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The objective of this study was to test whether adding a text message campaign about the importance of eating eggs and other nutrition-related behaviours to an on-going package of large-scale, diverse social and behaviour change interventions would improve four types of nutrition-related knowledge and behaviour outcomes: child diets (egg consumption as the primary outcome), maternal diets, maternal nutrition knowledge, and maternal participation in additional interventions. The cluster-randomized controlled trial involved a repeat cross-sectional design, recruiting families with children 12-23 months of age at baseline and endline in one plains district of Nepal. Throughout the 1000-day period, 51 text messages were sent to each household at specific time points to reinforce ideal diets and other nutrition-related practices and promote engagement with community health workers and other intervention platforms. The primary outcome was egg consumption and dietary diversity among young children. We found no population-level effect. Some evidence supports that for those who received and opened the SMS intervention, it improved child egg consumption (odds ratio [OR]: 1.41, 95% confidence interval [CI]: 1.03-1.93), child minimum dietary diversity (OR: 1.36, 95% CI: 1.07-1.73), child dietary diversity scores (β: 0.15, 95% CI: 0.01-0.24), as well as maternal IYCF knowledge (β: 0.21, 95% CI: 0.08-0.35), participation in health mothers' group meetings (OR: 3.03, 95% CI: 1.91-4.84) and Bhanchhin Aama listenership (OR: 1.36, 95% CI: 1.07-1.73). This study highlights the importance of more research to understand the effectiveness of emerging digital interventions for behaviour change among specific populations, to facilitate nuanced targeting to those who can best benefit from these investments. Registered at clinicaltrials.gov with identifier NCT03926689., (© 2024 The Author(s). Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Limited evidence exists on the costs of scaled-up multisectoral nutrition programmes. Such evidence is crucial to assess intervention value and affordability. Evidence is also lacking on the opportunity costs of implementers and participants engaging in community-level interventions. We help to fill this gap by estimating the full financial and economic costs of the United States Agency for International Development-funded Suaahara II (SII) programme, a scaled-up multisectoral nutrition programme in Nepal (2016-2023). We applied a standardized mixed methods costing approach to estimate total and unit costs over a 3.7-year implementation period. Financial expenditure data from national and subnational levels were combined with economic cost estimates assessed using in-depth interviews and focus group discussions with staff, volunteers, community members, and government partners in four representative districts. The average annual total cost was US$908,948 per district, with economic costs accounting for 47% of the costs. The annual unit cost was US$132 per programme participant (mother in the 1000-day period between conception and a child's second birthday) reached. Annual costs ranged from US$152 (mountains) to US$118 (plains) per programme participant. Personnel (63%) were the largest input cost driver, followed by supplies (11%). Community events (29%) and household counselling visits (17%) were the largest activity cost drivers. Volunteer cadres contributed significant time to the programme, with female community health volunteers spending a substantial amount of time (27 h per month) on SII activities. Multisectoral nutrition programmes can be costly, especially when taking into consideration volunteer and participant opportunity costs. This study provides much-needed evidence of the costs of scaled-up multisectoral nutrition programmes for future comparison against benefits., (© 2024 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Maternal and child undernutrition remain major public health problems in Nepal. Suaahara is a USAID-funded multi-sectoral nutrition programme aiming to strengthen local nutrition governance to reduce maternal and child undernutrition, among other objectives. The purpose of this study is to present findings from a recent qualitative evaluation of Suaahara II's influence on the decentralised implementation of Nepal's Multi-sectoral Nutrition Plan (MSNP) and identifying gaps and areas for improvement at the federal, provincial, and local levels to strengthen nutrition governance. This study employed multiple qualitative methods, engaging over 100 multi-sectoral nutrition stakeholders across three levels of government and eight districts. Thematic qualitative analysis was employed to identify emergent and salient themes, which were triangulated with other secondary data sources. Suaahara II had a positive influence on strengthening horizontal coordination for implementing the MSNP and effectively leveraged existing networks to strengthen implementation of nutrition-focused activities at the municipal level. Although there was an observable increased demand for nutrition budgets attributable to Suaahara II activities, sufficient allocation and utilisation, particularly in non-health sectors, did not meet these levels. Nepal's shift to federalism hindered vertical coordination of MSNP implementation. Some formal coordination mechanisms were strengthened, but variation in their effectiveness to strengthen horizontal and vertical coordination to implement MSNP activities continues. Finally, limited government ownership over nutrition activities and facilitating multi-sector coordination to implement the MSNP threatened sustainability of Suaahara II's outcomes on nutrition governance. Future programmes should continue to build on the progress made under Suaahara II, and specifically aim to address challenges in vertical coordination to strengthen nutrition governance in Nepal., (© 2024 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

High intakes of sodium, sugar, saturated fats, and trans-fats contributed to 187.7 million disability adjusted life years from noncommunicable diseases globally. Understanding of the global evidence on interventions to reduce consumption of various types of unhealthy food across diverse contexts is needed. We conducted a scoping review to examine the existing evidence on behavior change interventions (BCIs) to address unhealthy food consumption. Through a systematic search of 3 databases conducted in December 2022, 2730 records were retrieved, and 145 studies met the eligibility criteria for review. Only 19% of the studies ( n = 28) were from low- and middle-income countries. The key target group for most BCIs was adults ≥20 y ( n = 79). Interventions were conducted across 7 types of settings: schools ( n = 52), digital ( n = 30), community ( n = 28), home ( n = 14), health facility ( n = 12), worksite ( n = 6), and market ( n = 3). There were 4 mutually inclusive intervention types-information, education, and communication ( n = 141); food/beverage substitution ( n = 10); interactive games ( n = 7); and labeling/warnings at point-of-purchase ( n = 3). The study outcomes included consumption of sugar-sweetened beverages ( n = 74), packaged salty snacks/fast food ( n = 61), sweets ( n = 43), and saturated fat ( n = 41). Drivers of food choice behaviors, such as knowledge, attitudes, and beliefs; motivation and expectancies; and self-efficacy were reported in 43% of studies. On the basis of reported impact of BCIs on study outcomes, more interventions targeted at adults had positive impacts compared with those targeted at children; intervention packages, including multiple information, education, and communication components also reported impacts more often than single informational interventions. Interpretation of the findings was complicated by the lack of comparability in interventions, evaluation designs, outcome measures of unhealthy food consumption, duration of interventions, and study contexts. Future studies should invest in critical yet underrepresented regions, examine behavioral determinants of unhealthy food consumption and the sustainability of behavior change, and conduct further analysis of effectiveness from experimental studies., (© 2024 The Authors.)

Suaahara was an innovative, complex, multi-sectoral, large-scale, nutrition programme in Nepal to increase exposure to nutrition-related information and services, improve nutrition-related knowledge and practices among pregnant women and mothers of infants and young children, and improve their nutrition. This study evaluated the effectiveness of Suaahara to improve nutrition and nutrition-related practices by comparing changes over 10 years between intervention and comparison districts. The samples of households at baseline in 2012 and endline in 2022 were 2040 and 2480, respectively, from 120 old wards. The impact was estimated using intent-to-treat regression models in which survey year, arm and their interaction were fixed effects, accounting for district clustering, with the interaction estimating differences between arms in changes over time. The intervention, relative to comparison, reduced maternal underweight by 8.43 percentage points (p < 0.001), consistent with improved maternal and fetal condition that was manifested as the greater length of 0.761 z-scores (p = 0.004) of infants 0-5.9 months. Complementary feeding practices with children between 6 and 23.9 months of age improved more in the intervention than comparison districts: child dietary diversity by 0.294 food groups (p = 0.072) and minimum dietary diversity by 9.51 percentage points (p = 0.028), feeding sick child more (p = 0.002) and administering oral rehydration solution and zinc for diarrhoea (p = 0.057) by about 17 percentage points each, and minimum meal frequency (p = 0.004) and minimum acceptable diet (p = 0.022) by about 15 percentage points each. Substantial impacts were demonstrated despite political restructuring, earthquakes, and other major challenges that Nepal and Suaahara faced and limitations in statistical power because of the reduced number of districts that then could be included in the study. Registered at clinicaltrials.gov with identifier NCT05448287., (© 2024 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Background: Infection risk was significant for front-line nurses during the Covid-19 outbreak. The pandemic presented several ethical difficulties and sapped nurses' drive to labor harder for longer periods. This study evaluates registered nurses' perceptions of Covid-19 infection risk, ethical dilemmas, and motivating factors., Materials and Methods: During March and April 2022, 400 registered nurses from a newly established tertiary care hospital participated in this cross-sectional exploratory survey. The risk assessment scale, motivation to work scale, and ethical dilemma scale were used to assess the perceived risk of infection, motivational factors and ethical challenges experienced by the nurses. Appropriate descriptive and inferential statistics were applied to compute the results., Results: 76.4% of nurses feared working as a nurse put them at higher risk of infection. Besides the fear of contracting infection, nurses believed they were the source of infection to family members (70.8%) and people around (67.5%). 63.3% of nurses agree that they do not have the right to refuse treatment and every patient has the right to receive optimal care, regardless of age, gender, and medical conditions. Professional obligation to treat patients (72.3%) and sound professional knowledge and experience (83.5%) are important motivating factors to work during the pandemic. Multilinear regression analysis revealed that professional education (95% CI, 3.845 - 0.694, p = 0.005), Covid-19 positive status (95% CI,0.455-2.756, p = 0.006), and post-Covid-19 hospitalization (95% CI, 1.395-6.978, p = 0.003) and duration of hospitalization (95% CI, 0.754-0.058, p = 0.022) are independent predictors of higher perceived risk of infection among nurses., Conclusions: During the pandemic, nurses were afraid to work and faced personal and family risks of contracting the virus. Despite these challenges, they still feel a strong sense of commitment and dedication to providing the best possible care. Nurse administrators need to create a supportive environment that follows ethical principles and meets the needs of nurses to boost their motivation and encourage them to continue working for longer periods., (© 2023. The Author(s).)

In this work, we fabricated a versatile and noble metal free copper-based heterogeneous photocatalyst, representing a green shift away from precious group metals such as Ir, Ru, Pt, which have been widely utilized as photocatalysts. The successfully synthesized and characterized copper photocatalyst was employed to establish a cross dehydrogenative coupling via C-H activation between tertiary amines and carbon nucleophiles. The highly efficient copper-based photocatalyst was characterized by numerous physico-chemical techniques, which confirmed its successful formation as well as its high activity. Inductively coupled plasma (ICP-OES) analysis revealed that the composite Cu@Xantphos@ASMNPs had a very high loading of 0.423 mmol g -1 of copper. The magnetic Cu@Xantphos@ASMNPs were utilized as a potential heterogeneous photocatalyst for the very facile and regioselective conversion of aryl tetrahydroqinoline to the respective nitroalkyl aryl tetrahydroisoquinoline in high yield using air as an oxidant and methanol as a green solvent with irradiation with visible light under mild reaction conditions. Additionally, the catalyst shows exceptional chemical stability and reusability without any agglomeration even after several cycles of use, which is one of the key features of this material, rendering it a potential candidate from economic and environmental perspectives.

Introduction: The breast crawl technique is a strategy for initiating breastfeeding during the first hour of life, an important goal with long-lasting effects on newborn health and development. However, there is a lack of research to back up the benefits of the standard breast crawl technique over routine skin-to-skin care., Methods: A single-center single-masked randomized controlled trial was conducted among 132 women who had given birth vaginally to a full-term newborn. The study group had received the standard breast crawl (SBC) technique and the control group had received skin-to-skin contact (SSC). The outcome measures included time to initiation of breast crawl and breastfeeding, LATCH score, newborn breastfeeding behavior, time to expulsion of placenta, episiotomy suturing pain, amount of blood loss, and uterine involution., Results: Outcomes were analyzed for 60 women in each group who remained eligible. Compared with those in the SSC group, women in the SBC group had shorter time to initiation of the breast crawl (7.40 minutes vs 10.42 minutes, P = .001), shorter time to initiation of breast feeding (23.18 minutes vs 30.58 minutes, P = .003), higher LATCH scores (7.57 vs 5.35, P = .001), and higher newborn breastfeeding behavior scores (11.38 vs 9.08, P = .001). Women in the SBC group also had decreased mean time to birth of the placenta (4.67 minutes vs 6.58 minutes, P =.001), lower episiotomy suturing pain scores (2.72 vs 4.50, P =.001), and decreased maternal blood loss (16.66% vs 53.33%, P = .001); were more likely to involute the uterus below the umbilicus after 24 hours of birth (77% vs 10%, P = .001); and had higher maternal birth satisfaction score (7.15 vs 2.0, P = .001)., Discussion: The study demonstrates improvement of newborn and maternal short-term outcomes with use of the SBC technique. Findings support the use of SBC technique as a routine labor room practice to improve immediate maternal and newborn outcomes., (© 2023 by the American College of Nurse-Midwives.)

Given the role of malnutrition in childhood morbidity and mortality, the prioritisation of maternal and child nutrition programmes has grown significantly in the 21st century. Policies and programmes aim to improve infant and young child feeding, but questions persist about the most effective combination of interventions to achieve desired behaviour change. There is increasing interest in mobile-based interventions globally, but scant evidence exists to guide donors, policymakers and programme implementers on their effectiveness. Formative research was conducted to assess the feasibility and acceptance of text message-based interventions and to guide the final design of the text message intervention. This protocol is for a cluster-randomised controlled trial to test the effectiveness of adding text messaging to other ongoing SBC interventions to promote egg consumption, dietary diversity and other ideal dietary practices, particularly among children 12-23 months of age in Kanchanpur, Nepal. The trial findings will contribute to the emerging body of evidence on the effectiveness of using text messages for behaviour change, specifically for young child dietary outcomes in South Asia. Recent studies have suggested that mobile-based interventions alone may be insufficient but valuable when added to other social and behavioural interventions; this trial will help to provide evidence for or against this emerging theory. This trial was registered at ClinicalTrials.gov on 11 March 2019 (ID: NCT03926689) and has been updated twice., (© 2023 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Hierarchical micro/nanostructures are constructed by micro-scaled objects with nanoarchitectures belonging to an interesting class of crystalline materials that has significant applications in diverse fields. Featured with a large surface-to-volume ratio, facile mass transportation, high stability against aggregation, structurally enhanced adsorption, and catalytical performances, three dimenisional (3D) hierarchical metal oxides have been considered as versatile functional materials for waste-water treatment. Due to the ineffectiveness of traditional water purification protocols for reclamation of water, lately, the use of hierarchical metal oxides has emerged as an appealing platform for the remediation of water pollution owing to their fascinating and tailorable physiochemical properties. The present review highlights various approaches to the tunable synthesis of hierarchical structures along with their surface modification strategies to enhance their efficiencies for the removal of different noxious substances. Besides, their applications for the eradication of organic and inorganic contaminants have been discussed comprehensively with their plausible mechanistic pathways. Finally, overlooked aspects in this field as well as the major roadblocks to the implementation of these metal oxide architectures for large-scale treatment of wastewater are provided here. Moreover, the potential ways to tackle these issues are also presented which may be useful for the transformation of current water treatment technologies., (© 2023 Wiley-VCH GmbH.)

The intriguing features of surface-engineered hexagonal two-dimensional boron nitride ( h -BN) nanostructures have captivated the immense interest of researchers working in the arena of materials science. Inspired by striking attributes exhibited by h -BN nanosheets as the support material, we devoted our efforts towards synthesizing a novel magnetically retrievable h -BN/Fe 3 O 4 /APTES-AMF/Cu II catalytic system, which was then comprehensively characterized using various techniques including SEM, TEM, EDX, SEM-based elemental mapping, ED-XRF, AAS, XRD, FT-IR, VSM, XPS, TGA, and BET. Further, the catalytic potential of h -BN/Fe 3 O 4 /APTES-AMF/Cu II nanocomposites was investigated in the one-pot multicomponent coupling reaction to gain access to a library of biologically active 2-amino-4-aryl(or heteroaryl)-7,7-dimethyl-5-oxo-5,6,7,8-tetrahydro-4 H -chromene-3-carbonitriles under ambient conditions. In addition, the use of green solvent, facile magnetic recoverability, and reusability of up to six successive runs made this protocol environmentally benign and economical. This work throws light on the development of covalently functionalized 2D-BN nanostructure-based copper catalysts and establishes its significance in furnishing industrially demanding products that would pave the way towards sustainable chemistry.

To date, remarkable progress has been achieved in the development of photocatalysts owing to their high activity, selectivity, and tunable light absorption in the visible light range. Recently, heterogeneous photocatalytic systems have emerged as potential candidates due to their beneficial attributes ( e.g. , high surface area, ease of functionalization and facile separation). Herein, we provide a concise overview of the rational design of heterogeneous photocatalysts by grafting photoactive complexes on heterogeneous support matrices via covalent grafting and their detailed characterization techniques, which have been followed by the landmark examples of their applications. Also, major challenges and opportunities in the forthcoming progress of these appealing areas are emphasised.

Background: Nepal's female community health volunteers (FCHVs) each lead a monthly health mothers' group (HMG) to share health-related information and engage communities in the health system. Suaahara II (SII), a US Agency for International Development-funded multisectoral nutrition program, uses social and behavior change interventions to promote HMG participation and uses its health systems interventions to strengthen HMG quality., Objectives: This study aimed to explore HMG functionality and variation across Nepal, including barriers and facilitators to attending HMG meetings., Methods: SII's cross-sectional annual survey data from 16 districts ( n  = 192 FCHVs and 1850 mothers with children <2 y) were used. Descriptive and logistic regression analyses were conducted where the outcome variable was whether mothers were active HMG members or not, with FCHV and maternal characteristics as explanatory variables. Qualitative data were obtained from 3 of 16 survey districts ( n  = 30 observations, n  = 30 in-depth interviews with mothers, and n  = 16 focus group discussions with mothers, family members, FCHVs, health workers, and SII staff)., Results: Among FCHVs, 90% reported facilitating HMG meetings, whereas 64% of mothers reported HMG availability, and only 25% reported participating actively in meetings. Household head sex, maternal age, maternal education, maternal self-efficacy, and engagement with an FCHV and SII were associated with whether mothers were active participants in HMG meetings. Qualitative findings highlighted systems-level barriers, including lack of FCHV skills, demotivation, and heavy workload. Mothers noted time as the major constraint and family support, the HMG's savings component, and active FCHVs as facilitators to participation., Conclusions: Findings suggest that both supply- and demand-side solutions are needed to improve HMG performance and uptake in Nepal. These solutions need to include improving FCHV skills and motivating them to provide high-quality HMG services, as well as encouraging family members to support women so that they have time to participate in the HMGs., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.)

In this work, we have reported a noble metal free heterogeneous photocatalyst to carry out direct (het)arene C-H arylation and solvent-free CO 2 capture via single-electron transfer processes at room temperature and under pressure. The catalytic system comprises a cobalt(III) complex grafted over the silica coated magnetic support for the efficient recovery of the photocatalytic moiety without hampering its light-harvesting capability. The novel Earth-abundant cobalt(III) based photocatalyst possesses various fascinating properties such as high surface area to volume ratios, large pore volume, crystalline behaviour, high metal loading, excellent stability and reusability. The general efficacy of the highly abundant and low-cost cobalt based heterogeneous nanocatalyst was checked for the selective conversion of aryldiazonium salts into synthetically and pharmaceutically significant biaryl motifs under ambient conditions upon irradiation with visible light. The highly efficient photocatalytic conversion of carbon dioxide (CO 2 ) to a value-added chemical was accomplished under mild reaction conditions with high selectivity, showing the added benefit of operational simplicity.

Despite significant advancements in modern agricultural practices, efficient handling of pesticides is a must as they are continuously defiling our terrestrial as well as aquatic life. During the last couple of decades, substantial efforts by various research groups have been devoted to find innovative solutions to remove pesticides from our environment in a greener way. In this regard, functionalized silica nanoparticles (NPs) have gained considerable attention of scientific community due to their notable properties such as amenable design, large surface area as well as fine-tunable and uniform pore structures which make them an ideal material for pesticides removal. The present review aims to proffer current scientific progress attained by silica-based nanostructures as an excellent material for effective removal of noxious agrochemicals. Further, a brief discussion on the synthetic strategies as well as intrinsic benefits associated with different morphologies of silica have also been highlighted in this article. It also summarizes the recent reports on silica assisted degradation of pesticides via enzymatic, chemical as well as advanced oxidation protocols. Additionally, it presents a critical analysis of different support materials for decontamination of our ecosystem. The review concludes with potential challenges, their possible solutions along with key knowledge gaps and future research directions for successful deployment of silica supported materials in degradation of pesticides at commercial scale., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Tuning the structural architecture of the pristine two dimensional hexagonal boron nitride (h-BN) nanosheets through rational surface engineering have proven advantageous in the fabrication of competent catalytic materials. Inspired by the performance of h-BN based nanomaterials in expediting key organic transformations, we channelized our research efforts towards engineering the inherent surface properties of the exclusively stacked h-BN nanosheets through the incorporation of a novel competent copper complex of a bidentate chelating ligand 2-hydroxy-4-methoxybenzophenone (BP). Delightfully, this hybrid nanomaterial worked exceptionally well in boosting the [3 + 2] cycloaddition reaction of azide and nitriles, providing a facile access to a diverse variety of highly bioactive tetrazole motifs. A deep insight into the morphology of the covalently crafted h-BN signified the structural integrity of the exfoliated h-BN@OH nanosheets that exhibited lamellar like structures possessing smooth edges and flat surface. This interesting morphology could also be envisioned to augment the catalysis by allowing the desired surface area for the reactants and thus tailoring their activity. The work paves the way towards rational design of h-BN based nanomaterials and adjusting their catalytic potential by the use of suitable complexes for promoting sustainable catalysis, especially in view of the fact that till date only a very few h-BN nanosheets based catalysts have been devised., (© 2021. The Author(s).)

'Epigenetic' regulation of genes via post-translational modulation of proteins is the current mainstay approach for the disease therapies, particularly explored in the Histone Deacetylase (HDAC) class of enzymes. Mainly sight saw in cancer chemotherapeutics, HDAC inhibitors have also found a promising role in other diseases (neurodegenerative disorders, cardiovascular diseases, and viral infections) and successfully entered in various combination therapies (pre-clinical/clinical stages). The prevalent flexibility in the structural design of HDAC inhibitors makes them easily tuneable to merge with other pharmacophore modules for generating multi-targeted single hybrids as a novel tactic to overcome drawbacks of polypharmacy. Herein, we reviewed the putative role of prevalent HDAC hybrids inhibitors in the current and prospective stage as a translational approach to overcome the limitations of the existing conventional drug candidates (parent molecule) when used either alone (drug resistance, solubility issues, adverse side effects, selectivity profile) or in combination (pharmacokinetic interactions, patient compliance) for treating various diseases., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Growth monitoring and promotion (GMP) is both a service for diagnosing inadequate child growth in its earliest stages and a delivery platform for nutrition counselling. The widespread use of GMP services in developing countries has the potential to substantially reduce persistent child undernutrition through early diagnosis and by linking caregivers and their children to key health and nutrition services. However, researchers have questioned the effectiveness of GMP services, which are frequently undermined by underdeveloped health systems and inconsistent implementation. This analysis examined both supply- and demand-side factors for GMP utility in Nepal from the perspectives of beneficiaries and service providers, particularly focusing on three components of GMP: growth assessment, analysis of growth status and counselling. The most common factors influencing GMP uptake included beneficiaries' perceptions of the relative importance of GMP and the knowledge and skill of frontline workers. Both providers and beneficiaries viewed GMP as a secondary health and nutrition activity and therefore less important than curative services. We found deficits in GMP-related knowledge and skills among providers (i.e. health workers and female community health volunteers), as well as indications of poor training quality and coverage. Furthermore, we found variation in GMP utilization by maternal age, education and residency (alone, nuclear or extended), as well as household socio-economic well-being and rurality. This study is the first to assess factors influencing both beneficiaries and service providers for GMP utilization. Further research is needed to explore the implementation of improved GMP protocols and to evaluate facility-level implementation barriers., (© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Objectives: Maternal health-seeking behaviors are critical to improving maternal and child health in low-income countries. This study investigates associations between maternal decision-making input and their health-seeking behaviors in the first 1000-day period between pregnancy and a child's second birthday in Nepal., Methods: We used data from a cross-sectional survey conducted in 2018 in 16 districts of Nepal. Among the 3648 households surveyed, 1910 mothers of a child 0 to 24 months with complete data were included for analyses. Logistic regression was used to examine associations between decision-making input and the utilization of antenatal, delivery and postnatal care services, and attendance at health mothers' group (HMG) meetings. We also used negative binomial regression to assess the relationship between her decision-making input and participation in growth monitoring and promotion (GMP) in the 6 months prior to the survey. For each relationship examined, we adjusted for clustering, as well as potentially confounding factors at individual and household levels., Results: After adjusting for confounders, maternal decision-making input had a small but positive and significant association with receiving at least 4 antenatal care visits (OR = 1.09, 95% CI 1.02, 1.17), attendance at GMP in the 6 months prior to the survey (IRR = 1.02, 95% CI 1.00, 1.04), and HMG attendance (OR = 1.10, 95% CI 1.03, 1.17), but not with receiving at least 3 postnatal care visits or delivering in a health institution., Conclusions for Practice: Our findings indicated that empowering women and mothers in household decision-making might warrant greater attention when developing future policies and programs in Nepal.

In the present report, an environmentally benign magnetically recoverable nickel(ii)-based nanoreactor as a heterogeneous catalyst has been developed via a template free approach. The catalytic performance of the synthesized catalyst is assessed in the confined oxidative coupling of arenethiols with arylhydrazines to form unsymmetrical diaryl sulfides under aerobic conditions. The salient features of our protocol include oxidant- and ligand-free conditions, use of water as a green solvent, room temperature and formation of nitrogen and water as the only by-products. Moreover, a broad range of functional groups are tolerated well and provide the corresponding diaryl sulfides in moderate to good yields. Moreover, the heterogeneous nature of the catalyst permits facile magnetic recovery and reusability for up to seven runs, making the present protocol highly desirable from industrial and environmental standpoints., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

In this work, biologically significant 3,3-di(indolyl)indolin-2-ones have been synthesized using a silica-coated magnetic-nanoparticle-supported 1,4-diazabicyclo[2.2.2]octane (DABCO)-derived and acid-functionalized ionic liquid as the catalytic entity. The fabricated nanocomposite catalyzes the pseudo-three-component reaction of isatins and indoles explicitly via hydrogen-bonding interactions between substrates and the catalyst. The nanocatalytic system utilizes water as the green reaction medium to obtain a library of indolinones in good to excellent yields under mild reaction conditions. Besides, the catalyst could be easily recovered from the reaction mixture through simple external magnetic forces, which enables excellent recyclability of the catalyst for successive runs without appreciable loss in catalytic activity. Hence, the outcomes of the present methodology make the nanocatalyst a potential candidate for the development of green and sustainable chemical processes., Competing Interests: The authors declare no competing financial interest., (Copyright © 2019 American Chemical Society.)

The prevalence of maternal and child malnutrition in Nepal is among the highest in the world, despite substantial reductions in the last few decades. One effort to combat this problem is Suaahara II (SII), a multi-sectoral program implemented in 42 of Nepal's 77 districts to improve dietary diversity (DD) and reduce maternal and child undernutrition. Using cross-sectional data from SII's 2017 annual monitoring survey, this study explores associations between exposure to SII and maternal and child DD. The study sample included 3635 mothers with at least one child under the age of five. We focused on three primary SII intervention platforms: interpersonal communication (IPC) by frontline workers, community mobilization (CM) via events, and mass media through a weekly radio program (Bhanchhin Aama); and also created an exposure scale to assess the dose-response relationship. DD was measured both as a continuous score and as a binary measure of meeting the recommended minimum dietary diversity of consuming foods from at least 5 of 10 food groups for mothers and at least 4 of 7 food groups for children. We used linear and logistic regression models, controlling for potentially confounding factors at the individual and household level. We found a positive association between any exposure to SII platforms and maternal DD scores (b = 0.09; p = 0.05), child (aged 2-5 years) DD scores (b = 0.11; p = 0.03), and mothers meeting minimum dietary diversity (OR = 1.16; p = 0.05). There were significant, positive associations between both IPC and CM events and meeting minimum DD (IPC: OR = 1.31, p = 0.05; CM: OR = 1.37; p<0.001) and also between CM events and DD scores (b = 0.14; p = 0.03) among mothers. We found significant, positive associations between mass media and meeting minimum DD (OR: 1.38; p = 0.04) among children aged 6-24 months and between mass media and DD scores (b = 0.15; p = 0.01) among children aged 2-5 years. We also found that exposure to all three platforms, versus fewer platforms, had the strongest association with maternal DD scores (b = 0.45; p = 0.01), child (aged 2-5 years) DD scores (b = 0.41; p<0.001) and mothers meeting MDD (OR = 2.33; p<0.001). These findings suggest that a multi-pronged intervention package is necessary to address poor maternal and child dietary practices and that the barriers to behavior change for maternal diets may differ from those for child diets. They also highlight the importance of IPC and CM for behavior change and as a pre-requisite to mass media programs being effective, particularly for maternal diets., Competing Interests: The authors have declared that no competing interests exist.

In the present work, we report the fabrication of a highly versatile ruthenium-based magnetically recoverable photoredox nanocatalyst with a large surface area. This visible light harvesting nanocatalyst was effectively used for cross-dehydrogenative coupling via C-H activation between tertiary amines and various carbon nucleophiles with high regioselectivity to afford the C-C coupled products in good to excellent yield using air as an oxidant under ambient conditions. The Ru-based catalyst was found to be a potential candidate from economical and environmental perspectives due to its magnetic recoverability and reusability.

In order to maintain a healthy organisation of bionetworks, both qualitative and quantitative estimation of hexavalent chromium in food and beverage samples is required based on proper quality control and assurance. Nonetheless, conventional quantitation techniques for hexavalent chromium generally suffer from certain limitations (e.g., the need for expertise, costly equipment, and a complicated procedure). This research was performed to elaborate a novel method to quantify hexavalent chromium based on an electrochemical cyclic voltammetry technique. To this end, nanochips of manganese oxide (Mn 3 O 4 : approximately 80-90 nm diameter and 10 nm thickness) were synthesized using a chemical method and characterized with spectroscopic and microscopic approaches. These nanochips were employed as proficient electrocatalytic materials in direct redox sensing of hexavalent chromium in both real samples and laboratory samples. Manganese oxide nanochips felicitated large surface area and catalytic action for direct electrochemical reduction of hexavalent chromium at electrode surface. This fabricated nanochip sensor presented a detection limit of 9.5 ppb with a linear range of 50-400 ppb (sensitivity of 25.88 µA cm -2 ppb -1 ).

Objective: To evaluate the impact of a peer facilitator (PF) approach for improving mothers' knowledge and practices relating to maternal and child nutrition., Design: A quasi-experimental design nested within a large-scale integrated nutrition programme, Suaahara, in Nepal. Suaahara interventions were implemented in all study sites, but peer facilitators were used in only half of the study sites., Setting: Rural, disadvantaged villages in three districts of Nepal: Bhojpur, Bajhang and Rupandehi., Subjects: Mothers of children aged 6-23·9 months (n 1890)., Results: Differences over time between comparison (C) and intervention (I) groups show that the PF approach had a significant positive impact on several indicators of mothers' knowledge and practices relating to maternal and child nutrition: (i) knowing that fruits and vegetables are good for children 6-23·9 months (C: -0·7, I: 10·6; P=0·03); (ii) child dietary diversity (C: 0·02, I: 0·04; P=0·02); (iii) child minimum dietary diversity (≥4 of 7 food groups; (C: 6·9, I: 16·0; P=0·02); (iv) maternal dietary diversity (C: 0·1, I: 0·4; P=0·01); and (v) maternal minimum dietary diversity (≥4 food groups; C: 3·6, I: 14·0; P=0·03). Additionally, exposure to a PF three or more times in the past 6 months was positively associated with a small improvement in maternal (β=0·06, P=0·04) and child (β=0·06, P=0·02) dietary diversity scores. Improvements were not observed in maternal health-seeking behaviours such as number of antenatal care visits., Conclusions: Peer mobilization is a potential approach for improving health- and nutrition-related knowledge and behaviours among women in hard-to-reach communities of Nepal.

The burden of undernutrition in South Asia is greater than anywhere else. Policies and programmatic efforts increasingly address health and non-health determinants of undernutrition. In Nepal, one large-scale integrated nutrition program, Suaahara, aimed to reduce undernutrition among women and children in the 1,000-day period, while simultaneously addressing inequities. In this study, we use household-level process evaluation data (N = 480) to assess levels of exposure to program inputs and levels of knowledge and practices related to health, nutrition, and water, sanitation, and hygiene (WASH). We also assess Suaahara's effect on the differences between disadvantaged (DAG) and non-disadvantaged households in exposure, knowledge, and practice indicators. All regression models were adjusted for potential confounders at the child-, maternal-, and household levels, as well as clustering. We found a higher prevalence of almost all exposure and knowledge indicators and some practice indicators in Suaahara areas versus comparison areas. A higher proportion of DAG households in Suaahara areas reported exposure, were knowledgeable, and practiced optimal behaviors related to nearly all maternal and child health, nutrition, and WASH indicators than DAG households in non-Suaahara areas and sometimes even than non-DAG households in Suaahara areas. Moreover, differences in some of these indicators between DAG and non-DAG households were significantly smaller in Suaahara areas than in comparison areas. These results indicate that large-scale integrated interventions can influence nutrition-related knowledge and practices, while simultaneously reducing inequities., (© 2017 John Wiley & Sons Ltd.)

Vertical climbing is an essential behavior for arboreal animals, yet limb mechanics during climbing are poorly understood and rarely compared with those observed during horizontal walking. Primates commonly engage in both arboreal walking and vertical climbing, and this makes them an ideal taxa in which to compare these locomotor forms. Additionally, primates exhibit unusual limb mechanics compared with most other quadrupeds, with weight distribution biased towards the hindlimbs, a pattern that is argued to have evolved in response to the challenges of arboreal walking. Here we test an alternative hypothesis that functional differentiation between the limbs evolved initially as a response to climbing. Eight primate species were recorded locomoting on instrumented vertical and horizontal simulated arboreal runways. Forces along the axis of, and normal to, the support were recorded. During walking, all primates displayed forelimbs that were net braking, and hindlimbs that were net propulsive. In contrast, both limbs served a propulsive role during climbing. In all species, except the lorisids, the hindlimbs produced greater propulsive forces than the forelimbs during climbing. During climbing, the hindlimbs tends to support compressive loads, while the forelimb forces tend to be primarily tensile. This functional disparity appears to be body-size dependent. The tensile loading of the forelimbs versus the compressive loading of the hindlimbs observed during climbing may have important evolutionary implications for primates, and it may be the case that hindlimb-biased weight support exhibited during quadrupedal walking in primates may be derived from their basal condition of climbing thin branches., Competing Interests: Competing interestsThe authors declare no competing or financial interests., (© 2017. Published by The Company of Biologists Ltd.)

Background: Suaahara, a large-scale integrated program, aimed to improve diets and nutritional status among women and children, in part by facilitating enhanced homestead food production (EHFP)., Objective: This study examines associations between EHFP and maternal and child dietary diversity and variations by season and agroecological zone (AEZ): mountains and terai., Methods: We used data from household monitoring surveys (n = 2101 mothers; n = 994 children, 6-23 months), which included a 7-day dietary recall and maternal report on participation in 5 EHFP activities-received vegetable seeds, chicks, and technical support and participated in training and EHFP groups. We constructed binary variables for each activity and a scale (0-5) summing participation. For dietary diversity, we used the Women's Dietary Diversity Score using 10 food groups and 7 food groups for child diets. Multivariable linear regression analyses were used to assess associations between EHFP participation and dietary diversity by season and AEZ, controlling for potential confounders and clustering., Results: In adjusted models, we found positive associations between dietary diversity and chicks, technical support, and EHFP beneficiary groups; the magnitude of the associations varied by season and AEZ. The degree of participation in 5 EHFP activities was positively associated with maternal dietary diversity in the terai (β = .24, P < .001) and mountains (β = .12, P = .01) and child dietary diversity in the terai (β = .35, P < .001) during the winter. No associations were found in the rainy season., Conclusion: Our findings highlight the potential for EHFP to address dietary diversity constraints among this population. Variation by subnational setting and seasonality suggest that policies and programs should be contextualized.

Background: To describe the methodology and baseline data of a population-based study designed to determine the prevalence of glaucoma and to study the risk factors for glaucoma development in a Nepali population., Design: Population-based cross-sectional study., Participants: Subjects 40 years and above residing in Bhaktapur District., Patients and Methods: Power calculations suggest that a sample size of 4758 is required. Thirty clusters were randomly selected from the 2 municipalities and 16 Village Development Committees of Bhaktapur District in Nepal. A door-to-door census was conducted in the selected clusters to identify citizens 40 years of age and older. Demographic details were collected and a structured interview, regarding awareness for cataract and glaucoma was taken. All individuals fulfilling the eligibility criteria were recruited and referred to the Tilganga Institute of Ophthalmology in Kathmandu for a detailed clinical examination including glaucoma diagnostic procedures. Peripheral blood samples were taken to facilitate future genetic analysis., Main Outcome Measures: Prevalence of glaucoma, risk factors and genetic screening., Results: A total of 4800 people were selected. The mean age of participants was 55.4 ± 12.3 years (range: 40-99) and 51.8% were female. In total, 64.8% of our cohort was aged less than 59 years and 60.5% were illiterate. Among the various ethnic races, 69.7% belonged to the Newar ethnic group., Conclusion: This study will determine the prevalence of glaucoma and allow for an increased understanding of the risk factors for glaucoma development in this region., (© 2010 The Authors. Clinical and Experimental Ophthalmology © 2010 Royal Australian and New Zealand College of Ophthalmologists.)

Rice Bran Oil (RBO) has got many health benefits. RBO has been analyzed for physico-chemical characteristics and compared with those of groundnut oil (GNO). The two oils were similar in various physicochemical characteristics. The major difference in the two oils lay in the amount of unsaponifiable matter, which was higher in the case of RBO. To find the in vivo antioxygenic potential of RBO, particularly its ability to protect against oxidative stress, rats were divided into two groups of 10 animals, each and were maintained on diets containing RBO or GNO for a period of 4 weeks. After which stress was induced to half the animals of each group by administering intraperitoneally N-nitrosodiethylamine (NDEA) (100 mg/kg) body weight and remaining half served as respective controls. Animals were sacrified 1 week after stress induction. Intraperitoneal administration of NDEA resulted in a significant reduction in body weight and feed intake, the effect being appreciably less in RBO fed group. NDEA toxicity was mainly reflected in liver as supported by increased activities of enzymes of liver function test (AST, ALT, ALP) on stress induction but the effect was appreciably of lesser degree in the group fed on RBO. The urea levels were also less in the group fed on RBO, The lipid peroxidation (LPO) increased on stress induction in erythrocytes and in all the tissues, the increase being less in RBO fed group except in kidneys. Stress induction resulted in decreased catalase (CAT) activity, the decrease being less in RBO fed group. The increase in peroxidase (Px) activity on stress induction was more in RBO fed group. Stress induction had no significant effect on superoxide-dismutase (SOD) activity except in liver and heart where it increased on stress induction. Thus, it appears that inclusion of RBO in the diet improves the antioxygenic potential and protect against oxidative stress.