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The treatment modality of gastric adenocarcinoma (GCA) depends on the stage of the disease at the clinical presentation. Long delays are probably an unfavorable factor for the patient's prognosis. A prospective longitudinal, study involving 145 consecutive GCA was conducted at the National Hospital of Sri Lanka (NHSL). The overall delay (in weeks) was recorded for each patient and divided into four periods-patient, endoscopy, pathology and treatment. The median and Interquartile Range (IQR) duration of delays were calculated and differences were explored with chi square test and Mann Whitney U test Survival analysis was done with Kaplan Meier technique and Cox regression. The median duration of delays for patient, endoscopy, histology reporting delay, other histology delay (specimen transfer delay and report receipt delay) and treatment were 18 (IQR 14–27), 2 (IQR 2–3), 3 (IQR 2–3), 2 (IQR 1–2) and 6 (IQR 4–8) weeks respectively. Delayed patient presentation to hospital was associated with significant adverse median survival 16 (IQR 11.5–22.5) weeks versus 20 (IQR 16–27.5) weeks, p = 0.004. Delay in initiating treatment was associated with significantly lower median survival 04 (IQR 4–6) weeks versus 06 (IQR 4–8) weeks, p = 0.003. Over 60% of both proximal and distal GCA presented at an advanced radiological stage (stage III/IV). The Kaplan Meier analysis showed that the higher hazard function was associated with a higher tumour stage and undergoing chemotherapy. Age of the patient and the treatment modality were significant predictors of the survival. Patient delay and delay in initiation of definitive treatment are the most important factors that adversely affect the outcomes of GCA. Public health interventions aiming to shorten the patient delay time with proper referral for specialist care would play an important role. Also, it is important to minimize these preventable delays and there should be time limits in producing the histopathology report and to establish online portals of hospital and laboratory information systems for easy access of histology reports in future. [ABSTRACT FROM AUTHOR]

Background: The majority of low- and middle-income countries (LMICs) do not have adequate civil registration and vital statistics (CRVS) systems to properly support health policy formulation. Verbal autopsy (VA), long used in research, can provide useful information on the cause of death (COD) in populations where physicians are not available to complete medical certificates of COD. Here, we report on the application of the SmartVA tool for the collection and analysis of data in several countries as part of routine CRVS activities.Methods: Data from VA interviews conducted in 4 of 12 countries supported by the Bloomberg Philanthropies Data for Health (D4H) Initiative, and at different stages of health statistical development, were analysed and assessed for plausibility: Myanmar, Papua New Guinea (PNG), Bangladesh and the Philippines. Analyses by age- and cause-specific mortality fractions were compared to the Global Burden of Disease (GBD) study data by country. VA interviews were analysed using SmartVA-Analyze-automated software that was designed for use in CRVS systems. The method in the Philippines differed from the other sites in that the VA output was used as a decision support tool for health officers.Results: Country strategies for VA implementation are described in detail. Comparisons between VA data and country GBD estimates by age and cause revealed generally similar patterns and distributions. The main discrepancy was higher infectious disease mortality and lower non-communicable disease mortality at the PNG VA sites, compared to the GBD country models, which critical appraisal suggests may highlight real differences rather than implausible VA results.Conclusion: Automated VA is the only feasible method for generating COD data for many populations. The results of implementation in four countries, reported here under the D4H Initiative, confirm that these methods are acceptable for wide-scale implementation and can produce reliable COD information on community deaths for which little was previously known. [ABSTRACT FROM AUTHOR]

Objective: EQ-5D-3L is a generic QOL tool used mainly in economic evaluations. Burden of Chronic Kidney Disease (CKD) is rising in Sri Lanka. Assessing the validity of generic QOL tools creates new opportunities of their utilization among patients with CKD. Methods: A cross-sectional study was conducted among 1036 CKD patients, selected using the simple random sampling technique. The validity was tested with six a-priori hypotheses. These included construct validity assessments, evaluating convergent validity and performing known group comparisons. EQ-5D-3L, Short Form-36 (SF-36) were used to assess QOL. Center for Epidemiological Studies Depression Scale (CES-D-20) and General Health Questionnaire-12 (GHQ-12) were used to assess the presence of depression and psychological distress respectively. Internal consistency of the whole tool and when each item is removed was assessed by Cronbach alpha. Results: The response rate was 99.2%. Majority of participants were males (n = 646,62.4%) in the age category of 41–60 (n = 530; 51.2%). Most were in either stage 4 or 5 of CKD (n = 646,75.1%). The summary measures of SF-36, positively and significantly correlated with the EQ-5D-3L index and VAS scores (p<0.001). EQ-5D-3L QOL scores were significantly different between the group with depression and without as measured by CES-D-20 (p<0.001). Assessed using GHQ-12, similar significance was detected between the group with psychological distress and without (p<0.001). The Cronbach alpha was 0.834 and when each item was removed, ranged from 0.782 to 0.832. Conclusion: EQ-5D-3L is a valid generic QOL tool with satisfactory internal consistency to be used among CKD patients in the pre-dialysis stage. [ABSTRACT FROM AUTHOR]

Quality of life (QOL) reflects the individual's perception of the position within living contexts. This study was done to describe pre- and post-stroke QOLs of stroke survivors. A prospective longitudinal study was done among stroke survivors admitted to 13 hospitals in the western province of Sri Lanka. The calculated sample size was 260. The pre-stroke and post-discharge one-month QOL was gathered using short form-36 (SF-36) QOL tool. SF-36 includes questions on eight domains: general health, physical functioning, pain, role limitation due to physical problems, social functioning, vitality, role limitations due to emotional problems, and mental health. Univariate analysis was followed by determining the independent risk factors through multivariate analysis. The response rate was 81%. The disability was measured by the modified Rankin scale which ranges from 0 (no symptoms) to 6 (fatal outcome). The median (IQR) disability score was 4 (3 to 5). The post-discharge QOL scores were significantly lower than pre-stroke values (p < 0.05). With a higher pre-stroke QOL, younger age was significantly associated in six domains and higher income and better health infrastructure in two domains (p < 0.05). Six factors were determined to be independent risk factors for lower post-discharge QOL scores of SF-36: younger age (for general health and role limitation-physical domains), female gender (for physical functioning and pain domains), lower health infrastructure (for general health, vitality, and mental health domains), lower education (for pain domain), higher disability (for general health, physical functioning, vitality, social functioning, and mental health domains), and hypercholesterolemia (for role limitation-emotional domain). Stroke survivors have not regained their pre-stroke QOL at 1 month following the hospital discharge irrespective of income level and pre-stroke QOL. Higher pre- and post-stroke QOLs are associated with better statuses of social determinants of health. [ABSTRACT FROM AUTHOR]

Background: Pre-event Quality of Life (QOL) reflects the true social circumstances in which people live prior to the onset of myocardial infarctions. It is believed to be a predictor of the post-event QOL. The aim of this study was to describe the pre-event QOL and its influence on the post-event Quality of Life among patients with ST elevation (STEMI) and Non-ST elevation myocardial infarctions (NSTEMI) using Short Form-36 (SF-36), a generic QOL tool with 8 domains. Documented literature is rare in this regard in Sri Lanka, which is a lower-middle-income country.Methods: A cross-sectional study with a 28-day post-discharge follow-up was carried out in 13 hospitals. Three hundred and forty-four patients who were diagnosed with STEMI or NSTEMI were recruited during the hospital stay. The pre-event QOL was measured using an interviewer-administered questionnaire which included the SF-36 QOL tool and medical details. Follow-up QOL was gathered using a questionnaire that was filled and posted back by participants. Of the recruited sample, 235 responded for the follow-up component. Analysis was conducted for associations between pre- and post-discharge QOL. Furthermore, comparisons were made between the STEMI and NSTEMI groups. Mann Whiney U test, Wilcoxon signed rank test and chi square test were used in the analysis.Results: The post-event QOL was lower in seven out of eight domains than the pre-event QOL (p < 0.05). The NSTEMI group had more risk factors and a significantly lower pre-event QOL for seven domains (p < 0.05), when compared to the STEMI group. For seven domains, the post-discharge QOL was not significantly different (p > 0.05) between the STEMI and NSTEMI groups. Post-discharge general-health QOL domain score was higher than the pre-MI score (p = 0.028) and was higher in the STEMI group compared to the NSTEMI group (p = 0.042). Regression analysis showed a significant beta coefficient between pre- and post-QOL for five domains in STEMI and for all domains in NSTEMI groups when adjusted for the disease severity. The R square values ranged from 12.3 to 62.3% for STEMI and 7.3 to 64.8% for NSTEMI.Conclusions: Pre-event QOL is lower in the NSTEMI group compared to the STEMI group. Patients do not regain the previous QOL within one month post-discharge. Post-discharge QOL can be predicted by the pre-event QOL for most domains. [ABSTRACT FROM AUTHOR]

The Ultra Violet Imaging Telescope (UVIT) is one of the major scientific instruments on the proposed ASTROSAT mission of the Indian Space Research Organisation. The design of a telescope to meet the scientific requirements within the weight and volume constraints of the satellite bus has been a major challenge. The design has also to meet the qualification levels for launch into orbit as well as the thermal environment in orbit. Here we present the overall design of the UVIT mechanical structure with details of some critical aspects. [ABSTRACT FROM AUTHOR]

Over the last 5 years, UVIT has completed observations of more than 500 proposals with ∼ 800 unique pointings. In addition, regular planned monitoring observations have been made and from their analysis various key parameters related to in orbit performance of UVIT have been quantified. The sensitivities of the UV channels have remained steady indicating no effect of potential molecular contamination confirming the adequacy of all the protocols implemented for avoiding contamination. The quality of the PSF through the years confirms adequacy of thermal control measures. The early calibrations obtained during the Performance Verification (PV) phase have been further revised for more subtle effects. These include flat fields and detector distortions with greater precision. The operations of UVIT have also evolved through in orbit experience, e.g. tweaking of operational sequencing, protocol for recovery from bright object detection (BOD) shutdowns, parameters for BOD thresholds, etc. Finally, some effects of charged particle hits on electronics led to opimised strategy for regular resetting. The Near-UV channel was lost in one of such operations. All the above in-orbit experiences are presented here. [ABSTRACT FROM AUTHOR]

Ultra Violet Imaging Telescope (UVIT) is one of the 5 instruments on AstroSat satellite, which was launched on September 28, 2015. UVIT was designed to make images with a resolution of < 1. 8 ′ ′ , simultaneously in two ultraviolet channels: Far Ultraviolet (130–180 nm) and Near Ultraviolet (200–300 nm). Images are also made in visible region (320–550 nm) for tracking drifts in pointing. The shortest wavelengths to be observed with UVIT can be heavily absorbed by mono-molecular deposits/contamination on the optical surfaces. Keeping contamination under control in UVIT was a major challenge and it required a variety of actions: (i) strict control of the payload materials and process, (ii) mechanical configuration, (iii) baking of all the parts to release all the adsorbed molecules etc., (iv) assembly in ultra cleanrooms, (v) pre-inspection and auditing of all the areas, in which UVIT was placed, for any potential for contamination, (vi) continuous purging, with ultra-pure nitrogen gas, till a few days before the launch, etc. In order to minimise any possible cross contaminations from the other payloads/satellite, the doors of UVIT were opened 2 months after the launch. The high performance in the orbit and high stability of the sensitivity over 4 years in the orbit shows that the contamination was negligible. This paper presents the processes and protocols followed during the integration and testing phase to minimise the contamination in order to prevent any performance degradation. [ABSTRACT FROM AUTHOR]

The High Altitude GAmma-Ray (HAGAR) array is a wavefront sampling array of 7 telescopes, set-up at Hanle, at 4270mamsl, in the Ladakh region of the Himalayas (Northern India). It constitutes the first phase of the HImalayan Gamma-Ray Observatory (HIGRO) project. HAGAR is the first array of atmospheric Cherenkov telescopes established at a so high altitude, and was designed to reach a relatively low threshold (currently around 200 GeV) with quite a low mirror area (31m²). Regular source observations are running since September 2008. Estimation of the sensitivity of the experiment is undergoing using several hours of data from the direction of Crab nebula, the standard candle source of TeV gamma-ray astronomy, and from dark regions. Data were acquired using the On-source/Off-source tracking mode, and by comparing these sky regions the strength of the gamma-ray signal could be estimated. Gamma-ray events arrive close to telescope axis direction while the cosmic-ray background events arrive from the whole field of view. We discuss our analysis procedures for the estimate of arrival direction, estimate of gamma ray flux from Crab nebula, and the sensitivity of the HAGAR system, in this paper. [ABSTRACT FROM AUTHOR]

The outer atmosphere of the sun - called the corona - has been observed during total solar eclipse for short periods (typically < 6 min), from as early as the eighteenth century. In the recent past, space-based instruments have permitted us to study the corona uninterruptedly. In spite of these developments, the dynamic corona and its high temperature (1-2 million K) are yet to be fully understood. It is conjectured that their dynamic nature and associated energetic events are possible reasons behind the high temperature. In order to study these in detail, a visible emission line space solar coronagraph is being proposed as a payload under the small-satellite programme of the Indian Space Research Organisation. The satellite is named as Aditya-1 and the scientific objectives of this payload are to study: (i) the existence of intensity oscillations for the study of wavedriven coronal heating; (ii) the dynamics and formation of coronal loops and temperature structure of the coronal features; (iii) the origin, cause and acceleration of coronal mass ejections (CMEs) and other solar active features, and (iv) coronal magnetic field topology and three-dimensional structures of CMEs using polarization information. The uniqueness of this payload compared to previously flown space instruments is as follows: (a) observations in the visible wavelength closer to the disk (down to 1.05 solar radii); (b) high time cadence capability (better than two-images per second), and (c) simultaneous observations of at least two spectral windows all the time and three spectral windows for short durations. [ABSTRACT FROM AUTHOR]

Objective: Occupational hazards is an area where many countries have begun to pay more emphasis as it affects the health of many particularly in developing countries. However, documented literature is scarce in this regard although occupational hazards are common in workplaces. The study was carried out with the objective of describing the physical hazards and control measures adopted in the formal medium and large-scale industrial sector in Sri Lanka. Results: Of the 69 units of the 25 factories, physical hazards detected in the workplaces were; excessive noise (78.3%), poor light (58%), increased temperature (65.2%), and poor ventilation (68.1%). Over 50% of large machinery and 33% of medium-scale machinery were not adequately guarded. Nearly 41% of the machinery were difficult to operate, of them 36.2% had controls in positions which were hard to reach. Of safety measures adopted, only 34.8% had proper demarcation of areas with 28.9% displaying safety signs. Housekeeping was poor in 59.4% and less than 40% had safe storage of raw materials and end products. [ABSTRACT FROM AUTHOR]