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Background Influenza remains a major threat to public health. Live-attenuated influenza vaccines (LAIV) have been shown to be effective, particularly in children. Follicular T helper (TFH) cells provide B-cell help and are crucial for generating long-term humoral immunity. However the role of TFH cells in LAIV-induced immune responses is unknown. Methods We collected tonsils, plasma, and saliva samples from children and adults receiving LAIV prior to tonsillectomy. We measured influenza-specific TFH-cell responses after LAIV by flow cytometry and immunohistochemistry. Systemic and local antibody responses were analysed by hemagglutination inhibition assay and enzyme-linked immunosorbent assay. Results We report that LAIV induced early (3–7 days post-vaccination) activation of tonsillar follicles and influenza-specific TFH-cell (CXCR5+CD57+CD4+ T cell) responses in children, and to a lesser extent in adults. Serological analyses showed that LAIV elicited rapid (day 14) and long-term (up to 1 year post-vaccination) antibody responses (hemagglutination inhibition, influenza-specific IgG) in children, but not adults. There was an inverse correlation between pre-existing influenza-specific salivary IgA concentrations and tonsillar TFH-cell responses, and a positive correlation between tonsillar TFH-cell and systemic IgG induction after LAIV. Conclusions Our data, taken together, demonstrate an important role of tonsillar TFH cells in LAIV-induced immunity in humans., Live attenuated influenza vaccine induces rapid influenza-specific tonsillar TFH-cell and antibody responses in children, but is less potent in adults. The magnitude of influenza-specific TFH-cell responses inversely correlated with pre-existing salivary IgA, and directly associated with post-vaccination antibody fold-induction.

Influenza vaccination often results in a large percentage of low responders, especially in high-risk groups. As a first line of defense, natural killer (NK) cells play a crucial role in the fight against infections. However, their implication with regard to vaccine responsiveness is insufficiently assessed. Therefore, this study aimed at the validation of essential NK cell features potentially associated with differential vaccine responsiveness with a special focus on NKG2C- and/or CD57-expressing NK cells considered to harbor memory-like functions. To this end, 16 healthy volunteers were vaccinated with an adjuvanted pandemic influenza vaccine. Vaccine responders and low responders were classified according to their hemagglutination inhibition antibody titers. A majority of responders displayed enhanced frequencies of NKG2C-expressing NK cells 7- or 14-days post-vaccination as compared to low responders, whereas the expression of CD57 was not differentially modulated. The NK cell cytotoxic potential was found to be confined to CD56dimCD16+ NKG2C-expressing NK cells in the responders but not in the low responders, which was further confirmed by stochastic neighbor embedding analysis. The presented study is the first of its kind that ascribes CD56dimCD16+ NKG2C-expressing NK cells a crucial role in biasing adaptive immune responses upon influenza vaccination and suggests NKG2C as a potential biomarker in predicting pandemic influenza vaccine responsiveness.

No abstract available

Introduction: The peri-orbital contusion (PC) is a common injury in day to day surgical casualties. It is a common injury observed in patients who are in an unconscious state following head injuries. The aim of the study is to describe characteristics of PC and understand its relationship with associated injuries, especially with facial injuries and intracranial injuries. Methods: This retrospective study reviewed the medico-legal examination forms (MLEF) of 67 inward patients in Teaching Hospital, Karapitiya and District General Hospital, Matara with peri-orbital contusions following trauma during a period of six months from January 2020 to June 2020. Results: A total number of 67 patients were included with 81% being male patients. The commonest soft tissue injuries around the PCs were abrasions (n=39, 71%) and 25 (38%) of the study sample had fractures of the skull. The majority (n=22, 88%) of them had fractures of facial bones followed by vault and basal skull fractures. The majority of PCs (45%) were blue in colour and only 8% were red. The red colour was observed only in PCs of less than 24 hours. The main cause for PC was due to direct blow to the eye while the rest (n=29, 45%) were due to the indirect blow. A higher incidence of fracture of the head was observed in assaults (39%). Conclusions: The commonest cause for the black eye in the study sample was the direct blow with a blunt force in an assault. The red colour was observed in PC of less than 24 hours duration. The PC had not caused major injuries to the eye but there was frequent involvement of facial bone fractures.

Summary: Outer membrane vesicles (OMV) were first described approximately 50 years ago, and for many years were considered to be an artefact of bacterial growth. Since that initial discovery, it has become evident that OMVs are produced by almost all Gram-negative bacteria as part of their normal growth in addition to driving pathogenesis within the host. More recently, the identification of membrane vesicle (MV) production by some Gram-positive bacteria, parasites, fungi, mycobacteria and infected host cells has significantly broadened the field of MV production and emphasised their importance to pathogenesis. In this review we will focus on discussing recent advances in the field of bacterial membrane vesicle biogenesis and the mechanisms whereby they modulate immunity and contribute to pathogenesis. We will highlight findings identifying the contribution of extracellular vesicles produced by Gram-positive bacteria, fungi, parasites and infected host cells in mediating pathogenesis in addition to the functions of MVs produced by commensal bacteria. Finally, we discuss recent progress in the development of bacterial MVs as novel vaccines capable of mediating cellular and humoral immune responses.

Background We analyzed the impact of the anti-T-cell agents basiliximab and antithymocyte globulins (ATG) on antibody and cell-mediated immune responses after influenza vaccination in solid-organ transplant recipients. Methods 71 kidney and heart transplant recipients (basiliximab [ n = 43] and ATG [ n = 28]) received the trivalent influenza vaccine. Antibody responses were measured at baseline and 6 weeks post-vaccination by hemagglutination inhibition assay; T-cell responses were measured by IFN-γ ELISpot assays and intracellular cytokine staining (ICS); and influenza-specific memory B-cell (MBC) responses were evaluated using ELISpot. Results Median time of vaccination from transplantation was 29 months (IQR 8–73). Post-vaccination seroconversion rates were 26.8% for H1N1, 34.1% for H3N2 and 4.9% for influenza B in the basiliximab group and 35.7% for H1N1, 42.9% for H3N2 and 14.3% for influenza B in the ATG group ( p = 0.44, p = 0.61, and p = 0.21, respectively). The number of influenza-specific IFN-γ-producing cells increased significantly after vaccination (from 35 to 67.5 SFC/10 6 PBMC, p = 0.0007), but no differences between treatment groups were observed ( p = 0.88). Median number of IgG-MBC did not increase after vaccination (H1N1, p = 0.94; H3N2 p = 0.34; B, p = 0.79), irrespective of the type of anti-T-cell therapy. Conclusions After influenza vaccination, a significant increase in antibody and T-cell immune responses but not in MBC responses was observed in transplant recipients. Immune responses were not significantly different between groups that received basiliximab or ATG.

Child abuse is a complex problem. It is sensitive in nature and requires a comprehensive police investigation. Police officers are at the forefront of this issue and hence it is important that they have optimal skills when investigating cases of suspected child abuse. This article evaluates the effectiveness of a short-term, 6-hour, child protection training provided to 39 Sri Lankan police officers (37 female). The effectiveness of the program was assessed using a scale at pre- and post-program. The results indicated that the training significantly increased participants’ knowledge on aspects of child abuse. However, the program did not significantly affect their attitudes about child abuse or their perceived skill in managing cases of abuse. Qualitative feedback from the participants and their superior officers, obtained during a group discussion, indicated that the training had been effective and the learning outcomes had been achieved. This article makes recommendations for improving the child protection services in middle-income countries such as Sri Lanka, in terms of multiphasic and comprehensive training for police officers.

Healthcare workers (HCW) were prioritized for vaccination during the 2009 influenza A(H1N1)pdm09 pandemic. We conducted a clinical trial in October 2009 where 237 HCWs were immunized with a AS03-adjuvanted A(H1N1)pdm09 monovalent vaccine. In the current study, we analyzed the homologous and cross-reactive H1N1 humoral responses using prototype vaccine strains dating back to 1977 by the haemagglutinin inhibition (HI), single radial hemolysis SRH), antibody secreting cell (ASC) and memory B cell (MBC) assays. The cellular responses were assessed by interferon-γ (IFN-γ) ELISPOT and by intracellular staining (ICS) for the Th1 cytokines IFN-γ, interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α). All assays were performed using blood samples obtained prior to (day 0) and 7, 14 and 21 d post-pandemic vaccination, except for ASC (day 7) and ICS (days 0 and 21). Vaccination elicited rapid HI, SRH and ASC responses against A(H1N1)pdm09 which cross reacted with seasonal H1N1 strains. MBC responses were detected against the homologous and seasonal H1N1 strains before vaccination and were boosted 2 weeks post-vaccination. An increase in cellular responses as determined by IFN-γ ELISPOT and ICS were observed 1–3 weeks after vaccination. Collectively, our data show that the AS03-adjuvanted A(H1N1)pdm09 vaccine induced rapid cellular and humoral responses against the vaccine strain and the response cross-reacted against prototype H1N1 strains dating back to 1977. publishedVersion

Early Violence Prevention (EVP) programs are a concept alien to policy makers of the Early Childhood Care and Education in Sri Lanka, even though Sri Lanka as a has country experienced violence for almost fourt decades. This study explores the perceived preschool teacher practices pertaining to EVP (preventing/minimizing aggressive behaviors and promoting prosocial behaviors) within Sri Lankan preschool teachers using a survey (n = 275) and a semi structured interviews (n = 23). The results conveyed that Sri Lankan preschool teacher recognize such practices as a necessity and seemed to be practicing a wide spectrum of behaviors. These could be categorized on several dimensions: telling/teaching vs. doing activities, individual focused vs. group/social, authoritative/instructive vs. democratic, child initiated good practices vs. bad practices. Practices could also be categorized into religious activities, activities with emphasis on silence, praise, techniques to prevent discrimination, techniques to divert attention, socially focused, direct conflict management, instructional emphasis, empowering the children, moral and teacher initiated action. These activities were carried out using stories, puppets and role-plays. The study also provides recommendations to policy developers in the context of culture sensitive early violence prevention practices for Sri Lankan preschool children.

In this paper we present the work in progress of WireMe IoT development platform, a simple way to deploy IoT systems in an intuitive approach. WireMe platforms' simplified software and hardware modules enables users to deploy personalized web interface and program their hardware modules to achieve their home automation tasks without having deep technical knowledge in either of the above domains, with the help of visual programming. Apart from that, advanced users may extend this approach with the framework provided so that they can build their hardware and software modules to support our WireMe IoT platform as well. With this platform, kids can learn to build programming logics and learn about programming with code generation as well as people can build their typical IoT automation systems to monitor and control their IoT modules.

Adolescence is a time of change and transition, specifically in the context of interpersonal relationships with significant adults in their lives. Adolescence is also a period in which vastly reflects growing psychological and emotional independence from adults and proximity and dependence to peers. Therefore, adolescents often must negotiate and establish relationships with adults under less than optimal conditions. Thus, nature and quality of relationship interactions between teachers and adolescents are fundamental to understanding adolescent psychosocial wellbeing. A particular concern lies with the adolescents who do not enjoy positive, supportive relationships with their teachers. Such adolescents are often at risk for academic and psychosocial problems. The present study explores Sri Lankan adolescents’ perceived relationship interactions with their teachers and its impact on their psychosocial wellbeing, using in depth interviews. The findings provide specific components pertaining to strong positive relationships such as empathy, warmth, sense of comfort, guidance, provision of financial assistance when in need and confidentiality. However, adolescents also mentioned teachers as figures detrimental to their wellbeing.

The present study explored the Sri Lankan pre/school teachers’ (n = 365) knowledge, and perceived skills of child protection against their general attitudes pertaining to violence/ abuse as well as their specific attitudes pertaining corporal punishment using a four point rating scale. Results conveyed that while teachers’ knowledge and perceived skills of child protection was high, teacher who favored corporal punishment as an acceptable mode of disciplinary strategy had higher knowledge (M = 32.1, S.D = 3.02) than those who did not (M = 31.29; S.D = 2.97), t(363) = 2.634, p = .009. Based on its findings, the study offers recommendation for teacher trainers and child protection practitioners.

This study explores the Sri Lankan students’ perceptions of their school counselors and counseling services available to them. It comprises of two phases involving data collected through in-depth interviews (n = 10) and semi-structured interviews using a survey questionnaire (n = 126). The data were collected during two measurement points.Findings convey that the students did not provide positive evaluations of school counseling services during both phases, depicting the reluctance to access it due to several key factors. They are: social stigma associated with accessing counseling services, location of the counseling room, misperceptions pertaining to its aims and objectives, ignorance, and lack of time. The study provides suggestions and recommendations for policy makers, teacher educators and school counselors with the broad aim of improving the quality of the school counseling services in Sri Lanka.

Annually, influenza virus infection has a large socioeconomic burden on society, with 500 000 fatal cases globally [1–3]. The World Health Organization estimates that 20% of children are infected with influenza virus each year, and they are the main source of spread of the virus and have a high burden of the disease [4]. Vaccination is the cornerstone of prophylaxis and is recommended for high-risk patients. The trivalent inactivated influenza vaccine (TIV) is safe and provides protection but may not be the optimal vaccine for young children, owing to their lack of previous infection. Since 2003, the cold-adapted live attenuated influenza vaccine (LAIV), administered as a nasal spray, has been approved in the United States for individuals aged 2–49 years. The vaccine was licensed in Europe in 2012 (for individuals aged 2–17 years) and was implemented in the British childhood vaccination campaign, beginning in 2013 [5]. In June 2014, the Advisory Committee on Immunization Practices preferentially recommended LAIV in healthy children 2–8 years old when it is immediately available [6]. Despite many years on the market, there are no established correlates of protection for LAIV. Efficacy studies and observational data suggest that the LAIV provides higher levels of protection than TIV in children [7–11]. The hemagglutination inhibition (HI) titer is widely used as a surrogate correlate of protection after TIV receipt; however, the cutoff titer of 1:40 is based on adult trials. There is debate on both the protective HI level in children and the fact that an HI titer underestimates the protection obtained by LAIV [12–14]. Cellular immunity may be a better measure of protective immunity after LAIV in children [15]. CD4+ T cells have the ability to act as effector cells and to direct and generate specific memory CD4+ and CD8+ T-cell subsets with diverse functions [16–18]. Animal and human studies have demonstrated protective cellular immunity after LAIV [10, 19–21]. Therefore, the duration and quality of the immune response in humans after LAIV needs to be studied. We conducted a pediatric clinical trial to elucidate the immunological mechanisms induced by LAIV, with emphasis on the long-term, strain-specific cellular immune responses. Our study is unique, as we obtained sequential blood samples from young children up to 1 year after vaccination, allowing us to compare and analyze serum and cellular responses in the same child. Our results indicate that LAIV induces long-term humoral and cellular immune responses in children and that priming is important in determining the magnitude of the response.

Conceptions of mental illness are often decided by the socio-cultural background and other socio-demographic factors. The aim of the present study was to assess the perceived knowledge, attitudes and perceived behaviors pertaining to mental illness within the Sri Lankan public. In order to achieve this aim, 167 participants (Females = 97; Males = 70) from 17districts in Sri Lanka were given a survey questionnaire to assess their knowledge, attitudes and perceived practices towards PwMI. The results conveyed that in general participants had high to moderate knowledge, were open minded, displayed pro-integrated attitudes and high to moderate sensitivity towards PwMI. Results also conveyed that there is a positive relationship among knowledge, attitudes, and perceived behaviors towards PwMI.

Maintaining the tapping quality in rubber fields is the key requirement to obtain potential yield with minimum harm to the tree. It also determines productivity and the economical lifespan of 30 years and sustainable rubber industry. The length of the tapping cut, the depth, the thickness of the bark shaving, and the slope of the tapping cut are the main factors determining the tapping quality. Use of a stencil according to the intended tapping frequency, i.e. d2, d3, d4, etc., to mark the guidelines to maintain the proper tapping angle of 30 degrees to the horizontal, and the bark consumption allowed for one year, are all equally contribute to maintaining the tapping quality. About 5000 ha. was surveyed to assert the tapping quality and to make recommendations. The average bark consumption rate per panel was four years deviating from recommended six years under d2 tapping. The monitory loss per hectare under this bark consumption rate is Rs.2.5 million at a productivity level of 1000 kg/ha/y and Rs.350.00 per kg of rubber. Trees affected by tapping panel dryness varied and was over 70% in some extreme cases. Introducing a quarter cut on the upper opposite panel of the tree ceased the situation to a greater extent.

Very few studies have explored young children’s aggressive behaviors in collective cultures or in South Asian contexts. The present study reconnoitres in depth; the nature, types, prevalence and antecedents of aggressive behaviors displayed by Sri Lankan preschool children. The study was carried out in two phases using a mixed method; 1. Preschool teacher interviews (N = 23) with teachers from 14 varied preschool contexts in Sri Lanka, and 2. Observations of aggressive behaviors of 16 preschool children displaying prominent overt, and relational aggression from four varied preschool communities selected from a group of 135 children. Findings of this study make important contributions to aggressive behaviors within Sri Lankan preschool children and discuss them in the back drop of global research findings. Findings also provide new information regarding the manner in which aggression was expressed by the observed group of preschool children, labeled as ‘playful aggressive parodies’ by the author.

Academic achievement or (academic) performance is the outcome of education — the extent to which a student, teacher or institution has achieved their educational goals. Academic achievement generally refers to how well a student is accomplishing his or her tasks and studies. The most well-known indicator of academic achievement is the student’s ‘score’ for their classes and overall tenure. Many variables affect the academic achievement of the student i.e. Meta cognition, executive function, intelligence etc. The present study will investigate the relation between Meta cognition, executive function, intelligence and academic achievement. For this purpose a sample of 100 students (6th to 8th) was selected and data was collected.

Outer membrane vesicles were first described approximately 50 years ago and for many years were considered to be an artifact of bacterial growth. Since that initial discovery, it has become evident that outer membrane vesicles are produced by almost all Gram-negative bacteria as part of their normal growth in addition to driving pathogenesis within the host. More recently, the identification of membrane vesicle (MV) production by some Gram-positive bacteria, parasites, fungi, mycobacteria and infected host cells has significantly broadened the field of MV research and emphasized their importance to pathogenesis. In this review, we will focus on discussing recent advances in the field of bacterial MV biogenesis and the mechanisms whereby they modulate immunity and contribute to pathogenesis. We will highlight findings identifying the contribution of extracellular vesicles produced by Gram-positive bacteria, fungi, parasites, and infected host cells in mediating pathogenesis in addition to the functions of MVs produced by commensal bacteria. Finally, we will discuss recent progress in the development of bacterial MVs as novel vaccines capable of mediating cellular and humoral immune responses.

The study was undertaken to identify the sources of stress among students of high and low academic performance. The questionnaire was administered on 656 pure science and applied science under graduate students from Bangalore city. Academic performance is referred to the end-term results in the previous semester. The tool used for the present study was Stressful Life Events Inventory – Student form (Rao, 1986). The findings of the study showed that majority of the students’ perceived education as more stressful. High and low academic performing students as well as pure and applied science course students differed significantly on sources of stress. Implications and suggestions of the study were discussed with teachers and an enrichment program on stress management was employed.

The aim of the present study is to explore Sri Lankan adolescents’ relationships with their parents, siblings and peers. To investigate this aspect a semi-structured interview schedule was used to interview 10 adolescents (6 girls and 4 boys aged at 15 to 18 years) from varied socioeconomic backgrounds, belonging to varied communities (sports clubs, plantation sector, urban, rural) . The results conveyed that parents, siblings and peers had an impact on the psychosocial wellbeing of the studied adolescents. However, positive relationships with parents, siblings and peers did not seem to be the only influence on adolescent wellbeing. Adolescents in the study who reported abusive and neglecting experiences from parents also reported well-being and attributed it to multitude of other factors.

Highly pathogenic avian influenza H5N1 infection remains a public health threat and vaccination is the best measure of limiting the impact of a potential pandemic. Mucosal vaccines have the advantage of eliciting immune responses at the site of viral entry, thereby preventing infection as well as further viral transmission. In this study, we assessed the protective efficacy of hemagglutinin (HA) from the A/Indonesia/05/05 (H5N1) strain of influenza virus that was produced by transient expression in plants. The plant-derived vaccine, in combination with the mucosal adjuvant (3′,5′)-cyclic dimeric guanylic acid (c-di-GMP) was used for intranasal immunization of mice and ferrets, before challenge with a lethal dose of the A/Indonesia/05/05 (H5N1) virus. Mice vaccinated with 15 μg or 5 μg of adjuvanted HA survived the viral challenge, while all control mice died within 10 d of challenge. Vaccinated animals elicited serum hemagglutination inhibition, IgG and IgA antibody titers. In the ferret challenge study, all animals vaccinated with the adjuvanted plant vaccine survived the lethal viral challenge, while 50% of the control animals died. In both the mouse and ferret models, the vaccinated animals were better protected from weight loss and body temperature changes associated with H5N1 infection compared with the non-vaccinated controls. Furthermore, the systemic spread of the virus was lower in the vaccinated animals compared with the controls. Results presented here suggest that the plant-produced HA-based influenza vaccine adjuvanted with c-di-GMP is a promising vaccine/adjuvant combination for the development of new mucosal influenza vaccines. publishedVersion

Shoot die back condition has been observed in young budding rubber plants (Hevea brasiliensis Muell. Arg.) raised in polybags under hot and dry weather conditions in the recent past, partly due to failure of the root system, and therefore, it is imperative to find ways to improve the root system while enhancing other growth performances of rubber seedlings. In the present study, the effect of sodium nitroprusside (SNP) as a nitric oxide (NO) donor on root architecture and growth characteristics of polybagged rubber seedlings raised under glass house conditions and at two growth stages (one month and five months after transplanting) was investigated. In this communication, we report that exogenous application of SNP to rubber seedlings greatly induced lateral and feeder roots and root hair emergence and elongation, while improving primary root (tap root) growth and other growth characteristics of the shoot i.e., stem diameter, shoot height, leaf area and shoot and root biomasses in a dose-dependent manner. SNP concentration between 50 μM - 300 μM was found to be the best range. To our knowledge, this is the first report on exploring the effect of NO on root architecture and growth performance of rubber seedlings by exogenous application of SNP.

Studies were carried out on the effect of seed coat removal and nitric oxide (NO) donor sodium nitroprusside (SNP) treatment on germination and growth of seedling and budded plants of rubber (Hevea brasiliensis). Interaction effects were observed between seed coat treatment and SNP treatments for germination time and percentage germination. Decoated seeds germinated earlier and improved synchronicity than intact seeds (with seed coat) and achieved 50% germination within nine days. SNP treatment at all four concentrations (20, 50, 100 and 200 μM) hastened the germination and increased the percentage germination especially when decoated seeds were used. Shoot and root attributes of seedlings (stock plants) derived from the seeds treated with SNP, especially at 50-100 μM, were significantly improved as compared to those from control and mock treated seeds. Growth of the budded plants were better when stock plants derived from SNP treated seeds were used. Therefore, NO treatment coupled with decoating could effectively be utilized to improve the germination and growth of seedling and budded plants of rubber. To our knowledge, this is the first report on redox priming of rubber seeds with SNP.

No abstract available

Sri Lanka Journal of Child Health , 2015; 44 (1): 58-60 DOI: http://dx.doi.org/10.4038/sljch.v44i1.7965