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Summary: DNA methyl transferase-1 or DNMT1 maintains DNA methylation in the genome and is important for regulating gene expression in cells. Aberrant changes in DNMT1 activity and DNA methylation are commonly observed in cancers and many other diseases. Recently, a number of long intergenic non-protein-coding RNAs or lincRNAs have been shown to play a role in regulating DNMT1 activity. CCDC26 is a nuclear lincRNA that is frequently mutated in cancers and is a hotbed for disease-associated single nucleotide changes. However, the functional mechanism of CCDC26 is not understood. Here, we show that this lincRNA is concentrated on the nuclear periphery. Strikingly, in the absence of CCDC26 lincRNA, DNMT1 is mis-located in the cytoplasm, and the genomic DNA is significantly hypomethylated. This is accompanied by double-stranded DNA breaks and increased cell death. These results point to a previously unrecognized mechanism of lincRNA-mediated subcellular localization of DNMT1 and regulation of DNA methylation.

There has been a growing interest in the Food-medicine interface due to its legal and commercial importance with the development of both food and medicine industries. Food and medicine--even though some foods have therapeutic (curative or preventive) properties--are two different entities, regulated by different legal regimes. Hence, the distinction between food and medicine is crucial in order to protect the interests of consumers. This study is a doctrinal review on the food-medicine interface at international level with particular reference to its application in the Sri Lankan context. There seems to be a lack of global policy consensus or coherent legal regime regarding the food-medicine interface, and the same is true for Sri Lanka. Both Western and Ayurveda drugs are registered with the competent authorities in Sri Lanka: The National Medicines Regulatory Authority and Ayurveda Department, respectively. To register a food as a drug, these authorities can use two criteria: 1. recognised medicinal properties and 2. therapeutic (curative or preventive) purpose of consumption. The registration of a food commodity by these two competent authorities can be taken as a criterion to identify them as medicines thus, to differentiate them in a legal sense from food per se. From a legal perspective, any food not registered by one of these two authorities--irrespective of their therapeutic (curative or preventive) benefits—is considered to be simply a food. This demarcation of the food-medicine interface could be used by industries for the purpose of marketing strategies and law enforcing officers for the purposes of law enforcement.

BackgroundThe Leprosy Post-Exposure Prophylaxis (LPEP) program explored the feasibility and impact of contact tracing and the provision of single dose rifampicin (SDR) to eligible contacts of newly diagnosed leprosy patients in Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka and Tanzania. As the impact of the programme is difficult to establish in the short term, we apply mathematical modelling to predict its long-term impact on the leprosy incidence.MethodologyThe individual-based model SIMCOLEP was calibrated and validated to the historic leprosy incidence data in the study areas. For each area, we assessed two scenarios: 1) continuation of existing routine activities as in 2014; and 2) routine activities combined with LPEP starting in 2015. The number of contacts per index patient screened varied from 1 to 36 between areas. Projections were made until 2040.Principal findingsIn all areas, the LPEP program increased the number of detected cases in the first year(s) of the programme as compared to the routine programme, followed by a faster reduction afterwards with increasing benefit over time. LPEP could accelerate the reduction of the leprosy incidence by up to six years as compared to the routine programme. The impact of LPEP varied by area due to differences in the number of contacts per index patient included and differences in leprosy epidemiology and routine control programme.ConclusionsThe LPEP program contributes significantly to the reduction of the leprosy incidence and could potentially accelerate the interruption of transmission. It would be advisable to include contact tracing/screening and SDR in routine leprosy programmes.

Abstract Phytomedicines are becoming more popular in treatment of infectious diseases worldwide. Cinnamomum verum essential oil (EO) has been used as a therapeutic alternative for various diseases. This study aimed to evaluate the antibacterial and antibiofilm activity of the C. verum leaf EO against Pseudomonas aeruginosa, Staphylococcus aureus and Klebsiella pneumoniae. Effect of EO vapor on planktonic cells was determined using microatmosphere technique. CLSI M7-A10 method was employed in Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) experiments. Effect of EO on established biofilms was quantified and visualized using XTT and Scanning Electron Microscope (SEM). In-vitro toxicity was evaluated using Human Keratinocytes (HaCaT). Chemical analysis of EO was done using Gas Chromatography- Mass Spectrometry (GC-MS). All tested strains were sensitive to cinnamon oil vapor. EO exhibited 0.5 and 1.0 mg/mL MIC and MBC against all test strains. Minimum Biofilm Inhibitory and Biofilm Eradication Concentrations (MBIC50 and MBEC) were 1.0 and 4.0 mg/mL. SEM indicated cellular shrinkages, cell wall damages, and decreased biofilm densities. Cinnamon oil didn’t show any toxicity on HaCaT cell at any concentration tested. Eugenol was the most abundant compound in C. verum oil. C. verum EO shows an antibacterial and antibiofilm activity with minimal toxicity on host.

Summary: Background: Innovative approaches are required for leprosy control to reduce cases and curb transmission of Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools. We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose rifampicin (SDR) into routine leprosy control activities. Methods: The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility study implemented within the leprosy control programmes of Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka, and Tanzania. LPEP explored the feasibility of combining three key interventions: systematically tracing contacts of individuals newly diagnosed with leprosy; screening the traced contacts for leprosy; and administering SDR to eligible contacts. Outcomes were assessed in terms of number of contacts traced, screened, and SDR administration rates. Findings: Between Jan 1, 2015, and Aug 1, 2019, LPEP enrolled 9170 index patients and listed 179 769 contacts, of whom 174 782 (97·2%) were successfully traced and screened. Of those screened, 22 854 (13·1%) were excluded from SDR mainly because of health reasons and age. Among those excluded, 810 were confirmed as new patients (46 per 10 000 contacts screened). Among the eligible screened contacts, 1182 (0·7%) refused prophylactic treatment with SDR. Overall, SDR was administered to 151 928 (86·9%) screened contacts. No serious adverse events were reported. Interpretation: Post-exposure prophylaxis with SDR is safe; can be integrated into different leprosy control programmes with minimal additional efforts once contact tracing has been established; and is generally well accepted by index patients, their contacts, and health-care workers. The programme has also invigorated local leprosy control through the availability of a prophylactic intervention; therefore, we recommend rolling out SDR in all settings where contact tracing and screening have been established. Funding: Novartis Foundation.

Bacterial lipases play important roles during infection. The Staphylococcus aureus genome contains several genes that encode well-characterized lipases and several genes predicted to encode lipases or esterases for which the function has not yet been established. In this study, we sought to define the function of an uncharacterized S. aureus protein, and we propose the annotation S. aureus lipase 3 (SAL3) (SAUSA300_0641). We confirmed that SAL3 is a lipase and that it is surface associated and secreted through an unknown mechanism. We determined that SAL3 specifically hydrolyzes short chain (4-carbon and fewer) fatty acids and specifically binds negatively charged lipids including phosphatidic acid, phosphatidylinositol phosphate, and phosphatidylglycerol, which is the most abundant lipid in the staphylococcal cell membrane. Mutating the catalytic triad S66-A, D167-A, S168-A, and H301-A in the recombinant protein abolished lipase activity without altering binding to host lipid substrates. Taken together we report the discovery of a novel lipase from S. aureus specific to short chain fatty acids with yet to be determined roles in host pathogen interactions.

Giant cell urothelial carcinoma is a rare variant of bladder cancer recognized by the current World Health Organization classification of urologic tumours. It is an aggressive tumour with a poor prognosis that usually presents at an advanced stage. It is characterized histologically by pleomorphic giant cells. We discuss a case of giant cell urothelial carcinoma presenting at an early stage in a previously well 62-year-old woman. Histology showed a tumour comprising pancytokeratin positive bizarre mononuclear and multi-nuclear giant cells admixed with areas of conventional urothelial carcinoma and carcinoma in situ. Three-month follow-up cystoscopy and magnetic resonance imaging showed no evidence of recurrence or pelvic lymphadenopathy.

Many hospitals face a common challenge: limited space for a high number of patients. This has led to quick patient throughput, which can impact patient perception of discharge readiness. This study examined whether a poster highlighting tasks to complete as part of the discharge process improved caregiver perception of readiness to transition home. Using a sequential, exploratory mixed methods design, focus groups were convened to explore clinical staff perspective on the discharge process on 3 pediatric inpatient units at a large, urban, pediatric academic medical center in the United States. Analysis of this content informed the design of a poster intervention to “nudge” caregivers (eg, parents, legal guardians) toward readiness and self-efficacy that was then tested in a randomized, controlled experiment. The poster focused on practical knowledge for specific areas of transition adjustment, such as medication and care recipient recovery behaviors, barriers, and enablers. Caregivers (n = 135) completed surveys at discharge indicating their perceived readiness to transition home with their child. Analysis of covariance was used to test the effect of the poster condition (poster vs no poster) on caregiver readiness, preparedness, and confidence for discharge while controlling for previous admission history. Significant effects for poster presence were found on caregivers’ perceived readiness for discharge, F 1,125 = 7.75, P = .006, Cohen’s d = 0.44; and caregivers’ perceived preparedness for the transition home, F 1,121 =7.24, P = .008, Cohen’s d = 0.44. Only a marginal effect was found for poster condition on caregivers’ confidence ratings, F 1,125 = 2.93, P = .090, Cohen’s d = 0.29. The results suggest that simple nudges in the patient care environment may yield measurable improvements in caregiver outcomes.

Abstract Clopidogrel is the most common and widely used antiplatelet agent for patients with coronary artery disease following confirmation by electrocardiographic studies. The nonresponsiveness of patients to clopidogrel and the possibility of testing for clopidogrel resistance by platelet function assays (PFA) are contentious issues. Light transmission aggregometry (LTA) is considered as the gold standard test among all PFA. In this review, the most commonly used PFA used for monitoring the effect of clopidogrel, LTA, vasodilator‐stimulated phosphoprotein assay phosphorylation, rotational thromboelastometry (ROTEM) delta and ROTEM platelet, thromboelastography, PFA‐100, VerifyNow P2Y12 assay, Multiplate analyzer, Plateletworks assay and pharmacogenetic studies, are comparatively discussed including their principles of action, advantages, and disadvantages. VerifyNow P2Y12 assay can be accepted as the ideal point of care test out of the discussed assays. However, modified assays are required which could overcome the limitations associated with currently available assays.

BackgroundThe leprosy services utilization by the patients at the clinic and field level should be high to achieve the target of eliminating leprosy as a public health problem in Sri Lanka. Furthermore, assessing patient and health system delay of a diagnosis and patient knowledge on disease are of equal importance to reveal the accurate picture.Methods and findingsA descriptive cross-sectional study was conducted to assess the utilization of government healthcare services by 672 adult leprosy patients in Western Province (WP). Paucibacillary patients diagnosed at least six months and above, and Multibacillary patients diagnosed at least 12 months and above were selected by consecutive sampling method. An interviewer-administered questionnaire (IAQ) was used for data collection. Clinic utilization by leprosy patients was 87.8%. The mean patient-related delay (time taken from the onset of symptoms to the encounter of a doctor/health facility for the first time) was 16.8 months and health care system delay (time taken from the date of clinic registration to start of treatment) was 21.2 days. The overall delay was 17.5 months. Services provided by the Medical Officer of Health (MOH) office for families affected with leprosy was known by 53.8% (n = 298) of patients. Majority of family contacts were examined at the hospitals (n = 299, 44%), 30.8% (n = 207) by the Public Health Inspectors (PHI) and 7% (n = 46) at the MOH offices. PHIs had visited 56.7% (n = 401) of the patient's houses and 54% (n = 363) had received health education by PHI. Mean knowledge score was 50.7 (SD = 17.9). More than half (57.9%, n = 389) of the study sample had a good or very good knowledge level.ConclusionsUtilization of clinic services was satisfactory. However, a considerable patient-related delay was found. Half of the patients were aware of available field services and a majority of contact screening was conducted at hospitals. Patient knowledge on leprosy was satisfactory.

BACKGROUND Essential oils (EO) extracted from Cinnamomum verum has been used as an antimicrobial agents for centuries. The effects of C. verum leaf oil against virulence of microorganisms is not well studied yet. OBJECTIVES This study evaluates the effect of C. verum leaf oil against three virulence factors of Candida albicans, C. tropicalis and C. dubliniensis and its in-vivo toxicity. METHODS Chemical composition of EO was determined using gas chromatography-mass spectrometry (GC-MS). Minimum inhibitory concentration (MIC) was determined using clinical and laboratory standards institute (CLSI) M27-A3 broth microdilution. Effect of EO on initial adhesion was quantified using XTT assay after allowing Candida cells to adhere to the polystyrene surface for 2 h. Biofilm formation of Candida in the presence of EO was quantified using XTT viability assay. Efficacy on reduction of germ tube formation was evaluated using standard protocol. Visualisation of biofilm formation and progression under the EO treatment were done using scanning electron microscope (SEM) and Time lapses microscope respectively. In-vivo toxicity of EO was determined using Galleria mellonella larvae. Chlorhexidine digluconate: positive control. RESULTS Eugenol was the main compound of EO. MIC was 1.0 mg/mL. 50% reduction in initial adhesion was achieved by C. albicans, C. tropicalis and C. dubliniensis with 1.0, > 2.0 and 0.34 mg/mL respectively. 0.5 and 1.0 mg/mL significantly inhibit the germ tube formation. MBIC50 for forming biofilms were ≤ 0.35 mg/mL. 1.0 mg/mL prevent biofilm progression of Candida. SEM images exhibited cell wall damages, cellular shrinkages and decreased hyphal formation. No lethal effect was noted with in-vivo experiment model at any concentration tested. CONCLUSION C. verum leaf oil acts against virulence factors of Candida and does not show any toxicity.

Biological brain stores massive amount of information. Inspired by features of the biological memory, we propose an algorithm to efficiently store different classes of spatio-temporal information in a Recurrent Neural Network (RNN). A given spatio-temporal input triggers a neuron firing pattern, known as an attractor, and it conveys information about the class to which the input belongs. These attractors are the basic elements of the memory in our RNN. Preparing a set of good attractors is the key to efficiently storing temporal information in an RNN. We achieve this by means of enhancing the “separation” and “approximation” properties associated with the attractors, during the RNN training. We furthermore elaborate how these attractors can trigger an action via the readout in the RNN, similar to the sensory motor action processing in the cerebellum cortex. We show how different voice commands by different speakers trigger hand drawn impressions of the spoken words, by means of our separation and approximation based learning. The method further recognizes the gender of the speaker. The method is evaluated on the TI-46 speech data corpus, and we have achieved 98.6% classification accuracy on the TI-46 digit corpus.

Background: Due to the similarity between the dengue (DENV) and the Japanese encephalitis virus (JEV) there is potential for immune cross-reaction. We sought to identify T cell epitopes that are specific to JEV and do not cross react with DENV.Methodology: 20mer peptides were synthesized from regions which showed >90% conservation. Using IFNγ cultured ELISpot assays, we investigated JEV-specific T cell responses in DENV− and JEV− non-immune individuals (DENV−JEV− = 21), JEV seronegative and had not received the JE vaccine, but who were DENV seropositive (DENV+JEV− = 22), JEV+(seropositive for JEV and had received the JE vaccine), but seronegative for DENV (DENV−JEV+ = 23). We further assessed the responses to these peptides by undertaking ex vivo IFNγ assays and flow cytometry.Results: None of DENV−JEV− individuals responded to any of the 20 JEV-specific peptides. High frequency of responses was seen to 6/20 peptides by individuals who were JEV+ but DENV−, where over 75% of the individuals responded to at least one peptide. P34 was the most immunogenic peptide, recognized by 20/23 (86.9%) individuals who were DENV−JEV+, followed by peptide 3 and peptide 7 recognized by 19/23 (82.6%). Peptide 34 from the NS2a region, showed

Introduction. Nonpuerperal uterine inversion (NPUI) is a rare clinical problem with diagnostic and surgical challenges. The objective of our study was to review the literature on NPUI and describe causative pathologies, diagnosis, and different surgical options available for treatment. Materials and Methods. A comprehensive literature review was carried out on MEDLINE and Google Scholar databases to look for NPUI using the term “non-puerperal uterine inversion,” and further went through the cross-references of the published articles. Data are published case reports from 1911 to September 2018. Of the 153 published cases, 133 reports had adequate details of surgery for analysis. These reports were analyzed, concerning the clinical presentation, methods of diagnosis, and surgical treatment. Results. Mean age of the women was 46.3 years (standard deviation: 18, N = 153). Leiomyoma remained the commonest (56.2%) aetiology. While malignancies contributed to 32.02% of cases, 9.2% were idiopathic. High degree of clinical suspicion and identification of unique features on ultrasonography and magnetic resonance imaging enable prompt diagnosis. In cases of uncertainty, laparoscopy or biopsy of the mass was used to confirm the diagnosis. Hysterectomy or repositioning and repair of the uterus are the only treatment options available. The surgical methods implemented were analyzed in three aspects: route of surgical access, method of repositioning, and final surgical procedure undertaken. The majority (48.8%) had only abdominal access, while 27.1% had both abdominal and vaginal access. Haultain procedure was the most useful procedure for reposition (18.0%) of the uterus. The majority (39.7%) required abdominal hysterectomy with or without debulking of the tumour abdominally, while 15.0% had uterine repair after repositioning. We reviewed the different surgical techniques and described and proposed a treatment algorithm. Conclusions. Fibroids were the commonest cause for NPUI. Malignancies accounted for one-third of cases. A combined abdominal and vaginal approach, followed by hysterectomy or repair after repositioning, seems to be better for nonmalignant cases.

Self-assembly is an important process in biological systems and also a promising avenue toward dynamic and responsive micro- and nano-technologies. This study discusses the non-equilibrium self-assembly of inherently magnetic bacteria oriented perpendicular to a solid surface. An interplay between hydrodynamic and magnetic interactions leads to stable three-dimensional clusters in the long-time regime, which may be programmatically assembled, disassembled, and translated across a surface. The implications of the findings for the rational design of non-equilibrium self-assembly in general are discussed.

This study determined the physical property variations during the traditional fermentation of Morinda citrifolia L. (noni) juice and their correlations to antioxidant capacity were identified. The temperature and pH of the juice, temperature, and humidity within the fermenter and juice volume were monitored. Both temperatures were within the range of 29.5–33 °C. The pH of the juice decreased from 3.98 to 3.23. The humidity increased rapidly from 98.95% to 99.90%. The maximum juice volume was about 1.37 L. The maximum antioxidant capacity was around 84% of the DPPH scavenging activity. Therefore, the physical property variations cannot be correlated significantly to the antioxidant capacity of noni juice.

Abstract The tremendous advances achieved in the biophotonics technologies have intensified the necessity for non-invasive modalities that can characterize diverse biological materials with increased sensitivity and resolution. Optical coherence tomography (OCT) is one of the techniques that has been applied for biological applications in medicine and agriculture to identify structural properties. Herein, we report the successful incorporation of OCT for the identification of morphological changes that occur as a result of the bitter rot disease, through continuous detection of structural changes. Detailed inner morphological structural changes occurring in fruit specimens were precisely analyzed as a function of the disease incubation period using OCT. The conducted histological correlation and quantitative three-dimensional evaluations provide a robust platform for further discoveries related to plant materials. The results highlight the initial identification of bitter rot progression on apple specimens owing to the non-invasive inspection capability of OCT. Therefore, we expect that the proposed method will enable immediate sensitivity improvements in the inspection of plant diseases for postharvest utility.

Since early 1980’s, the production and usage of Polychlorinated biphenyls (PCBs) have been banned throughout the world due to its carcinogenicity to humans and animals. However, due to the large half-lives of PCBs, large amounts of stocks are still available in storage. This study presents the validation data of the method developed for analysis of Aroclor 1260 in transformer oils in order to determine the concentrations for systematic disposal and destruction. The transformer oil samples were prepared according to the ASTM D 4059 with few modifications. PCBs in transformer oils were extracted with iso-octane followed by deactivated florisil cleanup and detection by GC – ECD using HP 5 GC column (30 m x 0.32 mm x 0.25 μm). The study was performed under matrix matched condition to eliminate the matrix effect that was found to be significant. The method was found linear over a wide working range from 2.5 ppm – 100 ppm with a regression coefficient of 0.994 and a lower limit of determination of 2.5ppm. Method showed satisfactory repeatability with relative standard deviation below 7% over the entire working range. Accuracy of the method was assured using spike recoveries at 5 ppm, 10 ppm and 50 ppm with 85%, 105% and 93% respectively. The selectivity of Aroclor 1260 was confirmed against Aroclor 1254 and Aroclor 1242 considering uniquely identified non – overlapping chromatographic peaks. Based on the performance characteristics, this method can be suggested as an accurate and precise methodology to analyze Aroclor 1260 present in transformer oil.

No abstract availabl

Introduction and Objective: Chlorhexidine is used as an oral mouthwash to reduce oral colonization related to dental disease. Triphala (An ayurvedic preparation from the dried fruits of Emblica officinalis, Terminalia bellirica and Terminalia chebula) and Mimusops elengi(Munamal) are used as mouthwashes in Ayurvedic medicine and are known to have antimicrobial activity.This study was aimed to determine the effect of 0.2% Chlorhexidine gluconate, Triphala and Mimusops elengi (Munamal) on Candida species and three common bacterial pathogens.Methods: The effect of 0.2% chlorhexidine gluconate, Triphala and Mimusops elengi (Munamal) aqueous extracts against Candida spp., Staphylococcus aureus, and methicillin resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa were determined using an agar well diffusion method. Minimum inhibitory concentration (MIC) of Triphala and Munamal aqueous extracts for the microorganisms were determined using broth micro dilution method with alamar blue modification.Results: 0.2% Chlorhexidine gluconate showed a zone of inhibition for all test microbial strains. Triphala demonstrated activity against all tested microbial species except Candida glabrata, Candida dubliniensis and Escherichia coli. Munamal Pothu demonstrated activity against Staphylococcus aureus and MRSA only. Chlorhexidine gluconate inhibited the growth of Candida (C. albicans and C. tropicalis) at 1/512 dilution (MIC = 0.004 mg/ml for both organisms). The MIC of Triphala for C. albicans and C. tropicalis was 32.5 mg/ml. Anti-candida activity of Chlorhexidine gluconate was achieved at very low concentrations.Conclusions: Triphala as a potential oral mouthwash agent with activity against C. albicans and C. tropicalis requires further investigation.

Abstract Boolean satisfiability (k-SAT) is an NP-complete (k ≥ 3) problem that constitute one of the hardest classes of constraint satisfaction problems. In this work, we provide a proof of concept hardware based analog k-SAT solver, that is built using Magnetic Tunnel Junctions (MTJs). The inherent physics of MTJs, enhanced by device level modifications, is harnessed here to emulate the intricate dynamics of an analog satisfiability (SAT) solver. In the presence of thermal noise, the MTJ based system can successfully solve Boolean satisfiability problems. Most importantly, our results exhibit that, the proposed MTJ based hardware SAT solver is capable of finding a solution to a significant fraction (at least 85%) of hard 3-SAT problems, within a time that has a polynomial relationship with the number of variables(

Laser transmission welding offers significant benefits over conventional welding techniques enabling single-stage rapid plastic joining. The quality of laser transmission welded products is commonly assessed by measuring the weld penetration depth, hardened weld boundary, and inspecting the formation of porosity. However, the existing methods of verification are inevitably accompanied by destruction of the specimen. Thus, non-destructive quality assessment methods for laser transmission welding have gained attention recently. Here, we demonstrated an extended industrial application of 860 nm wavelength-based spectral domain optical coherence tomography for the non-destructive inspection of the aforementioned quality parameters of laser transmission welded industrial plastic materials, i.e., polycarbonate and acrylonitrile butadiene styrene copolymer. The acquired cross-sectional resolution and volumetric and intensity profiles sufficiently contributed to the quality assessment procedure, revealing the weld boundary and porosity formation, and thus confirming the potential applicability of optical coherence tomography for the quality inspection of laser transmission welded products.

Background: Breast carcinoma (BCa) is the commonest malignancy among women worldwide and in Sri Lanka. Several prognostic indices are described for BCa. Aims: To assess clinicopathological features and prognostic indices derived from routine clinical, histopathological and immunohistochemical (IHC) data, in a cohort of patients undergoing primary surgery for BCa and to determine their prognostic impact on short-term disease free survival. Setting and Design: This is a bidirectional cohort study of 208 women undergoing primary surgery for BCa at the National Hospital of Sri Lanka, from 2012-2014, excluding post-neoadjuvant chemotherapy cases. Material and Methods: Clinical details, tumor size and nodal status were obtained from histopathology reports. Histopathology and estrogen/progesterone receptor and HER2 status were reviewed. Molecular subtype based on IHC was determined. Nodal ratio (number of positive nodes/total number retrieved) and Nottingham prognostic index were calculated. Follow up information was obtained by patient interviews and record review. Statistical Analysis: Data was analyzed by univariate and multivariate Cox regression using SPSS19.0. Results: Mean follow-up duration was 27.16 months (0.5-52 months, s = 9.35 months). 174 (82.9%) remained disease free with 19 (9%) deaths. Thirteen (6.2%) survived with metastasis and 4 (1.9%) with recurrences. On univariate Cox regression, tumor, nodal and TNM stages, nodal ratio and lymphovascular invasion (LVI) were predictive of disease free survival (DFS) (P = 0.001, P = 0.021, P = 0.022, P = 0.002, P = 0.018). On multivariate analysis TNM stage and LVI were predictive of DFS. Conclusion: TNM stage and LVI were the most important predictors of short-term disease free survival in this study population, confirming that early detection of BCa at a lower stage has a significant impact on short-term outcomes.

Background: Although clinical and demographic patterns in presentation of autism in the developed world have been extensively studied, comparable data from developing countries remain scarce. While a few attempts have been made previously to describe autistic children in some areas in Sri Lanka (SL), there are gaps in the understanding of autism in the local setting. Methods: Data on all patients diagnosed with autism in two child mental health clinics at a tertiary care center in central SL were abstracted retrospectively from clinic records over a period of 30 years since the inception of the clinics. Diagnosis of autism in these clinics has been based on criteria in the International Classification of Diseases-10th version. Results: Autism had been diagnosed in 77 patients. Of them, 58.4% were male. The mean age at first presentation was 6.7 years. While the number of autistic patients presenting to the clinic has increased over time, the age of presentation has remained largely unchanged. Delayed speech (23.4%) and poor social interactions (23.4%) were the two common primary concerns of parents leading to referral. Among medical comorbidities, epilepsy was the commonest (19.5%). The majority of patients (85.7%) had needed help with activities of daily living. In 62.3% of patients, no therapeutic interventions were documented. Conclusions: There are a substantial dearth and delay in presentation of autism in SL. Multiple deficiencies noted in the management of these patients indicate the need to improve awareness as well as resources and services dispensed for autism in SL.

Many studies have shown that person-organization value fit effect on employee commitment, job satisfaction, involvement, communication, cooperation, and profit gains in organizations. Leader behavior is another important factor effects on employee performance in organizations. However research investigated on interaction effect of leader behavior and person-organization value fit on employee performance is mostly absent in literature. This study examined the effect of leader behavior, person-organization value fit and their interactions on employee commitment, participation for group decision making and trust in their leaders in Sri Lankan organizations. A questionnaire survey was undertaken to evaluate employees’ ratings on these variables. Hypotheses testing were done by using Analysis of Covariates. Results revealed that both leader behavior and person-organization value fit are powerful predictors for employee performance. Theoretical and practical implications of these results and directions for future research are discussed.