project is able to detect LAEs at z~7 with a high efficiency., 12 pages, 12 figures, submitted to PASP

We present griz light curves of 251 Type Ia Supernovae (SNe Ia) from the first 3 years of the Dark Energy Survey Supernova Program's (DES-SN) spectroscopically classified sample. The photometric pipeline described in this paper produces the calibrated fluxes and associated uncertainties used in the cosmological parameter analysis (Brout et al. 2018-SYS, DES Collaboration et al. 2018) by employing a scene modeling approach that simultaneously forward models a variable transient flux and temporally constant host galaxy. We inject artificial point sources onto DECam images to test the accuracy of our photometric method. Upon comparison of input and measured artificial supernova fluxes, we find flux biases peak at 3 mmag. We require corrections to our photometric uncertainties as a function of host galaxy surface brightness at the transient location, similar to that seen by the DES Difference Imaging Pipeline used to discover transients. The public release of the light curves can be found at https://des.ncsa.illinois.edu/releases/sn., Comment: 12 Pages, 8 Figures, Submitted to ApJ, Comments welcome

Transneptunian objects (TNOs) are a source of invaluable information to access the history and evolution of the outer solar system. However, observing these faint objects is a difficult task. As a consequence, important properties such as size and albedo are known for only a small fraction of them. Now, with the results from deep sky surveys and the Gaia space mission, a new exciting era is within reach as accurate predictions of stellar occultations by numerous distant small solar system bodies become available. From them, diameters with kilometer accuracies can be determined. Albedos, in turn, can be obtained from diameters and absolute magnitudes. We use observations from the Dark Energy Survey (DES) from November 2012 until February 2016, amounting to 4292847 CCD frames. We searched them for all known small solar system bodies and recovered a total of 202 TNOs and Centaurs, 63 of which have been discovered by the DES collaboration until the date of this writing. Their positions were determined using the Gaia Data Release 2 as reference and their orbits were refined. Stellar occultations were then predicted using these refined orbits plus stellar positions from Gaia. These predictions are maintained, and updated, in a dedicated web service. The techniques developed here are also part of an ambitious preparation to use the data from the Large Synoptic Survey Telescope (LSST), that expects to obtain accurate positions and multifilter photometry for tens of thousands of TNOs., 25 pages, submitted to Astronomical Journal

We present the first cosmological parameter constraints using measurements of type Ia supernovae (SNe Ia) from the Dark Energy Survey Supernova Program (DES-SN). The analysis uses a subsample of 207 spectroscopically confirmed SNe Ia from the first three years of DES-SN, combined with a low-redshift sample of 122 SNe from the literature. Our "DES-SN3YR" result from these 329 SNe Ia is based on a series of companion analyses and improvements covering SN Ia discovery, spectroscopic selection, photometry, calibration, distance bias corrections, and evaluation of systematic uncertainties. For a flat LCDM model we find a matter density Ωm = 0.331 +_ 0.038. For a flat wCDM model, and combining our SN Ia constraints with those from the cosmic microwave background (CMB), we find a dark energy equation of state w = -0.978 +_ 0.059, and Ωm = 0.321 +_ 0.018. For a flat w0 w aCDM model, and combining probes from SN Ia, CMB and baryon acoustic oscillations, we find w0 = -0.885 +_ 0.114 and wa = -0.387 +_ 0.430. These results are in agreement with a cosmological constant and with previous constraints using SNe Ia (Pantheon, JLA).

Thirty five years after the identification of the human immunodeficiency virus (HIV) as the etiologic agent for AIDS, there are still no effective vaccines and no sterilizing cures. Fortunately, combination antiretroviral therapy (ART) has turned a deadly disease into a manageable, chronic condition. Effective and lifelong antiretroviral therapy is the foundation of the fight to reduce HIV-associated morbidity and mortality, and to improve the quality of life for the estimated 36.9 million persons living with HIV. Increasingly, antiretroviral medications also are being used to protect HIV-negative individuals from HIV infection. Antiretroviral treatment, however, is associated with numerous toxicities that range from mild to life-threatening and that affect nearly all organ systems. As the number of people on ART increases and the population ages, genetic predictors of toxicities and age-related morbidities due to ART become increasingly critical. HIV/AIDS has been subjected to intensive genetic investigation in an effort to explain the variability in HIV/AIDS, to identify potential targets for therapeutic intervention, and to reveal the genetic basis for interpersonal and inter-population variation in efficacy and toxicities associated with antiretroviral therapies An and Winkler [1]; Aouizerat et al. [145]; Tozzi [31]. These studies have identified a number of genetic variants that are important correlates of HIV pathogenesis and antiretroviral therapy. Whole-genome association studies in the general population have revealed genetic factors associated with metabolic disorders (i.e., type 2 Diabetes mellitus and lipodystrophy); genetic profiling might have utility in the choice of ART regimens to avoid drugs associated with metabolic toxicities. Pharmacogenetics is just beginning to be incorporated into clinical practice, most notably screening for HLA-B*5701, which is associated with abacavir hypersensitivity reaction. Pharmacogenetics is also being applied to drug selection at the population level particularly in resource-limited settings, based in part on the population prevalence of fast and slow metabolizing variants in a given geographic region or among specific human populations. Here we review the role of pharmacogenetics and pharmacogenomics in HIV therapy and drug-related toxicities, the utility of genetic screening for personalized HIV care, and what is needed to bring personalized, genetics-informed care to the clinic.

BACKGROUND Prior studies found overweight or obese HIV-infected individuals had greater early CD4 cell recovery on antiretroviral therapy (ART), but the results have been inconsistent. We assessed the longitudinal relationship between body mass index (BMI) and CD4 cell recovery on ART in a large, multisite cohort to identify potential physiologic links between adiposity and CD4 cell expansion. METHODS We modeled the relationship of time-updated BMI with CD4 count in patients starting ART from 17 North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) cohorts. The primary analysis used a linear mixed effects model incorporating up to 13 years of data per patient and adjusted for age, sex, race, ART regimen, baseline CD4 count and other covariates. Sensitivity analyses limited the cohort to patients with sustained viral suppression or censored at virologic failure. RESULTS Fourteen thousand eighty-four HIV-infected individuals initiating ART contributed data between 1998 and 2010. Time-updated BMI was significantly associated with CD4 cell recovery over time (P < 0.001). After 5 years of ART, the mean CD4 count at a BMI of 30 kg/m was 22% higher than at a BMI of 22 kg/m (606 vs. 498 cells per microliter) and 34% higher at a BMI of 40 kg/m (665 vs. 498 cells per microliter). Results were similar in the sensitivity analyses. DISCUSSION Higher BMI is associated with long-term advantages in immune recovery on ART. Although it is unclear if this impacts health outcomes, including balancing the negative health effects of obesity, elucidating the underlying mechanism could identify therapies for patients with suboptimal immune reconstitution.

Antiretroviral therapy (ART) and retention in care are essential for the prevention of mother-to-child HIV transmission (PMTCT). We aimed to assess the effect of a family-focused, integrated PMTCT care package.In this parallel, cluster-randomised controlled trial, we pair-matched 12 primary and secondary level health-care facilities located in rural north-central Nigeria. Clinic pairs were randomly assigned to intervention or standard of care (control) by computer-generated sequence. HIV-infected women (and their infants) presenting for antenatal care or delivery were included if they had unknown HIV status at presentation (there was no age limit for the study, but the youngest participant was 16 years old); history of antiretroviral prophylaxis or treatment, but not receiving these at presentation; or known HIV status but had never received treatment. Standard of care included health information, opt-out HIV testing, infant feeding counselling, referral for CD4 cell counts and treatment, home-based services, antiretroviral prophylaxis, and early infant diagnosis. The intervention package added task shifting, point-of-care CD4 testing, integrated mother and infant service provision, and male partner and community engagement. The primary outcomes were the proportion of eligible women who initiated ART and the proportion of women and their infants retained in care at 6 weeks and 12 weeks post partum (assessed by generalised linear mixed effects model with random effects for matched clinic pairs). The trial is registered with ClinicalTrials.gov, number NCT01805752.Between April 1, 2013, and March 31, 2014, we enrolled 369 eligible women (172 intervention, 197 control), similar across groups for marital status, duration of HIV diagnosis, and distance to facility. Median CD4 count was 424 cells per μL (IQR 268-606) in the intervention group and 314 cells per μL (245-406) in the control group (p0·0001). Of the 369 women included in the study, 363 (98%) had WHO clinical stage 1 disease, 364 (99%) had high functional status, and 353 (96%) delivered vaginally. Mothers in the intervention group were more likely to initiate ART (166 [97%] vs 77 [39%]; adjusted relative risk 3·3, 95% CI 1·4-7·8). Mother and infant pairs in the intervention group were more likely to be retained in care at 6 weeks (125 [83%] of 150 vs 15 [9%] of 170; adjusted relative risk 9·1, 5·2-15·9) and 12 weeks (112 [75%] of 150 vs 11 [7%] of 168 pairs; 10·3, 5·4-19·7) post partum.This integrated, family-focused PMTCT service package improved maternal ART initiation and mother and infant retention in care. An effective approach to improve the quality of PMTCT service delivery will positively affect global goals for the elimination of mother-to-child HIV transmission.Eunice Kennedy Shriver National Institute of Child Health and Human Development and US National Institutes of Health.

A search for the exotic meson X(5568) decaying into the B_{s}^{0}π^{±} final state is performed using data corresponding to 9.6 fb^{-1} from pp[over ¯] collisions at sqrt[s]=1960 GeV recorded by the Collider Detector at Fermilab. No evidence for this state is found and an upper limit of 6.7% at the 95% confidence level is set on the fraction of B_{s}^{0} produced through the X(5568)→B_{s}^{0}π^{±} process.

INTRODUCTION Integration of services to screen and manage mental health and substance use disorders (MSDs) into HIV care settings has been identified as a promising strategy to improve mental health and HIV treatment outcomes among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). Data on the extent to which HIV treatment sites in LMICs screen and manage MSDs are limited. The objective of this study was to assess practices for screening and treatment of MSDs at HIV clinics in LMICs participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. METHODS We surveyed a stratified random sample of 95 HIV clinics in 29 LMICs in the Caribbean, Central and South America, Asia-Pacific and sub-Saharan Africa. The survey captured information onsite characteristics and screening and treatment practices for depression, post-traumatic stress disorder (PTSD), substance use disorders (SUDs) and other mental health disorders. RESULTS Most sites (n = 76, 80%) were in urban areas. Mental health screening varied by disorder: 57% of sites surveyed screened for depression, 19% for PTSD, 55% for SUDs and 29% for other mental health disorders. Depression, PTSD, SUDs and other mental health disorders were reported as managed on site (having services provided at the HIV clinic or same health facility) at 70%, 51%, 41% and 47% of sites respectively. Combined availability of screening and on-site management of depression, PTSD, and SUDs, and other mental health disorders was reported by 42%, 14%, 26% and 19% of sites, respectively. On-site management of depression and PTSD was reported significantly less often in rural as compared to urban settings (depression: 33% and 78% respectively; PTSD: 24% and 58% respectively). Screening for depression and SUDs was least commonly reported by HIV programmes that treated only children as compared to HIV programmes that treated only adults or treated both adults and children. CONCLUSIONS Significant gaps exist in the management of MSDs in HIV care settings in LMICs, particularly in rural settings. Identification and evaluation of optimal implementation strategies to scale and sustain integrated MSDs and HIV care is needed.

Using stellar population models, we predicted that the Dark Energy Survey (DES) - due to its special combination of area (5000 deg. sq.) and depth ($i = 24.3$) - would be in the position to detect massive ($\gtrsim 10^{11}$ M$_{\odot}$) galaxies at $z \sim 4$. We confront those theoretical calculations with the first $\sim 150$ deg. sq. of DES data reaching nominal depth. From a catalogue containing $\sim 5$ million sources, $\sim26000$ were found to have observed-frame $g-r$ vs $r-i$ colours within the locus predicted for $z \sim 4$ massive galaxies. We further removed contamination by stars and artefacts, obtaining 606 galaxies lining up by the model selection box. We obtained their photometric redshifts and physical properties by fitting model templates spanning a wide range of star formation histories, reddening and redshift. Key to constrain the models is the addition, to the optical DES bands $g$, $r$, $i$, $z$, and $Y$, of near-IR $J$, $H$, $K_{s}$ data from the Vista Hemisphere Survey. We further applied several quality cuts to the fitting results, including goodness of fit and a unimodal redshift probability distribution. We finally select 233 candidates whose photometric redshift probability distribution function peaks around $z\sim4$, have high stellar masses ($\log($M$^{*}$/M$_{\odot})\sim 11.7$ for a Salpeter IMF) and ages around 0.1 Gyr, i.e. formation redshift around 5. These properties match those of the progenitors of the most massive galaxies in the local universe. This is an ideal sample for spectroscopic follow-up to select the fraction of galaxies which is truly at high redshift. These initial results and those at the survey completion, which we shall push to higher redshifts, will set unprecedented constraints on galaxy formation, evolution, and the re-ionisation epoch., Comment: 24 pages (41 with appendix), 16 figures, MNRAS in press

We perform a systematic search for long-term extreme variability quasars (EVQs) in the overlapping Sloan Digital Sky Survey (SDSS) and 3-Year Dark Energy Survey (DES) imaging, which provide light curves spanning more than 15 years. We identified ~1000 EVQs with a maximum g band magnitude change of more than 1 mag over this period, about 10% of all quasars searched. The EVQs have L_bol~10^45-10^47 erg/s and L/L_Edd~0.01-1. Accounting for selection effects, we estimate an intrinsic EVQ fraction of ~30-50% among all g, Comment: submitted to ApJ; comments welcome

Vanderbilt University affiliate Friends in Global Health was funded in 2008 to support comprehensive HIV/AIDS services in north-central Nigeria. We summarise programme characteristics and trends in enrolment and quality of data collection in this rural, resource-limited environment.We used routinely collected programme data in supported sites from June 1 2009 to September 30, 2013.Baseline characteristics were defined as those collected closest to a 90-day window period before and after enrolment. Summary characteristics were compared by site and enrolment year.We enrolled 3,960 HIV-infected patients into care (68% women), median age of 32 years [interquartile range (IQR): 27-40]. Most clients were married (79%) and unemployed (60%). At enrolment, median CD4+ cell count was 230 cells/μL (IQR: 114-390) and haemoglobin was 10.7 g/dL (IQR: 9.3-11.9). Advanced clinical disease [World Health Organization (WHO) clinical stage III/IV] at enrolment was documented in 29% of clients. Cumulative enrolment increased from 377 patients in 2009 to 3,960 patients by 2013.With each successive year, more clients were enrolled at earlier stages of disease; in 2009, 37% of patients were identified as WHO clinical stage I, while in 2013, 55% of patients were so classified. While documentation of clinical staging remained stable, the completeness of CD4+ cell count and haemoglobin data declined with time.Expanded testing in a comprehensive HIV programme in rural Nigeria brought persons to care at earlier stages of illness. Yet, as clinical services expanded, data collection quality declined. The paradox of successful scaling up HIV services but deteriorating quality of data underscores the importance of data management training and quality improvement efforts.

We characterize the variation in photometric response of the Dark Energy Camera (DECam) across its 520~Mpix science array during 4 years of operation. These variations are measured using high signal-to-noise aperture photometry of $>10^7$ stellar images in thousands of exposures of a few selected fields, with the telescope dithered to move the sources around the array. A calibration procedure based on these results brings the RMS variation in aperture magnitudes of bright stars on cloudless nights down to 2--3 mmag, with 1 mmag are plausibly attributable to spatial/temporal variations in aperture corrections. These variations can be inferred and corrected by measuring the fraction of stellar light in an annulus between 6" and 8" diameter. Key elements of this calibration include: correction of amplifier nonlinearities; distinguishing pixel-area variations and stray light from quantum-efficiency variations in the flat fields; field-dependent color corrections; and the use of an aperture-correction proxy. The DECam response pattern across the 2-degree field drifts over months by up to $\pm7$ mmag, in a nearly-wavelength-independent low-order pattern. We find no fundamental barriers to pushing global photometric calibrations toward mmag accuracy., Submitted to PASP

We report the discovery of a new quasar: SDSS J022155.26-064916.6. This object was discovered while reducing spectra of a sample of stars being considered as spectrophotometric standards for the Dark Energy Survey. The flux and wavelength calibrated spectrum is presented with four spectral lines identified. From these lines, the redshift is determined to be z is approximately equal to 0.806. In addition, the rest-frame u-, g-, and r-band luminosity, determined using a k-correction obtained with synthetic photometry of a proxy QSO, are reported as 7.496 $\times 10^{13}$ solar luminosities, 2.049 $\times 10^{13}$ solar luminosities, and $1.896 \times 10^{13}$ solar luminosities, respectively.

We report the observation and physical characterization of the possible dwarf planet \UZ\ ("DeeDee"), a dynamically detached trans-Neptunian object discovered at 92 AU. This object is currently the second-most distant known trans-Neptunian object with reported orbital elements, surpassed in distance only by the dwarf planet Eris. The object was discovered with an $r$-band magnitude of 23.0 in data collected by the Dark Energy Survey between 2014 and 2016. Its 1140-year orbit has $(a,e,i) = (109~\mathrm{AU}, 0.65, 26.8^{\circ})$. It will reach its perihelion distance of 38 AU in the year 2142. Integrations of its orbit show it to be dynamically stable on Gyr timescales, with only weak interactions with Neptune. We have performed followup observations with ALMA, using 3 hours of on-source integration time to measure the object's thermal emission in the Rayleigh-Jeans tail. The signal is detected at 7$\sigma$ significance, from which we determine a $V$-band albedo of $13.1^{+3.3}_{-2.4}\mathrm{(stat)}^{+2.0}_{-1.4}\mathrm{(sys)}$ percent and a diameter of $635^{+57}_{-61}\mathrm{(stat)}^{+32}_{-39}\mathrm{(sys)}$~km, assuming a spherical body with uniform surface properties., Comment: 13 pages, 4 figures, accepted by ApJ Letters

The coalescence of a binary neutron star (BNS) pair is expected to produce gravitational waves (GW) and electromagnetic (EM) radiation, both of which may be detectable with currently available instruments. We describe a search for a theoretically predicted r-process optical transient from these mergers, dubbed the kilonova (KN), using griz broadband data from the Dark Energy Survey Supernova Program (DES-SN). Some models predict KNe to be redder, shorter-lived, and dimmer than supernovae (SNe), but at present the event rate of KNe is poorly constrained. We simulate observations of KN and SN light curves with the Monte-Carlo simulation code SNANA to optimize selection requirements, determine search efficiency, and predict SN backgrounds. We also perform an analysis using fake point sources on images to account for anomalous efficiency losses from difference-imaging on bright low-redshift galaxies. Our analysis of the first two seasons of DES-SN data results in 0 events, and is consistent with our prediction of 1.1 background events based on simulations of SN. Given our simulation prediction, there is a 33 percent chance of finding 0 events in the data. Assuming no underlying galaxy flux, our search sets 90 percent upper limits on the KN volumetric rate of $1.0\times10^7$ Gpc$^{-3}$ yr$^{-1}$ for the dimmest KN model we consider (peak i-band absolute magnitude $M_i=-11.4$ mag) and $2.4\times10^4$ Gpc$^{-3}$ yr$^{-1}$ for the brightest ($M_i=-16.2$ mag). Accounting for efficiency loss from host galaxy Poisson noise, these limits are 1.1 times higher; accounting for anomalous subtraction artifacts on bright galaxies, these limits are ~3 times higher. While previous KN searches were based on triggered follow-up, this analysis is the first untriggered optical KN search and informs selection requirements and strategies for future KN searches and GW follow-up observations.

Despite efforts to halt mother-to-child transmission of HIV, incident pediatric HIV infections continue to occur, especially in sub-Saharan Africa (SSA). In 2011, 90% of the 390,000 new pediatric HIV cases worldwide were in SSA, and nearly all infections were acquired via vertical transmission.1 The early initiation of HIV-infected infants on antiretroviral therapy (ART) is associated with better clinical and immunological outcomes and improved survival.3-7 Yet early ART initiation in children is only achievable if HIV-infected infants are identified via Early Infant Diagnosis (EID) testing. This task is proving daunting; in 2012, only a third of HIV-exposed infants across reporting countries underwent EID testing.2 EID coverage was even worse in SSA, where 6 of 31 countries reported EID testing rates below 10%, resulting in millions of undiagnosed HIV-exposed infants.2,8 ART coverage among HIV-infected children in 2012 was also approximately half the coverage for adults (34% vs. 64%, respectively).2 Nigeria has the second-largest number of persons living with HIV in the world and is a major contributor to the global epidemic of pediatric HIV/AIDS. Despite an estimated 59,000 children being newly infected with HIV in Nigeria in 2012 alone,2 EID service uptake remains extremely poor.9 Nigeria national guidelines recommend EID testing at 6 weeks postpartum, but HIV-1 DNA PCR testing for EID was performed in only 4% of eligible infants by 2 months of age in 2010.10 ART coverage among HIV-infected Nigerian children in 2010 was also a paltry 12%.2 Low uptake of EID may be due in part to low uptake of antenatal and postnatal care services by pregnant women,11 lack of service availability at rural clinical sites,12 as well as social and educational barriers that limit women’s ability to access these services.13-15 Other contributory factors include: limited number of centralized laboratories with requisite capacity to perform DNA PCR testing, long turn-around times, stock-outs of reagents and consumables, and logistical challenges with getting results back to facilities/healthcare providers. One of the goals of Nigeria’s national PMTCT scale-up plan is to provide at least 90% of all HIV-exposed infants with access to EID services by 2015.16 Accomplishing this goal will require changes to health care delivery that adequately address the mentioned barriers and contributing factors impeding EID uptake in Nigeria. The Vanderbilt Institute for Global Health (VIGH) was funded from 2008-2013 through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to assist in provision of comprehensive HIV/AIDS services in the Federal Capital Territory (FCT, Abuja) and rural parts of Kwara and Niger states in north-central Nigeria. Whereas several studies describing experiences with implementation of EID programs in SSA exist,17-21 there is a dearth of peer-reviewed reports from Nigeria, one of the 22 “Global Plan” focus countries.22 The aim of this study is to describe the characteristics of pregnant women enrolled in HIV care and treatment in VIGH-supported clinics in rural north central Nigeria, characterize those women who bring their HIV-exposed infants for EID, and to determine the maternal correlates associated with initiation of EID. Lessons learnt from rural Nigeria can help inform EID programming, family and community engagement, and quality improvement efforts in similarly challenging environments.

Despite seven years of investment from the President's Emergency Plan For AIDS Relief (PEPFAR), the expansion of human immunodeficiency virus (HIV)-related services continues to challenge Mozambique's health-care infrastructure, especially in the country's rural regions.In 2012, as part of a national acceleration plan for HIV care and treatment, Namacurra district employed a mobile clinic strategy to provide temporary manpower and physical space to expand services at four rural peripheral clinics. This paper describes the strategy deployed, the uptake of services and the key lessons learnt in the first 18 months of implementation.In 2012, Namacurra´s adult population was estimated to be 125,425, and of those 15,803 were estimated to be HIV infected. Although there is consistent government support of antiretroviral therapy (ART) programmes, national coverage remains low, with less than 15% of those eligible having received ART by December 2012.Between April 2012 and September 2013, Namacurra district enrolled 4832 new patients into HIV care and treatment. By using the mobile clinic strategy for ART expansion, the district was able to expand provision of ART from two to six (of a desired seven) clinics by September 2013.Mobile clinic strategies could rapidly expand HIV care and treatment in under-funded settings in ways that both build local capacity and are sustainable for local health systems. The clinics best serve as a transition to improved capacity at fixed-site services.Malgré les 7 années d'investissement du Plan d'urgence du Président des États-Unis d'Amérique pour la lutte contre le SIDA (PEPFAR), l'expansion des services de lutte contre le virus de l'immunodéficience humaine (VIH) est toujours un défi pour les infrastructures de soins de santé du Mozambique, en particulier dans les régions rurales du pays.En 2012, dans le cadre d'un plan d'accélération pour les soins et le traitement contre le VIH, le district de Namacurra a utilisé une stratégie de dispensaires mobiles pour fournir une main-d'œuvre temporaire et de l'espace physique afin d'étendre les services de lutte contre le VIH à 4 dispensaires périphériques ruraux. Cet article décrit la stratégie déployée, l'assimilation de ces services et les principaux enseignements tirés au cours des 18 premiers mois de mise en œuvre.En 2012, la population adulte de Namacurra était estimée à 125 425 personnes, et on estimait que 15 803 d'entre elles étaient infectées par le VIH. Malgré un soutien constant des programmes de traitement antirétroviral (TAR) de la part du gouvernement, la couverture nationale reste faible, avec moins de 15% des personnes éligibles ayant reçu un TAR en décembre 2012.Entre avril 2012 et septembre 2013, le district de Namacurra a inscrit 4832 nouveaux patients au programme de soins et de traitement contre le VIH. En utilisant la stratégie de dispensaires mobiles pour étendre le TAR, le district a pu développer la fourniture de TAR de 2 à 6 dispensaires (pour un nombre souhaité de 7) en septembre 2013.Les stratégies de dispensaires mobiles pourraient rapidement étendre les soins et les traitements contre le VIH dans les endroits sous-financés par des moyens qui renforcent les capacités locales et qui sont durables pour les systèmes de santé locaux. Les dispensaires servent au mieux de transition vers l'amélioration des capacités dans les services de site fixe.A pesar de los siete años de inversión del Plan de Emergencia del Presidente de los Estados Unidos de América para luchar contra el SIDA (PEPFAR), la expansión de los servicios relacionados con el virus de la inmunodeficiencia humana (VIH) continúa suponiendo un desafío para la infraestructura sanitaria de Mozambique, especialmente en las regiones rurales del país.En 2012, como parte de un plan de aceleración nacional para el cuidado y tratamiento del VIH, el distrito de Namacurra empleó una estrategia clínica móvil para suministrar mano de obra y espacio físico temporales para expandir los servicios a cuatro clínicas periféricas rurales. Este documento describe la estrategia empleada, la comprensión de servicios y las lecciones clave aprendidas en los primeros 18 meses de implementación.En 2012, la población adulta estimada de Namacurra era de 125 425 y de estas personas se estimaba que 15 803 estaban infectadas con el VIH. A pesar de haber un constante apoyo gubernamental de los programas de tratamiento antirretroviral (TAR), la cobertura nacional sigue siendo baja, menos de un 15 % de las personas seleccionadas habían recibido TAR antes de diciembre de 2012.Entre abril de 2012 y septiembre de 2013, el distrito de Namacurra inscribió a 4832 nuevos pacientes en el cuidado y tratamiento del VIH. Mediante el uso de la estrategia de la clínica móvil para la expansión de TAR, el distrito pudo expandir las provisiones de TAR de dos a seis clínicas (de las siete deseadas) antes de septiembre de 2013.Las estrategias de las clínicas móviles podrían expandir rápidamente el cuidado y tratamiento del VIH en situaciones de poca financiación de forma que crean capacidad local y sean sostenibles para los sistemas sanitarios locales. Las clínicas sirven de la mejor manera como transición a la capacidad mejorada en servicios en lugares fijos.رغم مرور سبعة أعوام من الاستثمار على خطة الرئيس الطارئة للإغاثة من مرض الإيدز (PEPFAR)، ما زال التوسع في الخدمات ذات الصلة بفيروس العوز المناعي البشري يشكل تحدياً للبنية الأساسية للرعاية الصحية في موزامبيق، لا سيما في المناطق الريفية من البلد.في عام 2012، استخدمت مقاطعة ناماكورا استراتيجية العيادات المتنقلة، كجزء من خطة التسريع الوطنية لرعاية فيروس العوز المناعي البشري وعلاجه، لتوفير القوة العاملة المؤقتة والمساحة المادية لتوسيع الخدمات في أربع عيادات ريفية. وتتناول هذه الورقة بالوصف الاستراتيجية التي تم نشرها والاستفادة من الخدمات والدروس الرئيسية المستفادة في أول 18 شهراً من التنفيذ.في عام 2012، كان عدد السكان في سن البلوغ في ناماكورا وفق التقديرات 125425 نسمة، وكان من بينهم 15803 شخصاً مصابين بعدوى فيروس العوز المناعي البشري. ورغم الدعم المتسق المقدم من الحكومة لبرامج العلاج بمضادات الفيروسات القهقرية، لا تزال التغطية الوطنية منخفضة، حيث حصل أقل من 15 % فقط من المؤهلين على العلاج بمضادات الفيروسات القهقرية بحلول كانون الأول/ ديسمبر 2012.بين نيسان/ أبريل 2012 وأيلول/ سبتمبر 2013 سجلت مقاطعة ناماكورا 4832 مريضاً جديداً في رعاية فيروس العوز المناعي البشري وعلاجه. وعن طريق استخدام استراتيجية العيادات المتنقلة لتوسيع العلاج بمضادات الفيروسات القهقرية، تمكنت المقاطعة من توسيع نطاق توفير العلاج بمضادات الفيروسات القهقرية من عيادتين إلى ست عيادات (من أصل سبع عيادات مرجوة) بحلول أيلول/ سبتمبر 2013.تتمتع استراتيجيات العيادات المتنقلة بالقدرة على توسيع نطاق رعاية فيروس العوز المناعي البشري وعلاجه على نحو سريع في المناطق منخفضة التمويل بطرق يمكنها بناء القدرة المحلية وتتمتع بالاستدامة بالنسبة للنظم الصحية المحلية. وتمثل العيادات تحولاً إلى تحسين القدرة في خدمات المواقع الثابتة.尽管获得总统防治艾滋病紧急救援计划（PEPFAR）七年的投资，莫桑比克的医疗基础设施依然面临着扩大艾滋病毒（HIV）相关服务的挑战，在该国的农村地区尤其如此。在2012年，作为全国性HIV护理和治疗加速计划的组成部分，纳玛库拉（Namacurra）地区采用移动诊所策略来提供临时人力和物理空间，以扩大四个农村外围诊所的服务。本文介绍了在开始18个月的实施过程中部署的战略、提供的服务和吸取的关键经验教训。2012年，纳玛库拉成年人口估计为125425人，其中估计有15803人受到艾滋病毒的感染。虽然始终有抗逆转录病毒疗法（ART）项目的政府支持，但是这种治疗的全国覆盖率仍然很低，到2012年12月，有资格获得这种治疗的人群中仅有不到15%的人接受了ART的治疗。在2012年4月至2013年9月，纳玛库拉地区招募了4832名新病人接受艾滋病护理和治疗。通过使用移动诊所战略进行ART扩展，该地区能够将ART治疗的提供点从两个诊所增加到2013年9月的六个（预期需要七个）。流动诊所策略可以迅速扩大资金短缺地区艾滋病的护理和治疗，其采取的方式既有利于建设本地能力，对当地卫生系统也是可持续的。这些诊所是改进固定网点服务能力的最好过渡形式。Несмотря на инвестиции, которые в течение семи лет выделялись в рамках Чрезвычайного плана Президента США по борьбе со СПИДом (PEPFAR), распространение услуг по борьбе с вирусом иммунодефицита человека (ВИЧ) продолжает оставаться проблемой для инфраструктуры здравоохранения Мозамбика, особенно в сельских регионах страны.В 2012 году в рамках Национального плана по активизации ухода и лечения ВИЧ-инфекции в районе Намакурра была использована стратегия передвижных клиник, которые предоставляли временный персонал и физическое пространство для расширения ассортимента услуг в четырех сельских периферийных клиниках. В этой статье описывается использованная стратегия, потребление услуг и главные уроки, извлеченные в ходе первых 18 месяцев реализации стратегии.В 2012 году взрослое население Намакурры оценивалось в 125 425 человек, из которых 15 803 человека, по оценкам, были инфицированы ВИЧ. Несмотря на постоянную государственную поддержку программ антиретровирусной терапии (АРТ), охват населения на национальном уровне остается низким, и менее чем 15% населения, имеющего право на АРТ, получили лечение к декабрю 2012 года.В период с апреля 2012 года по сентябрь 2013 года в районе Намакурра 4832 новых пациента были зачислены для участия в программе ухода и лечения ВИЧ. Используя стратегию передвижных клиник для расширения охвата АРТ, район смог расширить предоставление АРТ с двух до шести (из желаемых семи) клиник к сентябрю 2013 года.Стратегии передвижных клиник могут быстро расширить охват услугами ухода и лечения ВИЧ в условиях недостаточного финансирования таким путем, какой позволит нарастить местный потенциал, и являются рациональными для местных систем здравоохранения. Такие клиники являются наилучшим средством перехода к улучшенному потенциалу оказания услуг на базе стационарных учреждений.

Current trends in HIV/AIDS research in sub-Saharan Africa (SSA) highlight socially and culturally sensitive interventions that mobilize community members and resources for universal access to HIV prevention, treatment, and care services. These factors are particularly important when addressing the complex social and cultural nature of implementing services for prevention of mother-to-child transmission of HIV (PMTCT). Across the globe approximately 34 % fewer children were infected with HIV through the perinatal or breastfeeding route in 2011 (est. 330,000) than in 2001 (est. 500,000), but ongoing mother-to-child HIV transmission is concentrated in sub-Saharan Africa, where fully 90 % of 2011 cases are estimated to have occurred. Recent literature suggests that PMTCT in Africa is optimized when interventions engage and empower community members, including male partners, to support program implementation and confront the social, cultural and economic barriers that facilitate continued vertical transmission of HIV. In resource-limited settings the feasibility and sustainability of PMTCT programs require innovative approaches to strengthening male engagement by leveraging lessons learned from successful initiatives in SSA. This review presents an overview of studies assessing barriers and facilitators of male participation in PMTCT and new interventions designed to increase male engagement in East, West, and Central Africa from 2000-2013, and examines the inclusion of men in PMTCT programs through the lens of community and facility activities that promote the engagement and involvement of both men and women in transformative PMTCT initiatives.

BACKGROUND: Timely initiation of combination antiretroviral therapy (ART) in eligible HIV-infected patients is associated with substantial reduction in mortality and morbidity. Nigeria has the second largest number of persons living with HIV/AIDS in the world. We examined patient characteristics time to ART initiation retention and mortality at 5 rural facilities in Kwara and Niger states of Nigeria. METHODS: We analyzed program-level cohort data for HIV-infected ART-naive clients (>/=15 years) enrolled from June 2009 to February 2011. We modeled the probability of ART initiation among clients meeting national ART eligibility criteria using logistic regression with splines. RESULTS: We enrolled 1948 ART-naive adults/adolescents into care of whom 1174 were ART eligible (62% female). Only 74% of the eligible patients (n = 869) initiated ART within 90 days after enrollment. The median CD4 count for eligible clients was 156 cells/muL (interquartile range: 81-257) with 67% in WHO stage III/IV disease. Adjusting for CD4 count WHO stage functional status hemoglobin body mass index sex age education marital status employment clinic of attendance and month of enrollment we found that immunosuppression [CD4 350 vs. 200 odds ratio (OR) = 2.10 95% confidence interval (CI): 1.31 to 3.35] functional status [bedridden vs. working OR = 4.17 (95% CI: 1.63 to 10.67)] clinic of attendance [Kuta Hospital vs. referent: OR = 5.70 (95% CI: 2.99 to 10.89)] and date of enrollment [December 2010 vs. June 2009: OR = 2.13 (95% CI: 1.19 to 3.81)] were associated with delayed ART initiation. CONCLUSIONS: Delayed initiation of ART was associated with higher CD4 counts lower functional status clinic of attendance and later dates of enrollment among ART-eligible clients. Our findings provide targets for quality improvement efforts that may help reduce attrition and improve ART uptake in similar settings.

Nigeria has more HIV-infected women who do not receive needed services for the prevention of mother-to-child transmission of HIV (PMTCT) than any other nation in the world. To meet the UNAIDS/WHO goal of eliminating mother-to-child HIV transmission by 2015, multiple interventions will be required to scale up PMTCT services, especially to lower-level, rural health facilities. To address this, we are conducting a cluster-randomized controlled study to evaluate the impact and cost-effectiveness of a novel, family-focused integrated package of PMTCT services. A systematic re-assignment of patient care responsibilities coupled with the adoption of point-of-care CD4 + cell count testing could facilitate the ability of lower-cadre health providers to manage PMTCT care, including the provision and scale-up of antiretroviral therapy (ART) to pregnant women in rural settings. Additionally, as influential community members, male partners could support their partners' uptake of and adherence to PMTCT care. We describe an innovative approach to scaling up PMTCT service provision that incorporates considerations of where and from whom women can access services (task-shifting), ease of obtaining a CD4 + cell count result (point-of-care testing), the degree of HIV service integration for HIV-infected women and their infants, and the level of family and community involvement (specifically male partner involvement). This systematic approach, if proven feasible and effective, could be scaled up in Nigeria and similar resource-limited settings as a means to accelerate progress toward eliminating mother-to-child transmission of HIV and help women with HIV infection take ART and live long, healthy lives (Trial registration: NCT01805752).

Elevated serum levels of inflammatory biomarkers have been associated with increased mortality and morbidity among HIV-infected individuals receiving combination antiretroviral therapy (cART) in European and U.S. cohorts. Few similar data are available from sub-Saharan Africa, where most cART-treated adults reside and the prevalence of advanced immunosuppression and opportunistic infections (OIs) at cART initiation is higher. This was a retrospective nested case-control analysis of clinical trial data from the completed Adult Antiretroviral Treatment and Drug Resistance ("Tshepo") study, 2002-2007, Gaborone, Botswana. We measured pretreatment serum levels of interleukin-6 (IL-6), high sensitivity C-reactive protein, and D-dimer in stored plasma samples from 32 deceased participants (cases) and 64 survivors (controls), matched for age, sex, baseline CD4(+) cell count, and plasma HIV-1 RNA. Multivariate conditional logistic regression analyses were used to compare inflammatory biomarker levels, adjusting for pretreatment body mass index (BMI) and the presence of OIs. A total of 37 (5.7%) of 650 patients died on study, for a crude mortality rate of 20.6/1,000 person-years. Of 37 (86%) study participants who died on study 32 were included in this analysis. Causes of death (n=32) included non-AIDS-defining events (31.3%), HIV-related OIs (28.1%), cART/toxicity-related (21.9%), other infectious etiologies (15.6%), and unknown (3.1%). Median time to death was 31 weeks [interquartile range (IQR) 14-64]. Median baseline levels of all three biomarkers were higher in cases compared to matched controls. After adjusting for BMI and the presence of OIs, only baseline and most recent (near time of event) levels of IL-6 remained as significant predictors of all-cause mortality [adjusted OR (aOR)=1.25, 95% CI (1.05-1.48); p=0.012; and aOR=1.48 (1.05-2.09); p=0.027, respectively]. Serum IL-6 levels are important predictors of all-cause mortality in this adult urban sub-Saharan African cART-treated population. Future translational studies are warranted to better elucidate pathophysiology and inform the design of novel interventions to ameliorate the risk of death among these "at-risk" individuals.

Background Greater adipose tissue is associated with increased circulating high-sensitivity C-reactive protein (hsCRP) levels in HIV-infected adults on antiretroviral therapy (ART), but the relationship between adiposity and other inflammation biomarkers is not well-characterized. Methods We measured total and regional adipose tissue deposits using dual energy X-ray absorptiometry (DXA) and serum levels of interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) receptor 1 and 2, macrophage inflammatory protein-1α (MIP-1α), macrophage chemotactic protein-1 (MCP-1), soluble CD14 and hsCRP in a cohort of adults on long-term ART. Regression models were adjusted for age, sex, CD4+ T-cell count, smoking status, protease-inhibitor-use and daily use of either non-steroidal anti-inflammatory drugs or aspirin. Results The majority (77%) of the 85 study participants were male, median CD4+ T-cell count was 500 cells/ml (IQR 315-734) and median BMI was 25.1 kg/m2 (IQR 22.7-28.1). DXA measurements of total fat mass were positively associated with serum hsCRP (β =1.82, PConclusions Total and regional adiposity was associated with serum hsCRP, but not other inflammatory cytokines shown to predict morbidity and mortality in treated HIV. Greater adiposity is associated with higher MIP-1α and lower soluble CD14 levels, possibly reflecting an important role for cells of the monocyte/macrophage lineage.

Spatially-varying depth and characteristics of observing conditions, such as seeing, airmass, or sky background, are major sources of systematic uncertainties in modern galaxy survey analyses, in particular in deep multi-epoch surveys. We present a framework to extract and project these sources of systematics onto the sky, and apply it to the Dark Energy Survey (DES) to map the observing conditions of the Science Verification (SV) data. The resulting distributions and maps of sources of systematics are used in several analyses of DES SV to perform detailed null tests with the data, and also to incorporate systematics in survey simulations. We illustrate the complementarity of these two approaches by comparing the SV data with the BCC-UFig, a synthetic sky catalogue generated by forward-modelling of the DES SV images. We analyse the BCC-UFig simulation to construct galaxy samples mimicking those used in SV galaxy clustering studies. We show that the spatially-varying survey depth imprinted in the observed galaxy densities and the redshift distributions of the SV data are successfully reproduced by the simulation and well-captured by the maps of observing conditions. The combined use of the maps, the SV data and the BCC-UFig simulation allows us to quantify the impact of spatial systematics on $N(z)$, the redshift distributions inferred using photometric redshifts. We conclude that spatial systematics in the SV data are mainly due to seeing fluctuations and are under control in current clustering and weak lensing analyses. The framework presented here is relevant to all multi-epoch surveys, and will be essential for exploiting future surveys such as the Large Synoptic Survey Telescope (LSST), which will require detailed null-tests and realistic end-to-end image simulations to correctly interpret the deep, high-cadence observations of the sky., 13 pages, 12 figures

Uptake of HIV testing and antiretroviral therapy (ART) services during antenatal care (ANC) in rural Mozambique is disappointing. To nurture supportive male engagement in ANC services, we partnered with traditional birth attendants and trained a new type of male-to-male community health agent, "Male Champions", who focused on counseling male partners to create new, male-friendly community norms around engagement in spousal/partner pregnancies. We assessed ANC service uptake using a pre-post intervention design. The intervention was associated with increases in: (1) uptake of provider-initiated counseling and testing among pregnant woman (81 vs. 92 %; p

We present a measurement of the total WW and WZ production cross sections in pp collision at s=1.96 TeV, in a final state consistent with leptonic W boson decay and jets originating from heavy-flavor quarks from either a W or a Z boson decay. This analysis uses the full data set collected with the CDF II detector during Run II of the Tevatron collider, corresponding to an integrated luminosity of 9.4 fb-1. An analysis of the dijet mass spectrum provides 3.7σ evidence of the summed production processes of either WW or WZ bosons with a measured total cross section of σWW+WZ=13.7±3.9 pb. Independent measurements of the WW and WZ production cross sections are allowed by the different heavy-flavor decay patterns of the W and Z bosons and by the analysis of secondary-decay vertices reconstructed within heavy-flavor jets. The productions of WW and of WZ dibosons are independently seen with significances of 2.9σ and 2.1σ, respectively, with total cross sections of σWW=9.4±4.2 pb and σWZ=3.7-2.2+2.5 pb. The measurements are consistent with standard-model predictions.

Astrophysical Journal Letters 826.2 (2016): L29 reproduced by permission of the AAS, We report the results of a Dark Energy Camera optical follow-up of the gravitational-wave (GW) event GW151226, discovered by the Advanced Laser Interferometer Gravitational-wave Observatory detectors. Our observations cover 28.8 deg2 of the localization region in the i and z bands (containing 3% of the BAYESTAR localization probability), starting 10 hr after the event was announced and spanning four epochs at 2-24 days after the GW detection. We achieve 5σ point-source limiting magnitudes of i ≈ 21.7 and z ≈ 21.5, with a scatter of 0.4 mag, in our difference images. Given the two-day delay, we search this area for a rapidly declining optical counterpart with ≥ 3σ significance steady decline between the first and final observations. We recover four sources that pass our selection criteria, of which three are cataloged active galactic nuclei. The fourth source is offset by 5.8 arcsec from the center of a galaxy at a distance of 187 Mpc, exhibits a rapid decline by 0.5 mag over 4 days, and has a red color of i - z ≈ 0.3 mag. These properties could satisfy a set of cuts designed to identify kilonovae. However, this source was detected several times, starting 94 days prior to GW151226, in the Pan-STARRS Survey for Transients (dubbed as PS15cdi) and is therefore unrelated to the GW event. Given its long-term behavior, PS15cdi is likely a Type IIP supernova that transitioned out of its plateau phase during our observations, mimicking a kilonova-like behavior. We comment on the implications of this detection for contamination in future optical follow-up observations, P.S.C. is grateful for support provided by the NSF through the Graduate Research Fellowship Program, grant DGE1144152. R. J.F. gratefully acknowledges support from NSF grant AST– 1518052 and the Alfred P. Sloan Foundation. D.E.H. was supported by NSF CAREER grant PHY-1151836. He also acknowledges support from the Kavli Institute for Cosmological Physics at the University of Chicago through NSF grant PHY- 1125897 as well as an endowment from the Kavli Foundation. The DES Data Management System is supported by the NSF under grant number AST-1138766. The DES participants from Spanish institutions are partially supported by MINECO under grants AYA2012-39559, ESP2013-48274, FPA2013-47986, and Centro de Excelencia Severo Ochoa SEV-2012-0234. Research leading to these results has received funding from the ERC under the EU’s 7th Framework Programme including grants ERC 240672, 291329,and 306478

Citation: Aaltonen, T., Amerio, S., Amidei, D., Anastassov, A., Annovi, A., Antos, J., . . . Zucchelli, S. (2016). Measurement of sin2 ?eff lept using e+e- pairs from ??/Z bosons produced in pp collisions at a center-of-momentum energy of 1.96 TeV. Physical Review D - Particles, Fields, Gravitation and Cosmology, 93(11). doi:10.1103/PhysRevD.93.112016

et al., A search for a Higgs boson with suppressed couplings to fermions, hf, assumed to be the neutral, lower-mass partner of the Higgs boson discovered at the Large Hadron Collider, is reported. Such a Higgs boson could exist in extensions of the standard model with two Higgs doublets, and could be produced via pp¯→H±hf→W∗hfhf→4γ+X, where H± is a charged Higgs boson. This analysis uses all events with at least three photons in the final state from proton-antiproton collisions at a center-of-mass energy of 1.96 TeV collected by the Collider Detector at Fermilab, corresponding to an integrated luminosity of 9.2 fb−1. No evidence of a signal is observed in the data. Values of Higgs-boson masses between 10 and 100 GeV/c2 are excluded at 95% Bayesian credibility., This work was supported by the U.S. Department of Energy and National Science Foundation; the Italian Istituto Nazionale di Fisica Nucleare; the Ministry of Education, Culture, Sports, Science and Technology of Japan; the Natural Sciences and Engineering Research Council of Canada; the National Science Council of the Republic of China; the Swiss National Science Foundation; the A. P. Sloan Foundation; the Bundesministerium für Bildung und Forschung, Germany; the Korean World Class University Program, the National Research Foundation of Korea; the Science and Technology Facilities Council and the Royal Society, United Kingdom; the Russian Foundation for Basic Research; the Ministerio de Ciencia e Innovación, and Programa Consolider-Ingenio 2010, Spain; the Slovak R&D Agency; the Academy of Finland; the Australian Research Council (ARC); and the EU community Marie Curie Fellowship Contract No. 302103.

Meeting the science goals for many current and future ground-based optical large-area sky surveys requires that the calibrated broadband photometry is stable in time and uniform over the sky to 1% precision or better. Past surveys have achieved photometric precision of 1-2% by calibrating the survey's stellar photometry with repeated measurements of a large number of stars observed in multiple epochs. The calibration techniques employed by these surveys only consider the relative frame-by-frame photometric zeropoint offset and the focal plane position-dependent illumination corrections, which are independent of the source color. However, variations in the wavelength dependence of the atmospheric transmission and the instrumental throughput induce source color-dependent systematic errors. These systematic errors must also be considered to achieve the most precise photometric measurements. In this paper, we examine such systematic chromatic errors using photometry from the Dark Energy Survey (DES) as an example. We define a natural magnitude system for DES and calculate the systematic errors on stellar magnitudes, when the atmospheric transmission and instrumental throughput deviate from the natural system. We conclude that the systematic chromatic errors caused by the change of airmass in each exposure, the change of the precipitable water vapor and aerosol in the atmosphere over time, and the non-uniformity of instrumental throughput over the focal plane, can be up to 2% in some bandpasses. We compare the calculated systematic chromatic errors with the observed DES data. For the test sample data, we correct these errors using measurements of the atmospheric transmission and instrumental throughput. The residual after correction is less than 0.3%. We also find that the errors for non-stellar objects are redshift-dependent and can be larger than those for stars at certain redshifts., 16 pages, 9 figures, AJ accepted

We have developed a crowdsourcing web application for image quality control employed by the Dark Energy Survey. Dubbed the "DES exposure checker", it renders science-grade images directly to a web browser and allows users to mark problematic features from a set of predefined classes. Users can also generate custom labels and thus help identify previously unknown problem classes. User reports are fed back to hardware and software experts to help mitigate and eliminate recognized issues. We report on the implementation of the application and our experience with its over 100 users, the majority of which are professional or prospective astronomers but not data management experts. We discuss aspects of user training and engagement, and demonstrate how problem reports have been pivotal to rapidly correct artifacts which would likely have been too subtle or infrequent to be recognized otherwise. We conclude with a number of important lessons learned, suggest possible improvements, and recommend this collective exploratory approach for future astronomical surveys or other extensive data sets with a sufficiently large user base. We also release open-source code of the web application and host an online demo version at http://des-exp-checker.pmelchior.net, Comment: 12 pages, 7 figures, accepted by Astronomy & Computing

The proportion of overweight and obese adults in the United States and Canada has increased over the past decade, but temporal trends in body mass index (BMI) and weight gain on antiretroviral therapy (ART) among HIV-infected adults have not been well characterized. We conducted a cohort study comparing HIV-infected adults in the North America AIDS Cohort Collaboration on Research and Design (NA-ACCORD) to United States National Health and Nutrition Examination Survey (NHANES) controls matched by sex, race, and age over the period 1998 to 2010. Multivariable linear regression assessed the relationship between BMI and year of ART initiation, adjusting for sex, race, age, and baseline CD4(+) count. Temporal trends in weight on ART were assessed using a generalized least-squares model further adjusted for HIV-1 RNA and first ART regimen class. A total of 14,084 patients from 17 cohorts contributed data; 83% were male, 57% were nonwhite, and the median age was 40 years. Median BMI at ART initiation increased from 23.8 to 24.8 kg/m(2) between 1998 and 2010 in NA-ACCORD, but the percentage of those obese (BMI ≥30 kg/m(2)) at ART initiation increased from 9% to 18%. After 3 years of ART, 22% of individuals with a normal BMI (18.5-24.9 kg/m(2)) at baseline had become overweight (BMI 25.0-29.9 kg/m(2)), and 18% of those overweight at baseline had become obese. HIV-infected white women had a higher BMI after 3 years of ART as compared to age-matched white women in NHANES (p = 0.02), while no difference in BMI after 3 years of ART was observed for HIV-infected men or non-white women compared to controls. The high prevalence of obesity we observed among ART-exposed HIV-infected adults in North America may contribute to health complications in the future.

The Tshepo study was the first clinical trial to evaluate outcomes of adults receiving nevirapine (NVP)-based versus efavirenz (EFV)-based combination antiretroviral therapy (cART) in Botswana. This was a 3 year study (n=650) comparing the efficacy and tolerability of various first-line cART regimens, stratified by baseline CD4(+):200 (low) vs. 201-350 (high). Using targeted maximum likelihood estimation (TMLE), we retrospectively evaluated the causal effect of assigned NNRTI on time to virologic failure or death [intent-to-treat (ITT)] and time to minimum of virologic failure, death, or treatment modifying toxicity [time to loss of virological response (TLOVR)] by sex and baseline CD4(+). Sex did significantly modify the effect of EFV versus NVP for both the ITT and TLOVR outcomes with risk differences in the probability of survival of males versus the females of approximately 6% (p=0.015) and 12% (p=0.001), respectively. Baseline CD4(+) also modified the effect of EFV versus NVP for the TLOVR outcome, with a mean difference in survival probability of approximately 12% (p=0.023) in the high versus low CD4(+) cell count group. TMLE appears to be an efficient technique that allows for the clinically meaningful delineation and interpretation of the causal effect of NNRTI treatment and effect modification by sex and baseline CD4(+) cell count strata in this study. EFV-treated women and NVP-treated men had more favorable cART outcomes. In addition, adults initiating EFV-based cART at higher baseline CD4(+) cell count values had more favorable outcomes compared to those initiating NVP-based cART.

The Cox proportional hazards model or its discrete time analogue, the logistic failure time model, posit highly restrictive parametric models and attempt to estimate parameters which are specific to the model proposed. These methods are typically implemented when assessing effect modification in survival analyses despite their flaws. The targeted maximum likelihood estimation (TMLE) methodology is more robust than the methods typically implemented and allows practitioners to estimate parameters that directly answer the question of interest. TMLE will be used in this paper to estimate two newly proposed parameters of interest that quantify effect modification in the time to event setting. These methods are then applied to the Tshepo study to assess if either gender or baseline CD4 level modify the effect of two cART therapies of interest, efavirenz (EFV) and nevirapine (NVP), on the progression of HIV. The results show that women tend to have more favorable outcomes using EFV while males tend to have more favorable outcomes with NVP. Furthermore, EFV tends to be favorable compared to NVP for individuals at high CD4 levels.

As increasing numbers of persons are placed on potentially life-saving combination antiretroviral therapy (cART) in sub-Saharan Africa, it is imperative to identify the psychosocial and social factors that may influence antiretroviral (ARV) medication adherence. Using an 87 question survey, the following data were collected from patients on cART in Botswana: demographics, performance (Karnofsky) score, perceived stigma and level of HIV disclosure, attitudes and beliefs concerning HIV/AIDS, substance and/or drug use, depression, and pharmacy and healthcare provider-related factors. Overall adherence rates were determined by patient self-report, institutional adherence, and a culturally modified Morisky scale. Three hundred adult patients were recruited between April and May 2005. The overall cART adherence rate was 81.3% based on 4 day and 1 month patient recall and on clinic attendance for ARV medication refills during the previous 3 months. Adults receiving cART for 1–6 months were the least adherent (77%) followed by those receiving cART for greater than 12 months (79%). Alcohol use, depression, and nondisclosure of positive HIV status to their partner were predictive of poor adherence rates (p value

Background—National initiatives offering NNRTI-based combination antiretroviral therapy (cART) have expanded in sub-Saharan Africa (SSA). The Tshepo study is the first clinical trial evaluating the long-term efficacy and tolerability of EFV- vs. NVP-based cART among adults in Botswana. Methods—Three year randomized study (n = 650) using a 3×2×2 factorial design comparing efficacy and tolerability among: A: ZDV/3TC vs. ZDV/ddI vs. d4T/3TC; B: EFV vs. NVP, and C: Com-DOT vs. standard adherence strategies. This manuscript focuses on comparison B. Results—There was no significant difference by assigned NNRTI in time to virologic failure with resistance (log-rank p = 0.14), NVP vs. EFV risk ratio (RR) = 1.54 [0.86-2.70]. Rates of virologic failure with resistance were 9.6% NVP-treated [6.8-13.5] vs. 6.6% EFV-treated [4.2-10.0] at 3 years. Women receiving NVP-based cART trended towards higher virological failure rates when compared to EFV-treated women, Holm-corrected log-rank p = 0.072, NVP vs. EFV RR = 2.22 [0.94-5.00]. 139 patients had 176 treatment modifying toxicities, with shorter time to event in NVP-treated vs. EFV-treated, RR = 1.85 [1.20-2.86], log-rank p = 0.0002. Conclusions—Tshepo-treated patients had excellent overall immunologic and virologic outcomes, and no significant differences were observed by randomized NNRTI comparison. NVPtreated women trended towards higher virologic failure with resistance compared to EFV-treated women. NVP-treated adults had higher treatment modifying toxicity rates when compared to those receiving EFV. NVP-based cART can continue to be offered to women in SSA if routine safety monitoring chemistries are done and the potential risk of EFV-related teratogenicity is considered.

Numerous national antiretroviral (ARV) treatment initiatives offering protease inhibitor-sparing combination antiretroviral therapy (cART) have recently commenced in southern Africa, the first of which began in Botswana in January 2002. Evaluation of the efficacy and tolerability of various protease inhibitor-sparing cART regimens requires intensive study in the region, as does investigation of the development of drug resistance and the optimal means of sustaining adherence. The "Tshepo" Study is the first large-scale, randomized, clinical trial that addresses these important issues among HIV-1 subtype C-infected ARV treatment-naive adults in southern Africa.The Tshepo Study is a completed, open-labeled, randomized study that enrolled 650 ARV-naive adults between December 2002 and 2004. The study is a 3 x 2 x 2 factorial design comparing the efficacy and tolerability among factors: (1) 3 combinations of nucleoside reverse transcriptase inhibitors (NRTIs): zidovudine (ZDV) + lamivudine (3TC), ZDV + didanosine (ddI), and stavudine (d4T) + 3TC; (2) 2 different nonnucleoside reverse transcriptase inhibitors (NNRTIs): nevirapine and efavirenz; and (3) 2 different adherence strategies: the current national "standard of care" versus an "intensified adherence strategy" incorporating a "community-based directly observed therapy." Study patients were stratified into 2 balanced CD4 T-cell count groups: less than 201 versus 201-350 cells per cubic millimeter with viral load greater than 55,000 copies per milliliter. Following Data Safety Monitoring Board recommendations in April 2006, ZDV/ddI-containing arms were discontinued due to inferiority in primary end point, namely, virologic failure with resistance. We report both overall data and pooled data from patients receiving ZDV/ddI- versus ZDV/3TC- and d4T/3TC-containing cART through April 1, 2006.Four hundred fifty-one females (69.4%) and 199 males with a median age of 33.3 years were enrolled into the study. The median follow-up as of April 1, 2006, was 104 weeks, and loss to follow-up rate at 2 years was 4.1%. The median baseline CD4 T-cell count was 199 cells per cubic millimeter [interquartile ratio (IQR) 136-252], and the median plasma HIV-1 RNA level was 193,500 copies per milliliter (IQR 69-250, 472-500). The proportion of participants with virologic failure and genotypic resistance mutations was 11% in those receiving ZDV/ddI-based cART versus 2% in those receiving either ZDV/3TC- or d4T/3TC-based cART (P = 0.002). The median CD4 T-cell count increase at 1 year was 137 cells per cubic millimeter (IQR 74-223) and 199 cells per cubic millimeter (IQR 112-322) at 2 years with significantly lower gain in the ZDV/ddI arm. At 1 and 2 years, respectively, 92.0% and 88.8% of patients had an undetectable plasma HIV-1 RNA level (or = 400 copies/mL). Kaplan-Meier survival estimates at 1 and 2 years were 96.6% and 95.4%. One hundred twenty patients (18.2%) had treatment-modifying toxicities, of which the most common were lipodystrophy, anemia, neutropenia, and Stevens-Johnson syndrome. There was a trend toward difference in time to treatment-modifying toxicity by pooled dual-NRTI combination and no difference in death rates.The preliminary study results show overall excellent efficacy and tolerability of NNRTI-based cART among HIV-1 subtype C-infected adults. ZDV/ddI-containing cART, however, is inferior to the dual NRTIs d4T/3TC or ZDV/3TC when used with an NNRTI for first-line cART.

BACKGROUND: Antiretroviral treatment (ART) initiatives have now been established in many sub-Saharan African countries showing early benefits. To date few results are available concerning long-term clinical outcomes in these treatment programs. METHODS: Response to ART is described in the first HIV-1C-infected adults enrolled in the Botswana Antiretroviral Treatment Program in 2002. Data analysis was conducted on available longitudinal data up to 1st April 2007. RESULTS: Six hundred thirty-three severely immunodeficient patients with a median CD4+ cell count of 67 cells/microl were initiated on non-nucleoside reverse transcriptase inhibitor-based combination ART and followed for a median of 41.9 months. The median CD4+ cell count increases were 169 302 and 337 cells/microl at 1 3 and 5 years respectively. The percentages of patients with a viral load of less than 400 copies/ml at 1 3 and 5 years were 91.3 90.1 and 98.3% respectively. Seventy-five percent of patients did not miss a single or missed only one monthly ART pickup per year with a mean pickup rate of 92.5%. The Kaplan-Meier survival estimates [95% confidence interval (CI)] at 1 3 and 5 years were 82.7% (81.2 and 84.3%) 79.3% (77.6 and 81.0%) and 79.0% (77.3 and 80.7%) respectively. At 6 months the risk of treatment modification for anemia was 6.94% (5.9 and 8.0%) for cutaneous hypersensitivity reactions 1.3% (0.8 and 1.7%) and 1.1% (0.7 and 1.6%) for hepatotoxicity. CONCLUSION: This initial group of adults on ART in Botswana had excellent sustained immunologic virologic and clinical outcomes for up to 5 years of follow-up with low mortality among those surviving into the second year of ART.

In parallel with the rollout of Botswana’s national antiretroviral therapy (ART) program, the Botswana Ministry of Health established the KITSO AIDS Training Program by entering into long-term partnerships with the Botswana–Harvard AIDS Institute Partnership for HIV Research and Education and others to provide standardized, country-specific training in HIV/AIDS care. The KITSO training model has strengthened human capacity within Botswana’s health sector and been indispensable to successful ART rollout. Through core and advanced training courses and clinical mentoring, different cadres of health care workers have been trained to provide high-quality HIV/AIDS care at all ART sites in the country. Continuous and standardized clinical education will be crucial to sustain the present level of care and successfully address future treatment challenges.

Millions of HIV-infected women in developing countries are in need of safe and highly effective antiretroviral therapy. Pregnancy rates are usually high in developing countries and efavirenz (EFV) use in women of childbearing age is of concern because of its potential teratogenicity. As part of a prospective study comparing 6 initial highly active antiretroviral therapy (HAART) regimens 3 of which contained EFV pregnancy and birth outcomes were evaluated among female participants enrolled in a randomized clinical trial in Botswana. Before enrollment all female participants indicated a willingness to avoid pregnancy for the 3-year duration of the study. Monthly urine pregnancy testing and regular contraceptive education and counseling were given to all women on study. Four hundred fifty-one (69.4%) of 650 enrolled study participants were female and experienced 71 pregnancies for a rate of 7.9 per 100 person-years during the study. The mean time from HAART initiation to time of first pregnancy was 385 days. The median birth weight of babies was 2950 g (interquartile range: 2700-3250 g); the gender of babies (24 female and 15 male) and occurrence of early pregnancy loss (42%) and stillbirths (3%) did not differ between EFV- and non-EFV-exposed pregnancies (P = 0.7). First-trimester EFV exposure occurred in 38 (53.5%) of the 71 pregnancies; 22 (57.9%) of these 38 pregnancies resulted in live births. One infant (4.5%) of the 22 EFV-exposed live births had a congenital abnormality with right limb shortening that was assessed to be unrelated to EFV exposure. The restoration of health and longevity in many HAART-treated women is often accompanied by childbearing as evidenced by the large fraction of women in our cohort who became pregnant despite their initial statements of intent to avoid pregnancy. Of 22 first-trimester EFV-exposed live births 1 neonate was found to have a major congenital abnormality; however this defect was unrelated to EFV exposure. The small sample size is insufficient to estimate accurately the underlying risk of congenital malformation after exposure to EFV in early pregnancy underscoring the importance of reporting to the existing international Antiretroviral Pregnancy Registry. In addition to accessing safe and effective HAART regimens HIV-infected women require access to comprehensive family planning services including contraception and procreation counseling. (authors)

Background HIV voluntary counseling and testing (VCT) utilization remains low in many sub-Saharan African countries, particularly in remote rural settings. We sought to identify factors associated with service awareness and service uptake of VCT among female heads of household in rural Zambézia Province of north-central Mozambique which is characterized by high HIV prevalence (12.6%), poverty, and suboptimal health service access and utilization. Methods Our population-based survey of female heads of household was administered to a representative two-stage cluster sample using a sampling frame created for use on all national surveys and based on census results. The data served as a baseline measure for the Ogumaniha project initiated in 2009. Survey domains included poverty, health, education, income, HIV stigma, health service access, and empowerment. Descriptive statistics and logistic regression were used to describe service awareness and service uptake of VCT. Results Of 3708 women surveyed, 2546 (69%) were unaware of available VCT services. Among 1162 women who were aware of VCT, 673 (58%) reported no prior testing. In the VCT aware group, VCT awareness was associated with higher education (aOR = 2.88; 95% CI = 1.61, 5.16), higher income (aOR = 1.41, 95% CI = 1.06, 1.86), higher numeracy (aOR = 1.05, CI 1.03, 1.08), more children

We describe an algorithm for identifying point-source transients and moving objects on reference-subtracted optical images containing artifacts of processing and instrumentation. The algorithm makes use of the supervised machine learning technique known as Random Forest. We present results from its use in the Dark Energy Survey Supernova program (DES-SN), where it was trained using a sample of 898,963 signal and background events generated by the transient detection pipeline. After reprocessing the data collected during the first DES-SN observing season (Sep. 2013 through Feb. 2014) using the algorithm, the number of transient candidates eligible for human scanning decreased by a factor of 13.4, while only 1 percent of the artificial Type Ia supernovae (SNe) injected into search images to monitor survey efficiency were lost, most of which were very faint events. Here we characterize the algorithm's performance in detail, and we discuss how it can inform pipeline design decisions for future time-domain imaging surveys, such as the Large Synoptic Survey Telescope and the Zwicky Transient Facility. An implementation of the algorithm and the training data used in this paper are available at http://portal.nersc.gov/project/dessn/autoscan., Comment: 24 pages, 9 figures, 4 tables v3: added link to training data / implementation

We measure the particle-level forward-backward production asymmetry in b¯b pairs with masses (mb¯b) larger than 150 GeV/c2, using events with hadronic jets and employing jet charge to distinguish b from ¯b. The measurement uses 9.5 fb−1 of p¯p collisions at a center-of-mass energy of 1.96 TeV recorded by the CDF II detector. The asymmetry as a function of mb¯b is consistent with zero, as well as with the predictions of the standard model. The measurement disfavors a simple model including an axigluon with a mass of 200 GeV/c2, whereas a model containing a heavier 345 GeV/c2 axigluon is not excluded., Physical Review D, 92 (3), ISSN:1550-7998, ISSN:0556-2821, ISSN:1550-2368

In industrialized countries, it is recommended that adults with human immunodeficiency virus type 1 (HIV-1) infection undergo baseline screening for pathogens that might cause latent or active infections, such as syphilis, hepatitis B, hepatitis C, infection due to Toxoplasma gondii, and cytomegalovirus infection. A paucity of data exist from sub-Saharan Africa describing the prevalence of these pathogens. We report data for HIV-1-infected adults referred for initiation of highly active antiretroviral therapy in Botswana.

We report Tevatron results on the B c − meson in Run II. The B c − meson has been observed in semileptonic decays, B c − → J / ψ l − ν X , by both the CDF and DO collaborations at a significance greater than 5 σ . For DO, the candidate B c − → J / ψ μ − X events are used to extract measurements of the mass and lifetime of the B c − meson. For CDF, the B c − → J / ψ l − ν X observations have resulted in measurements of the relative production times branching ratio with respect to B − → J / ψ K − decays and a precise determination of the lifetime of the B c − : c τ ( B c − ) = 0.474 −0.066 +0.073 ± 0.033 ps . Also for CDF, an observation of B c − → J / ψ π − decays at a significance exceeding 6 σ results in a precise determination of the mass of the B c − : M ( B c − ) = 6275.2 ± 4.3 ± 2.3 MeV / c 2 .