Urban Settings Research Articles

High-resolution greenspace dynamic data cube from Sentinel-2 satellites over 1028 global major cities

Greenspace, offering multifaceted ecological and socioeconomic benefits to the nature system and human society, is integral to the 11th Sustainable Development Goal pertaining to cities and communities. Spatially and temporally explicit information on greenspace is a premise to gauge the balance between its supply and demand. However, existing efforts on urban greenspace mapping primarily focus on specific time points or baseline years without well considering seasonal fluctuations, which obscures our knowledge of greenspace’s spatiotemporal dynamics in urban settings. Here, we combined spectral unmixing approach, time-series phenology modeling, and Sentinel-2 satellite images with a 10-m resolution and nearly 5-day revisit cycle to generate a four-year (2019–2022) 10-m and 10-day resolution greenspace dynamic data cube over 1028 global major cities (with an urbanized area >100 km2). This data cube can effectively capture greenspace seasonal dynamics across greenspace types, cities, and climate zones. It also can reflect the spatiotemporal dynamics of the cooling effect of greenspace with Landsat land surface temperature data. The developed data cube provides informative data support to investigate the spatiotemporal interactions between greenspace and human society.

A case report of plasma exchange in imidacloprid poisoning: A promising therapeutic approach for acute toxicity

Abstract: Imidacloprid, a neonicotinoid insecticide, is commonly used in agricultural and urban settings for pest control. However, its toxic effects on both target and nontarget organisms, including humans, have raised concerns. Imidacloprid poisoning can result in a wide range of symptoms, including neurological, gastrointestinal, and cardiovascular manifestations, and may even be fatal in severe cases. In recent years, plasma exchange has emerged as a potential therapeutic approach in cases of imidacloprid poisoning, with promising outcomes reported in a few published case reports. This article reviews the role of plasma exchange in imidacloprid poisoning, highlighting its mechanism of action, clinical indications, technical aspects, and potential benefits. The article also discusses the current evidence supporting the use of plasma exchange in imidacloprid poisoning, including relevant case reports and studies. While plasma exchange appears to be a promising adjunctive therapy in managing imidacloprid poisoning, further research and clinical experience are needed to establish its effectiveness and safety. This article emphasizes the importance of early recognition and management of imidacloprid poisoning, including considering plasma exchange as a potential treatment modality in severe cases.

ISLAND: Interpolating Land Surface Temperature using land cover

Cloud occlusion is a common problem in the field of remote sensing, particularly for retrieving Land Surface Temperature (LST). Remote sensing thermal instruments onboard operational satellites are supposed to enable frequent and high-resolution observations over land; unfortunately, clouds adversely affect thermal signals by blocking outgoing longwave radiation emission from the Earth’s surface, interfering with the retrieved ground emission temperature. Such cloud contamination severely reduces the set of serviceable LST images for downstream applications, making it impractical to perform intricate time-series analysis of LST. In this paper, we introduce a novel method to remove cloud occlusions from Landsat 8 LST images. We call our method ISLAND, an acronym for Interpolating Land Surface Temperature using land cover. Our approach uses LST images from Landsat 8 (at 30m resolution with 16-day revisit cycles) and the NLCD land cover dataset. Inspired by Tobler’s first law of Geography, ISLAND predicts occluded LST through a set of spatio-temporal filters that perform distance-weighted spatio-temporal interpolation. A critical feature of ISLAND is that the filters are land cover-class aware, making it particularly advantageous in complex urban settings with heterogeneous land cover types and distributions. Through qualitative and quantitative analysis, we show that ISLAND achieves robust reconstruction performance across a variety of cloud occlusion and surface land cover conditions, and with a high spatio-temporal resolution. We provide a public dataset of 20 U.S. cities with pre-computed ISLAND LST outputs. Using several case studies, we demonstrate that ISLAND opens the door to a multitude of high-impact urban and environmental applications across the continental United States.

Government promotion and city image: visitor intentions in Macao

PurposeThis study aims to critically evaluate the impact of government tourism promotion methods on city image and visiting intentions and to explore the moderating effect of tourism experience on two of the conceptualized relationships, using Macao as a case study.Design/methodology/approachThe research analyzed responses from 407 Macao visitors during the pandemic to determine the effects of tourism promotion methods on the city’s image and visiting intention using structural equation modeling (SEM) to test the hypotheses.FindingsThis study revealed that tourism promotion methods positively impact the city’s image and visiting intentions. City image also mediates the relationship between tourism promotion methods and visiting intentions. Furthermore, tourism experience moderates the relationships between promotion methods and city image and between promotion methods and visiting intentions.Research limitations/implicationsThe study’s findings on the effects of promotion methods utilized by local governments support and expand upon existing theoretical frameworks within the realm of nonprofit organizations’ management and marketing for destination marketing organizations (DMOs). However, the cross-sectional design limits causality, and findings may not be generalizable beyond Macao without further comparative research.Practical implicationsThis study provides valuable insights for policymakers and marketers to design promotional campaigns that deliver authentic and memorable experiences, aligning with their promotional promises, especially in postpandemic contexts.Social implicationsThis research contributes to the theoretical and methodological advancement of management and marketing for DMOs from a public sector perspective, highlighting the critical role of government involvement in urban tourism promotion.Originality/valueThe research offers valuable insights into how promotional activities influence visiting intentions, advancing tourism management and marketing for DMOs from a nonprofit perspective. The study validates theories and adds unique insights by focusing on Macao’s postpandemic recovery, offering practical implications for similar urban settings.

Groundwater monitoring infrastructure: Evaluation of the shallow urban and coastal network in Ōtautahi Christchurch

Study regionŌtautahi Christchurch, New Zealand Study focusUrban shallow groundwater monitoring networks are becoming widespread in New Zealand and globally. A reliable groundwater monitoring infrastructure is important to develop knowledge on water table aquifers in coastal cities like Ōtautahi Christchurch. Previous investigations have shown shallow groundwater vulnerability to salinisation and contamination in urban settings, and shallow groundwater exacerbates flooding from climate change and the impact of rising sea levels. New hydrological insights for the regionFollowing the 2010–2011 Canterbury earthquake sequence, shallow groundwater data acquisition and the establishment of a geotechnical database in Ōtautahi Christchurch provided unprecedented information on subsurface conditions. The installation of the groundwater monitoring infrastructure opened the field of New Zealand-based urban hydrogeological studies, including continuous measurements of groundwater levels. This study presents the hydrogeological context of Ōtautahi Christchurch, provides an overview of seismic impacts on groundwater, and documents the monitoring network’s development. Methods for assessing the monitoring network included field surveys and digital information review. The overall good condition and robustness of the network mean the dataset held by the city and regional councils should be more widely used to benefit the community. Implications for researchers and network asset managers mean that the maintenance and availability of the data should be prioritised. Records from urban shallow groundwater monitoring networks are becoming an essential source of information to manage urban water resources under climate change and sea-level rise conditions.

Sero-Prevalence and Distribution of Hepatitis B Surface Antigenaemia among People Living in Urban Settings in Rivers State of Nigeria

Sero-Prevalence and Distribution of Hepatitis B Surface Antigenaemia among People Living in Urban Settings in Rivers State of Nigeria

Transculturation in Latin American Video Game Production: Between Regionalism and Cosmopolitanism

This research explores the manifestation of transculturation, a literary paradigm designed to situate Latin American production in the context of globalization, in video game production, evaluating its applicability to the study of cultural representation. Embracing a documentary research and content analysis methodology, the study analyzes 29 video games from nine Latin American countries, classifying them as “regionalist” or “cosmopolitan” based on settings, themes, audiovisual elements, and intertextual references. The regionalist category exhibits a preference for realism, natural settings, representation of myths, and an emphasis on cultural preservation. Conversely, the cosmopolitan category favors the fantastic, urban settings, reinterpretation of myths, and an emphasis on cultural exchange. By scrutinizing video games through the lens of transculturation, the study revalidates this theory as a relevant paradigm for understanding cultural representation in the digital age, offering new insights into the interplay between local and global influences in Latin American video game narratives.

Developing a Training Program for a Personal Navigation Intervention for Individuals with Disabilities

Purpose: The purpose of this project was to identify, develop, and assess the feasibility of a complex intervention to support independent public transportation for individuals with cognitive disabilities in a midsized urban setting. Methods: We used the Medical Research Council framework to develop and evaluate a complex intervention. The complex intervention was an education and training program that supported personal navigation for individuals with disabilities (PNID) and was part of the Smart Columbus Mobility Assistance for People with Cognitive Disabilities (MAPCD) project. The identification, development, and feasibility of the PNID education and training program was iterative and included seven stages, which started with engaging with external stakeholders and ended with describing future directions for the implementation of the complex intervention. Results: The result was an evidence-based, theory-informed, and stakeholder supported education and training program to support public transportation for individuals with cognitive disabilities. The intervention was based on frameworks, models, and theories including a sociotechnical architecture model. The sociotechnical architecture was operationalized using the WayFinder system, a personal transportation assistant that consists of both a smartphone application and a web-based portal. The education and training program consisted of five activities. Conclusions: The PNID education and training program and MAPCD project provide a framework for the identification, development, implementation, and evaluation of sociotechnical architectures that support independent public transportation for individuals with disabilities in midsize urban settings.

Factors influencing households' satisfaction with drinking water availability in Bujumbura municipality, Burundi

ABSTRACT Consumer satisfaction and drinking water availability in evolving urban settings are major issues and their understanding is a key to improving water service quality and managing water utility. This study aims to examine factors influencing subscribers' satisfaction with drinking water availability in the Municipality of Bujumbura, Burundi. To achieve this, a survey was carried out from 3 to 21 May 2021 on a random sample of 391 subscribers. The outcome variable was the logarithm of the odds of being satisfied with drinking water availability and explanatory variables included sociodemographic factors (commune, gender, age, education level, marital status, and religion), water distribution factors and co-production-related factors. The chi-square test (Fisher's exact test if conditions are not met) and binary fixed-effects logistic regression models were applied to these data using R software, version 4.1.2. Findings showed that the time of drinking water supply and frequency of water-related outages significantly influenced satisfaction with drinking water availability after adjustment for age. This study could help decision-makers who are in charge of drinking water distribution identify other factors associated with water availability satisfaction in Bujumbura Municipality and other urban settings.

Graywater Treatment Efficiency and Nutrient Removal Using Moving Bed Biofilm Reactor (MBBR) Systems: A Comprehensive Review

Using wastewater in response to water-related challenges from climate variation has gained significance. Various sophisticated technologies have been developed to meet the demand for wastewater treatment and reuse. Graywater, an intrinsic component of wastewater, is acknowledged for its practical potential in the context of reuse. Decentralized wastewater treatment systems, exemplified by Moving Bed Biofilm Reactors (MBBRs), have emerged as efficient alternatives in urban settings. By comparing the physicochemical analyses conducted in the three treatment units and evaluating the treatment efficiency of each unit, we will first establish the validity of the MBBR system for treating and recycling graywater, achieving up to 98% elimination rates for BOD5. Subsequently, the possibility of optimizing the system will be explored by evaluating the different treatment stages of MBBR reactors.

Veterinary perspectives on the urbanization of leishmaniosis in Morocco

BackgroundLeishmaniosis caused by Leishmania infantum, L. major and L. tropica is endemic in Morocco. Growing evidence of both human and canine Leishmania infections in urban centres has been reported. Since many forms of the disease are zoonotic, veterinarians play an important role in leishmaniosis control by intervening at the parasite host level. This study aimed to bring together One Health principles to connect canine and feline leishmaniosis epidemiology within urban centres of Morocco (Rabat and Fez) and assess the level of awareness of Moroccan veterinarians about facing this threat.MethodsA molecular survey was conducted for Leishmania DNA detection in canine (n = 155) and feline (n = 32) whole-blood samples. Three conventional polymerase chain reaction (PCR) protocols were implemented. The first PCR aimed at identifying infected animals by targeting Leishmania spp. kinetoplast minicircle DNA (kDNA). The second and third PCR targeted the Leishmania internal transcribed spacer region (ITS-1) and the Leishmania small subunit ribosomal RNA (SSUrRNA) gene, respectively, aiming at identification of the infecting species after Sanger sequencing-positive amplicons. Total immunoglobulin G (IgG) against Leishmania spp. was evaluated in 125 dogs by enzyme-linked immunosorbent assays (ELISA) using an in-house protocol, including three Leishmania-specific antigens (SPLA, rKDDR and LicTXNPx). Sera from 25 cats were screened for total IgG to Leishmania spp. by an indirect immunofluorescence antibody test (IFAT). An online questionnaire was presented to Moroccan veterinarians addressing their knowledge and practices towards animal leishmaniosis.ResultsOverall, 19.4% of the dogs tested positive for Leishmania kDNA and ITS-1 and sequencing revealed infection with L. infantum among PCR-positive dogs. These animals presented a wide range of ELISA seropositivity results (16.7%, 34.9% and 51.6%) according to the tested antigens (rKDDR, SPLA and LicTXNPx, respectively). Use of kDNA-PCR revealed 12.5% cats positive to Leishmania spp. otherwise found to be seronegative by IFAT.ConclusionsA considerable prevalence of infection was identified in dogs from urban centres of Morocco. Additionally, this is the first report of feline infection with Leishmania spp. in this country and in urban settings. Moroccan veterinarians are aware that animal leishmaniosis is endemic in Morocco, representing a public health threat, and are knowledgeable about canine leishmaniosis diagnosis and treatment.Graphical

PROMOTE: An Innovative Curriculum to Enhance the Maternity Care Workforce.

Maternal morbidity and mortality disproportionally affect marginalized populations in both rural and urban settings. While the workforce of family physicians (FPs) who provide maternity care is declining, an enhanced obstetrics (OB) curriculum during residency training can help prepare future FPs to provide competent pregnancy care, particularly in marginalized communities. We developed an innovative OB curriculum-PROMOTE: Primary care obstetrics and maternal outcomes training enhancement-in an urban underserved residency program in Pennsylvania that directly addressed barriers previously known to impact maternity care practice. We created a clinical competency assessment aligned with Accreditation Council for Graduate Medical Education requirements, and we reviewed resident feedback and logs throughout and upon completion of the track. After 3 years of implementation, 23 of 48 (48%) total residents entered and/or completed PROMOTE, compared to 17 of 45 (38%) total residents who chose the OB track in the 5 years prior to implementation. Postimplementation, 29.6% of total graduates practice inpatient obstetrics, compared to 26.6% prior to implementation. Twice annual competency evaluations were completed for all residents on the track. Our review of resident submitted feedback, logs, and competency assessments suggests that the curriculum has positively impacted their knowledge, skills, and clinical care provision. PROMOTE's curricular innovation enhances obstetrical training by addressing known facilitators and barriers to practicing family medicine obstetrics. PROMOTE was implemented in an existing family medicine residency with an obstetrics track and could be adapted by other residency programs to enhance the future maternity care workforce.

Sociodemographic inequalities in residential nighttime light pollution in urban Bulgaria: An environmental justice analysis

IntroductionOutdoor nighttime light (NTL) is a potential anthropogenic stressor in urban settings. While ecological studies have identified outdoor NTL exposure disparities, uncertainties remain about disparities in individual exposure levels, particularly in Europe. AimTo assess whether some populations are disproportionately affected by outdoor NTL at their residences in urban Bulgaria. MethodsWe analyzed 2023 data from a representative cross-sectional survey of 4,270 adults from the five largest Bulgarian cities. Respondents’ annual exposures to outdoor artificial nighttime luminance were measured using satellite imagery and assigned at their places of residence. We calculated the Gini coefficient as a descriptive NTL inequality measure. Associations between respondents’ NTL exposure levels and sociodemographic characteristics were assessed by estimating quantile mixed regression models. Stratified regressions were fitted by gender and for each city. ResultsWe found moderate distributive NTL inequalities, as indicated by a 0.214 Gini coefficient. Regression analyses found associations between greater NTL exposure and higher educational attainment. Respondents with incomes perceived as moderate experienced less NTL exposure at the 0.5 and 0.8 quantiles, while unemployed respondents experienced lower exposure at the 0.2 and 0.5 quantiles. We observed null associations for the elderly and non-Bulgarian ethnicities. Regardless of the quantile, greater population density was associated with higher NTL levels. Stratification by sex did not yield substantial differences in the associations. We observed notable city-specific heterogeneities in the associations, with differences in the magnitudes and directions of the associations and the NTL quantiles. ConclusionsNTL exposures appeared to embody an environmental injustice dimension in Bulgaria. Our findings suggest that some sociodemographic populations experience higher exposure levels to NTL; however, those are not necessarily the underprivileged or marginalized. Identifying populations with high exposure levels is critical to influencing lighting policies to ease related health implications.

Resident’s Perception towards Green Spaces Urban Areas of Mirpur AJK Pakistan, A Cross-Sectional Study

Urbanization with increasing proportion of the population living in cities limits access to nature and increases exposure to environmental hazards, such as air and noise pollution. Green spaces offer solutions by increasing the quality of urban settings, promoting sustainable lifestyles, and improving both the health and the well-being of urban residents. Aim of the study was to assess perceived advantages and disadvantages of urban green spaces (UGS). A cross sectional study, was conducted on the 200 residents of Mirpur district of Azad Jammu and Kashmir Pakistan. There were 54.5% of males and 44.5% of females in the study sample and 79% (n=79) of them were of age between 31-40 years. 164 (82%) individuals in the collected sample fall into high educational level. For positive attributes of urban green spaces most visitors reported strongly agree response. The highest strongly agree response (62%) is for importance of parks. Promotion of elders’ and physical health also showed strongly agreed responses of 60% and 58% respectively. The agreed response was the highest for ‘neighbors’ meetup’ (43.5%) and for the rest it was mental health (40%), people likeness (37%) and property value (38.5%). Commercial encroachment was the highest strongly agreed response (30.5%) and time wastage was the highest strongly disagreed response (21.5%). Visitors reported strongly agree response to scenic beauty (67.5%), air quality (49%) and reduce heat wave (40.5%). Agreed responses were topped by environmental conditions (37%) followed by almost equal responses for rainfall source (25.5%), biodiversity and noise pollution (23%). Fast and unplanned urbanization is threatening UGS. Our study highlighted visitors’ perception about UGS which would help in their development and improved quality.

Social Determinants of Health, Tribal Payments, and Probability of Contracting COVID-19 in American Indian and Alaska Native Peoples.

Little is known about the relationships between demographic and economic social determinants of health and the probability of contracting COVID-19 in American Indian and Alaska Native (AI/AN) peoples. In addition, we do not know if and how tribal payments, unique to AI/AN peoples, are associated with the probability of contracting COVID-19. We surveyed 767 AI/AN patients of five geographically disparate health organizations that primarily served AI/AN peoples in urban settings between January and May of 2021. We used univariate modified Poisson regressions to estimate the influence of age, gender, household composition, education, household income, and tribal payments on risk of contracting COVID-19, with results presented as both risk and risk difference. Fifteen percent of the sample contracted COVID-19, and individuals who lived in households with two or more generations had an 11-percentage point elevated risk of contracting COVID-19 compared to those who lived alone. Twenty-seven percent of participants received tribal payments; receipt was associated with seven percentage points (change from 18% probability to 11% probability) lower risk of contracting COVID-19. Our findings showed interventions specifically designed to reduce the spread of COVID-19 in multigenerational households, and regular tribal payments may help improve health outcomes in urban AI/AN populations.

Dynamic Research on the Collaborative Governance in Urban and Rural Black-Odorous Water: A Tripartite Stochastic Evolutionary Game Perspective

The issue of black-odorous water (BOW) represents a formidable challenge to the current aquatic ecosystems, and its governance exhibits characteristics of low efficiency, susceptibility to relapse, and fragmented management under the Central Environmental Protection Inspection, thereby emerging as a dynamically complex issue in the ecological governance of urban and rural settings. This study introduces Gaussian white noise to simulate environmental uncertainty and design a stochastic evolutionary game model encompassing the central government, local governments, and societal forces based on evolutionary game theory and classical governance theories and concepts. Numerical simulations are conducted to explore trajectories of the strategic evolution of various subjects influenced by numerous factors. Results indicate that under the environment of random disturbances, the strategies of the game subjects show significant fluctuations, but actively cultivating the subject’s initial willingness facilitates collaboration governance in inspection. Moreover, joint construction of a “belief system” by multi-subjects, the intensity of inspection interventions, the integration of heterogeneous resources, and effective punitive measures all influence the governance of BOW, but the efficiency of resource allocation should be considered throughout the governance process. Recommendations are made finally for collaborative governance of urban and rural BOW, promoting the sustainable development of the ecological environment.

Effects of growth space limitation on allometry of Ficus spp. In urban habitats

Tree morphological traits are related to the structural stability and their ability to provide ecological benefits such as carbon sequestration and water conservation. The allometric relationship can be used to construct the corresponding prediction equations in forests. However, the urban environment differs from the natural environment for trees. This study aims to enhance the urban tree growth model by classifying urban habitats. We achieved this by collecting morphological traits (DBH, height, crown depth, and width) commonly used in growth model researches of six Ficus spp. in Guangzhou, China, including Ficus virens, Ficus religiosa, Ficus elastica, Ficus benjamina, Ficus altissima, Ficus celebensis. We specifically examine how these trees grow in different urban settings. Urban habitats are classified based on growth space limitations, considering above-ground and underground. Results showed that certain morphologies in urban habitats did not conform to allometry (R2 < 0.4), and the model fitted with height as independent variable is better than that fitted with DBH. The model parameter following allometric relationship with tree height as the independent variable showed no significant difference, but the fit was worse in different urban habitats. On the contrary, models with DBH as the independent variable showed differences, for example, the allometric exponent of maximum crown width relative to DBH were 0.915 and 0.557 in two different habitats. Crown depth and tree height showed significant and stable allometry in the three habitats. The response of tree morphology to different habitats varied, and the allometric relationships among morphological traits showed differences in habitats where the growth space was limited. This underscores the considerable effect of the urban environment on urban tree growth models. Consequently, we recommend developing a series urban tree growth models tailored to different urban habitats to accurately quantify urban ecosystem services for assessing their sustainability in urban development and planning.

Prevalence of unruptured intracranial aneurysms (UIAs) examined in the trauma population

BackgroundPrevious data on the prevalence of unruptured intracranial aneurysms (UIAs) vary widely, and studies based on these data are plagued with unintentional bias. Accurate prevalence data are paramount for any...

A physics-guided automated machine learning approach for obtaining surface radiometric temperatures on sunny days based on UAV-derived images

Urban surface radiometric temperatures, approximate to the surface kinetic temperatures, are predominantly retrieved using satellites or unmanned aerial vehicles (UAVs) and exhibit pronounced spatiotemporal variations. Despite numerous methods ranging from empirical to physical models for obtaining urban microscale surface radiometric temperatures via UAVs, challenges remain given the limited physical significance and substantial professional barriers to method application. Against this background, this study introduces a novel and straightforward approach for acquiring spatially distributed radiometric temperatures on sunny days without understanding the complex radiative transfer process as well as acquiring low-altitude atmospheric parameters. An automated machine learning was employed to train a model capable of efficiently estimating radiometric temperatures. Training and testing datasets were created based on the urban radiative transfer equation, incorporating three independent variables: UAV-measured surface brightness temperature, broadband emissivity, and sky view factor, which collectively represent the diverse thermal environments across different surface characteristics and urban layouts during sunny transitional and summer seasons. The model's accuracy was subsequently confirmed through direct comparisons with radiometric temperatures retrieved from UAV-collected multimodal images and kinetic temperatures synchronously collected on the ground across four periods. The results indicate that AutoGluon achieved high accuracy (MAE: 0.04 K; RMSE: 0.06 K; R2: 0.99). Additional ground measurement validations further demonstrated the model's reliability, with absolute biases on sunlit surfaces maintained within 1.25 K. Given its capability for real-time, high-spatial-resolution mapping of radiometric temperatures (April test: 8.70 cm, July test: 6.89 cm) in urban microscales with considerable heterogeneity, such a method is envisioned to be an effective tool for the dynamic monitoring and management of thermal environments at the microscale level in urban settings.

Regional variations in HIV diagnosis in Japan before and during the COVID-19 pandemic

BackgroundThe number of people undergoing voluntary HIV testing has abruptly decreased since 2020. The geographical heterogeneity of HIV infection and the impact of COVID-19 on the diagnosis of HIV at regional level are important to understand. This study aimed to estimate the HIV incidence by geographical region and understand how the COVID-19 pandemic influenced diagnosis of HIV. MethodsWe used an extended back-calculation method to reconstruct the epidemiological dynamics of HIV/AIDS by geographical region. We used eight regions: Tokyo, the capital of Japan, Hokkaido plus Tohoku, Kanto plus Koshinetsu (excluding Tokyo), Hokuriku, Tokai, Kinki, Chugoku plus Shikoku, and Kyushu plus Okinawa. Four different epidemiological measurements were evaluated: (i) estimated HIV incidence, (ii) estimated rate of diagnosis, (iii) number of undiagnosed HIV infections, and (iv) proportion of HIV infections that had been diagnosed. ResultsThe incidence of HIV/AIDS during the COVID-19 pandemic from 2020 to 2022 increased in all regions except Kanto/Koshinetsu (51.3 cases/year), Tokyo (183.9 cases/year), Hokuriku (1.0 cases/year), and Tokai (43.1 cases/year). The proportion of HIV infections that had been diagnosed only exceeded 90% in Tokyo (91.7%, 95% confidence interval (CI): 90.6, 93.3), Kanto/Koshinetsu (91.0%, 95% CI: 87.3, 97.8), and Kinki (92.5%, 95% CI: 90.4, 95.9). The proportion of infections that had been diagnosed was estimated at 83.3% (95% CI: 75.1, 98.7) in Chugoku/Shikoku and 80.5% (95% CI: 73.9, 91.0) in Kyusyu/Okinawa. ConclusionsIn urban regions with major metropolitan cities, including Tokyo, Kinki, and Kanto/Koshinetsu, the number of undiagnosed HIV infections is substantial. However, the proportion of undiagnosed infections was estimated to be smaller than in other regions. The diagnosed proportion was the lowest in Kyusyu/Okinawa (80.5%), followed by Chugoku/Shikoku and Hokkaido/Tohoku. The level of diagnosis in those regional prefectures may have been more influenced and damaged by the COVID-19 pandemic than in urban settings.