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Abstract Continuous‐flow intersections (CFI), also known as displaced left‐turn (DLT) intersections, aim to improve the efficiency and safety of traffic junctions. A CFI introduces additional cross‐over intersections upstream of the main intersection to split the left‐turn flow from the through movement before it arrives at the main intersection which decreases the number of conflict points between left‐turn and through movements. This study develops and examine a two‐step optimization model for CFI traffic signal control design and demonstrates its performance across more than 300 different travel demand scenarios. The proposed model is compared against a state‐of‐practice CFI signal control model as a benchmark. Microsimulation results suggest that the proposed model reduces average delay by 17% and average queue length by 32% for a full CFI compared with the benchmark signal control model.

Introduction SUV measurements from static brain [18F]FDG PET acquisitions are a commonly used tool in preclinical research, providing a simple alternative for kinetic modelling, which requires complex and time-consuming dynamic acquisitions. However, SUV can be severely affected by the animal handling and preconditioning protocols, primarily by those that may induce changes in blood glucose levels (BGL). Here, we aimed at developing and investigating the feasibility of SUV-based approaches for a wide range of BGL far beyond normal values, and consequently, to develop and validate a new model to generate standardized and reproducible SUV measurements for any BGL.Material and methods We performed dynamic and static brain [18F]FDG PET acquisitions in 52 male Sprague-Dawley rats sorted into control (n = 10), non-fasting (n = 14), insulin-induced hypoglycemia (n = 12) and glucagon-induced hyperglycemia (n = 16) groups. Brain [18F]FDG PET images were cropped, aligned and co-registered to a standard template to calculate whole-brain and regional SUV. Cerebral Metabolic Rate of Glucose (CMRglc) was also estimated from 2-Tissue Compartment Model (2TCM) and Patlak plot for validation purposes.Results Our results showed that BGL=100±6 mg/dL can be considered a reproducible reference value for normoglycemia. Furthermore, we successfully established a 2nd-degree polynomial model (C1=0.66E-4, C2=-0.0408 and C3=7.298) relying exclusively on BGL measures at pre-[18F]FDG injection time, that characterizes more precisely the relationship between SUV and BGL for a wide range of BGL values (from 10 to 338 mg/dL). We confirmed the ability of this model to generate corrected SUV estimations that are highly correlated to CMRglc estimations (R2= 0.54 2TCM CMRgluc and R2= 0.49 Patlak CMRgluc). Besides, slight regional differences in SUV were found in animals from extreme BGL groups, showing that [18F]FDG uptake is mostly directed toward central regions of the brain when BGLs are significantly decreased.Conclusion Our study successfully established a non-linear model that relies exclusively on pre-scan BGL measurements to characterize the relationship between [18F]FDG SUV and BGL. The extensive validation confirmed its ability to generate SUV-based surrogates of CMRglu along a wide range of BGL and it holds the potential to be adopted as a standard protocol by the preclinical neuroimaging community using brain [18F]FDG PET imaging.

El conocimiento detallado de aquellos factores que presentan mayor relevancia en la probabilidad de venta de las viviendas puede resultar de suma importancia al tratarse de una inversión a largo plazo. Tras identificar una serie de bloques que marcan la evolución de la venta de las mismas (las características internas del inmueble en cuestión, su localización, su grado de sobreprecio y, sobre todo, un interés real por parte del comprador), se presenta un estudio novedoso que modeliza la probabilidad de venta de los inmuebles a lo largo del tiempo mediante técnicas de machine learning aplicadas a problemas de supervivencia, logrando valores de C-index de 76% y 72% en chalés y pisos, respectivamente. El proceso metodológico se ha testado sobre la capital de España, Madrid, a partir de los datos recopilados desde la principal plataforma de mercado del país durante el periodo 2018-2019. Estos datos fueron ponderados según información oficial, pero la metodología es escalable a cualquier municipio. No solo vendedores, compradores o intermediarios pueden verse beneficiados con este aporte, sino también los agentes públicos, de cara a tomar decisiones enfocadas al diseño o prevención en el tema de la vivienda.

Abstract In this paper we explore the temporal dynamics of spatial inequality in housing prices for Madrid, the capital city of Spain. Spatial inequalities are a concerning feature of urban areas across the globe. It has been suggested that within cities housing prices are becoming more geographically unequal over time, particularly since the 2008 housing market crash. However, more evidence is needed at the intra-urban level to understand neighbourhood house price differences in large urban areas. Changes are analysed during a key period of the housing market bust (2010–2015) and boom (2016–2019), using data from a major housing listing portal. Fine grain space-time analysis of the distribution of housing prices supports an increase in spatial inequality and polarisation at the neighbourhood level. Two spatially differentiated housing sub-markets of high- and low-priced housing are identified. The persistence and growth of spatial house price inequality has important societal implications for the wealth gap and segregation of rich and poor in cities.

Background: This study aimed to compare the humoral responses to mRNA COVID-19 vaccination in people living with HIV (PWH) and HIV-negative individuals. Methods: We included PWH with an undetectable viral load under ART and HIV-negative participants from the French nationwide ANRS COV-POPART cohort who had received two doses of vaccine as a primary vaccination. We compared humoral response between controls and PWH, stratified by CD4 cell count (

Background: Throughout HIV infection, productively infected cells generate billions of viral particles and are thus responsible for body-wide HIV dissemination, but their phenotype during AIDS is unknown. As AIDS is associated with immunological changes, analyzing the phenotype of productively infected cells can help understand HIV production during this terminal stage. Methods: Blood samples from 15 untreated viremic participants (recent infection, n=5; long-term infection, n=5; active opportunistic AIDS-defining disease, n=5) and 5 participants virologically controlled on antiretroviral therapy (ART) enrolled in the Analysis of the Persistence, Reservoir and HIV Latency (APRIL) study (NCT05752318) were analyzed. Cells expressing the capsid protein p24 (p24+ cells) after 18 hours of resting or 24 hours of stimulation (HIV-Flow) revealed productively infected cells from viremic participants or translation-competent reservoir cells from treated participants, respectively. Results: The frequency of productively infected cells tended to be higher during AIDS in comparison with recent and long-term infections (median, 340, 72, and 32/million CD4+ T cells, respectively) and correlated with the plasma viral load at all stages of infection. Altogether, these cells were more frequently CD4low, HLA-ABClow, CD45RA-, Ki67+, PD-1+, with a non-negligible contribution from pTfh (CXCR5+PD-1+) cells, and were not significantly enriched in HIV coreceptors CCR5 nor CXCR4 expression. The comparison markers expression between stages showed that productively infected cells during AIDS were enriched in memory and exhausted cells. In contrast, the frequencies of infected pTfh were lower during AIDS compared to non-AIDS stages. A UMAP analysis revealed that total CD4+ T cells were grouped in 7 clusters and that productive p24+ cells were skewed to given clusters throughout the course of infection. Overall, the preferential targets of HIV during the latest stages seemed to be more frequently highly differentiated (memory, TTD-like) and exhausted cells and less frequently pTfh-like cells. In contrast, translation-competent reservoir cells were less frequent (5/million CD4+ T cells) and expressed more frequently HLA-ABC and less frequently PD-1. Conclusions: In long-term infection and AIDS, productively infected cells were differentiated and exhausted. This could indicate that cells with these given features are responsible for HIV production and dissemination in an immune dysfunction environment occurring during the last stages of infection.

IntroductionClinical research has focused on risk factors and treatment for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), particularly in people with a comorbidity including the human immunodeficiency virus (HIV), but little attention has been paid to the care pathway. This article aims to show how living with HIV may have been a biopsychosocial burden or boost in care pathways for Covid-19.MethodPeople living with HIV (PLHIV) from 9 clinical centers were invited to participate in this qualitative study. The sampling was purposive with a maximum variation in their sociodemographic profiles. Semi-structured interviews were conducted until data saturation, then coded for thematic analysis, using an inductive general approach.ResultsWe interviewed 34 PLHIV of which 20 had SARS-COV-2 once. They were 24 males, 26 born in France; median age: 55. Twenty had a CD4 number above 500, and all were on antiretroviral therapy (ART). HIV appeared as a burden when Covid-19 symptoms reminded HIV seroconversion, fear of contamination, and triggered questions about ART effectiveness. HIV was not considered relevant when diagnosing Covid-19, caused fear of disclosure when participants sought SARS-COV-2 testing, and its care in hospitals was disrupted by the pandemic. ART-pill fatigue caused avoidance for Covid-19 treatment. As a boost, living with HIV led participants to observe symptoms, to get advice from healthcare professionals, and screening access through them. Some participants could accept the result of screening or a clinical diagnosis out of resilience. Some could consider ART or another drug prescribed by their HIV specialist help them to recover from Covid-19.ConclusionLiving with HIV could function as a burden and/or a boost in the care pathways for Covid-19, according to patients' relationship to their HIV history, comorbidities and representation of ART. Covid-19 in PLHIV needs further qualitative study to gain a more comprehensive assessment of the pandemic's consequences on their lives and coping strategies.

RESUMEN El objetivo del estudio fue estimar la prevalencia de lesiones sospechosas de maltrato infantil (MI) en clínicas de Odontopediatría de una Universidad Pública Colombiana. Estudio descriptivo en 100 binomios padres-niños de 6 a 9 años y estudiantes de Odontología. Se diseñó y aplicó cuestionario indagando variables sociodemográficas, sospecha general de MI y se evaluó clínicamente sospecha de MI según lesiones orofaciales. Se realizó estadística descriptiva y análisis bivariado utilizando prueba X2. Los resultados muestran prevalencia de sospecha general de MI del 12 % y sospecha de MI según lesiones orofaciales del 24 %; la lesión extraoral e intraoral más prevalente fue la laceración (10%). Se hallaron relaciones significantes entre sospecha general de MI con desgarro del frenillo labial, múltiples cicatrices, quemaduras sugestivas de MI, marcas de mordidas, contusiones y laceración en labios (p

Clustering algorithms have proven to be a useful tool to extract knowledge and support decision making by processing large volumes of data. Hard and fuzzy clustering algorithms have been used successfully to identify patterns and trends in many areas, such as finance, healthcare, and marketing. However, these algorithms significantly increase their solution time as the size of the datasets to be solved increase, making their use unfeasible. In this sense, the parallel processing of algorithms has proven to be an efficient alternative to reduce their solution time. It has been established that the parallel implementation of algorithms requires its redesign to optimise the hardware resources of the platform that will be used. In this article, we propose a new parallel implementation of the Hybrid OK-Means Fuzzy C-Means (HOFCM) algorithm, which is an efficient variant of Fuzzy C-Means, in OpenMP. An advantage of using OpenMP is its scalability. The efficiency of the implementation is compared against the HOFCM algorithm. The experimental results of processing large real and synthetic datasets show that our implementation tends to more efficiently solve instances with a large number of clusters and dimensions. Additionally, the implementation shows excellent results concerning speedup and parallel efficiency metrics. Our main contribution is a Fuzzy clustering algorithm for large datasets that is scalable and not limited to a specific domain.

La salud oral juega un papel importante en el bienestar general de los pacientes y no debe ser descuidada aún en circunstancias adversas. En situaciones de crisis sanitarias como la pandemia COVID-19, suele limitarse el acceso a servicios de salud oral, especialmente en pacientes con condiciones especiales que requieren intervenciones clínicas, controles y seguimientos a tratamientos nuevos o ya programados. El presente artículo reporta el caso clínico de una paciente de 8 años con síndrome de Down, atendida mediante teleconsulta en odontología. La intervención se planeó en tres etapas: a. Diseño y aplicación de instrumentos de evaluación de riesgo familiar y oral, b. Orientación en salud oral y familiar, y c. Seguimiento de actividades. Para la intervención, se aplicaron cuatro instrumentos, los cuales apoyaron la medición de variables del estudio. El abordaje en teleodontología con este paciente tuvo una duración de 3 meses, con consultas semanales usando la aplicación de WhatsApp. Se identificaron factores de riesgo para la salud oral del paciente y su familia como presencia de biofilm dental, alto consumo de azúcar, baja frecuencia del cepillado bucal y limitada fuente de ingresos económicos a causa de la pandemia COVID-19 entre otros. Dentro de los resultados del seguimiento por teleodontología, se logra disminuir los factores de riesgos ambientales, familiares e individuales del paciente, con apoyo de sus padres. De este abordaje en teleodontología, los investigadores concluyen que las teleconsulta en odontología representan un recurso valioso de atención integral en salud oral.

BackgroundWe aimed to evaluate the incidence rates between 2010 and 2015 for invasive cervical cancer (ICC), breast cancer (BC), and colorectal cancer (CRC) in people living with HIV (PLWH) in France, and to compare them with those in the French general population. These cancers are targeted by the national cancer-screening program.SettingThis is a retrospective study based on the longitudinal data of the French Dat'AIDS cohort.MethodsStandardized incidence ratios (SIR) for ICC and BC, and incidence rates for all three cancers were calculated overall and for specific sub-populations according to nadir CD4 cell count, HIV transmission category, HIV diagnosis period, and HCV coinfection.ResultsThe 2010-2015 CRC incidence rate was 25.0 [95% confidence interval (CI): 18.6-33.4] per 100,000 person-years, in 44,642 PLWH (both men and women). Compared with the general population, the ICC incidence rate was significantly higher in HIV-infected women both overall (SIR = 1.93, 95% CI: 1.18-3.14) and in the following sub-populations: nadir CD4 ≤ 200 cells/mm3 (SIR = 2.62, 95% CI: 1.45-4.74), HIV transmission through intravenous drug use (SIR = 5.14, 95% CI: 1.93-13.70), HCV coinfection (SIR = 3.52, 95% CI: 1.47-8.47) and HIV diagnosis before 2000 (SIR = 2.06, 95% CI: 1.07-3.97). Conversely, the BC incidence rate was significantly lower in the study sample than in the general population (SIR = 0.56, 95% CI: 0.42-0.73).ConclusionThe present study showed no significant linear trend between 2010 and 2015 in the incidence rates of the three cancers explored in the PLWH study sample. Specific recommendations for ICC screening are still required for HIV-infected women and should focus on sub-populations at greatest risk.

BackgroundIn the past years, we observed a sharp increase of Syphilis, especially among male who have sex with male (MSM), either HIV-infected, or on pre-exposure prophylaxis (PrEP). Our aim was to assess syphilis prevalence and incidence among people living with HIV (PLWH) and PrEP users.MethodsPLWH were included from 2010 to 2020 and PrEP users from 2016 to 2020 from the Dat'AIDS French cohort. We calculated syphilis prevalence and incidences for first infections, re-infections, and iterative infections (> 2 times). T-Tests, Wilcoxon tests and Chi2 test were used for descriptive analysis and multivariate logistic regression models were used to estimate Odds ratios (OR) and 95% confidence intervals (95% CI) for factors associated with syphilis.ResultsAmong the 8 583 PLWH, prevalence of subject with past or present syphilis was 19.9%. These subjects were more likely MSM or transgender and aged over 35 years, but prevalence was lower in AIDS subjects. Same pattern was seen for incident infection and re-infection. Incidence was 3.8 per 100 person-years for infection and 6.5 per 100 person-years for re-infection. Among 1 680 PrEP users, syphilis prevalence was 25.8%, with an estimated 7.2% frequency of active syphilis. Risk of syphilis infection was higher in male and increased with age. Incidence was 11.2 per 100 person-years for infection and 11.1 per 100 person-years for re-infection.ConclusionSyphilis prevalence and incidence were high, especially in older MSM with controlled HIV infection and PrEP users, enhancing the need to improve syphilis screening and behavioral risk reduction counseling among high-risk subjects.

Background: Assessment of the kinetics of SARS-CoV-2 antibodies is essential in predicting risk of reinfection and durability of vaccine protection. Methods: This is a prospective, monocentric, longitudinal, cohort clinical study. Healthcare workers (HCW) from Strasbourg University Hospital were enrolled between April 6th and May 7th, 2020 and followed up to 422 days. Serial serum samples were tested for antibodies against the Receptor Binding Domain (RBD) of the spike protein and nucleocapsid protein (N) to characterize the kinetics of SARS-CoV-2 antibodies and the incidence of reinfection. Live-neutralization assays were performed for a subset of samples before and after vaccination to analyze sensitivity to SARS-CoV-2 variants. Findings: A total of 4290 samples from 393 convalescent COVID-19 and 916 COVID-19 negative individuals were analyzed. In convalescent individuals, SARS-CoV-2 antibodies followed a triphasic kinetic model with half-lives at month (M) 11–13 of 283 days (95% CI 231–349) for anti-N and 725 days (95% CI 623–921) for anti-RBD IgG, which stabilized at a median of 1.54 log BAU/mL (95% CI 1.42–1.67). The incidence of SARS-CoV-2 infections was 12.22 and 0.40 per 100 person-years in COVID-19-negative and COVID-19-positive HCW, respectively, indicating a relative reduction in the incidence of SARS-CoV-2 reinfection of 96.7%. Live-virus neutralization assay revealed that after one year, variants D614G and B.1.1.7, but less so B.1.351, were sensitive to anti-RBD antibodies at 1.4 log BAU/mL, while IgG ≥ 2.0 log BAU/mL strongly neutralized all three variants. These latter anti-RBD IgG titers were reached by all vaccinated HCW regardless of pre-vaccination IgG levels and type of vaccine. Interpretation: Our study demonstrates a long-term persistence of anti-RBD antibodies that may reduce risk of reinfection. By significantly increasing cross-neutralizing antibody titers, a single-dose vaccination strengthens protection against variants. Fun1ding: None.

Traffic congestion is largely due to the high proportion of solo drivers during peak hours. Ridesharing, in the sense of carpooling, has emerged as a travel mode with the potential to reduce congestion by increasing the average vehicle occupancy rates and reduce the number of vehicles during commuting periods. In this study, we propose a simulation-based optimization framework to explore the potential of subsidizing ridesharing users, drivers, and riders, so as to improve social welfare and reduce congestion. We focus our attention on a realistic case study representative of the morning commute on Sydney’s M4 Motorway in Australia. We synthesize a network model and travel demand data from open data sources and use a multinomial logistic model to capture users’ preferences across different travel roles, including solo drivers, ridesharing drivers, ridesharing passengers, and a reserve option that does not contribute to congestion on the freeway network. We use a link transmission model to simulate traffic congestion on the freeway network and embed a fixed-point algorithm to equilibrate users’ mode choice in the long run within the proposed simulation-based optimization framework. Our numerical results reveal that ridesharing incentives have the potential to improve social welfare and reduce congestion. However, we find that providing too many subsidies to ridesharing users may increase congestion levels and thus be counterproductive from a system performance standpoint. We also investigate the impact of transaction fees to a third-party ridesharing platform on social welfare and traffic congestion. We observe that increasing the transaction fee for ridesharing passengers may help in mitigating congestion effects while improving social welfare in the system.

The association between white matter hyperintensities (WMH) and amyloid accumulation over time in cognitively normal, amyloid-negative elderly people remains largely unexplored. In order to study whether baseline WMH were associated with longitudinal subthreshold amyloid accumulation, 159 cognitively normal participants from the Alzheimer’s Disease Neuroimaging Initiative who were amyloid-negative at baseline were examined. All the participants underwent a T1 and a Fluid-Attenuated Inversion Recovery MRI scan at baseline. Amyloid PET imaging was performed at baseline and follow-up visits in 2-year intervals for up to 8 years. Partial volume correction was applied for quantifying cortical Standardised Uptake Value Ratios (SUVR). The associations between global and regional WMH burden and amyloid accumulation were assessed using linear mixed models adjusted by demographic characteristics and baseline SUVR. Partial volume correction increased the measured annual rate of change (+2.4%) compared to that obtained from non-corrected data (+0.5%). There were no significant correlations between baseline WMHs and baseline subthreshold cortical amyloid uptake. In a longitudinal analysis, increased baseline cortical SUVR and increased baseline burden of global (p ​= ​0.006), frontal (p ​= ​0.006), and parietal WMH (p ​= ​0.003) were associated with faster amyloid accumulation. WMH-related amyloid accumulation occurred in parietal, frontal, and, to a lesser extent, cingulate cortices. These results remained unchanged after a sensitivity analysis excluding participants with the highest cortical SUVRs. This is the first study to identify a specific spatial distribution of WMH which is associated with future amyloid accumulation in cognitively normal elderly subjects without PET-detectable amyloid pathology. These findings may have important implications in prevention trials for the early identification of amyloid accumulation.

We report the observation of the controlled expansion of a two-dimensional (2D) quantum gas confined onto a curved shell-shaped surface. We start from the ellipsoidal geometry of a dressed quadrupole trap and introduce a novel gravity compensation mechanism enabling to explore the full ellipsoid. The zero-point energy of the transverse confinement manifests itself by the spontaneous emergence of an annular shape in the atomic distribution. The experimental results are compared with the solution of the three-dimensional Gross–Pitaevskii equation and with a 2D semi-analytical model. This work evidences how a hidden dimension can affect dramatically the embedded low-dimensional system by inducing a change of topology.

Abstract Background HCV treatment uptake has drastically increased in HIV-HCV coinfected patients in France since direct-acting antiviral (DAA) treatment approval, resulting in HCV cure in 63% of all HIV-HCV patients by the end of 2015. We investigated the impact of scaling-up DAA on HCV prevalence in the whole HIV population and in various risk groups over the next 10 years in France using a transmission dynamic compartmental model. Methods The model was based on epidemiological data from the French Dat’AIDS cohort. Eight risk groups were considered, including high-risk (HR) and low-risk (LR) men who have sex with men (MSM) and male/female heterosexuals, intra-venous drug users, or patients from other risk groups. The model was calibrated on prevalence and incidence data observed in the cohort between 2012 and 2015. Results On January 1, 2016, 156,811 patients were registered as infected with HIV in France (24,900 undiagnosed patients) of whom 7938 (5.1%) had detectable HCV-RNA (722 undiagnosed patients). Assuming a treatment coverage (TC) rate of 30%/year (i.e., the observed rate in 2015), model projections showed that HCV prevalence among HIV patients is expected to drop to 0.81% in 2026. Sub-analyses showed a similar decrease of HIV-HCV prevalence in most risk groups, including LR MSM. Due to higher infection and reinfection rates, predicted prevalence in HR MSM remained stable from 6.96% in 2016 to 6.34% in 2026. Increasing annual TC rate in HR MSM to 50/70% would decrease HCV prevalence in this group to 2.35/1.25% in 2026. With a 30% TC rate, undiagnosed patients would account for 34% of HCV infections in 2026. Conclusions Our model suggests that DAA could nearly eliminate coinfection in France within 10 years for most risk groups, including LR MSM. Elimination in HR MSM will require increased TC.

IntroductionAchieving functional cure of chronic HBV infection (Hepatitis B surface antigen [HBsAg] clearance, eventually followed by acquisition of anti-hepatitis B surface antigen [Anti-HBs]) in individuals with HIV and HBV infections is a rare event. In this setting, factors related to HBV cure have not yet been fully characterized.MethodsHIV-infected individuals with chronic HBV infection enrolled in the French Dat'AIDS cohort (NCT02898987), who started combined antiretroviral (cART)-anti-HBV treatment were retrospectively analyzed for HBsAg loss and Anti-HBs seroconversion.ResultsOverall, 1419 naïve-subjects received three different cART-anti-HBV treatment schedule: (1) 3TC or FTC only (n = 150), (2) TDF with or without 3TC or FTC (n = 489) and (3) 3TC or FTC as first line followed by adding/switching to TDF as second line (n = 780). Individuals were followed-up for a median of 89 months (IQR, 56-118). HBV-DNA was < 15 IU/mL in 91% of individuals at the end of the follow-up. Overall, 97 individuals cleared HBsAg (0.7/100 patient-years), of whom, 67 seroconverted for Anti-HBs (0.5/100 patient-years). A high CD4 nadir, a short delay between HBV diagnosis and treatment, a longer time on HBV therapy, an African origin and TDF-based therapy were independent predictors of HBsAg clearance (Probability of odds ratio [OR]>1, >95%) suggested by Bayesian analysis. Also, TDF-based regimen as first line (OR, 3.03) or second line (OR, 2.95) increased rates of HBsAg clearance compared to 3TC or FTC alone, with a 99% probability.ConclusionsHBsAg clearance rate was low in HIV-HBV co-infected cART-anti-HBV treated individuals, but was slightly improved on TDF-based regimen.