Intervention Scenarios Research Articles

The Potential for Lifestyle Intervention Among Patients Undergoing Transurethral Resection of Bladder Tumour Based on Patient Needs Including Smoking and Other Risky Lifestyle Factors: A Cross-Sectional Study

Bladder cancer is the tenth most common cancer worldwide, with non-muscle invasive bladder cancer (NMIBC) accounting for 75% of cases. Transurethral resection of bladder tumours (TURBT) is the standard treatment, but it is associated with significant risks of complications and recurrence. Risky lifestyle factors, including smoking, malnutrition, obesity, risky alcohol use, and physical inactivity (collectively termed SNAP factors), may worsen surgical outcomes and increase cancer recurrence. Prehabilitation programmes targeting these modifiable risk factors could improve patient outcomes. This cross-sectional study assessed 100 TURBT patients at a Danish university hospital to determine the prevalence of SNAP factors and the potential for lifestyle interventions. Data were collected via structured interviews, and intervention scenarios were projected based on efficacy rates of 5–100%. In total, 58% of patients had at least one risky SNAP factor, with smoking (29%) being the most prevalent, followed by physical inactivity (19%) and risky alcohol use (18%). Obesity (7%) and malnutrition (8%) were less common. Seventeen percent had multiple SNAP factors. No significant demographic indicators were associated with the presence of SNAP factors. TURBT patients with NMIBC show a high prevalence of risky lifestyle factors, including smoking and obesity, with over half affected. Systematic screening and targeted interventions could significantly improve patient outcomes and long-term health.

Unearthing Agricultural Land Use Dynamics in Indonesia: Between Food Security and Policy Interventions

Despite its essential and irreplaceable role in food security, the agricultural sector is often perceived as having the potential to be sacrificed in the name of economic growth, leading to significant land cover transformation into built-up areas and plantations. This complexity prompts critical questions regarding the efficacy of agricultural policy interventions, including augmenting production capacity, diversifying commodities, and expanding agricultural land in light of Indonesia Emas 2045, which embodies Indonesia’s ambitious multidimensional developmental transformation. This study employed a system dynamic approach with region-based closed feedback, focusing on four primary commodities: rice, cassava, corn, and palm oil. It concludes that food vulnerability will become increasingly severe by 2045, particularly in Java Island, which, despite being the sole area with a food surplus, is also experiencing escalating development pressures. In other regions, this pressure transforms transitory land from areas growing rice to areas growing other agricultural commodities, and subsequently to built-up land. The policy intervention scenario, albeit less impactful in reflecting substantial land cover changes nationally, can facilitate swift commodity production. This study emphasizes the necessity of intensifying rather than expanding agricultural land.

System Dynamics Modeling of Caries Severity States in Long-Term Care.

Dental caries among long-term care (LTC) residents is a persistent and complex problem driven by social and structural factors. Systems thinking may be useful in considering novel approaches to reducing disease. This study aimed to develop a system dynamics model to simulate the progression of dentate older adults in LTC through caries severity states and estimate the effects of 3 intervention scenarios on the progression of caries: preventive topical fluoride (TF), arrest of caries with silver diamine fluoride (SDF), and a combination of TF and SDF. Dentate older adults in LTC were categorized into 4 caries severity states by their number of untreated carious lesions. The model assumed that changes in severity states were consistent with incidence rates reported in the literature and available billing data for dental care and that individuals move in and out of the system by entering and exiting the facility or experiencing edentulism. For all scenarios, the proportion of dentate older adults in LTC with 1 or more untreated lesions stays stable, the distribution of disease shifts from a high severity state, and the system approaches equilibrium after 4 y. The TF intervention predicts minimal impacts on decreasing the proportion of dentate older adults with 1 or more untreated lesions (2.5% decrease), while the SDF intervention and the combination interventions were most disruptive. There was a 29.6% and 33.6% decrease, respectively. Given the specific population dynamics in LTC, these findings suggest that long-term (greater than 4 y) interventions should be designed to address both the management of existing lesions and their incidence. This system dynamics model allows researchers to render institution-specific data points from LTCs to estimate the effects of proposed interventions at the respective site.

Estimated health effect, cost, and cost-effectiveness of mandating sodium benchmarks in Australia's packaged foods: a modelling study

Excess dietary sodium is a leading cause of death and disability globally. Because packaged foods are a major source of sodium in many countries, including Australia, mandatory limits for sodium might improve population health. We aimed to estimate the long-term health and economic effect of mandating such thresholds in Australia. We used a multiple cohort, proportional, multistate, life table model to simulate the effect of mandating either the WHO global sodium benchmarks or the currently non-mandatory Australian Healthy Food Partnership (HFP) sodium targets. We compared maintaining the current sodium intake status quo with intervention scenarios, using nationally representative data on dietary intake, sodium in packaged foods, and food sales volume. Blood pressure and disease burden data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study. The effect of sodium reduction on blood pressure and disease risk was modelled on the basis of meta-analyses of randomised trials and cohort studies. Intervention and health-care costs were used to calculate the incremental cost per health-adjusted life-year (HALY) gained. Costs and HALYs were discounted annually at 3%. Compared with the status quo intervention, mandating the WHO benchmarks could be cost saving over the first 10 years (AUD$223 [95% uncertainty interval 82-433] million saved), with 2743 (1677-3976) cardiovascular disease deaths and 43 971 (26 892-63 748) incident cardiovascular disease events averted, and 11 174 (6800-16 205) HALYs gained. Over the population's lifetime, the intervention was cost effective (100·0% probability). Mandating the HFP sodium targets was also estimated to be cost effective (100·0% probability), but with 29% of the health benefits compared with the WHO benchmarks. Our modelling study supports mandating sodium thresholds for packaged foods as a cost-effective strategy to prevent death and disease in Australia. Although making Australia's voluntary reformulation targets mandatory might save thousands of lives, mandating the WHO global benchmarks could yield substantially greater health gains. None.

Data-driven Huntington's disease progression modelling and estimation of societal cost in the UK.

We develop a Huntington's disease (HD) progression model and integrate this with a novel economic model, accounting for the major factors of the HD's societal cost. Data from the Enroll-HD observational study were used to fit a continuous-time hidden Markov disease progression model, which identified five distinct states. The number of disease states was determined using a cross-validated maximum likelihood approach. A novel data augmentation method was used to correct the biased life expectancy of the progression model. Multiple sources of cost data were then mapped to Enroll-HD variables using expert experience. A simulation of a synthetic patient population was used to show the feasibility of the approach in estimating population costs and the impact of hypothetical intervention scenarios. Our results confirm that early cognitive decline, which is not captured by the total functional capacity score currently used by clinicians but flagged up in HD integrated staging system, can be quantified from participants' visits. Finally, the results of the UK cost modelling show that indirect costs of HD such as state benefits and lost gross domestic product contribution could be the driving factors for the societal cost, over and above health and social care costs.

Multimodal human-computer interaction in interventional radiology and surgery: a systematic literature review.

As technology advances, more research dedicated to medical interactive systems emphasizes the integration of touchless and multimodal interaction (MMI). Particularly in surgical and interventional settings, this approach is advantageous because it maintains sterility and promotes a natural interaction. Past reviews have focused on investigating MMI in terms of technology and interaction with robots. However, none has put particular emphasis on analyzing these kind of interactions for surgical and interventional scenarios. Two databases were included in the query to search for relevant publications within the past 10 years. After identification, two screening steps followed which included eligibility criteria. A forward/backward search was added to identify more relevant publications. The analysis incorporated the clustering of references in terms of addressed medical field, input and output modalities, and challenges regarding the development and evaluation. A sample of 31 references was obtained (16 journal articles, 15 conference papers). MMI was predominantly developed for laparoscopy and radiology and interaction with image viewers. The majority implemented two input modalities, with voice-hand interaction being the most common combination-voice for discrete and hand for continuous navigation tasks. The application of gaze, body, and facial control is minimal, primarily because of ergonomic concerns. Feedback was included in 81% publications, of which visual cues were most often applied. This work systematically reviews MMI for surgical and interventional scenarios over the past decade. In future research endeavors, we propose an enhanced focus on conducting in-depth analyses of the considered use cases and the application of standardized evaluation methods. Moreover, insights from various sectors, including but not limited to the gaming sector, should be exploited.

Calculating potential impact fractions to assess the impact of tobacco control policies

Abstract This presentation will provide a straightforward and accessible method for evaluating the effectiveness of various tobacco control policies in reducing the smoking-associated disease burden. To estimate numbers and proportions of potentially avoidable disease cases under different policy intervention scenarios (such as cigarette tax/price increases, comprehensive marketing ban, and plain packaging), this approach entails the calculation of age- and sex-specific potential impact fractions, representing the percentage change in disease risk following changes in exposure to smoking. The approach can account for lag and latency periods between reductions in smoking prevalence and declines in disease excess risks. The future disease burden is estimated by combining data on the incidence or mortality of the disease of interest, published effect sizes of tobacco control policies, and national smoking prevalence data. Intervention scenarios are compared against a status quo scenario that assumes the continuation of recent smoking trends. The presentation will outline the approach, using the example of smoking-associated cancer, and discuss model assumptions, required data, and sensitivity analyses. This straightforward modelling framework enables the comparison of different health policy measures’ impacts, providing valuable insights for policymakers and public health officials regarding the potential public health impact of tobacco control policy measures.

Carving out space for co-creation in implementation of evidence-based mental health interventions

Abstract Background Mental health is identified as a pressing public health priority for European countries challenged by societal changes. The ADVANCE project aims to strengthen our understanding of mental health promotion and prevention in seven countries in Europe. In Denmark, the research project sets out to understand how WHO’s stress management intervention Self Help Plus can be embedded within social and integration programmes for adults who have experienced migration. Methods We are using a common methodology across the 7 country projects oriented by co-creation with end users and relevant stakeholders to initially develop implementation scenarios and stigma reduction strategies. We will present findings from this process and reflect on the tension and potential of the co-creation methodology in the implementation of evidence-based mental health interventions. Results In the first project phase of problem analysis and co-creation, the project’s society advisory group discussed 10 tailored intervention scenarios. Then, a Delphi survey and two rounds of scenario-based workshops with additional involvement of 16 end users/actors resulted in a final implementation scenario and stigma reduction strategies. We identified and reflected on questions around ownership of the project, boundaries of the proposed intervention, alignment of expectations, and intervention sustainability within the parameters of the ADVANCE project. Conclusions Even when interventions are pre-selected in response to funding calls, co-creation can facilitate the development of acceptable and sustainable implementation strategies. However, meaningful co-creation requires time, flexibility, and negotiation, which is not always guaranteed. Key messages • Co-creation creates productive tension and potential for the implementation of ADVANCE. • Space for co-creation was negotiated with collaborators to ensure meaningful engagement.

Co-creating stigma-prevention strategies for mental health interventions with migrant populations

Abstract Background The ADVANCE project aims to address mental health disparities among people in a situation of vulnerability in Europe. Through a co-creation approach, workshops were conducted to devise stigma prevention strategies during the implementation of mental health promotion interventions for migrant populations in Italy and Denmark. Methods The methodology involved two rounds of scenario-based workshops, a participatory method that elicit expert opinions to solve local problems and anticipate future ones. Round 1 included two separate workshops with (1) end-users and umbrella organizations, and (2) healthcare practitioners and decision-makers, to ensure diverse perspectives and minimize the impact of power imbalances. Participants brainstormed strategies to minimize stigma and optimize the intervention scenario. In Round 2, a mixed-group workshop was held to refine the strategies. Workshops occurred in Copenhagen and Verona in March 2024. Content analysis of the data was carried out. Results In Denmark, discussions emphasized tailored presentation of the intervention promoting shared experiences and normalizing mental health challenges, language sensitivity, participation through self-identification, and attention to relational aspects in intervention delivery to combat stigma effectively and enhance acceptability and engagement with the intervention. In Italy, proposed strategies included group exercises to raise awareness and promote open dialogue about cultural differences, language barriers, and discrimination. Discussions also considered the intersectionality of stigma, including factors like gender, socioeconomic status, and sexual orientation. Common themes included language sensitivity, facilitator training, and inclusive and safe spaces. Conclusions Scenario-based workshops can be a valuable tool to facilitate the co-creation of stigma-prevention strategies while involving all stakeholders in promoting effective mental health interventions. Key messages • Co-creation approach fostered stakeholder collaboration, yielding tailored strategies that promote inclusivity, acceptability and engagement with mental health interventions for migrant populations. • Context-specific approaches that emphasize trust, confidentiality and cultural sensitivity were prioritised to tackle stigma when implementing interventions and promoting mental health equity.

The effect of digital therapeutics intervention on improving hypertension management in adults: a meta-analysis of randomized controlled trial.

Digital therapeutics (DTx) intervention is an emerging therapy for the treatment and long-term management of hypertension. We aim to systematically evaluate the overall effect of DTx intervention on improving hypertension management. The systematic review and meta-analysis of RCTs was conducted and the PubMed, EMBASE, Web of Science, and Cochrane Library were searched to identify eligible RCTs published between Jan 1, 1982 and Sep 10, 2023. Random-effect models were utilized to pool estimates of net changes in systolic blood pressure (BP), diastolic BP, BP control rate, body mass index, weight, waist circumference, and physical activity between the DTx group and control group. 15 RCTs were included with a total of 3789 participants. Compared with the control group, DTx intervention was associated with significant changes in systolic BP, diastolic BP, and BP control rate of -3.75 mmHg(95% CI -5.74 to 1.77), -1.79 mmHg (95% CI -2.81 to -0.77) and 1.47% (95% CI 1.10 to 1.95), respectively. In addition, DTx intervention was statistically significant for improving other risk factors such as lower BMI (-0.5 kg/m2, 95% CI -0.86 to -0.15), increased physical activity (66.73 min/week, 95%CI 49.64 to 83.81), and reduced waist circumference (-2.91 cm, 95% CI -5.15 to -0.66). No difference between groups was demonstrated in weight (P = 0.30). Subgroup analyses revealed consistent effects of the change in SBP and DBP across study duration, age, sample size, patient baseline status, and intervention scenario settings(P > 0.05). DTx intervention may be useful for lowering BP and long-term management of hypertension. More large-size trials providing evidence on the same product are needed.

Stranded Asset Impairment Estimates of Thermal Power Companies Under Low-Carbon Transition Scenarios

The aspiration to reach the net zero carbon target has initiated new ideas for the sustainable development of the world economy. However, it has also accelerated the formation of stranded assets in high-carbon-emitting companies. Taking a Chinese thermal power company as an example, this paper proposes a model to estimate the degree of impairment loss for thermal power companies by integrating the net present value model with forward-looking carbon emission pathways under different policy intervention scenarios. The results show that under the low-carbon transition scenario with different policy interventions, the percentage of impairment loss of thermal power companies reaches up to 64.09%. Furthermore, impairment losses formed by stranded assets in the thermal power sector impose a severe shock on the national economy, as most of the impairment losses will ultimately be borne by the state treasury. Compared with conventional thermal power generation, new-energy power generation has a weak performance in delaying company bankruptcy caused by stranded assets. Therefore, in the process of a low-carbon transition, governmental departments should focus on the impairment loss of thermal power companies caused by stranded assets and should further integrate “green support” and “brown punishment” policies to effectively promote the low-carbon transition of thermal power companies.

The MAXLab aggression and bystander intervention scenario set (MAXLab_ABISS): A modular scenario set for studying decision making in situations of interpersonal violence in virtual reality

Abstract Objective This Research Note describes the MAXLab Aggression and Bystander Intervention Scenario Set (MAXLab_ABISS) and provides empirical examples of its applicability. We describe the scenarios, elaborate on the production process, provide technical specifications, and explain how materials can be obtained. Method This modular stimulus set, which is currently available in the English, German and Dutch language, includes 360° videos for studying decision-making in interpersonal violence. It offers researchers a complimentary method to collect data on emotions, perceptions, and reactions to violent situations using immersive technology. Results Analysis from two samples (n = 101 and n = 55) show the immersive scenarios of the stimulus set are effective at evoking targeted emotional experiences at the moment of a crime decision. Conclusion MAXLab_ABISS is a safe and effective tool for studying decision making in real-life, emotion-laden criminogenic settings. We offer insights for how researchers can further use the materials to study decision making related to crime and violence.

Systems modelling and simulation to guide targeted investments to reduce youth suicide and mental health problems in a low–middle-income country

BackgroundDespite suicide’s public health significance and global mental health awareness, current suicide prevention efforts show limited impact, posing a challenge for low- and middle-income countries. This study aimed to develop a dynamic simulation model that could be used to examine the potential effectiveness of alternative interventions for reducing youth mental health problems and suicidal behavior in Bogotá, Colombia.MethodsA system dynamics model was designed using a participatory approach involving three workshops conducted in 2021 and 2022. These workshops engaged 78 stakeholders from various health and social sectors to map key mental health outcomes and influential factors affecting them. A model was subsequently developed, tested, and presented to the participants for interactive feedback, guided by a moderator. Simulation analyses were conducted to compare projected mental health outcomes for a range of intervention scenarios with projections for a reference scenario corresponding to business-as-usual.ResultsA total of 6670 suicide attempts and 347 suicides are projected among 7 − 17-year-olds from January 1, 2023, to early 2031 under the business-as-usual scenario. Mental health issues among 12 − 17-year-olds are projected to increase from 18.9% (2023) to 27.8% (2031), and substance use issues from 2.29 to 2.49% over the same period. School-based suicide prevention and gatekeeper training are the most effective strategies, reducing total numbers of suicide attempts and suicides by more than 20% (i.e., compared to business-as-usual). However, discontinuous funding significantly hinders these effective suicide prevention efforts.ConclusionsSystems modelling is an important tool for understanding where the best strategic financial and political investments lie for improving youth mental health in resource-constrained settings.

Transmission of respiratory diseases in high-metabolic environments: A case study of gym

Outbreaks of respiratory infectious diseases have often been reported in fitness centers, likely attributed to high population density, extensive shared surfaces, and elevated metabolic equivalent (MET) levels. This study analyzed the behaviors of 30 gym attendees to establish a connection between exercise intensity and virus exposure. Close interactions among participants were tracked using self-developed wearable devices that utilized computer vision technologies, while surface-contact behaviors were recorded using video cameras. A multi-route transmission model for respiratory infectious diseases was subsequently created, integrating the observed behaviors. The Omicron variant of COVID-19 served as a case study to evaluate infection risk via various transmission routes and to assess the efficacy of interventions. The METs during physical activity were about 3.5 times higher than those recorded at rest. The average interpersonal distance during close interactions in the gym was measured at 0.82 m, with 36.7 % of interactions occurring face-to-face. On average, the participants made contact with surfaces 770.3 times per hour, with 517.5 of these contacts involving public surfaces. The hourly infection rate was calculated at 18.5 %, with long-range airborne transmission and close contact accounting for 70.1 % and 28.5 % of the cases, respectively. To mitigate transmission risk, several intervention scenarios were modeled. These included (1) 100 % mask-wearing with N95 masks and occupancy reduced to 62 % (25 m2/person); (2) 100 % mask-wearing with surgical masks and occupancy reduced to 26 % (59.6 m2/person); (3) no mask-wearing, with occupancy reduced to 18 % (86.1 m2/person). All scenarios fulfilled the criteria for achieving an Rt below 1, indicating that under these conditions, gyms could be reopened safely.

Equity Market Pricing and Central Bank Interventions: A Panel Data Approach

This paper analyzes the effects of central bank interventions via large-scale purchases of government debt securities on the pricing of stock market indices. This study examines the effects of changes in the size of the Federal Reserve’s balance sheet in three intervention scenarios: during the 2008–2013 period, the 2020–2022 period, and in the years between by using the instrumental variables three-stage least squares (3SLS) method for a time series approach, and calculates the effects of these interventions on each index in a fund of funds setup using the panel data strategy. This study confirms that large-scale purchases of government debt securities in response to the Great Recession and COVID-19 crises influenced the pricing of equity markets via their effect on the pricing of treasury bonds, with different degrees of sensitivity of each index to the effects on yields. Although the findings apply to the U.S. market, the results indicate that the pricing of small capitalization indices such as the Russell 2000 are less sensitive to changes in treasury yields caused by central bank interventions than large capitalization indices such as the DJIA. This research contributes to the understanding of financial asset pricing, particularly by identifying price distortions within equity market portfolios.

Assessing the Impact of Federal Reserve Policies on Equity Market Valuations: An Instrumental Variables Approach

This study investigates the impact of Central Bank interventions on the pricing dynamics of select stock markets. The research utilizes the instrumental variables three-stage least square (3SLS) model approach. It analyses the effects of variations in the Federal Reserve’s balance sheet size across three distinct intervention scenarios: the 2008–2013 Great Recession, the 2020–2021 COVID-19 pandemic periods, and an overarching analysis spanning these timelines. Our methodology includes estimations of the Seemingly Unrelated Regression Equations (SURE), and the results are robust under the two-step Generalized Method of Moments (GMM). Our findings indicate that changes in the size of the Fed’s balance sheet correlate significantly with the pricing of principal U.S. equity market indices. This correlation reflects a time-dependent effect emanating from the Fed’s balance sheet expansion, marking a growing divergence between the adaptability of pricing mechanisms in equity and debt markets. Notably, the Federal Reserve’s interventions during the COVID-19 crisis are associated with an increase of approximately 0.0403 basis points per billion in treasury yields. This research makes a significant contribution to the understanding of financial asset pricing, particularly by elucidating the extent to which interventions in government debt securities engender price distortions in certain equity markets.

Causal inference of urban heat island effect and its spatial heterogeneity: A case study of Wuhan, China

The accelerated urbanization process has exacerbated the urban heat island effect, leading to significant negative impacts on the physical and mental health of urban residents. A deeper understanding of the mechanisms underlying the urban heat island phenomenon is essentially beneficial for providing scientific supports towards improving the urban thermal environment. To address the challenge of effectively depicting the complex interactions among urban environment factors, this study employed the Peter-Clark causal discovery algorithm to analyze the causal structure of urban thermal driving factors, and validated the effectiveness of the 6 key factors directly influencing the surface urban heat island intensity (SUHII). In response to the inadequacy of existing big data causal inference tools in assessing the spatial heterogeneity of causal effects, this study proposed a method for evaluating the causal effects on SUHII and their spatial heterogeneity based on local analysis and geospatial causal principle. The result for 4 different intervention scenarios in this study show that there is obvious spatial heterogeneity in the causal effects of different interventions on SUHII in Wuhan, and that increasing greenery and preserving natural environments is an effective way to mitigate the urban heat island (UHI) effect. This approach, provides a new perspective for studying the phenomenon of UHI and insights of potential approaches for mitigating UHI.

Projecting the Dynamic Trends of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Modeling the Epidemic in Sichuan Province, China

ObjectiveOur study aimed to provide a comprehensive overview of the current status and dynamic trends of the human immunodeficiency virus (HIV) prevalence in Sichuan, the second most heavily affected province in China, and to explore future interventions. MethodsThe epidemiological, behavioral, and population census data from multiple sources were analyzed to extract inputs for an acquired immunodeficiency syndrome (AIDS) epidemic model (AEM). Baseline curves, derived from historical trends in HIV prevalence, were used, and the AEM was employed to examine future intervention scenarios. ResultsIn 2015, the modeled data suggested an adult HIV prevalence of 0.191% in Sichuan, with an estimated 128,766 people living with HIV/AIDS and 16,983 individuals with newly diagnosed infections. Considering current high-risk behaviors, the model predicts an increase in the adult prevalence to 0.306% by 2025, projecting an estimated 212,168 people living with HIV/AIDS and 16,555 individuals with newly diagnosed infections. ConclusionHeterosexual transmission will likely emerge as the primary mode of AIDS transmission in Sichuan. Furthermore, we anticipate a stabilization in the incidence of AIDS with a concurrent increase in prevalence. Implementing comprehensive intervention measures aimed at high-risk groups could effectively alleviate the spread of AIDS in Sichuan.

A Novel Shielding Device for Cardiac Cath Labs.

This research evaluates the effectiveness of a large specialized cardiac catheterization laboratory shielding device (SCCLSD) placed perpendicular to the patient compared to traditional shielding methods in reducing occupational exposure to scattered x rays, contributing to the ongoing enhancement of radiation safety in the cardiac catheterization laboratory (CCL) setting. An experimental setup involving an anthropomorphic phantom on the catheterization table simulated radiation scatter from a patient. Measurements were taken systematically at various grid points and heights in the CCL using a Fluke 451P ion chamber while mimicking a real interventional scenario. In-air peak exposure rates were analyzed at head, chest, and waist heights in the anteroposterior (AP) position. Results demonstrated that the SCCLSD provided a superior radiation shadow and effective whole-body radiation exposure reduction compared to conventional shielding devices. Considering that conventional shielding requires staff to wear lead aprons, an effective dose equivalent correction factor was applied for exposure measurements without the SCCLSD. Even after the correction factor, the SCCLSD continued outperforming lead aprons and offered whole-body protection, including the head and arms, which is typically neglected with conventional shielding. The SCCLSD also reduces exposure to the eyes, aligning with lower occupational exposure recommendations from ICRP and NCRP. However, proper CCL staff positioning is important in maximizing the effectiveness of the SCCLSD. Future research avenues may explore exposure rates at different C-arm angles to more completely assess the SCCLSD's impact on occupational exposure.

Projected impact of fast-tracking of anti-retroviral treatment coverage on vertical transmission of HIV in India.

One of the five high-level goals under Phase V of the National AIDS and STD Control Programme (NACP) of the Government of India is the elimination of vertical transmission of HIV. In this paper, we estimate the potential impact of maintaining and enhancing the anti-retroviral treatment under the NACP in terms of averting new infections and vertical transmission rates vis-à-vis no intervention scenario. We used India's HIV Estimates 2022 models to create treatment coverage scenarios of no interventions, status quo, business as usual, on-track and fast-track scenarios from 2023 to 2030. Our analysis indicates that fast-tracking scale-up of treatment services would avert almost 41000 child infections from 2023 to 2030 leading to a vertical transmission rate of around 7.70% in 2030 vis-a-vis no interventions scenario. Higher and sustained ART coverage would not only take the country closer to the elimination goals but would also prevent thousands of vertical transmissions, thus bringing a lot of benefits to HIV-positive pregnant women and their families. Supported by efforts for the prevention of new infections in the general population, India is on track for the attainment of elimination of vertical transmission of HIV by 2030.