Overview

Our team’s participation the iGEM competition is profoundly driven by a commitment to Human Practices. We believe that at the heart of technological progress is its responsibility to serve humanity with compassion and care. Our mission certainly extends beyond the wet lab and the development of products; it is a journey to understand and embody public service. We aspire to learn about the caring for the public in tangible and effective altruisms. Such passion fuels our actionable steps.

Reaching Consensus within the Team

When we first gathered to brainstorm what project to take on, someone suggested helping with menstrual pain and using menstrual blood for health checks, especially for high school female students. It took us into a controversial debate, and not everyone was on board at first, especially the male members. They agreed that the issues was important, but they thought it might be awkward to get involved with a topic that seemed like a "girl's issue." But that's what made us want to find out more, so we did a survey to see what everyone really thought about it (you can check out the full survey in this PDF).

As we talked things over, the female member on the team shared info about women's health, showing the male members articles and studies to read. By the time we got the survey results, people were a lot more into the idea than they were at the beginning.

This effort not only bridged the gap in perspectives within our team but also sparked an informed understanding of the potential concerns among the public. We realized that to shift public attitudes, we first needed to transform our own. With this in mind, we set out to interview gynecological doctors to gain insights into the significance of developing screening products for gynecological diseases and to equip ourselves with the knowledge necessary before we educate the wider community.

Our discussions about the overall framework of our Human Practices unfolded alongside our project timeline, and we consolidated our plans as detailed in our initial proposal. Our Human Practices initiatives will be organized into three main categories:

A - Designing the product: Here, we focus on creating a user-centric design that is not only effective but also sensitive to the needs of our target demographic.

B - Informing the public: We aim to raise awareness and provide valuable information about women's health issues.

C - Combating the status quo: We are determined to challenge existing misconceptions and work towards a more inclusive and informed society when it comes to women's health.

By structuring our efforts in this way, we aim to create a comprehensive approach that not only develops a product but also fosters a community of informed and empathetic individuals.

A – Designing the Product

As an integral part of our project, our product is deeply integrated with our human practice. Interviews with experts and manufacturing experts greatly informed our prototypes and testing of our design and hardware. This chapter of our Human Practices includes interviews with manufacturers and experts that informed this section and building, prototyping, and user testing of the product design.

 

A-1 Necessity of an Early Screening Product

The interview with Dr. He took place offline in a hospital. The motivation behind this interview was to extend our understanding and knowledge of women’s health issues to an expert in the field. Early screening can reduce mortality rates, increase cure rates, and identify precancerous lesions before they develop into more severe conditions. With this in mind, the goal is to make screening more accessible, efficient, and less invasive through sanitary napkins embedded with antibodies to monitor biomarkers. We wish to communicate this idea to field experts and receive constructive feedback. Although there are substantial articles and research reports for both health indicators, the interview was an opportunity to receive expert feedback tailored to our specific goals.  

To achieve this goal, Dr. He, a gynecologist from a hospital with professional qualifications in women’s health and disease treatment, was interviewed. The interview focused on the current challenges in screening, the potential benefits of antibody-embedded sanitary napkins, and the practical considerations for implementing such a product in clinical settings. It also touched on the significance of female menstrual education to both genders in detecting and preventing diseases and mitigating menstrual stigma. Dr. He has extensive experience in the field and has worked with countless patients with gynecological diseases, from basic inflammations to cervical and breast cancers. 

The discussions from the interview were insightful. This includes broadened our understanding of: 

• Convenience of Use & Market Potential: Antibody-embedded sanitary pads would offer women a noninvasive and convenient method of monitoring potential health issues. Dr. He foresees that such innovation will receive a high demand in the market if it is made, especially if they are proven reliable and can replace some of the traditional blood-based tests like CA125 screenings or even more invasive physical examinations like laparoscopy as regular screening methods. Many leading companies in the medical industry have been attempting to achieve this. 

• Sensitivity vs. Accuracy: In detecting antibodies from menstrual blood, a trade-off exists between sensitivity and accuracy: if the sensitivity is too high, the accuracy might be impaired, and if the sensitivity is too low, many false-negative cases may emerge. It is critical to find the balance between the two to ensure the most optimal functionality of the sanitary napkin and reduce unnecessary panic. 

• Menstrual Flow Considerations: The success of detecting issues depends heavily on the volume of menstrual blood, raising challenges regarding the timing and quantity needed for accurate readings.  

• Public Education: Dr. He states that students from international schools are provided with holistic sexual education courses, but public school students lack this. She also addresses the fact that nationwide, many patients are ashamed to talk about gynecological diseases. Education is particularly important to enhance awareness. 

• Privacy and Acceptance: The product is highly private. The public will likely accept this early screening form, assuming it is accurate, affordable, and convenient. But it may take some tiem, similar to colorectal cancer gene tests, which initially faced resistance but became popular due to convenience. 

In short, the interview with Dr. He was insightful. She emphasized that innovations such as embedding biological antibodies in sanitary napkins could significantly improve health monitoring for women, offering a convenient, non-invasive method to track indicators like CA125 and interleukin-6. However, Dr. He pointed out that challenges remain, particularly regarding the sensitivity and accuracy of the antibodies and the varying amounts of menstrual blood that could impact detection.  

Despite these hurdles, Dr. He expressed optimism about the market demand for such a product. This method may replace traditional tests to monitor health regularly, further enhancing women's access to critical screenings. In addition to technology, educating the young population regardless of gender and raising public health awareness is vital in combating late diagnosis and reducing mortality rates. These insights are foundational in our project, inspiring our later educational HP activities and laboratory designs. 

 

A-2 Biomarker Selection

We interviewed a number of gynecologists to advise us on the project before the formal experiment began. Dr. Feng Shuai gave us valuable advice. At the early stage of the interview, we were still selecting biomarkers for our experiment to see which antigen to bind to the antibody, so we hope to get some inspiration through this interview. And Dr. Feng also affirmed the value of our project. When asked under what circumstances would a patient come for cervical cancer or tumor screening, Dr. Feng told us that most patients generally only come for screening when there are obvious symptoms, so the situation may not be too optimistic. Therefore, this also confirms the significance of our project because it can be used as a preliminary detection means through a very convenient method to help women as early as possible to diagnose gynecological diseases. In addition, Dr. Feng Shuai also gave us some options on biomarkers. He said that if we want to focus on the confirmation of cervical cancer, we can use markers such as C19-9 and CA125, which are more specific for ovarian cancer.

 

A-3 Learning about antigen detection on Lateral Flow Assay Test Papers

The interview with Ms. Gao was conducted online via Tencent Meeting at a key stage in the project, where we brainstormed and investigated various technical mechanisms to display results upon the positive detection of presence of disease biomarkers. One of them was the colloidal gold lateral flow immunoassay. The primary goal of this interview was to receive expert interviews on these proposed mechanisms. We hope to gain insights to help us refine the pad proposal and assess the feasibility of different hardware solutions. 

To improve the project’s overall proposal, we interviewed Ms. Gao, the General Manager of Shenzhen Xuhong Medical Technology Co., Ltd. She has been working on in vitro and tumor markers diagnostic reagents and instruments. She has extensive experience in immunology, product development, and medical device operations. With over 15 years in the industry, Ms. Gao has successfully managed the entire product lifecycle, from development to mass sales. Her background makes her a key figure in understanding the project's technical and business aspects. The 1-hour interview provided us with critical considerations, tackling from the feasibility to accuracy of the product:

Ms. Gao stated that ovarian cancer is a threatening disease for the female population around 55 years-old. Due to its lack of evident symptoms until the later stages, 69% of the diagnosed patients in China are at Stage IV, leading to 15,000 deaths annually. HE4 is a protease inhibitor that is found to be highly expressed in ovarian cancer tissues. The serum HE4 levels in most ovarian cancer patients were significantly elevated, and its sensitivity was better than CA125. Hence, she suggested that if we aspire to focus on early screening for female-targeting cancers, HE4 is a critical biomarker to consider.

Ms. Gao noted that creating the product and promoting it for public use is challenging. One of the major obstacles was the nature of menstrual blood. It is a whole blood, meaning that it contains many endometrial cells, cervical mucus, and vaginal secretions along with the blood cells and proteins. If not adequately filtered, these additional elements can interfere with antigen-antibody testing. The complexity of these components requires a precise mechanism to isolate the relevant biomarkers, such as CA125 and IL-6, without compromising the test's accuracy. Achieving this balance is crucial for effective implementation.

As with Dr. He’s insights, Ms. Gao also emphasized the difficulty in balancing the sensitivity and accuracy of the immunoassay used in the product. High sensitivity is essential to detect low levels of biomarkers like CA125 and IL-6, but increasing sensitivity can sometimes reduce accuracy, leading to false positives or less reliable results. This can cause unnecessary anxiety for the users. The trade-off is a significant challenge for developing a reliable and commercially viable product. Consequently, Ms. Gao advised us to consider the Receiver Operating Characteristic test (ROC)

As we adopted scFv instead of the entire antibody, Ms. Gao suggested that consistency in raw materials and production batch stability is crucial for an accurate product. We should design realistic hardware reproducible by factories, as any alteration in the production product may impair the reliability of the test results. Ensuring raw material quality and handling is essential to produce such screening tools. 

All in all, the interview with Ms. Gao provided key insights into the technical and manufacturing challenges of developing a sanitary napkin-based early screening tool. The major takeaways include the complexity of working with menstrual blood due to its mixed composition, the balance sensitivity between immunoassay accuracy, and the importance of consistent raw materials and manufacturing stability, particularly as we opted for scFv antibodies. This feedback was essential for refining the project’s design and feasibility.

A-4 How should we utilize the test results upon disease biomarker detection?

Key takeaways:

1) The results should be used for risk screening rather than medical diagnosis

2) In clinical practices, there is no single marker that has strong specificity for one disease. Biomarkers should be used for general healthy-unhealthy screening

3) Other than cancers, we should pay more attention on inflammations.

Our response:

1) We initially wanted to find markers such as CA125 to focus the detection on ovarian cancer. After this interview, we changed our project goal to early screening of disease. Therefore, in the next step, we expanded our search for biomarkers.

2) We expanded our goal from only cancer to include non-cancerous diseases.

Dr. Zhou, the Deputy Chief Physician of Obstetrics and Gynecology at Beijing Hospital.

In terms of biomarkers for cancer detection, we discussed using CA125 and IL6. 

Dr. Zhou mentioned that these markers lack specificity. For example, CA125 can rise due to menstruation or inflammation, making it unsuitable for early detection or screening. Similarly, IL6 can rise due to inflammation and infections. Both does not serve as a specified early indicator of cancer. 

In term of the utilization of menstrual blood, Doctor Zhou provides several insights.

Doctor Zhou first warns us the possibility of blood contamination during the testing process.

Doctor Zhou also think that menstrual blood might offer a way to assess the uterine or vaginal environment; however, no specific biomarker for this purpose has been identified yet. Currently, people mainly do diagnosis based on evaluation of vaginal microenvironment. This technique still requires visits to the hospital. Only antigen-antibody tests can be self-administered; all other tests need to be sent to a laboratory for analysis.

We also discussed the significance and methods of education for the project.

Dr. Zhou highlighted the importance of public education to promote regular health check-ups, especially for early detection. Women, particularly in underprivileged regions, often do not prioritize or understand the importance of these screenings. Public health initiatives need to emphasize awareness through different platforms, including short videos sharing case studies and medical knowledge. This educational outreach is crucial, as untreated infections could lead to severe outcomes, including infertility.

In summary, Dr. Zhou believes women would generally be open to these products, though it’s crucial to conduct pre-experiments to gauge reception and assess the product’s effectiveness. 

A-5 Learning about Biomarkers

Based on the suggestions we received from doctor’s clinical practices, we then search in the medical literatures and found a list of potential biomarker candidates.

Through literature review and doctor interviews, we learned about many disease biomarkers as our target candidates. These include: 

1. CA125 (Cancer Antigen 125): CA125 is a tumor marker primarily used in the management of ovarian cancer. It is often used to monitor the treatment response and to detect the recurrence of the disease. However, elevated levels can also be found in other non-ovarian cancers.
2. CA199 (Carbohydrate Antigen 19-9): CA199 is a tumor marker that is often elevated in pancreatic cancer but can also be increased in other malignancies and some non-malignant conditions. It is used as a diagnostic, prognostic, and therapeutic indicator in pancreatic cancer .
3. HE4 (Human Epididymis Protein 4): HE4 is a blood test that is used, along with CA125, for the diagnosis and monitoring of ovarian cancer. It is a relatively new biomarker and has been found to be useful in differentiating ovarian cancer from other benign conditions.
4. SCC (Squamous Cell Carcinoma Antigen): SCC is a tumor marker used for the detection and monitoring of various types of squamous cell carcinomas, including those of the cervix, lungs, and head and neck. It is particularly useful in monitoring the response to treatment and detecting recurrence .
5. CEA (Carcinoembryonic Antigen): CEA is a protein that is often elevated in several types of cancer, including colorectal, breast, ovarian, and lung cancer. It is used to monitor the effectiveness of treatment and to detect the recurrence of cancer. However, it is not specific to any particular type of cancer and can also be elevated in non-malignant conditions.
6. AFP (Alpha-fetoprotein): AFP is a protein normally produced by a developing fetus. Elevated levels of AFP can be found in patients with liver cancer, germ cell tumors of the testicles or ovaries, and some other types of cancer. It is used for diagnosis, monitoring treatment, and detecting recurrence .
7. β-hCG (Beta-human Chorionic Gonadotropin): Produced by cells during pregnancy, β-hCG can also be produced by some germ cell tumors and other types of cancer. It is used to monitor the effectiveness of treatment for these cancers and to detect the recurrence of the disease.
8. CA72-4: CA72-4 is a tumor marker that is used in the diagnosis and monitoring of gastric cancer. It may also be elevated in other malignancies and non-malignant conditions. When used in combination with other tumor markers, it can improve the accuracy of cancer detection .
9. NSE (Neuron-Specific Enolase): NSE is an enzyme that can be elevated in patients with small cell lung cancer and neuroendocrine tumors. It is used to monitor the response to treatment and to detect the recurrence of these types of cancer .
10. ER (Estrogen Receptor) and PR (Progesterone Receptor): ER and PR are proteins that are found in certain types of breast cancer. They are used to determine the most appropriate treatment for breast cancer patients and to predict the likelihood of the cancer responding to hormone therapy .
11. HPV-DNA: Human Papillomavirus (HPV) DNA testing is a method used to detect the presence of high-risk HPV types that are associated with cervical cancer. It is used as a primary screening tool for cervical cancer in many countries.

A-5.1 Criteria for Selecting CA125 and IL-6

After careful study, we still find CA125 a great biomarker for general disease screening.

CA125, even though mostly known as an indicator of ovarian cancer, shows abnormal concentration elevations in many common gynecological diseases, such as Endometriosis, Endometrial cancer, Adenomyosis, and etc.The diseases indicated by CA125 covers a wide range of population group.

At the same time, IL-6 is a common inflammation marker. In fact, gynecological inflammation is significantly more common than cancers in female patients. Such inflammations and infections are also hard to cure and often transform into chronicle conditions, posing a long-term burden on females. Besides, IL-6 is not only associated with inflammations but also indicative of various other conditions, including some cancers.

At this point, we converged on the main design: using CA125 and IL-6 for high-risk screening of gynecological disease.

A-6 Interview with Dr. Huang from Qianjin Group: Integrating a Hardware into Pads for Clear Read-out

Key takeaways:

1) Try artificial menstrual blood to explore the color display and infiltration through layers

2) Creating a separate measuring component and open a display window on the back of the pad

3) Consider effects of varying menstrual blood quantity

We had the privilege to contact Dr. Huang from Qianjin Pharmaceutical to learn more about the potential challenges and solutions when integrating a test paper into sanitary pads. Dr. Huang has been the chief engineering manager on the sanitary production line in the group, and Qianjin Pharmaceutical, a company with extensive experience in the craftsmanship of sanitary pads, has been dedicated to women's health for many years. Their product line, "Qianjin Jingya," is a brand of medical-grade sanitary pads that employs the company's proprietary "Qianjin Cotton" technology to provide professional and healthy sanitary products.

Drawing on years of research and development experience, Dr. Huang first mentioned regulatory policies. The product we envision can only be classified as a general antiseptic product and cannot be registered as a medical device, which limits its precision and market potential.

Dr. Huang discussed how the materials of sanitary pads could potentially affect the accuracy of tests. Different types of non-woven fabrics, and even the adhesives used between fabrics, could impact the test results. She advised us to conduct further testing experiments in the future product design process. She suggested we try to create artificial menstrual blood to explore the color display at different depths and viscosities to avoid interference in color reading. At the same time, the product design must consider whether different menstrual flows affect the test results.

Considering cost, Dr. Huang recommended not changing the existing structure of sanitary pads but instead creating a separate measuring component that could be directly integrated into the sanitary pad production process, thus avoiding changes to the sanitary pad production line and reducing additional costs. She proposed opening a window on the bottom of the sanitary pad to observe the test strip results. She emphasized the importance of product pricing, ensuring that consumers in need can purchase the product at an affordable price.

Additionally, Dr. Huang mentioned the higher value of smart sanitary pads, which could monitor health conditions through a mobile app, and the potential for collecting health monitoring data for research and utilization.

A-6.1 Conclusion for Implementation Challenges

Combining the previous physicians’ suggestions and manufacturing experts’ advice, we are facing the following development challenge to address.

1) Control the sampling quantity of the menstrual blood when the flow quantity changes over time

2) Understand the influence of color and viscosity of artificial menstrual blood through layers of sanitary pad materials

Our proposal to solve the problems converges on the development of a small hardware including three major parts.

1. Silicone Panel: This panel has a whole with certain depth to collect blood sample on one end, and a channel from the whole to guide menstrual fluid efficiently onto the test strip and to serve as a holder for the test strip, keeping it in place.
2. Test Strip: The test strip works similar to COVID-19 antigen tests; it uses the lateral flow immunoassay mechanism where a line with specific scFv antibodies will be lined up and if the biomarker is detected in high abundance, the test strip would reflect this visually providing the user with a straightforward and immediate result.
3. PVP Membrane: We designed a bottom for the whole with PVP film membrane, a water-soluble membrane that would dissolve after a few minutes exposure to liquid, such as water or blood. When dissolved, blood is no longer collected and thus ensure the test trip is not flooded with blood that would affect the reading of the result.

A-7 Silicone Panel for Blood Sample Collection

The illustration explains the basic ideas behind the overall product design. The sample collection and read-out hardware will be installed under the blood absorption layer in the sanitary pads, to exclude the debris of dead cells and other organisms.

We can adjust the depth and the area of the whole, and also the thickness of the PVP membrane, so that we can control the amount of blood to collect before the membrane is totally dissolved. Before it dissolves, we need to make sure the blood reach the upper level so that the blood sample will be drawn onto the test strip. After that, no blood will be drawn to the test strip.

We plan to create a 3D-printed mold, followed by injecting liquid silicone into the mold. After curing, the process will form the upper component with precise dimensions while ensuring the product remains soft and elastic, without affecting its usability.

The figures illustrated the original solid works 3D model design (you can download the original files on our Hardware page), and as-printed model (middle figure), and the silicone panel model.

A-8 Fabricating PVP Film for Blood Sample Control

Based on the protocol from work [], we fabricated a simple PVP membrane film.

Depending on the thickness we prepare the film in the petri dish, and also the concentration of the PVP solution (10% and 15%), we can vary the time before the film dissolves around 2-3 minutes. See the following video.

https://video.igem.org/w/sPUbAEKKieAaPGiBN5jnSv

A-9 Making the Simulated Menstrual Blood from Literature

We fabricated artificial menstrual blood based on the reference protocol. We tested an assortment of sanitary pad products. The effects and colors of the artificial blood and based on team member’s experience, the color and viscosity closely resemble the real-life materials.

We sandwiched a sample test strip in the pad and soaked the pad with a typical amount of fluid. The results showed that the test strip can successfully draw the fluid, and also, very importantly, the color of the blood do not interfere with the color of reading the test lines.

A-10 User Assessments: Need for a thinner installation

In previous test, we used a simpler option 2 design for installation. However, in the test we found the fluid has a chance of leakage through the bottom of the whole for sample collection. We changed our installation design to option 1.

We asked a few members to assess whether the silicone panel design is too thick. According to safety considerations, we did not ask any people to test the product in daily use, but we simply asked them to feel the thickness of the product with their hands and make suggestions based on experience. According to the feedback, we made a thinner version of the silicon panel.

This figure shows the thinner silicone 3D mold, and the silicon panel. The middle figures show the interior of how the panel and the test paper is sandwiched between sanitary layers. The rightmost figures shows the overall thickness is a bit over 2 mm, which should not lead to any discernible discomfort according to hand-feeling tests.

B - Informing the Public

Lack of awareness and knowledge prevent many women from seeking the help they need or even recognizing that they are sick. Through this portion of our human practice, we wish to educate the people and communities around us in hopes that this new knowledge will lead to the prevention of more serious conditions int he future. In this part of our Human Practices, we will demonstrate

- Integrated Human Practices that informed this section 

- In-person information sharing events  

- Social media outreach 

- Informative fliers 

B-1 Reaching out to the Public

We learned from the experts and their opinions on embedding test strips in sanitary pads to promote regular screening for gynecological diseases. However, whether the public accepts this idea is yet undetermined. This activity aims to gather insights into women's health and physical examination practices through a questionnaire. This information is crucial for understanding women's perceptions, frequency, and concerns regarding health check-ups, which can help in designing better health products and services tailored to their needs. Ultimately, we hope to hear the public’s opinion on the proposed sanitary pads. Otherwise, if it was manufactured and no one was willing to use it, the pad would waste resources.

We conducted a fifteen-question questionnaire to assess the public’s interest in the innovative sanitary napkin. The questionnaire included single-choice, multiple-choice, matrix-sliding bar, and free-response questions. The first question asked for the participant's consent, given the purpose of the research. The following four questions targeted the participants’ demographics, including gender, age group, province, city, and region, and their residential location. These factors may influence their response and access to menstrual resources and knowledge. Thus, we were engaging in obtaining their demographics. Finally, the rest of the questions were tailored to menstrual health awareness, physical examination frequency, and thoughts on the innovative sanitary napkins.

The questionnaire offered valuable insights from 660 random individuals (excluding the male and those who selected “no” for the consent) across various age groups and residential locations. These include:

Perceived Importance of Regular Check-ups: Most respondents indicated that regular physical examinations are vital for maintaining health. They rated an average of 4.72 on a scale from 0 to 5, with five being extremely important. However, with 93.44% of the participants residing in the city, this only underscores a general health awareness among middle—to high-social-status women regarding the role of preventive healthcare in their overall well-being.

Frequency of Examinations and Influencing factors: Responses revealed that many women typically visit healthcare facilities for check-ups on an annual basis. However, there are variations in frequency, suggesting that while some prioritize regular visits, others may have longer intervals due to personal circumstances or barriers to access. These include health awareness (59.91%), study/work pressure (37.17%), access to medical resources (36.88%), and financial considerations(31.78%). Understanding these barriers can help in designing interventions to encourage more frequent examinations.

Motivations for Health Check-ups: Women seek physical examinations primarily because of preventive care and monitoring existing health issues. Secondary motivations often relate to specific health concerns or recommendations from healthcare providers. The factors above for frequency of examinations also affect the eagerness of women to attend health examinations.

Interest in Innovative Testing Methods: There is a notable interest in utilizing self-testing methods. 73.76% of the participants would want/accept incorporating test strips into sanitary napkins for regular health monitoring during menstruation. Many regard this innovative approach as empowering women to take charge of their health by enabling them to conduct checks in the privacy and comfort of their homes. Conversely, many expressed their concern for the product’s accuracy and reliability.

In summary, the questionnaire results are critical to designing and modifying health products and services that improve women's health outcomes, as they reflect the needs and preferences of the target demographic. We identified health awareness, study/work pressure, access to medical resources, and financial concerns as the leading factors prohibiting regular physical examination. We are also glad that many public members have accepted our proposed product. But, indeed, the accuracy and reliability is worth more investigation to make this product truly accessible and effective for everyone.

B-2 Different Diseases for Different age groups

In this online interview, Dr. Huang Yan shared her professional insights into common gynecological diseases and women's health issues. Dr. Huang emphasized the prevalence of gynecological inflammation and menstrual irregularities in gynecological clinics, and mentioned the important role of sanitary pads in women's health. She believes that integrating early checks through sanitary pads is an innovative method that can detect and prevent inflammation, and may even identify the causes of abnormal uterine bleeding, such as endometrial cancer.

Dr. Huang also stressed the importance of health education for women of different age groups and proposed different educational strategies for adolescent, reproductive age, and menopausal women.

1. Adolescent girls: Dr. Huang recommends going into schools to conduct face-to-face science popularization education with adolescent girls, teaching them how to prevent common gynecological inflammations and what symptoms require medical attention. She emphasized the importance of educating young women to recognize symptoms that need medical intervention.
2. Reproductive age women: For women of reproductive age, Dr. Huang mentioned that community-based science popularization education should be conducted because women in this stage may face different health issues, such as infertility.
3. Menopausal women: Dr. Huang pointed out that menopausal women often encounter problems like abnormal uterine bleeding, so health education should focus on how to identify and prevent common diseases at this age.
4. Importance of education: Dr. Huang emphasized the importance of science popularization education in raising women's health awareness and promoting timely medical treatment. She mentioned various methods of education, including online platforms (such as TikTok, Xiaohongshu) and offline printed materials (such as health education brochures, flyers). She emphasized the importance of choosing the right education method based on the age group.

B-3 Challenges and Resources in Exposing the Public to the New Product

We interviewed Ms. Freda from Reed Exhibitions, one of the world's leading organizers of professional exhibitions and conferences. The group organizes a variety of professional exhibitions and conferences globally, covering multiple industries such as healthcare, construction, tourism, maritime, food, and hospitality. Reed Exhibitions has offices around the world, including the Americas, Europe, the Middle East, Africa, and the Asia-Pacific region. It hosts over 500 exhibitions annually, serving tens of thousands of exhibitors and professional audiences worldwide.

Freda offered the following advice:

1. Challenges in Promoting Products in Different Regions, Especially Underdeveloped Areas:

   We discussed the challenges of promoting disease-testing sanitary pads in different regions, especially in underdeveloped areas. The main issues include potential low acceptance of new products by local communities and possible cultural and cognitive barriers.

   The importance of education and publicity was emphasized to raise awareness and acceptance of the product among the target population.

   Suggestions were made to increase the accessibility of the product in these areas by simplifying product design and reducing costs.

2. Considering Other Promotion Channels, Such as Exhibitions and International Organizations:

   We explored the feasibility of promoting products through exhibitions and international organizations. These channels can provide additional exposure and recognition for the product.

   The possibility of establishing industry contacts and partnerships through participation in relevant exhibitions and events was discussed.

   The idea of leveraging the resources and networks of international organizations to expand the promotion and distribution of the product in target areas was proposed.

3. Emphasizing the Importance of Product Quality and Safety:

   We discussed the importance of product quality and safety for consumer trust. It was emphasized that products need to meet national and international standards.

   Suggestions for product quality control were made, including implementing strict quality management systems during the production process.

   The discussion included how to improve the product's credibility by obtaining certifications and using safe materials.

4. Discussing How to Use New Media to Raise Public Awareness of Women's Health Issues:

We explored the use of new media platforms (such as social media, video platforms) to raise public awareness of women's health issues.

Ideas were proposed for creating educational content (such as videos, blog posts) to popularize women's health knowledge and how to integrate product information into this content.

In response to the advice and feedbacks we received from interviews and surveys, we conducted the following activities to inform the public about necessary female health knowledge.

B-4 Family education 

In order to improve the majority of women's awareness and understanding of gynecological diseases, we decided to start from the family around us. The members of the group in turn to the family members such as mom, dad, grandma and so on about gynecological diseases and their importance and how to prevent and so on. After the education, family members reported that they had learned a lot, and also paid more attention to and understood gynecological diseases. And we also asked them about their previous views on gynecological diseases, and we did find that a lot of women feel that this type of disease is shameful and unimportant, so this also confirms the need to spread the knowledge of gynecological diseases widely. 

B-5 Social Media Outreach

We learned from many sources that new platforms of social media are good channels for healthcare outreach. We created educational videos and published on the following platforms:

Wechat Video Account: Wechat is nowadays the most popular social media platform in China.

Bilibili.tv: a video sharing platform mostly popular in teenage and youth in their twenties.

Tiktok and Weibo:

The Himalaya Podcast:

These public education activities are documented in more details on our Education page.

B-6 Information Flyers.

We created flyers and small-sized posters to introduce knowledge about gynecological diseases and to encourage people to get wellness checkups. The flyers and posters are distributed to various groups of audience in our in-person activities, such as the lecture at the CITIC bank, the fundraising event, and the in-school lectures. Refer to our Education page for more information.

B-7 Educational Lectures

We carried out a series of educational lectures to inform the public about diseases they should receive early health checkups for. The lectures covered the three main age groups learned from the previous expert interviews. Particularly, the lecture content and the disease symptoms knowledge were selected based on the most common disease occurring in each age group.

Please refer to our Education page for details, and we encourage all readers to use these documented educational materials for general education.

C- Challenging the Status Quo

Through our surveys and interviews we found that even today an almost unconscious taboo exists for topics related to female reproductive health; this weird and unnecessary sense of shame prevents women and girls from reaching out for help or trying to learn more about themselves. Through this portion of our human practice, we wish to bring this topic into the mainstream and show that avoidance is completely unnecessary.  

 

C-1 Tanzania Women's Health Investigation

As part of our human practices program, our team conducted an investigation into women's health issues in Tanzania. This project was initiated to gain real-world insights into the challenges faced by women in developing countries and to validate our understanding of the potential impact of our modified sanitary pad with built-in test paper for gynecological disease detection.

One of the team captains, Zhang Shuhe (Max), traveled to Tanzania in August 2024, leveraging connections made through a wildlife photography competition. This opportunity allowed him to conduct interviews in various locations, including Arusha, areas surrounding Lake Natron, and a hotel in Serengeti. The investigation was a collaborative effort, with team captains Li Chunman (Mandy) and Xu Yijia (Claire) contributing to the development and refinement of the interview questions.

Through interviews with local women and men, as well as field observations, Max was able to conclude that:

1. There is a lack of systematic and official education on menstruation, physiological issues, and disease prevention, especially among the majority population living in poverty.

2. There is a shortage of menstrual products, particularly sanitary pads, most acutely affecting those in poverty.

3. Cultural attitudes towards discussing women's health issues are slowly changing, but there's still room for improvement.

These findings confirmed our initial assumptions about the need for accessible diagnostic tools and education in developing countries. For instance, Jessica, a 32-year-old assistant hotel manager, noted the absence of regular classes or programs about female health in schools, reinforcing our understanding of the educational gaps that exist in many communities.

The availability of sanitary products varied depending on location and economic status. Sawu, a 28-year-old hotel receptionist living in a city, suggested that sanitary products were accessible to a large portion of the urban population. However, she acknowledged that her perspective might be limited to her urban environment and economic status. This information helped us understand the potential disparities in distribution channels for menstrual products.

To complement our field research, we also conducted online research and reviewed articles to gain a broader understanding of women's health issues in Tanzania. This research revealed some concerning statistics:

- Only 40% of Tanzanian women are concerned about their reproductive health.

- The country has an average of only 21,000 female physiological examination records annually, despite having a female population of 15 million.

- Only 4% of medical facilities nationwide are public or accredited hospitals, and among all medical facilities, only 10% have regular gynecological examination equipment.

These findings from both our field investigation and supplementary research underscored the critical need for accessible diagnostic tools like our modified sanitary pad and reinforced the potential impact of our project.

In response to our findings, our team developed an action plan to address some of the immediate needs of the community while also considering the potential future implementation of our product. Our actions included:

1. Donation of Reusable Sanitary Pads:

   Recognizing the urgent need for menstrual products, especially in rural areas, we organized a donation drive within our team. At least five team members each contributed more than 100 RMB through UNICEF's official charity shop on WeChat. These funds were specifically earmarked for the purchase and distribution of reusable, high-quality sanitary pads to communities in need in Tanzania.

2. Educational Resource Development:

   We compiled a list of common female health issues and their simple solutions, based on information gathered during our interviews and research. This resource was designed to be easily understood and shared within the community. We sent this information to one of our local contacts, a driver we met during the investigation, who expressed interest in sharing this knowledge in his community.

While our team's immediate ability to implement large-scale changes was limited due to the nature of our visit and the developmental stage of our product, these actions represent our commitment to addressing the issues we observed. They also serve as a foundation for potential future initiatives as our project progresses.

This investigation in Tanzania provided our team with valuable insights into the challenges faced by women in developing countries. From our field research, we gained a more comprehensive understanding of the real-world context for women's health issues. This experience not only reinforced the importance of our project but also allowed our IGEM team to take initial steps towards addressing these issues. As we move forward, the lessons learned from this Tanzania investigation will continue to guide our efforts in developing a truly impactful solution for women's health globally.

C-2 Understanding the female health challenge in China’s under-developed areas

As part of our human practices, we interviewed a key member of the AiXiaoYa Foundation, an organization known for its work in menstrual health in developing regions of China. The interview took place on August 28, 2022, via an online meeting.

Our objectives were to gain expert insights into menstrual health initiatives, societal awareness, and potential impacts of our technology. The foundation representative provided valuable perspectives on current challenges and the pros and cons of technological interventions in menstrual health monitoring.

This interview reinforced our existing approach of combining practical aid with education. It also provided new insights that shaped our outreach efforts. In response, we expanded our public workshop presentations, conducting sessions at both Beijing World Youth Academy (BWYA) and CITIC Bank. We also enhanced our online educational content across our existing social media channels to make menstrual health knowledge more accessible to a wider audience.

Recognizing the importance of supporting underdeveloped areas, we developed a WeChat donation applet to facilitate contributions to menstrual health initiatives. Additionally, we created customized "I have sanitary napkins, you can borrow from me" pendants for our online shop, aiming to eradicate period shame and encourage mutual support among girls.

This expert consultation provided valuable insights that helped refine our project's focus, validating our approach of combining technological solutions with practical education and support initiatives.

C-3 Fundraising via Online Merch Store and In-person Charity Sales

We opened our online merchandise store on the platform called Weidian, all products for sale, including stickers, pins, canvas bags and more, are our own original designs. All sales revenue would go to charity donations, as well as raising public awareness of female health.

In addition to the online sale, we also conducted offline charity sales, selling goods and distributing originally designed disease promotional flyers and posters, achieving both fundraising and promotional purposes.

C-5 ‘You can ask me for pads’ initiative

Every woman may suddenly face an embarrassing urgent need for sanitary pads. Sometimes it's because the menstrual cycle was miscalculated, sometimes it's because of irregular periods, and sometimes it's due to certain diseases or infections that lead to a demand for sanitary pads. We have designed an acrylic badge that reads "You can ask me for pads” to be attached on any bags by team members and volunteers. We have collected a batch of high-quality sanitary pads, some provided by volunteers, and some carefully selected by us.