A) Is the "triple approach" combining intervention by 1) home health education (HHE) by trained community workers plus 2)trained government primary health center mid-level providers (MLP) led care plus 3) trained private practitioners better thanthe "dual approach" (1 and 2 only), and better than no intervention (or usual care) in lowering blood pressure (BP) amongadults with hypertension in rural communities in Pakistan and Sri Lanka?B) Is the "dual approach" (1 and 2) better than no intervention (or usual care) in lowering BP among adults withhypertension in rural communities in Pakistan and Sri Lanka?C) Are the above-mentioned triple and dual approach incrementally cost- effective in terms of cost per projectedcardiovascular disease disability adjusted life-years (CVD DALYs) averted from the societal, government and participants'perspectives?The ancillary research question is:D) Are either of the above-mentioned triple or dual approach interventions better than usual care, and is triple approachbetter than dual approach in reducing left ventricular mass among adults with stage 2 systolic hypertension (systolic BP >=160 mm Hg) in rural communities in Pakistan and Sri Lanka? Cardiovascular disease (CVD) has become the leading cause of mortality worldwide, accounting for 30% of deaths even inlow- and middle- income countries (LMICs). In South Asia, high rates of CVD are observed at a younger age than in othercountries, causing a greater loss of productive life years with severe economic consequences. High blood pressure (BP)confers the greatest attributable risk to death and disease associated with CVD.Our Wellcome Trust funded Control of Blood Pressure and Risk Attenuation (COBRA) trial (2004 to 2007) in Karachi,Pakistan, suggested the combined strategy of family based home health education (HHE) delivered by trained communityhealth workers (CHW) plus care of patients by trained private general practitioners (GP) to optimally manage hypertensionhad the most marked beneficial impact on BP compared to usual care, or single interventions. However, the COBRAintervention was designed for an urban South Asian setting, where private GPs cater to over 75% of the patients seekingcare. Therefore, the trial did not use the public health infrastructure per se, nor did it evaluate whether mid-level providers(MLP) can deliver first steps of hypertension care including prescribing first and second line anti-hypertensive medications.Most of South Asia is still rural (64% Pakistan, 85% Sri Lanka) where prevalence of hypertension is high and healthcareinfrastructure and provider characteristics are very different compared to the urban setting. About 40-50% patients in ruralPakistan and Sri Lanka seek care (including prescription medications) from MLPs (visiting nurse, dispenser, assistantmedical officer) at the government community clinics. Thus whether hypertension management by this cadre of MLPs iseffective, especially when rolled out using government healthcare infrastructure is not known. Our proposed study isdesigned to answer this question in rural Pakistan and Sri Lanka.We propose a cluster RCT in 30 rural communities in Pakistan and Sri Lanka including 2500 individuals with hypertensionwith 2 year follow-up to evaluate the effectiveness of "triple approach" of combining intervention by 1) HHE plus 2) trainedgovernment primary health center MLP plus 3) trained private practitioners or "dual approach" of combining intervention of1 and 2 only compared to no intervention (or usual care) on lowering blood pressure, and to determine whether theseapproaches are incrementally cost-effective.The delivery of care by the various public providers and the private sector is now recommended by the World HealthOrganization in several communicable disease control programs, such as Directly Observed Treatment (DOTS) fortuberculosis and management of malaria. However, evidence on the effectiveness of using the same platform for chronicnon-communicable disease management is rather scarce.Moreover, wider discussion among the relevant stakeholders in South Asia to refine and implement the proposed activitieswould be beneficial, and would increase the likelihood of up-scaling the cost-effective strategies which could also beextended to other chronic diseases (and even infectious diseases) in an integrated manner that is potentially sustainableand applicable in rural settings across many Asian countries with similar ethnic populations and healthcare infrastructure.Comparing and contrasting the experiences from Sri Lanka and Pakistan should also provide valuable lessons not only forthese two countries but also for other countries in the region and beyond.

This project aims to reduce the impact of marine plastic pollution in South East Asia by understanding how microorganisms living on plastic surfaces affect the pollution threat and by exploring the potential of these microorganisms to provide a solution to the problem. SE Asian seas receive outputs from five of the top ten global emitters of plastic debris but there is little understanding of the threat to ecosystems and 650 million humans living in the region posed by 'plastispheres', the term used to describe the combination of plastic and the microorganisms that live on it. We need to characterise the microorganisms living on plastics in the sea and explore how they affect the breakdown of plastic. Through this we will understand how microorganisms transform plastic surfaces and determine the ultimate fate of plastic detritus in the marine environment. We need to measure the impact these plastispheres have on marine environments and wildlife in order to accurately characterise the hazard posed by plastispheres, and not just plastics, to the region's ecosystems. We will search for solutions to removing plastics and grow an informed and connected community of regional stakeholders in order to reduce environmental damage by current and future plastic pollution. This project coordinates the expertise of researchers from Singapore, UK, Indonesia,the Philippines and Vietnam to carry out laboratory and field experiments on microbial colonisation and transformation of plastic. We will analyse the DNA of biofilms and use microscopy to measure plastic degradation to identify the microorganisms living on the plastics and how they affect the plastic breakdown. We will quantify the volume, type and location of plastisphere loads in key habitats and animals to measure the impact plastispheres have on selected coastal ecosystems - mangroves, coral reefs and beaches. We will direct enzymes discovered in biofilms for use in bioengineered recycling, helping the transition towards a circular plastics economy in which waste plastic is intercepted before it enters the sea and is converted into useful products. We will coordinate with regional policy organisations and action groups to grow an informed and connected community of plastic stakeholders. We will conduct workshops to share expertise, disseminate our ideas and engage with stakeholders in order to develop solutions applicable to the SE Asian region. The project will give a novel perspective that shows how the threats from marine plastic are mediated by microorganisms, facilitating innovative solutions and enhancing regional governance of marine plastic pollution.

In many distributed computing contexts, a need arises for two mutually-distrusting parties to undertake a joint calculation, often without the disclosure of the unprocessed data from one or both sides to the other. Sometimes a 'trusted third party' is used for this purpose - but immediately the verification of the trustworthiness of that party becomes a challenge. The cryptographic world has addressed this through the paradigm of secure multi-party computation - and the related problem of an untrusted processor through various schemes of homomorphic encryption. These are successful in many contexts, but imply certain overheads and complexities. We propose a different model, wherein the technologies of Trusted Computing are used to create an assured Trustworthy Remote Entity (TRE): this also enables us to develop duplex communications, which are seldom considered in the approaches described above. The main part of this project is devoted to developing and verifying a TRE-based solution for the substantial and far-reaching challenges of security and privacy in smart power grids: later in the project we consider the generalization of the approach to other similar problems, such as those in dynamic location-based road pricing. The 'big idea' is that the user can be signed up with a TRE, and have a high degree of confidence that their data (e.g. the information on how much electricity is being used right now) is not going to get in to the hands of someone who might use it against them (e.g. to work out when the home is unoccupied) - but the power company can also have from their side confidence that the data they receive is coming from one of their customers. If they need to reduce demand - in the extreme case by, say, remotely switching off somone's air conditioning unit fora time - they can send a signal back, confident that it will go to the right user, without knowing which customer that is. This approach can be generalised to many other situations: for example, the TRE could help to calculate a price for you to drive on a particular road at a particular time, without disclosing your movements to the transport authority. It could also pass back personalized (but anonymous) instructions on how to find a better route at the time.

Limiting global warming requires paradigm-shift discoveries in energy storage, leading to rechargeable batteries that give electric cars the desired 800-km range. The complementary use of synthesis and advanced characterization techniques in synergy with modelling have enabled the discovery of materials by design, which we apply here. We will discover nanomaterials and nanocomposites for long-lasting and inexpensive Sodium-ion batteries. We will combine computation with experiments to develop novel, inexpensive, NA-Super-Ionic-CONductor (NASICON) solid-electrolytes, NazZr2-yMySixP3-xO12, for safe solid-state batteries (SSB). By optimizing the composition and nanostructure of NaSICONs, we will decrease the operation temperatures of existing SSB from 200°C to ambient temperature. This synergistic approach is possible by bringing together the expertise of the PIs : NUS : high-throughput density functional theory; Softbond potentials for screening ion-transport, solid-state NMR. LRCS : synthesis, crystallography and electrochemistry; impedance spectroscopy and SSB manufacturing.