Normal Process Research Articles

A Human-in-the-Loop Method for Annotation of Events in Biomedical Signals.

Building large-scale data bases of biomedical signal recordings for training artificial-intelligence systems involves substantial human effort in data processing and annotation. In the case of event detection, experts need to exhaustively scroll through the recordings and highlight events of interest. We propose an iterative annotation support algorithm with a human in the loop to improve the efficiency of the annotation process. Our algorithm generates proposal events based on an event detection model trained on incomplete annotations. The human only needs to verify candidate events proposed by the tool instead of scrolling through the entire data set. Our algorithm iterates between proposal generation and verification to leverage the human-in-the-loop feedback to obtain a growing set of event annotations. Our algorithm finds a substantial amount of events at a fraction of the human time spent when comparing with a benchmark method and the normal manual process, finding all events in one data set and 70% of events in another with the human-in-the-loop only viewing 20% of the data. Our results show that combining human and computer effort can substantially speed up the annotation process for events in biomedical signal processing. Due to its simplicity and minimal reliance on task-specific information, our algorithm is broadly applicable, unlocking substantial improvements in the scalability and efficiency of biomedical signal annotation.

Evaluating the implementation of the Pediatric Acute Care Education (PACE) program in northwestern Tanzania: a mixed-methods study guided by normalization process theory

BackgroundIn low- and middle-income countries (LMICs), such as Tanzania, the competency of healthcare providers critically influences the quality of pediatric care. To address this issue, we introduced Pediatric Acute Care Education (PACE), an adaptive learning program to enhance provider competency in Tanzania’s guidelines for managing seriously ill children. Adaptive learning is a promising alternative to current in-service education, yet optimal implementation strategies in LMIC settings are unknown.Objectives(1) To evaluate the initial PACE implementation in Mwanza, Tanzania, using the construct of normalization process theory (NPT); (2) To provide insights into its feasibility, acceptability, and scalability potential.MethodsMixed-methods study involving healthcare providers at three facilities. Quantitative data was collected using the Normalization MeAsure Development (NoMAD) questionnaire, while qualitative data was gathered through in-depth interviews (IDIs) and focus groups discussions (FGDs).ResultsEighty-two healthcare providers completed the NoMAD survey. Additionally, 24 senior providers participated in IDIs, and 79 junior providers participated in FGDs. Coherence and cognitive participation were high, demonstrating that PACE is well understood and resonates with existing healthcare goals. Providers expressed a willingness to integrate PACE into their practices, distinguishing it from existing educational methods. However, challenges related to resources and infrastructure, particularly those affecting collective action, were noted. Early indicators point toward the potential for long-term sustainability of the PACE, but assessment of reflexive monitoring was limited due to the study’s focus on PACE’s initial implementation.ConclusionThis study offers vital insights into the feasibility and acceptability of implementing PACE in a Tanzanian context. While PACE aligns well with healthcare objectives, addressing resource and infrastructure challenges as well as conducting a longer-term study to assess reflexive monitoring is crucial for its successful implementation. Furthermore, the study underscores the value of the NPT as a framework for guiding implementation processes, with broader implications for implementation science and pediatric acute care in LMICs.

Acceptability and timing considerations when administering patient-reported outcome measures (PROMs) among people with chronic health conditions who are culturally and linguistically diverse (CALD): a qualitative study protocol

IntroductionPatient-reported outcome measures (PROMs) are validated and standardised questionnaires that capture patients’ own reports of their symptoms, functioning and well-being. PROMs can facilitate communication between patients and clinicians, reduce symptom...

Building a Human Ovarian Antioxidant ceRNA Network "OvAnOx": A Bioinformatic Perspective for Research on Redox-Related Ovarian Functions and Dysfunctions.

The ovary is a major determinant of female reproductive health. Ovarian functions are mainly related to the primordial follicle pool, which is gradually lost with aging. Ovarian aging and reproductive dysfunctions share oxidative stress as a common underlying mechanism. ROS signaling is essential for normal ovarian processes, yet it can contribute to various ovarian disorders when disrupted. Therefore, balance in the redox system is crucial for proper ovarian functions. In the present study, by focusing on mRNAs and ncRNAs described in the ovary and taking into account only validated ncRNA interactions, we built an ovarian antioxidant ceRNA network, named OvAnOx ceRNA, composed of 5 mRNAs (SOD1, SOD2, CAT, PRDX3, GR), 10 miRNAs and 5 lncRNAs (XIST, FGD5-AS1, MALAT1, NEAT1, SNHG1). Our bioinformatic analysis indicated that the components of OvAnOx ceRNA not only contribute to antioxidant defense but are also involved in other ovarian functions. Indeed, antioxidant enzymes encoded by mRNAs of OvAnOx ceRNA operate within a regulatory network that impacts ovarian reserve, follicular dynamics, and oocyte maturation in normal and pathological conditions. The OvAnOx ceRNA network represents a promising tool to unravel the complex dialog between redox potential and ovarian signaling pathways involved in reproductive health, aging, and diseases.

The Myosin-V Myo51 and Alpha-Actinin Ain1p Cooperate during Contractile Ring Assembly and Disassembly in Fission Yeast Cytokinesis.

Cytokinesis is driven in part by the constriction of a ring of actin filaments, myosin motors and other proteins. In fission yeast, three myosins contribute to cytokinesis including a Myosin-V Myo51. As Myosin-Vs typically carry cargo along actin filaments, the role of Myo51 in cytokinesis remains unclear. The previous work suggests that Myo51 may crosslink actin filaments. We hypothesized that if Myo51 crosslinks actin filaments, cells carrying double deletions of ain1, which encodes the crosslinker alpha-actinin, and myo51 (∆ain1 ∆myo51 cells) will exhibit more severe cytokinesis phenotypes than cells with the single ∆ain1 mutation. Contrary to our expectations, we found that the loss of Myo51 in ∆ain1 cells partially rescued the severity of the node clumping phenotype measured in ∆ain1 cells. Furthermore, we describe a normal process of contractile ring "shedding", the appearance of fragments of ring material extending away from the contractile ring along the ingressing septum that occurs in the second half of constriction. We measured that ∆ain1 ∆myo51 cells exhibit premature and exaggerated shedding. Our work suggests that Myo51 is not a simple actin filament crosslinker. Instead, a role in effective node motion better recapitulates its function during ring assembly and disassembly.

NIR-II light-activated and Cu nanocatalyst-enabled bioorthogonal reaction in living systems for efficient tumor therapy

Bioorthogonal reaction refers to chemical reactions that occur within a biological system without interfering the normal biochemical process, offering the unprecedented versatility in engineering chemical reactions within cells. However, the precise regulation of bioorthogonal reaction in living systems is mired by the complexity of the physiological environment and the toxicity of catalysts. Herein, considering the deeper tissue penetration and reduced phototoxicity compared to visible light and ultraviolet, a second near infrared (NIR-II) light-activated Cu-based bioorthogonal reaction is developed to achieve precise spatiotemporal control and effective switching for Cu(I)-catalyzed azide-alkyne cycloaddition (CuAAC) mediated chemical transformations in tumor, reducing the off-target effects. The catalytic activity of Cu catalyst through valence state interconversion between Cu(II) and Cu(I) can be precisely regulated in a reversible manner under NIR-II light irradiation-induced photoelectron transfer, which controls the extent of desired drug synthesis in bioorthogonal reaction. Meanwhile, the adverse effects of Cu(I) can be substantially mitigated within normal tissues due to their oxygen-rich condition. By utilizing NIR-II light and oxygen level, the Cu bioorthogonal catalyst achieves a balance between catalytic activity and biocompatibility. The ability to achieve precise spatiotemporal control and reversible catalysis makes this NIR-II light-mediated CuAAC platform an efficient and adaptable tool for bioorthogonal chemistry in living systems.

Comparison and development of cross-study normalization methods for inter-species transcriptional analysis.

Performing joint analysis of gene expression datasets from different experiments can present challenges brought on by multiple factors-differences in equipment, protocols, climate etc. "Cross-study normalization" is a general term for transformations aimed at eliminating such effects, thus making datasets more comparable. However, joint analysis of datasets from different species is rarely done, and there are no dedicated normalization methods for such inter-species analysis. In order to test the usefulness of cross-studies normalization methods for inter-species analysis, we first applied three cross-study normalization methods, EB, DWD and XPN, to RNA sequencing datasets from different species. We then developed a new approach to evaluate the performance of cross-study normalization in eliminating experimental effects, while also maintaining the biologically significant differences between species and conditions. Our results indicate that all normalization methods performed relatively well in the cross-species setting. We found XPN to be better at reducing experimental differences, and found EB to be better at preserving biological differences. Still, according to our in-silico experiments, in all methods it is not possible to enforce the preservation of the biological differences in the normalization process. In addition to the study above, in this work we propose a new dedicated cross-studies and cross-species normalization method. Our aim is to address the shortcoming mentioned above: in the normalization process, we wish to reduce the experimental differences while preserving the biological differences. We term our method as CSN, and base it on the performance evaluation criteria mentioned above. Repeating the same experiments, the CSN method obtained a better and more balanced conservation of biological differences within the datasets compared to existing methods. To summarize, we demonstrate the usefulness of cross-study normalization methods in the inter-species settings, and suggest a dedicated cross-study cross-species normalization method that will hopefully open the way to the development of improved normalization methods for the inter-species settings.

Road Crack Detection by Combining Dynamic Snake Convolution and Attention Mechanism

As one of the early manifestations of road pavement structure degradation, road cracks will accelerate the deterioration of the road if not detected and repaired in time. Aiming at the problems of low recall and incomplete crack detection in current road detection, based on the U-Net network, this paper proposed an Attention-Dynamic Snake Convolution U-Net (ADSC-U-Net) network. Firstly, the dynamic snake-shaped convolution was added to the normal downsampling process to make the network adaptively focus on the slender and curved local features, which can solve the problem of low accuracy of small crack detection. Secondly, the attention mechanism was used to pay better attention to the significant features of positive samples under the condition of a large proportion gap between positive and negative samples, which solved the problem of the poor crack integrity detection effect. Finally, the dataset was expanded by random vertical and horizontal flip operations, which solved the problem of network training overfitting caused by the small-scale datasets. The experimental results showed that, when the input image had a resolution of 480 × 320, evaluation indices P, R, and F1 of ADSC-U-Net on the self-built dataset were 74.44%, 68.77%, and 69.42%, respectively. Compared to SegNet, DeepLab, and DeepCrack, the P was improved by 1.90%, 2.49%, and 11.64%, respectively; the R was improved by 8.01%, 4.70%, and 59.58%, respectively; and the comprehensive evaluation index F1 was improved by 5.73%, 4.02%, and 55.87%, respectively, which proves the effectiveness of the proposed method.

English as second language learners' practices and experiences with written feedback

Feedback remains a controversial topic for several reasons, the most relevant being the effectiveness and students' appraisal of the practice. This article explores second language learners' perceptions of feedback as a teaching and learning strategy. In second language teaching, it is necessary to know learners' previous knowledge and experiences regarding how they receive feedback, since this practice has an impact on the improvement of writing. To this end, in this research, an online questionnaire was distributed to 202 participants taking an English course to ask them about: types of feedback received, preferences regarding feedback, effectiveness of feedback and experiences with feedback. Analysis of their responses, quantitative and qualitative, shows that participants have preferences about how they expect feedback to be given, although these are not consistent with what theory suggests as effective. In addition, participants argue that their experience with feedback is related to a rather normative correction in which teachers focus on attending to microstructural aspects; therefore, students' view of textual quality is linked to normative processes. These aspects are important to address in the development of writing classes for second-language learners.

Anti-populism and the Trump trauma in US foreign policy

Abstract In challenging normal patterns of foreign policy legitimation and undermining the internationalist consensus in favour of liberal hegemony, Donald Trump's populism constituted a political trauma for the foreign policy establishment (FPE) of the United States. How did the FPE respond? Based on a discursive approach and using the methodology of qualitative frame analysis, we examine the anti-populist response to the Trump trauma on the part of the FPE. The findings show how the FPE framed Trumpian populism as a political anomaly through interlocking frames of authoritarianism, irresponsibility and immaturity. This could only be rectified through a process of foreign policy normalization, carried through the first two years of the Joe Biden administration, which aimed to stabilize US leadership and restore the consensus that existed prior to the populist disruption. Highlighting the emotional dimensions of anti-populism, the article contends that to fully understand the effects of global populism, we must examine elite responses to populist ‘ruptures’ of the kind Trump represented. By extending the concept of anti-populism to debates on foreign policy, the article addresses existing gaps in the literatures on anti-populism and the effects of populist foreign policy.

Dysregulation of the Arachidonic Acid Pathway in Cystic Fibrosis: Implications for Chronic Inflammation and Disease Progression.

Cystic fibrosis (CF) is the most common fatal genetic disease among Caucasian people, with over 2000 mutations in the CFTR gene. Although highly effective modulators have been developed to rescue the mutant CFTR protein, unresolved inflammation and persistent infections still threaten the lives of patients. While the central role of arachidonic acid (AA) and its metabolites in the inflammatory response is widely recognized, less is known about their impact on immunomodulation and metabolic implications in CF. To this end, here we provided a comprehensive analysis of the AA metabolism in CF. In this context, CFTR dysfunction appeared to complexly disrupt normal lipid processing, worsening the chronic airway inflammation, and compromising the immune responses to bacterial infections. As such, potential strategies targeting AA and its inflammatory mediators are being investigated as a promising approach to balance the inflammatory response while mitigating disease progression. Thus, a deeper understanding of the AA pathway dysfunction in CF may open innovative avenues for designing more effective therapeutic interventions.

Methodology for assessing the effectiveness of the impact intermittent noise interference to a radar station with adaptive detection threshold formation

Problem statement. For aviation suppression equipment, it is characteristic to separate the modes of interference and reconnaissance radiation in time due to the problem of their electromagnetic compatibility. It is also possible to alternately suppress various objects with a limited bandwidth of the interference station. This leads to periodic interruptions of the noise interference and, consequently, a decrease in its spectral density. A feature of radar stations of the latest and modernized means of intercepting air defense systems aimed at hitting targets in a complex interference environment is adaptive control of parameters and modes of operation of various subsystems. In particular, modern radar stations provide for the adaptive formation of a detection threshold based on estimates of the statistical characteristics of such interference. Such estimates are formed over the interference integration interval, the size of which is generally selected from the condition of insignificant influence of signals reflected from the targets on them. Moreover, for the most correct consideration of the interference situation in the vicinity of the detected target, the strobe pulses of the false alarm probability stabilization circuit, forming the integration interval, are placed on both sides of the analyzed range resolution element. Goal. To evaluate the effect of intermittent noise interference parameters on the operation of radar stations with adaptive detection threshold foration. Assumptions. When developing the methodology, the following typical assumptions were made: in target detection mode, the radar station emits pulse signals with a low or medium pulse repetition rate; the signal reflected from the target, noise interference and internal noise are independent normal random processes; interference and internal noise have a uniform spectral density within the bandwidth of the radar receiver; the receiving path of the radar station has a traditional structure, which includes: an intermediate frequency amplifier, a linear amplitude detector, an integrator and a threshold device. Results. For the first time, the obtained technique takes into account the influence of time and energy parameters of intermittent noise interference on the probability of correct target detection by a radar station with adaptive detection threshold formation. Reducing the duration of the interference pulse in the period of intermittent noise interference leads to a nonlinear increase in the probability of correct target detection. To maximize this indicator, it is necessary to ensure a sufficiently high accuracy in estimating the statistical characteristics of the power of intermittent noise interference. The reliability of the results obtained using the developed methodology is confirmed by the fact that the effectiveness of intermittent noise interference, while excluding pauses in its radiation, is reduced to the effectiveness of continuous noise interference. Practical significance. The developed technique makes it possible to clarify the technical requirements for radar stations that implement flexible control of the target detection mode under the influence of intermittent noise interference of unknown intensity.

SVA Regulation of Transposable Element Clustered Transcription within the Major Histocompatibility Complex Genomic Class II Region of the Parkinson's Progression Markers Initiative.

SINE-VNTR-Alu (SVA) retrotransposons can regulate expression quantitative trait loci (eQTL) of coding and noncoding genes including transposable elements (TEs) distributed throughout the human genome. Previously, we reported that expressed SVAs and human leucocyte antigen (HLA) class II genotypes on chromosome 6 were associated significantly with Parkinson's disease (PD). Here, our aim was to follow-up our previous study and evaluate the SVA associations and their regulatory effects on the transcription of TEs within the HLA class II genomic region. We reanalyzed the transcriptome data of peripheral blood cells from the Parkinson's Progression Markers Initiative (PPMI) for 1530 subjects for TE and gene RNAs with publicly available computing packages. Four structurally polymorphic SVAs regulate the transcription of 20 distinct clusters of 235 TE loci represented by LINES (37%), SINES (28%), LTR/ERVs (23%), and ancient transposon DNA elements (12%) that are located in close proximity to HLA genes. The transcribed TEs were mostly short length, with an average size of 389 nucleotides. The numbers, types and profiles of positive and negative regulation of TE transcription varied markedly between the four regulatory SVAs. The expressed SVA and TE RNAs in blood cells appear to be enhancer-like elements that are coordinated differentially in the regulation of HLA class II genes. Future work on the mechanisms underlying their regulation and potential impact is essential for elucidating their roles in normal cellular processes and disease pathogenesis.

Histone H3 mutations and their impact on genome stability maintenance.

Histones are essential for maintaining chromatin structure and function. Histone mutations lead to changes in chromatin compaction, gene expression, and the recruitment of DNA repair proteins to the DNA lesion. These disruptions can impair critical DNA repair pathways, such as homologous recombination and non-homologous end joining, resulting in increased genomic instability, which promotes an environment favorable to tumor development and progression. Understanding these mechanisms underscores the potential of targeting DNA repair pathways in cancers harboring mutated histones, offering novel therapeutic strategies to exploit their inherent genomic instability for better treatment outcomes. Here, we examine how mutations in histone H3 disrupt normal chromatin function and DNA damage repair processes and how these mechanisms can be exploited for therapeutic interventions.

Starting the pill during adolescence: Age of onset and duration of use influence morphology of the hippocampus and ventromedial prefrontal cortex.

From adolescence, women become more likely to experience fear dysregulation. Oral contraceptives (OCs) can modulate the brain regions involved in fear processes. OCs are generally used for years and often initiated during adolescence, a sensitive period where certain brain regions involved in the fear circuitry are still undergoing important reorganization. It remains unknown whether OC use during adolescence may induce long-lasting changes in the fear circuitry. This study aimed to examine whether age of onset moderated the relationship between duration of use and fear-related brain structures. We collected structural MRI data in 98 healthy adult women (61 current users, 37 past users) and extracted grey matter volumes (GMV) and cortical thickness (CT) of key regions of the fear circuitry. Non-linear multiple regressions revealed interaction effects between age of onset and quadratic duration of use on GMV of the right hippocampus and right ventromedial prefrontal cortex (vmPFC). Among women who initiated OCs earlier in adolescence, a short duration of use was associated with smaller hippocampal GMV and thicker vmPFC compared to a longer duration of use. For both GMV and CT of the right vmPFC, women with an early OC onset had more grey matter at a short duration of use than those with a later onset. Our results suggest that OC use earlier in adolescence may induce lasting effects on structural correlates of fear learning and its regulation. These findings support further investigation into the timing of OC use to better comprehend how OCs could disrupt normal brain development processes.

Functional MRI Assessment of Brain Activity Patterns Associated with Reading in Medulloblastoma Survivors.

Medulloblastoma, a malignant brain tumor primarily affecting children, poses significant challenges to patients and clinicians due to its complex treatment and potential long-term cognitive consequences. While recent advancements in treatment have significantly improved survival rates, survivors often face cognitive impairments, particularly in reading, impacting their quality of life. According to the double deficit theory, reading impairments are caused by deficits in one or both of two independent reading-related functions: phonological awareness and rapid visual naming. This longitudinal study investigates neurofunctional changes related to reading in medulloblastoma survivors in comparison to controls using functional MRI acquired during rapid automatized naming tasks over three annual visits. Support vector machine classification of functional MRI data reveals a progressive divergence in brain activity patterns between medulloblastoma survivors and healthy controls over time, suggesting delayed effects of cancer treatment on brain function. Alterations in brain regions involved in visual processing and orthographic recognition during rapid naming tasks imply disruptions in the ventral visual pathway associated with normal orthographic processing. These alterations are correlated with performance in tasks involving sound awareness, reading fluency, and word attack. These findings underscore the dynamic nature of post-treatment neurofunctional alterations and the importance of early identification and intervention to address cognitive deficits in survivors.

Unmasking metabolic disruptors: The NEMESIS project's quest for Novel Biomarkers, Evidence on Adverse Effects, and Efficient Methodologies

Metabolism disrupting chemicals (MDCs) elicit negative effects on metabolically active organs such as the liver and the pancreas, altering normal metabolic processes. Chemicals that are known, or suspected MDCs include compounds found in everyday consumer products and food, making low-dose, continuous exposure inevitable for humans. Through the discovery of chemically induced metabolic disruption, a concern has surfaced whether and how MDCs impact human health and the development of metabolic diseases. This has accelerated research around the topic, and it has been found that exposure to MDCs is linked to increased incidence of metabolic diseases including obesity and liver steatosis. Effective regulatory action is hindered by the lack of accurate methods to identify MDCs. The NEMESIS project addresses this regulatory gap by investigating the mechanisms through which MDCs cause metabolic disruption. The project aims at identifying novel biomarkers of exposure and link exposure to disease outcomes. As chemical toxicity testing is rapidly moving towards new approach methodologies (NAMs), NEMESIS promotes non-animal methodologies by employing state-of-the-art in vitro methods, epidemiological data, systems biology approaches, and seeks to replace mammalian in vivo experiments with alternative models. By understanding mechanisms of MDC-induced metabolic health effects, and through the development of reliable effect biomarkers and testing strategies, the NEMESIS project aims to facilitate more effective regulatory measures to improve and protect the health and well-being of EU citizens. The project is particularly focused on maximizing its impact through effective dissemination and communication efforts, to ensure that the project’s message and results reach a broad audience and are tailored to different population groups. These actions will improve the risk assessment of MDCs and ensure that the EU citizens are informed and protected from the harmful effects of MDCs and can adapt their consumer patterns and behaviors to prevent exposure.

Process Evaluation of an Ambulance-Delivered Early Intensive Blood Pressure-Lowering Stroke Trial: Design, Rationale, and Reflection

Introduction: The fourth INTEnsive ambulance-delivered blood pressure Reduction in hyper-ACute stroke Trial (INTERACT4) is a large-scale, multicenter, prospective, randomized, open-label, blinded endpoint assessment trial, initiated in an ambulance in China, aiming at evaluating the effectiveness and safety of prehospital blood pressure (BP) lowering in patients with suspected acute stroke and elevated BP. A prespecified process evaluation is intended to explore the implementation of the trial intervention, provide support to interpret the trial outcomes and put forward suggestions to scale up the intervention in broader settings in the future. Methods: This process evaluation is a mixed-methods design, and follows the Normalization Process Theory (NPT) and the UK Medical Research Council (UK MRC) guidance. Fidelity, reach, acceptability, appropriateness, adoption, sustainability, and relevant contextual factors and mechanisms affecting the implementation of prehospital early intensive BP-lowering treatment will be analyzed. Semi-structured interviews with ambulance staff, ward and emergency department clinicians, and nurses are undertaken to explore perceptions of the intervention, contextual factors, and potential suggestions for future implementation in practice. Data from observational records, surveys, conventional monitoring data, on-site records, and case report forms will be analyzed to understand background care and context. Conclusion: The process evaluation of INTERACT4 will provide insights for the implementation of prehospital early intensive BP-lowering intervention in different health systems and help better explain the trial results for further scale up.

Review of Menstrual Hygiene Management Practices Among Adolescent Girls: Challenges, Health Implications, and Future Directions

Although a woman's menstruation is a normal biological process that is essential to her reproductive life, managing menstrual hygiene is still a major worldwide issue, especially for teenage girls in low- and middle-income nations. Maintaining dignity and one's physical and mental health depend on practicing proper menstrual hygiene. However, barriers to good menstrual hygiene habits persist due to cultural taboos, a lack of resources, and inadequate knowledge. Examining national and international policies targeted at resolving these concerns, this analysis examines the relationship between menstrual hygiene, adolescent health, and the right to health. The conversation emphasizes how important it is to manage menstrual hygiene in an appropriate way to prevent a girl's period from interfering with her everyday activities or undermining her self-esteem. A variety of menstruation items are assessed, with a focus on choosing the right goods to preserve hygiene, including sanitary pads, tampons, menstrual cups, and period underwear. The review also touches on the effects of menstruation problems on women's lives. The support that national and international initiatives like the Swachh Bharat Abhiyan, Beti Bachao Beti Padhao (BBBP), Rashtriya Kishor Swasthya Karyakram (RKSK), and the Scheme for Promotion of Menstrual Hygiene provide for the management of menstrual hygiene and adolescent health are examined. In order to guarantee that teenage girls may have healthy, productive lives with dignity and respect, the article emphasizes the need for ongoing efforts to enhance menstrual hygiene management via education, access to sanitary products, and the breakdown of societal taboos.

A Heterogeneous Acid-Base Organocatalyst For Cascade Deacetalisation-Knoevenagel Condensations.

Multifunctional heterogeneous catalysts are an effective strategy to drive chemical cascades, with attendant time, resource and cost efficiencies by eliminating unit operations arising in normal multistep processes. Despite advances in the design of such catalysts, the fabrication of proximate, chemically antagonistic active sites remains a challenge for inorganic materials science. Hydrogen-bonded organocatalysts offer new opportunities for the molecular level design of multifunctional structures capable of stabilising antagonistic active sites. We report the catalytic application of a charge-assisted, hydrogen-bonded crystalline material, bis(melaminium)adipate (BMA), synthesised from melamine and adipic acid, which possesses proximate acid-base sites. BMA exhibits high activity for the cascade deacetalisation-Knoevenagel condensation of dimethyl acetals to form benzylidenemalononitriles under mild conditions in water; BMA is amenable to large-scale manufacture and recycling with minimal deactivation. Computational modelling of the melaminium cation in protonated BMA explains the observed catalytic reactivity, and identifies the first demethoxylation step as rate-limiting, in good agreement with time-dependent 1H NMR and kinetic experiments. A broad substrate scope for the cascade transformation of aromatic dimethyl acetals is demonstrated.