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Abstract Background Temporary pacing is usually performed by cardiologists under fluoroscopic, echocardiographic, or ECG guidance. However, in the developing world, there are inadequate number of cardiologists, and C-arm, catheterization laboratories, or echocardiography are not available at primary or secondary healthcare facilities. In addition, in emergencies option of fluoroscopy and echocardiography is limited. So these patients are transferred to a facility where cardiologists and these facilities are available. Crucial time is lost in transit, which leads to increased mortality. In this study, we aimed to evaluate the safety, efficacy, and practicability of unguided temporary pacemaker insertion. Results A total of 1093 patients were enrolled in this study. After cannulating the internal jugular vein or subclavian vein, the pacing lead attached to the pulse generator was advanced blindly till ventricular pacing was achieved. Procedural success was taken as the primary endpoint. Secondary endpoints included the number of attempts taken for successful central venous puncture and procedural time. Complications and mortality were assessed for safety outcomes. Finally, the position of the pacing lead was assessed after the procedure on X-ray or fluoroscopy. The procedure was successful in all but one patient in whom a femoral vein approach was required because of brachiocephalic vein obstruction. Right internal jugular access was achieved in 981 (89.75%) patients. The mean number of attempts taken for achieving successful venous accesses was 1.54 ± 0.85; however, in 726 (66.42%) patients it was achieved in the first attempt. The mean procedural time was 11.5 ± 2.1 min. Overall, 117 (10.70%) patients developed complications; however, most of them were minor. Pneumothorax developed in 12 (1.1%) patients, of whom 2 needed an intercostal tube. Pericardial effusion was seen in 21 (1.92%) patients. Pacing lead tip was located in the right ventricular cavity abutting interventricular septum or free wall in 843 (77.20%) patients. No mortality attributable to procedure occurred. Conclusions Unguided temporary pacing via jugular or subclavian venous approach in an emergency setting is possible with high success and a low complication rate. Thus, it is a safe and effective procedure, and clinicians working at primary and secondary healthcare levels should be encouraged to perform this procedure. Trial registration UMIN Clinical Trials Registry, UMIN000046771. Registered 28 January 2022—Retrospectively registered, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000053348

Insistence and determination are main principles. They can be keys to success in life. Their absence causes a lack in many related values and manners. Therefore, pre-Islamic poets consistently discuss the principles of insistence. They are self-made, insistent on educational, social, political, economic and warfare positive life aspects. Therefore, poets gave some advice and guidance stressing virtues such as kindness, great hospitality and self-preservation even if these principles required leaving the tribe and relatives such as the lovers and family to maintain a social rank and value. Therefore, these ambitions can only be achieved and realized by patience and flexibility. In the pre-Islamic era, personality is valued in terms of rank, value, flourishing, vanity, and pride and dignity.

Abstract Purpose This research seeks to delve into the potential of solar power as a sustainable and renewable energy solution, specifically examining its effectiveness in addressing energy poverty within the complex framework of the Indian energy landscape. Methods Employing a mixed-methods approach, the research conducts an extensive literature review to establish the current knowledge landscape, identifying gaps and contextualizing the global and Indian scenarios. Quantitative analysis utilizes statistical data from sources such as the International Energy Agency, governmental reports, and research organizations to track the historical evolution of India’s energy supply and solar power capacity. Case studies from China, India, and Bangladesh are presented to draw insights from successful solar projects. Additionally, policy analysis evaluates the effectiveness of current and past energy policies in India in promoting solar adoption and mitigating energy poverty. Results The study unveils trends, and the impact of policy interventions in India’s energy landscape. Comparative analyses position India within the global solar PV market. Case studies illustrate successful solar projects’ impact on alleviating energy poverty. Policy analysis provides insights into the strengths and weaknesses of existing energy policies. Conclusion Solar power emerges as a promising solution to end energy poverty, demonstrating significant cost competitiveness and sustainable attributes. The research underscores the need for targeted policies, financial incentives, and technological innovations to overcome challenges. The findings contribute to the discourse on renewable energy’s role in sustainable development, emphasizing the potential for solar power to address energy poverty in India and beyond.

Article 35 of Minister of Industry Regulation No. 29 of 2017 states that besides manufacturing aspects, the calculation of Domestic Component Level (TKDN) for mobile devices may utilize an innovation-based calculation scheme. However, this policy is deemed biased as it only benefits large companies selling products without assembly in Indonesia, while their competitors have invested in local production infrastructure to fulfill TKDN obligations. This study aims to evaluate the TKDN Assessment Policy in the innovation-based calculation scheme. The research problem is whether this policy aligns with TKDN policies in Law No. 3 of 2014 concerning Industry. This research employs a normative legal approach, focusing on literature review and legislative analysis. Findings indicate that the TKDN regulation in the innovation-based calculation scheme provides flexibility for companies to meet TKDN standards more flexibly but also raises concerns about decreasing use of local components, contradicting the spirit of Law No. 3 of 2014, which promotes the use of domestic products to fulfill TKDN. Therefore, a thorough evaluation of the TKDN regulation in the innovation-based calculation scheme is needed to maintain the balance of the domestic industry.

ABSTRACT Introduction There is a paucity of research on and a limited understanding of patient and public involvement (PPI) in the context of research in homelessness and, in particular, direct involvement of people with lived and living experience of homelessness (PEH) as expert advisors. We aim to report on outcomes and reflections from lived experience advisory panel (LEAP) meetings and PPI activities, held throughout the study lifecycle of a pilot randomised‐controlled trial (RCT) focused on evaluating integrated health and practical support for PEH. Methods Community Pharmacy Homeless Outreach Engagement Non‐medical Independent prescribing Rx (PHOENIx Community Pharmacy RCT) is an integrated health and social care intervention for people experiencing homelessness who present to community pharmacy. Intervention includes weekly support from a pharmacist prescriber and a third sector support worker for up to 6 months. PPI activities undertaken throughout the study were documented, including outcomes of LEAP meetings. Outcome reporting followed Guidance for Reporting Involvement of Patients and the Public 2 Short Form (GRIPP2‐SF). Results In total, 17 members were recruited into the LEAP; six meetings (three in two study sites) were held. PPI input was also received through representation from homelessness third sector organisation staff as study co‐applicants and core membership in the trial steering committee. Together, the PPI activities helped shape the study proposal, design of study materials, data analysis and dissemination materials. LEAP panel members offered valuable input via their experience and expertise into the delivery and refinement of interventions. Although longitudinal input was received from some LEAP members, ensuring repeat attendance in the pre‐planned meetings was challenging. Conclusion People who face social exclusion and marginalisation can provide highly valuable input as equal partners in co‐design and delivery of interventions seeking to improve their health and well‐being. Fluid membership and flexible methods of seeking and incorporating advice can offer pragmatic approaches to minimising barriers to continued involvement in research. Patient or Public Contribution This study reports findings and learning relevant to involvement of people with lived and living experience of homelessness as advisors in a research study. It is important for researchers to offer fluid memberships and use diverse methods to receive input from lived experience members, as traditional PPI methodology may be insufficient to ensure inclusivity. Staff and volunteers from third sector organisations were important PPI partners who bring their experience based on frontline service provision, often as the first port of call for people experiencing severe and multiple disadvantage. Trial Registration ISRCTN88146807.

The increasing prevalence of diabetes necessitates the development of effective early detection methods to mitigate its health impacts. This paper investigates the impact of feature transformation and machine learning (ML) models on the early detection of diabetes using a binary tabular classification dataset. We explore three feature transformation techniques, no transformation, normalization, and min-max scaling, to assess their influence on the performance of various ML models. To comprehensively evaluate the effectiveness of these preprocessing techniques, we experimented with twelve different ML models, including both traditional algorithms and ensemble methods. A publicly available dataset has been used for this research, containing 768 samples and 8 features. To ensure their effectiveness, the models are assessed using several evaluation metrics, including accuracy, precision, recall, F1-score, and Area Under the Receiver Operating Characteristic Curve (AUC-ROC). Among the ML models, Light Gradient Boosting Machine (LGBM) achieved the highest accuracy of 82.91% when min-max scaling was applied to the data. Our results demonstrate the varying effectiveness of different combinations of feature transformation techniques and ML models in enhancing diabetes detection performance. Furthermore, it has been observed that the ensemble models generally achieved better performance than traditional ML models. These findings provide valuable insights for optimizing preprocessing and model selection strategies in the development of robust early diabetes detection systems.

Incorporating pumpkin pulp into tomato sauces could serve as a viable solution to meet the growing consumer demand for healthy foods that offer functional benefits. In this study, various pumpkin: tomato pulp ratios of 100:0; 0:100; 75:25; 50:50; and 25:75 were employed in the production of sauces and named S1, S2, S3, S4, and S5, respectively. The sauces were subsequently subjected to assess their physicochemical properties (color, pH, TSS, total sugar, reducing and non-reducing sugar), content of bioactive compounds (phenolics, flavonoids, vitamin C, and β-carotene content), antioxidant and anti-diabetic activities, and consumer approval. The changes in physicochemical properties among all samples were negligible. However, the amount of non-reducing sugar and total sugar were statistically distinct (p ≤ 0.05) among the formations and the order of rank was S5>S4>S3≈S2≈S1. The sauces enriched with tomato pulp exhibited elevated levels of phenolics, flavonoids, vitamin C, and β-carotene content. The formulations of sauces were ranked: S2>S5>S4>S3>S1 concerning phenolics, flavonoids, vitamin C, and β-carotene content. The antioxidant and antidiabetic activities were significantly higher in S2 followed by the rank: S2>S4≈S5>S1≈S3. Based on the results obtained from this research, it was observed that the product formulated up to a composition of 50 to 75 % tomato pulp and 50 to 25 % pumpkin pulp (S4 and S5) exhibited a greater degree of sensory appeal compared to S2 which is commercial tomato sauce (100 % tomato). Therefore, the use of pumpkin pulp has demonstrated its usefulness as a viable substitute for augmenting the levels of bioactive components, while concurrently mitigating the quantity of color, sugar, and other nutrition employed in conventional sauce formulations.

Phase change materials (PCMs) are used in buildings and automobiles to control the interior temperature, following to their high thermal storage capacity and energy efficiency. In summer, controlling the interior temperature of vehicles can be difficult, especially in cities where public transportation is excessively crowded. Typically, heating, ventilation, and air-conditioning systems are included to provide thermal comfort inside vehicles, but they use a significant amount fuel, which ultimately have negative impacts on the environment. In this study, a prototype bus model was developed from an actual bus and scaled-down to 1/20th size. A bulb was used as an internal heat source and experiments were conducted under the sun in summer to reflect scenarios of buses stuck in traffic. Various cases were considered by opening and closing the windows and doors and placing the PCM layer on the roof and covering the bulb. The results demonstrate that when the PCM is used to cover the bulb and roof, the interior temperature can drop to the ambient temperature and remain there for a longer period of time. In fact, keeping the windows and doors open results in a significantly lower indoor temperature than when they are closed. The results show that the heat from the engine makes a major contribution to raising the temperature inside of the vehicle. The results from the opened cases can be applied to various forms of public transportation worldwide, but for many closed vehicles, additional ducting systems integrated with PCM may be the best option.

Background and objective: Hypertension is a potentially dangerous health condition that can be detected by measuring blood pressure (BP). Blood pressure monitoring and measurement are essential for preventing and treating cardiovascular diseases. Cuff-based devices, on the other hand, are uncomfortable and prevent continuous BP measurement. Methods: In this study, a new non-invasive and cuff-less method for estimating Systolic Blood Pressure (SBP), Mean Arterial Pressure (MAP), and Diastolic Blood Pressure (DBP) has been proposed using characteristic features of photoplethysmogram (PPG) signals and nonlinear regression algorithms. PPG signals were collected from 219 participants, which were then subjected to preprocessing and feature extraction steps. Analyzing PPG and its derivative signals, a total of 46 time, frequency, and time-frequency domain features were extracted. In addition, the age and gender of each subject were also included as features. Further, correlation-based feature selection (CFS) and Relief F feature selection (ReliefF) techniques were used to select the relevant features and reduce the possibility of over-fitting the models. Finally, support vector regression (SVR), K-nearest neighbour regression (KNR), decision tree regression (DTR), and random forest regression (RFR) were established to develop the BP estimation model. Regression models were trained and evaluated on all features as well as selected features. The best regression models for SBP, MAP, and DBP estimations were selected separately. Results: The SVR model, along with the ReliefF-based feature selection algorithm, outperforms other algorithms in estimating the SBP, MAP, and DBP with the mean absolute error of 2.49, 1.62 and 1.43 mmHg, respectively. The proposed method meets the Advancement of Medical Instrumentation standard for BP estimations. Based on the British Hypertension Society standard, the results also fall within Grade A for SBP, MAP, and DBP. Conclusion: The findings show that the method can be used to estimate blood pressure non-invasively, without using a cuff or calibration, and only by utilizing the PPG signal characteristic features.

This review delves into the historical context, current epidemiological landscape, genomics, and pathobiology of monkeypox virus (MPXV). Furthermore, it elucidates the present vaccination status and strategies to curb the spread of monkeypox. Monkeypox, caused by the Orthopoxvirus known as MPXV, is a zoonotic ailment. MPXV can be transmitted from person to person through respiratory droplets during prolonged face-to-face interactions. While many cases of monkeypox are self-limiting, vulnerable groups such as young children, pregnant women, and immunocompromised individuals may experience severe manifestations. Diagnosis predominantly relies on clinical presentations, complemented by laboratory techniques like RT-PCR. Although treatment is often not required, severe cases necessitate antiviral medications like tecovirimat, cidofovir, and brincidofovir. Vaccination, particularly using the smallpox vaccine, has proven instrumental in outbreak control, exhibiting an efficacy of at least 85% against mpox as evidenced by data from Africa. Mitigating transmission requires measures like wearing surgical masks, adequately covering skin lesions, and avoiding handling wild animals.

Micro-extraction techniques with UV-Vis measurement have been developed and validated for the analysis of Cefixime (CFX) in pure and pharmaceutical form. In this work, the DLLME and SIHLLME methods were employed for the extraction, enrichment and evaluation of CFX in pure form and pharmaceuticals using UV-Vis spectroscopy at 274 and 282 nm, respectively. The type of dispersive and extraction solvents and their volumes, pH, the amount of salt, and the centrifuging time were among the experimental variables that were accomplished. Under the perfect conditions, the procedures were linear in the range of 5.0-100.0 and 1.0-15.0 μg/mL, with a correlation coefficient of determination (R2) of 0.9963 and 0.9984 for DLLME and SIHLLME, respectively, LOD was 3.7 and 0.11 µg/mL. Recovery of the target analyte in pharmaceuticals was 96.5%-102.4%. The method can be easily applied to CFX concentrations above this value, but needs further improvements before it can be used in pharmacokinetic studies where more sensitive methods can be found. A simple, inexpensive, accurate, and precise spectrophotometric assay of CFX in pharmaceutical formulations was developed and validated following DLLME and SIHLLME for routine analysis.

Abstract Human Respiratory Syncytial Virus (RSV) is one of the leading causes of lower respiratory tract infections (LRTI), responsible for infecting people from all age groups—a majority of which comprises infants and children. Primarily, severe RSV infections are accountable for multitudes of deaths worldwide, predominantly of children, every year. Despite several efforts to develop a vaccine against RSV as a potential countermeasure, there has been no approved or licensed vaccine available yet, to control the RSV infection effectively. Therefore, through the utilization of immunoinformatics tools, a computational approach was taken in this study, to design a multi-epitope polyvalent vaccine against two major antigenic subtypes of RSV, RSV-A and RSV-B. Potential predictions of the T-cell and B-cell epitopes were followed by extensive tests of antigenicity, allergenicity, toxicity, conservancy, homology to human proteome, transmembrane topology, and cytokine-inducing ability. The peptide vaccine was modeled, refined, and validated. Molecular docking analysis with specific Toll-like receptors (TLRs) revealed excellent interactions with suitable global binding energies. Additionally, molecular dynamics (MD) simulation ensured the stability of the docking interactions between the vaccine and TLRs. Mechanistic approaches to imitate and predict the potential immune response generated by the administration of vaccines were determined through immune simulations. Subsequent mass production of the vaccine peptide was evaluated; however, there remains a necessity for further in vitro and in vivo experiments to validate its efficacy against RSV infections.

Dementia is not a specific disease, but a general term for age-related decline or loss of memory, cognitive abilities including problem solving and decision-making, and one’s own language, which significantly interfere with daily life. Researchers around the world have developed ways to automate the diagnosis of dementia through the use of machine learning and data mining approaches. The aim of this research project is to design and develop a day-to-day activity prediction algorithm in order to accurately identify and differentiate the dementia affected patients from the healthy subjects, to ensure early diagnosis of dementia development. This research advocates a novel algorithm called ‘Sequence Prediction via All Discoverable Episodes (SPADE)’ as a statistical tool to map activities of daily life (ADLs) in different groups of people in order to develop a unique parameter for precise diagnosis. The results of our experiment demonstrated a significant difference (i.e. 11 %) in the sequence prediction peak accuracy between the healthy subjects and the residents with dementia. SPADE demonstrated an adequate accuracy (i.e. 80 % on average), with an improvement of about 12 % compared to the performance of M-SPEED in inferring future occurrences of activities. It is thus evident that the algorithms for activity predictions show promise for early detection of dementia symptoms without the use of any expensive clinical procedure.

The ongoing pandemic COVID-19 caused by Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) has wreaked havoc globally by affecting millions of lives. Although different countries found the implementation of emergency measures useful to combat the viral pandemic, many countries are still experiencing the resurgence of COVID-19 cases with new variants even after following strict containment guidelines. Country-specific lessons learned from the ongoing COVID-19 pandemic can be utilized in commencing a successful battle against the potential future outbreaks. In this article, we analyzed the overall scenario of the COVID-19 pandemic in Bangladesh from Alpha to Omicron variant and discussed the demographic, political, economic, social, and environmental influences on the mitigation strategies employed by the country to combat the pandemic. We also tried to explore the preparedness and precautionary measures taken by the responsible authorities, the choice of strategies implemented, and the effectiveness of the response initiated by the government and relevant agencies. Finally, we discussed the possible strategies that might help Bangladesh to combat future COVID-19 waves and other possible pandemics based on the experiences gathered from the ongoing COVID-19 pandemic.

Abstract Background People experiencing homelessness (PEH) have complex health and social care needs and most die in their early 40 s. PEH frequently use community pharmacies; however, evaluation of the delivery of structured, integrated, holistic health and social care intervention has not been previously undertaken in community pharmacies for PEH. PHOENIx (Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx) has been delivered and tested in Glasgow, Scotland, by NHS pharmacist independent prescribers and third sector homelessness support workers offering health and social care intervention in low threshold homeless drop-in venues, emergency accommodation and emergency departments, to PEH. Building on this work, this study aims to test recruitment, retention, intervention adherence and fidelity of community pharmacy-based PHOENIx intervention. Methods Randomised, multi-centre, open, parallel-group external pilot trial. A total of 100 PEH aged 18 years and over will be recruited from community pharmacies in Glasgow and Birmingham. PHOENIx intervention includes structured assessment in the community pharmacy of health, housing, benefits and activities, in addition to usual care, through weekly visits lasting up to six months. A primary outcome is whether to proceed to a definitive trial based on pre-specified progression criteria. Secondary outcomes include drug/alcohol treatment uptake and treatment retention; overdose rates; mortality and time to death; prison/criminal justice encounters; healthcare utilisation; housing tenure; patient-reported measures and intervention acceptability. Analysis will include descriptive statistics of recruitment and retention rates. Process evaluation will be conducted using Normalisation Process Theory. Health, social care and personal resource use data will be identified, measured and valued. Discussion If the findings of this pilot study suggest progression to a definitive trial, and if the definitive trial offers positive outcomes, it is intended that PHOENIx will be a publicly funded free-to-access service in community pharmacy for PEH. The study results will be shared with wider stakeholders and patients in addition to dissemination through medical journals and scientific conferences. Trial registration International Clinical Trial Registration ISRCTN88146807. Approved protocol version 2.0 dated July 19, 2022.

This study aims to find a suitable site for a nuclear power plant using the geographic information system and analytical hierarchy process in the Khulna division, Bangladesh. Selection of a suitable site for a nuclear power plant is vital for the safety of the installation, workers, the public, and the environment. This study was conducted considering four stages, namely conceptual and planning, area survey, site characterization, and site confirmation stage. In the area survey stage, six criteria were divided into twelve sub-criteria, namely population density, earthquake, river, riverbank erosion, airport, road and railway, protected area, forest, groundwater table, rainfall, wind speed, and thunderstorm. A suitability map of each sub-criterion was made using geographic information system software. The weighting of each criterion was determined using an analytical hierarchy process and finally, a geographic information system-based overlay analysis was performed to prepare the final suitability map of the Khulna division which indicates 315.30 km2 and 2991.27 km2 of its total area as the most suitable and suitable, respectively for nuclear power plant establishment. Twenty-six potential areas were selected from the most suitable areas for further study. This study follows a comprehensive methodology and thus may help policymakers for the establishment of nuclear power plants in Bangladesh and abroad.

Summary: Mechanisms of infection and pathogenesis have predominantly been studied based on differential gene or protein expression. Less is known about posttranslational modifications, which are essential for protein functional diversity. We applied an innovative glycoproteomics method to study the systemic proteome-wide glycosylation in response to infection. The protein site-specific glycosylation was characterized in plasma derived from well-defined controls and patients. We found 3862 unique features, of which we identified 463 distinct intact glycopeptides, that could be mapped to more than 30 different proteins. Statistical analyses were used to derive a glycopeptide signature that enabled significant differentiation between patients with a bacterial or viral infection. Furthermore, supported by a machine learning algorithm, we demonstrated the ability to identify the causative pathogens based on the distinctive host blood plasma glycopeptide signatures. These results illustrate that glycoproteomics holds enormous potential as an innovative approach to improve the interpretation of relevant biological changes in response to infection.

Background/Objectives: The objective of this study was to determine whether preoperative opioid education reduces opioid consumption after spine surgery and which educational methods are the most effective. Orthopedists are the most likely to prescribe opioids among all specialists. To alleviate the prescription opioid crisis, studies have identified ways to taper narcotic dosage and use following surgery. The role of preoperative education and its varying modalities on opioid consumption following spine surgery has yet to be reported in the literature. Methods: The study group received formal education describing the use of opioids, side effects, and alternatives to pain management. Patients were to choose their preferred modality of a 2 min narrated video and two handouts to be watched and read in their individual time, attending a small class led by a physician assistant where they watched the 2 min narrated video along with reading the two handouts or receiving a one-on-one session with the treating spine surgeon. Meanwhile, the control group received standard preoperative education. Refill prescriptions were collected from patients' electronic medical record charts at the 2-week, 1-month, 3-month, and 6-month postoperative follow-ups. The primary outcome measure was morphine equivalents (MME) of prescription opioids at six months following spine surgery. Results: At 2 weeks postoperatively, there were no statistically significant differences between patients who received any formal narcotic education and those who did not. At 1 and 3 months postoperatively, the video education group (p-value < 0.001), class education group (p-value < 0.001), and the one-on-one education group (p-value < 0.05) all had significant reductions in opioid consumption. At 6 months postoperatively, only the video education group (p-value < 0.001) and the class education group (p-value < 0.01) had significant reductions in opioid consumption. Conclusions: A two-fold approach with a video and handouts significantly decreases the prescription dosage at six months postoperatively and allows for early opioid cessation after undergoing spine surgery. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of research on and a limited understanding of patient and public involvement (PPI) in the context of research in homelessness and, in particular, direct involvement of people with lived and living experience of homelessness (PEH) as expert advisors. We aim to report on outcomes and reflections from lived experience advisory panel (LEAP) meetings and PPI activities, held throughout the study lifecycle of a pilot randomised‐controlled trial (RCT) focused on evaluating integrated health and practical support for PEH. Methods: Community Pharmacy Homeless Outreach Engagement Non‐medical Independent prescribing Rx (PHOENIx Community Pharmacy RCT) is an integrated health and social care intervention for people experiencing homelessness who present to community pharmacy. Intervention includes weekly support from a pharmacist prescriber and a third sector support worker for up to 6 months. PPI activities undertaken throughout the study were documented, including outcomes of LEAP meetings. Outcome reporting followed Guidance for Reporting Involvement of Patients and the Public 2 Short Form (GRIPP2‐SF). Results: In total, 17 members were recruited into the LEAP; six meetings (three in two study sites) were held. PPI input was also received through representation from homelessness third sector organisation staff as study co‐applicants and core membership in the trial steering committee. Together, the PPI activities helped shape the study proposal, design of study materials, data analysis and dissemination materials. LEAP panel members offered valuable input via their experience and expertise into the delivery and refinement of interventions. Although longitudinal input was received from some LEAP members, ensuring repeat attendance in the pre‐planned meetings was challenging. Conclusion: People who face social exclusion and marginalisation can provide highly valuable input as equal partners in co‐design and delivery of interventions seeking to improve their health and well‐being. Fluid membership and flexible methods of seeking and incorporating advice can offer pragmatic approaches to minimising barriers to continued involvement in research. Patient or Public Contribution: This study reports findings and learning relevant to involvement of people with lived and living experience of homelessness as advisors in a research study. It is important for researchers to offer fluid memberships and use diverse methods to receive input from lived experience members, as traditional PPI methodology may be insufficient to ensure inclusivity. Staff and volunteers from third sector organisations were important PPI partners who bring their experience based on frontline service provision, often as the first port of call for people experiencing severe and multiple disadvantage. Trial Registration: ISRCTN88146807. [ABSTRACT FROM AUTHOR]