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Abstract Background Multimorbidity among older adults is a growing concern in India. Multimorbidity is defined as the coexistence of two or more chronic health conditions in an individual. Primary studies have been conducted on risk factors of multimorbidity in India, but no systematic review has been conducted on this topic. This systematic review aimed to synthesize the existing evidence on risk factors of multimorbidity among older adults in India. Methods The JBI and Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines were followed. Several databases were searched for published and unpublished studies until August 03, 2022. The screening of titles and abstracts and full texts, data extraction, and quality assessment were conducted by two independent reviewers. Any disagreements were resolved through discussion or by involving a third reviewer. Data synthesis was conducted using narrative synthesis and random effects meta‐analysis, where appropriate. Results Out of 8781 records identified from the literature search, 16 and 15 studies were included in the systematic review and meta‐analysis, respectively. All included studies were cross‐sectional, and 10 met a critical appraisal score of more than 70%. Broadly, sociodemographic, lifestyle, and health conditions‐related factors were explored in these studies. The pooled odds of multimorbidity were higher in people aged ≥70 years compared to 60‐69 years (odds ratio (OR) 1.51; 95% confidence interval (CI) 1.20–1.91), females compared to males (1.38; 1.09–1.75), single, divorced, separated, and widowed compared to married (1.29; 1.11–1.49), economically dependent compared to economically independent (1.54; 1.21–1.97), and smokers compared to non‐smokers (1.33; 1.16–1.52) and were lower in working compared to not working (0.51; 0.36–0.72). Conclusion This systematic review and meta‐analysis provided a comprehensive picture of the problem by synthesizing the existing evidence on risk factors of multimorbidity among older adults in India. These synthesized sociodemographic and lifestyle factors should be taken into consideration when developing health interventions for addressing multimorbidity among older adults in India.

Abstract Unesbulin is being investigated in combination with dacarbazine (DTIC) as a potential therapeutic agent in patients with advanced leiomyosarcoma (LMS). This paper reports the pharmacokinetics (PK) of unesbulin, DTIC, and its unreactive surrogate metabolite 5‐aminoimidazole‐4‐carboxamide (AIC) in 29 patients with advanced LMS. Drug interactions between DTIC (and AIC) and unesbulin were evaluated. DTIC (1000 mg/m2) was administered to patients with LMS via 1‐h intravenous (i.v.) infusion on day 1 of every 21‐day (q21d) cycle. Unesbulin dispersible tablets were administered orally twice weekly (b.i.w.), starting on day 2 of every cycle, except for cycle 2 (C2), where unesbulin was dosed either on day 1 together with DTIC or on day 2, 1 day after DTIC administration. The PK of DTIC, AIC, and unesbulin in cycle 1 (C1) and C2 were estimated using noncompartmental analysis. DTIC and AIC were measurable immediately after the start of infusion and reached maximum plasma concentration (Cmax) immediately or shortly after end of infusion at 1.0 and 1.4 h (time to Cmax), respectively. Co‐administration of unesbulin orally at 200 mg or above with DTIC inhibited cytochrome P450 (CYP)1A2‐mediated DTIC metabolism, resulting in 66.7% reduction of AIC exposures. Such inhibition could be mitigated when unesbulin was dosed the day following DTIC infusion. Repeated unesbulin dosing demonstrated evidence of clinical CYP1A2 induction and increased AIC Cmax by 69.4% and area under concentration‐time curve to infinity by 57.9%. No meaningful difference in unesbulin PK was observed between C2 and C1. The combination therapy of 1000 mg/m2 i.v. DTIC q21d and 300 mg unesbulin b.i.w. in a staggered regimen is well‐tolerated in patients with LMS.

Purpose. Since February 2020, the world has been overwhelmed by the SARS-CoV-2 outbreak, and several patients suffered interstitial pneumonia and respiratory failure requiring mechanical ventilation, threatening the capability of healthcare systems to handle this amount of critical cases. Intravenous immunoglobulins (IVIG) possess potential immunomodulatory properties beneficial for COVID-19 patients, yet evidence supporting IVIG as adjunctive therapy remains sparse. This study evaluated the outcomes of adjunctive IVIG with the standard of care (SoC) in moderate-to-severe COVID-19 patients. Methods. This randomized study included 59 moderate-to-severe COVID-19 patients with known comorbidities. One arm (n = 33) received high-dose IVIG (400 mg/kg/day) within 48 hours for five days alongside SoC, while the other arm (n = 26) received SoC, comprising steroids, enoxaparin, and remdesivir. The primary endpoint was clinical improvement, as measured by the National Early Warning Score 2 (NEWS2) and discharged/death proportions. Secondary outcomes included IVIG safety, hospitalization duration, changes in oxygen saturation, inflammatory markers, IgG titer, CTSS (CT severity score), and radiological findings. Results. There was an improvement in the NEWS2 at the end of treatment in the IVIG arm (5.67 vs. 5.96). A significant absolute effect improvement (Day 1 vs. Day 9) was seen in serum LDH, D-dimer, hs-CRP, IL-6, CTSS, procalcitonin, respiratory rate, and chest radiographic findings. SARS-CoV-2 IgG titer increased significantly in the IVIG arm. There was a statistically significant reduction in mortality in the IVIG group (5 vs. 10). Conclusion. IVIG was a safe and effective adjunctive therapy to SoC treatment in moderate-to-severe COVID-19 patients needing ventilatory support. Furthermore, studies are required to validate our findings. This trial is registered with CTRI/2021/05/033622.

Clozapine is an antipsychotic medicine used to treat mental illnesses that is resistant to therapy. It can induce dose-dependent adverse effects such as increased susceptibility to infections and hematological irregularities. In this case report, we present a 37-year-old woman with schizoaffective disorder who experienced clozapine side effects following a moderate urinary tract infection (UTI). Her serum clozapine levels and side effects were increased throughout her UTI but resolved once the UTI was managed conservatively. We reviewed clozapine’s pharmacokinetic properties to understand why serum levels rose during infection. While we could not definitely explain the mechanism of elevation, we emphasize the importance of monitoring serum clozapine levels and keeping watchful for adverse effects, as well as heightened scrutiny, evaluation for recent infections, and regular monitoring of patients.

Rapid urbanisation has led to a dramatic increase in sewage sludge production. There are limited methods of managing sewage sludge along with high energy and monetary investment. A cost-effective, environment-friendly, and sustainable solution needs to be developed for the management of sewage sludge. In the current study, sludge from the Jagjeetpur sewage treatment plant (STP) had been collected, composted, and characterized during January and February 2022. A comparison of STP sludge compost and compost made from farmyard manure showed the presence of essential agricultural nutrients in them, due to which they find application for plant growth. Two products, Jaivik Poshak and Jaivik Prom, containing farmyard compost, were compared with the amended version of the same, containing compost from STP sludge instead of normal compost. The results showed that the modified Jaivik Poshak was the best for maintaining pH and increasing electrical conductivity. The available nitrogen in the soil upon its application increased by 1.6 times (p

Prolonged low-dose administration (PLDA) of several FDA-approved drugs for noncancer conditions or dietary compounds is associated with a lower incidence of specific types of cancers and with the lower formation of metastasis. However, the underlying mechanism is unknown; there is a discrepancy between the concentration of drugs needed to kill cancer cells in vitro and the actual serum levels (10 and >1000 times lower) found in patients. In this study, we evaluated the hypothesis that clonogenicity may be the target of PLDA. We compared the effect of nigericin (NIG) and menadione (MEN) on the human A549 and H460 lung and MCF-7 and MDA-MB-231 breast cancer cell lines using routine MTT and colony forming assays (CFA). The ability of both NIG and MEN to eliminate 100% of cancer cells was at least 2-10 times more potent in CFA compared to MTT assays. Our results revealed the existence of a short post-reattachment window of time when cancer cells growing at low density are more sensitive to PLDA of specific drugs likely by targeting clonogenic rather than proliferation pathways. This short ultrasensitive window of time (SUSWoT) was cell- and drug-type specific: the SUSWoT for NIG was present in H460, A549, and MDA-MB-231 cells but not evident in MCF-7 cells. Conversely, a similar SUSWoT for MEN was present in MCF-7, MDA-MD-231, and A549 cells but not evident in H460 cells. Our findings partially explain the decreased incidence of specific types of cancer by PLDA of FDA-approved drugs (or dietary compounds) for noncancer conditions.

Abstract Introduction Mass malaria vaccination, rather than vaccinating only children below age 5, has been proven to have the potential to reduce morbidity and mortality among those vaccinated, both young and old. Addressing vaccine scepticism and misinformation is crucial in African nations to build public trust in malaria prevention. Therefore, including a wider range of demographics in vaccine trials is necessary for equitable representation and achieving herd immunity against malaria. Aim This present article aims to identify some of the obstacles that impede malaria vaccination usage and acceptability in African Nations in combating malaria in the region as it continues to pose a significant global public health problem. Methodology A literature search was done on the Malaria vaccine between 2000 and 2023. Past and present articles/studies on this topic were consulted on PubMed, Google Scholar, Scopus and Web of Science using the following keywords; “Malaria,” “Vaccines,” “African Nations,” “Obstacles, Strategies,” and “Public Health.” Results The recently approved RTS, S/AS01, and R21/Matrix‐M™ Malaria vaccines have the potential to prevent numerous deaths and cases of Malaria in Africa. These vaccines Malaria vaccines are cost‐effective in African areas with moderate to high plasmodium falciparum and can be delivered through routine immunization. Conclusion To combat malaria effectively in African Nations, African leaders need to set up a comprehensive approach that involves; prevention, healthcare access, implementation research strategies towards adoption and acceptance of malaria vaccines in Africa as well as community engagement with the religious leaders, the market women, community heads, schools, as well as students’ union towards the willingness and acceptability of the malaria vaccines among the African populations.

Abstract The growing cognizance of spectrum scarcity has become a more significant concern in wireless radio communications. Due to the exponential growth of data transmission in intelligent wireless sensor networks, energy spectrum detection has become a promising solution for resolving spectrum shortages. Primary user emulation attack (PUEA) has been identified as a significant attack vector in the cognitive radio (CR) domain's physical layer. In comparison, the CR is a promising method to increase spectrum efficiency by allowing unlicensed secondary users (SUs) to access licensed frequency bands without interfering with approved primary users (PUs). The study's primary findings are the methodology for preventing PUEA using authentication tags, which are unique sequences. This research blends SC‐FDMA with CR to protect CR networks from PUEA attacks, a Latin square (LS) matrix tag generation system is proposed to mitigate the PUEA effect. The technology is meant to provide effective authentication and protection against malicious users. In a secured environment, the LS tag technique is utilized to track and estimate the PU. For example, the BER of both techniques is virtually identical between 0 and 4 dB, while the BER performance of the suggested LS tag generation improves with increasing signal‐to‐noise ratio (SNR). As a result, the suggested LS tag generation is less susceptible to PUEA. To diminish the influence of PUEA in CR networks, an efficient enlightening approach for making the future Green Cognitive Radio Wireless networks structure is proposed. The simulation results also demonstrate the resilience of the proposed CR spectrum sensing techniques for energy‐efficient knowledge at varying degrees to reduce the adverse effects of environmental technologies.

Miniature robots provide unprecedented access to confined environments and show potential for applications such as search‐and‐rescue and high‐value asset inspection. The capability of body deformation further enhances the reachability of these small robots in cluttered terrains similar to those of insects and soft arthropods. Motivated by this concept, compliant legged articulated robotic insect (CLARI), an insect‐scale 2.59 g quadrupedal robot capable of body deformation, is presented. The robot, currently, with tethered electrical connections for power and control is manufactured using laminate fabrication and assembled using origami pop‐up techniques. To enable locomotion in multiple shape configurations, a novel body architecture comprising modular, actuated leg mechanisms, is designed. CLARI has eight independently actuated degrees of freedom driven by custom piezoelectric actuators, making it mechanically dextrous. Herein, open‐loop robot locomotion at multiple stride frequencies (1–10 Hz) is characterized using multiple gaits (trot, walk, etc.) in three different fixed body shapes (long, symmetric, wide) and the robot's capabilities are illustrated. Finally, preliminary results of CLARI locomoting with a compliant body in open terrain and through a laterally constrained gap, a novel capability for legged robots, is demonstrated. These results represent the first step toward achieving effective cluttered terrain navigation with adaptable compliant robots in real‐world environments.

To promote sustainability, this review explores: 1) the utilization of affordable high‐performance sensors that can enhance food safety and quality, plant growth, and disease management and 2) the Internet of Things (IoT)‐supported sensors to empower farmers, stakeholders, and agro‐food industries via rapid testing and predictive analysis based on sensing generated informatics using artificial intelligence (AI). The performance of such sensors is noticeable, but this technology is still not suitable to be used in real applications owing to the lack of focus, scalability, well‐coordinated research, and regulations. To cover this gap, this review carefully and critically analyzes state‐of‐the‐art sensing technologies developed for food quality assurance (i.e., contaminants, toxins, and packaging testing) and plant growth monitoring (i.e., phenotyping, stresses, volatile organic components, nutrient levels, hormones, and pathogens) along with the possible challenges. The following has been proposed for future research: 1) promoting the optimized combination of green sensing units supported by IoT to perform testing at the location, considering the remote and urban areas as a key focus, and 2) analyzing generated informatics via AI should also be a focus for risk assessment understanding and optimizing necessary safety majors. Finally, the perspectives of IoT‐enabled sensors, along with their real‐world limitations, are discussed.

Abstract Background and Aims Antimicrobial resistance (AMR) is among the top public health concerns around the globe. Migrants, especially forced migrants, could be at higher risk of acquiring and transmitting AMR during their journeys or in host countries. There is limited understanding regarding migrants' living conditions and the wider factors contributing to their risk of acquiring infections, and behaviors around antimicrobial use, and AMR development. In this study, we aimed to explore transit experiences, living conditions, and antibiotic use of migrants living in the United Kingdom. Methods We conducted semistructured qualitative interviews with 27 participants and identified five themes regarding migrants' journey and their living conditions during transit and after arriving in the United Kingdom, their access to water, sanitation and hygiene (WASH), and their use of antibiotics. Results Migrants, particularly forced migrants, experienced unfavorable living conditions, poor access to WASH, and challenges in accessing healthcare, which further contributed to health conditions like urinary and skin problems. Isolation and difficulty in accessing healthcare played significant roles in migrants' perceived need for storing and using antibiotics as a safety net. Conclusion The findings highlight the need for coordinated and multilevel interventions to address these challenges and contribute toward tackling AMR and improving the health of this population group.

Abstract Background and Aims Ayurveda is a traditional medicine that originated in the Indian subcontinent, and its use remains widespread in the Indian subcontinent, especially for managing noncommunicable diseases (NCDs). It is also becoming increasingly popular in the Organization for Economic Co‐operation and Development (OECD) countries as complementary and alternative medicine. Qualitative research studies have been conducted in various OECD countries to explore the experiences, perceptions, and perspectives of Ayurvedic practitioners and patients with NCDs regarding the usage of Ayurveda for managing these conditions. However, to date, no systematic review on this topic has been published. Therefore, this systematic review aims to synthesize the experiences, perceptions, and perspectives of Ayurvedic practitioners and patients with NCDs on the usage of Ayurveda for managing these conditions in OECD countries. Methods The systematic review will be conducted in accordance with the joanna briggs institute systematic review guideline on qualitative evidence. We will include qualitative research studies conducted among Ayurvedic practitioners or adult patients with NCDs in any OECD member country to explore experiences, perceptions, or perspectives regarding the usage of Ayurveda for managing NCDs. MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), PsycINFO (Ovid), AMED, and Web of Science will be searched to identify published studies. EthOS and ProQuest Dissertations and Theses will be searched to identify unpublished studies. No date or language restrictions will be applied. Initially, a narrative synthesis will be conducted. Where possible, study findings will be pooled using the meta‐aggregation approach.

Abstract The joint radar‐communication (JRC) system is envisioned as an emerging sixth generation (6G) technology to tackle spectral congestion and hardware limitations by jointly implementing the communication and radar sensing on the same hardware platform and using the common radio frequency (RF) resources. Joint radar‐communication systems with a multi‐antenna setup leads to higher degrees of freedom, and hybrid beamforming can be exploited to achieve lower hardware complexity than conventional fully digital systems. This paper aims to design a spectral efficiency maximisation approach for a 6G inclined JRC system with hybrid beamforming and multi‐antenna setup while considering the interference between communication and radar operations and hardware impairments in the system. The rate expressions for communication and radar operations are defined, and the joint spectral efficiency is maximised via optimising the number of RF chains using an efficient selection algorithm taking into account the interference of one operation to the other and system hardware distortion. The simulation results are shown to support the effectiveness of the proposed approach, and they are compared with that of existing fully digital and hybrid beamforming based baseline methods with fixed number of RF chains. The proposed approach also exhibits a desirable communication‐radar trade‐off in terms of spectral efficiency gains.

Abstract In this study, we highlight some important factors in the specimen preparation methods for evaluating photovoltaic backsheet properties after accelerated aging. Two different sequences are considered: Method (I) cut‐then‐age: cut into 1‐cm wide strips and then expose to stress, and Method (II) age‐then‐cut: expose a larger sheet to stress and then cut into 1‐cm widths for mechanical property measurements. We also compare the effect of three cutting methods, (a) tensile specimen punch, (b) paper cutter, and (c) fresh razor blade. Several commercial backsheets were evaluated, with stress exposures including (a) pressure cooker test (PCT), (b) dry ultraviolet (UV) radiation exposure, and (c) UV combined damp heat tests. Fourier transform infrared spectrometer (FTIR) and intrinsic viscosity (IV) were used to analyze the materials on unstressed materials and samples exposed to PCT. The results show that both the cutting method and the time of cutting have an impact on the backsheet mechanical properties. Under UV exposure, Method II, age‐then‐cut, generally resulted in a higher average value, with more variation than Method I; however, if the side strips from Method II were excluded, the variation dropped to the same level. This is because the specimens at the sides of the sheet get additional damage from UV light from the exposed sides of the sample. In contrast to UV exposure, PCT specimens prepared by Method II result in lower average values and higher variability. This is attributed to embrittlement through the bulk of the sample where the cutting of embrittled specimens appears to result in more edge defects which can then initiate a break at smaller strains. The data suggest that for UV exposures, the specimens should be cut after aging and the exposed side specimens discarded, and that for PCT exposures, the specimens should be cut before the exposure.

Abstract Background and Aims Yoga has become increasingly popular in the world and the UK for improving health and well‐being. A growing body of research suggests that yoga could be used to improve the management of hypertension in addition to current management strategies. Previous cross‐sectional studies have also reported that hypertension is one of the most commonly disclosed health conditions in yoga sessions in the United Kingdom. Therefore, semi‐structured qualitative interviews were conducted with yoga providers in the United Kingdom (n = 19) to explore their knowledge, experiences, and attitudes toward delivering yoga to people with hypertension. Methods Interviews were audio‐recorded, transcribed verbatim, and analyzed thematically. Results Eight themes were identified. Yoga providers were generally aware of the health conditions of their attendees, and they had a reasonable knowledge of the causes, signs and symptoms, and management of hypertension. While most had received some information about hypertension as part of their initial yoga teaching training, this was generally felt to be limited. They mentioned the biopsychosocial benefits of yoga on hypertension but also expressed their concerns about the lack of regulation, the wide disparity in what is being delivered under the label of yoga, and the competency of some yoga providers. Conclusion The findings suggest that yoga provision in the United Kingdom should be regulated with a better link with health service providers. A manual and training for yoga providers in the United Kingdom for managing hypertension using yoga would be helpful to address the training needs of yoga providers. However, there is a need for more robust studies before recommending the implementation of yoga in the management of hypertension in the United Kingdom.

Abstract A therapeutic agent that targets both viral replication and the hyper‐reactive immune response would offer a highly desirable treatment for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2; COVID‐19) management. Emvododstat (PTC299) was found to be a potent inhibitor of immunomodulatory and inflammation‐related processes by the inhibition of dihydroorotate dehydrogenase (DHODH) to reduce SARS‐CoV‐2 replication. DHODH is the rate‐limiting enzyme of the de novo pyrimidine nucleotide biosynthesis pathway. This drug interaction study was performed to determine whether emvododstat was an inhibitor of breast cancer resistance protein (BCRP) transporters in humans. Potential drug–drug interactions (DDIs) between emvododstat and a BCRP transporter substrate (rosuvastatin) were investigated by measuring plasma rosuvastatin concentrations before and after emvododstat administration. There was no apparent difference in rosuvastatin plasma exposure. The geometric means of maximum plasma rosuvastatin concentrations (Cmax) were 4369 (rosuvastatin) and 5141 pg/mL (rosuvastatin + emvododstat) at 4 h postdose. Geometric mean rosuvastatin area under the concentration–time curve (AUC) from time 0 to the last measurable plasma concentration was 45 616 and 48 975 h·pg/mL when administered alone and after 7 days of b.i.d. emvododstat dosing, respectively. Geometric least squares mean ratios for Cmax and AUC were approximately equal to 1. Overall, administration of multiple doses of 100 mg emvododstat b.i.d. for 7 days in combination with a single dose of rosuvastatin was safe and well tolerated. Emvododstat can be safely administered with other BCRP substrate drugs. Hence, pharmacokinetic DDI mediated via BCRP inhibition is not expected when emvododstat and BCRP substrates are coadministered.

Abstract Introduction Over the last few decades, India has witnessed an increase in the number of people with type 2 diabetes mellitus (T2DM). Consequently, several clinical practice guidelines (CPGs) have been developed to assist western and traditional Indian medicine practitioners in managing this disease. This systematic review aimed to evaluate and synthesize the content and quality of these CPGs. Methods Several databases and sources were searched from inception to May 2022, to identify CPGs for managing adults with T2DM in India. The screening of titles and abstracts and full texts, data extraction and quality assessment were conducted by two independent reviewers. Any disagreements were resolved through discussion or by involving a third reviewer. A data extraction tool from a previous study was adapted to extract the content of the included CPGs, and the Appraisal of Guidelines for Research and Evaluation II tool was used to assess the quality of the included CPGs. A narrative synthesis was conducted. Results Of 3350 records identified, 11 were retrieved for full‐text screening and five CPGs were included in this systematic review—three focused on traditional Indian medicine (Ayurveda) and two focused on western medicine. These two western medicine CPGs contained comprehensive recommendations for managing T2DM but only one of these, the Research Society for the Study of Diabetes in India/Endocrine Society of India (RSSDI/ESI) CPG, was of high quality. Conclusions Only one CPG can be recommended for managing T2DM by western medicine practitioners in India. Future CPGs, especially for traditional Indian medicine practitioners, should be developed and updated using the standard CPG manuals and quality appraisal tools. Registration PROSPERO (CRD42021279499).

Abstract In this paper, an H‐type electric/hybrid electric aircraft propulsion architecture is proposed to address the issues associated with the radial electric propulsion architecture. In a radial architecture, a fault on the main bus or failure of the generator leads to shut down of all the propulsion motors in that channel, thus increasing the burden on the remaining motors to maintain the power required by the aeroplane. As a result, it is necessary to oversize the motors for the purpose of compensating for the loss of other motors. To mitigate these issues, a new H‐type architecture is introduced to isolate the particular faulty section while still maintaining power flow to the remaining healthy motors. The proposed architecture minimises the oversizing of various components in the system as compared to radial propulsion architecture. The sizing of components and the amount of overall mass reduction is discussed by using the proposed architecture. Typhoon Hardware in the Loop platform is used to validate the performance of both the architectures for faults at different locations, and the results are presented.

The review focuses on the emergence of 5G wireless communication and the need for multiple-input multiple-output antennas to support high-speed communication systems. The article discusses the advantages of MIMO antennas, including increased channel capacity and the ability to focus radio frequency energy on specific users. However, the challenges of creating compact MIMO antennas with ideal isolation are addressed, including short wavelengths, connection losses, constrained bandwidth, and path losses in the millimeter-wave range. Design techniques and methods to enhance the performance of conventional antennas for 5G applications are discussed, along with potential solutions for upcoming challenges. The article provides an overview of MIMO antennas for 5G applications, covering frequency bands, system architecture, advantages, challenges, advancements, performance enhancement techniques, design techniques, and state-of-the-art developments.

The continuous demand of today’s scenario and ecological consciousness has made the researchers think about the utilization of alternate sources of materials without compromising the mechanical behavior and characteristics while focusing on the fulfillment of the desired requirements in the wide range of industrial applications. The present work is a noble attempt and a step towards the development of silk fibre composites (SFCs) reinforced with the vinyl ester matrix material. The processing and fabrication of SFRCs have been carried out using the traditional hand layup technique using untreated silk fibres (SFs) and silk cloths (SCs) in the form of single, double, and triple layers of SFs and SCs laminates oriented in uniaxial and biaxial directions. For the prepared composite samples, the density and void contents in the sample, mechanical characteristics in terms of their tensile and flexural strength, and tribological characteristics as well as the electrical impedance have been investigated. The percentage void content was found to be within the acceptance limit. The tensile and flexural test results show a considerable increment which indicates proper stress transfer from matrix phase to fibre with triple-layer cloths showing the highest tensile and flexural properties. In the tribological test, the coefficient of friction is higher in the case of cloth loading as fibre concentration increases significantly. In the impedance test, almost for all samples, the trend of change in conductivity with applied frequency is the same. From the economic perspective, the proposed composite is suitable for a wide range of applications in industries as well as this can be utilized as an alternate source of traditionally used floor tiles currently using ceramic materials. Also, the proposed composite has a biodegradable characteristic that is completely in accordance with the demand and consciousness involved in environmental and ecological perspectives.

Abstract Background and Aims Schools represent a unique setting for promoting lifelong physical activity during critical development stages of life. Opportunities for in‐school physical activity largely depend upon school‐level policies, practices, and administrative support. A significant information gap exists on the factors influencing adolescents' participation in school‐based physical activity programs in Nigeria. This study aimed to identify and explore the barriers and facilitators of physical activity in school‐attending adolescents in Lagos State, Nigeria. Methods A qualitative study, using semistructured interviews, was conducted to explore the views and experiences of 21 decision‐makers who were responsible for planning the physical and health education curriculum in secondary schools in Lagos State, Nigeria. Data were analyzed using the thematic analysis framework. Results Eight themes were identified and explored. The barriers were (i) students' characteristics, (ii) parental objections, (iii) no prioritization of physical activity, (iv) insufficient resources, and (v) challenges with schools' initiatives. The facilitators were (vi) students' interests, (vii) students' awareness of benefits, and (viii) schools' initiatives. Conclusion Our study findings can help in designing interventions to increase physical activity among school‐attending adolescents in Lagos, Nigeria.

Abstract Aims The CardioMEMS HF System Post‐Market Study (COAST) was designed to evaluate the safety, effectiveness, and feasibility of haemodynamic‐guided heart failure (HF) management using a small sensor implanted in the pulmonary artery of New York Heart Association (NYHA) Class III HF patients in the UK, Europe, and Australia. Methods and results COAST is a prospective, international, multicentre, open‐label clinical study (NCT02954341). The primary clinical endpoint compares annualized HF hospitalization rates after 1 year of haemodynamic‐guided management vs. the year prior to sensor implantation in patients with NYHA Class III symptoms and a previous HF hospitalization. The primary safety endpoints assess freedom from device/system‐related complications and pressure sensor failure after 2 years. Results from the first 100 patients implanted at 14 out of the 15 participating centres in the UK are reported here. At baseline, all patients were in NYHA Class III, 70% were male, mean age was 69 ± 12 years, and 39% had an aetiology of ischaemic cardiomyopathy. The annualized HF hospitalization rate after 12 months was 82% lower [95% confidence interval 72–88%] than the previous 12 months (0.27 vs. 1.52 events/patient‐year, respectively, P

Abstract Aims Evaluate whether UK National Institute for Health & Care Excellence (NICE) chronic heart failure (HF) guidelines can be safely and effectively refined through specialist referral management. Methods and results All referrals to a UK centre 1/3/2019–30/5/2019 and 1/6/2020–31/7/2020 were reviewed by HF specialists. Patients were triaged to specialist assessment in HF clinic, according to the NICE HF diagnostic pathway [urgency based on N‐terminal pro brain natriuretic peptide (NTproBNP) levels], or the referrer given remote Advice & Guidance (A&G), to aid primary care management. Standardized triage criteria for recommending primary care management were (i) presentation inconsistent with HF, (ii) competing comorbidity/frailty meant specialist assessment in clinic not in patient's best interests, (iii) recent assessment for same condition, or (iv) patient had known HF. Following triage patients managed in the primary care were categorized as low or high risk of adverse outcomes. Outcome measures were 90 day all‐cause and HF hospital admission and mortality rates. Four hundred and eighty‐six patients had the median age of 80 (74–86) years, and 253 (52%) were male. Two hundred and six (42%) had NTproBNP > 2000 pg/mL. Primary care management was recommended for 128 patients (26%): 105 (22%) A&G alone and 23 input from community HF nurse specialists. Primary care management was recommended due to the following: presentation inconsistent with HF 53 (42%), more important competing comorbidity/frailty 35 (27%), recent assessment 17 (13%), and known HF 23 (18%). Patients managed in primary care had higher rates of all‐cause hospitalization (30% vs. 19%; P = 0.018) and death (7% vs. 2%; P = 0.0054) than those seen in HF clinic. Of those managed in primary care, 50 (39%) were determined to be at low risk and 78 (61%) at high risk. High‐risk patients were older (87 vs. 80 years; P = 0.0026), had much higher NTproBNP (2666 vs. 697 pg/mL; P

Abstract The continuous deterioration of the environment due to extensive industrialization and urbanization has raised the requirement to devise high‐performance environmental remediation technologies. Membrane technologies, primarily based on conventional polymers, are the most commercialized air, water, solid, and radiation‐based environmental remediation strategies. Low stability at high temperatures, swelling in organic contaminants, and poor selectivity are the fundamental issues associated with polymeric membranes restricting their scalable viability. Polymer‐metal‐carbides and nitrides (MXenes) hybrid membranes possess remarkable physicochemical attributes, including strong mechanical endurance, high mechanical flexibility, superior adsorptive behavior, and selective permeability, due to multi‐interactions between polymers and MXene's surface functionalities. This review articulates the state‐of‐the‐art MXene–polymer hybrid membranes, emphasizing its fabrication routes, enhanced physicochemical properties, and improved adsorptive behavior. It comprehensively summarizes the utilization of MXene–polymer hybrid membranes for environmental remediation applications, including water purification, desalination, ion‐separation, gas separation and detection, containment adsorption, and electromagnetic and nuclear radiation shielding. Furthermore, the review highlights the associated bottlenecks of MXene–Polymer hybrid‐membranes and its possible alternate solutions to meet industrial requirements. Discussed are opportunities and prospects related to MXene–polymer membrane to devise intelligent and next‐generation environmental remediation strategies with the integration of modern age technologies of internet‐of‐things, artificial intelligence, machine‐learning, 5G‐communication and cloud‐computing are elucidated.

Abstract Background In the Asia‐Pacific region, around one‐third of the children who are out‐of‐school have a disability and given that teacher readiness and capability are key contributors for inclusive education, it is high time for a mapping of disability inclusive teacher professional development (TPD) interventions in this region. Objectives The key objective of this evidence and gap map (EGM) is to locate evidence on interventions for in‐service TPD focussing on education for the inclusion of students with a disability in low‐ and middle‐income countries (LMICs) in the Asia‐Pacific region. Search Methods A broad range of bibliographic databases and repositories were searched electronically to identify the evidence published between January 2000 and December 2021. Key search platforms included the British Education Index (BEI), Education Research Complete (ERC), Education Resources Information Center (ERIC), SCOPUS, 3ie Development Evidence Portal (Evidence Hub) and the Campbell Collaborations Systematic Reviews and EGMs portal (Better evidence for a better world). In addition, potential program evaluations/impact reports, reviews, case studies, and program descriptions/summaries were sought through ‘snowballing’ based on searching bibliographies and reference lists of papers located during the search process, as well as specific searches of relevant grey literature. Selection Criteria To be eligible for inclusion, studies had to contain sufficient details about TPD interventions that support early childhood educators and kindergarten to Year 12 teachers to understand the needs of students with disabilities and aid them to create inclusive mainstream classrooms and/or provide improved support for students with disabilities in special education settings. Data Collection and Analysis A total of 820 records were entered into the MS Excel file in which the entire data extraction process was managed. All records were screened against the predefined inclusion and exclusion criteria. Data were extracted independently by two reviewers and any differences were resolved through consultations. All included studies and their characteristics were extracted from the MS Excel file and uploaded to the ACER server in.csv file format. The interactive, online EGM is available here: https://datavis.acer.org/gem/disability-inclusion-TPD/. Main Results Fifty studies from 16 countries out of the 41 LMICs in the Asia‐Pacific region were identified, whereby Thailand had the largest number of studies with evidence (7) followed by China, Vietnam, and India (5 each). Two main gaps in research about professional learning were identified. First, only three studies reported interventions aimed at supporting mental health among students with a disability. Second, no studies were found that reported on how teachers could support positive student behaviour. These gaps are important because research has persistently suggested that experiencing disability is an important risk factor for young people developing mental health conditions. Authors' Conclusions This report illustrates the critical value of evaluating and publishing evidence from disability inclusive TPD interventions in LMICs, including any that are ongoing, or are components of highly resource intensive large‐scale education sector programs.

Abstract Aim The study aimed to assess the dissatisfaction of people with type 2 diabetes mellitus (T2DM) with the care that they received at a diabetes outpatient clinic in Ningbo, China and to determine the associated factors. Methods A cross‐sectional study was conducted among 406 adults with T2DM in 2020–2021. Those who were treated at the diabetes outpatient clinic for at least six consecutive months before the survey date were eligible. The Short Assessment of Patient Satisfaction scale was used to assess participants' dissatisfaction with the care that they received. Results Of the participants, 25.1% were not satisfied with the care that they received at the diabetes outpatient clinic in Ningbo. The odds of dissatisfaction were higher in physically active people compared to those who were not (odds ratio [OR]: 3.41; 95% confidence interval [CI]: 1.56–7.45) and those with >1–5 years of T2DM compared to ≤1 year (OR: 2.18; 95% CI: 1.05–4.53). Conclusion A quarter of people with T2DM were dissatisfied with the care that they received at the diabetes outpatient clinic in Ningbo, China, and the factors associated with dissatisfaction were identified.

Habituation and sensitization represent nonassociative learning mechanisms in both non‐neural and neural organisms. They are essential for a range of functions from survival to adaptation in dynamic environments. Design of hardware for neuroinspired computing strives to emulate such features driven by electric bias and can also be incorporated into neural network algorithms. Herein, cellular‐like learning in oxygen‐deficient NiOx devices is demonstrated. Both habituation learning and sensitization response can be achieved in a single device by simply controlling the magnitude of the electric field. Spontaneous memory relaxations and dynamic redistribution of oxygen vacancies under electric bias enable such learning behavior of NiOx under sequential training. These characteristics in simple device arrays are implemented to learn alphabets as well as demonstrate simulated algorithmic use cases in digit recognition. Transition metal oxides with carefully prepared defect concentrations can be highly sensitive to electronic structure perturbations under moderate electrical stimulus and serve as building blocks for next‐generation neuroinspired computing hardware.

Abstract Origami is the art of paper folding that allows a single flat piece of paper to assume different 3D shapes depending on the fold patterns and the sequence of folding. Using the principles of origami along with computation imaging technique the authors demonstrate a versatile shape‐morphing microwave imaging array with reconfigurable field‐of‐view and scene‐adaptive imaging capability. Microwave/millimeter‐wave based array imaging systems are expected to be the workhorse for sensory perception of future autonomous intelligent systems. The imaging capability of a planar array‐based systems operating in complex scattering conditions have limited field‐of‐view and lack the ability to adaptively reconfigure resolution. To overcome this, here, deviations from planarity and isometry are allowed, and a shape‐morphing computational imaging system is demonstrated. Implemented on a reconfigurable Waterbomb origami surface with 22 active metasurface panels that radiate near‐orthogonal modes across 17–27 GHz, capability to image complex 3D objects in full details minimizing the effects of specular reflections in diffraction‐limited sparse imaging with scene adaptability, reconfigurable cross‐range resolution, and field‐of‐view is demonstrated. Such electromagnetic origami surfaces, through simultaneous surface shape‐morphing ability (potentially with shape‐shifting electronic materials) and electromagnetic field programmability, opens up new avenues for intelligent and robust sensing and imaging systems for a wide range of applications.