This study investigates the psychological and cultural motivations that underpin charitable giving in Sri Lanka,with particular attention to whether such behaviour can be considered genuinely altruistic.While charitab...This study investigates the psychological and cultural motivations that underpin charitable giving in Sri Lanka,with particular attention to whether such behaviour can be considered genuinely altruistic.While charitable acts are commonly perceived as selfless,this research highlights the complex and often contradictory nature of the motivations involved.Using a qualitative approach,semi-structured interviews were conducted with individuals who regularly engage in charitable activities.Thematic analysis revealed three overarching categories of motivation.The first,obliged motives stem from social expectations and religious duty.The second,independent motives reflect personal values and intrinsic satisfaction.The third,ambivalent motives are a novel category that captures the simultaneous interplay between self-serving and other-oriented intentions.The emergence of ambivalent motives is especially significant,as it challenges binary distinctions between altruism and egoism,suggesting that charitable giving frequently serves psychological,social,and existential needs alongside prosocial goals.The findings support established psychological frameworks such as Self-Determination Theory and the Theory of Planned Behavior,while also highlighting the unique cultural dynamics of Sri Lankan society,particularly the influence of Buddhist ethics and collectivist values.These cultural factors shape both the meaning and practice of giving,embedding it within broader narratives of moral obligation,social harmony,and spiritual merit.Ultimately,the study concludes that while charitable giving in Sri Lanka may outwardly appear altruistic,it is often driven by a complex mixture of internal and external motives,suggesting that authenticity in giving is rarely absolute but rather contextually and psychologically mediated.展开更多
Objective:To confirm the presence of Culex(Cx.)(Lophoceraomyia)cinctellus in Sri Lanka using morphological and molecular evidence.Methods:From October 2019 to April 2020,mosquito surveillance was conducted fort-nightl...Objective:To confirm the presence of Culex(Cx.)(Lophoceraomyia)cinctellus in Sri Lanka using morphological and molecular evidence.Methods:From October 2019 to April 2020,mosquito surveillance was conducted fort-nightly in the Banduragoda Public Health Inspector area.Larvae were collected using standard siphoning methods,while adults were sampled using Cattle Baited Trap,Gravid Traps,Light Traps,Bird-Baited Traps,Dog Baited Traps,and diurnal human landing collections.Specimens were transported to the Entomology Laboratory at the Medical Research Institute for identification.Morphological identification was performed using standard taxonomic keys.Molecular confirmation was achieved through DNA sequencing of mosquito head and thoracic regions,followed by sequence analysis using NCBI BLAST and Geneious software(version 7.1.3).Results:Adults of Cx.cinctellus were identified in Bird-Baited Traps and human bait collections.Unique morphological characteristics,including well-developed pulvilli,wing vein 1A ending before the apex of cross vein mcu,basal transverse pale bands on abdominal terga,and two labial basal setae on the proboscis,confirmed species identity.Morphometric measurements included mean thoracic length(0.58±0.02)mm,thoracic width(0.63±0.02)mm,abdominal length(2.15±0.03)mm,abdominal width(0.61±0.01)mm,and wing length(2.91±0.02)mm.Molecular analysis corroborated the morphological identification,affirming the species as Cx.cinctellus.COI sequences of the collected specimen(452 bp)were confirmed as Cx.cinctellus for sequence identity by BLAST and BOLD analysis.These sequences were subsequently deposited in GenBank under the accession number OR225623.1.Conclusions:This study documents the first occurrence of Cx.cinctellus in Sri Lanka,highlighting the need to enhance entomological surveillance to monitor its dispersal and population dynamics.展开更多
The World Health Organization declared Sri Lanka a malaria eliminated country in 2016[1-3].At present,the country is in the phase of preventing the re-establishment of malaria[4].However,travelers who contract the dis...The World Health Organization declared Sri Lanka a malaria eliminated country in 2016[1-3].At present,the country is in the phase of preventing the re-establishment of malaria[4].However,travelers who contract the disease overseas in malaria endemic countries continue to present a constant risk of re-establishing malaria in Sri Lanka,where malaria-transmitting mosquitos is prevalent.In this context,robust measures are being implemented in the country to prevent re-establishment of malaria and to stop travelers infected with malaria progressing into severe disease and death.展开更多
Dengue fever presents a significant and persistent public health challenge in Sri Lanka.The disease,transmitted by Aedes aegypti and Aedes albopictus mosquitoes,affects individuals across all age groups,with working p...Dengue fever presents a significant and persistent public health challenge in Sri Lanka.The disease,transmitted by Aedes aegypti and Aedes albopictus mosquitoes,affects individuals across all age groups,with working populations and school-aged children at higher risk due to increased outdoor exposure[1].Dengue transmission in Sri Lanka is seasonal with two high transmission waves corresponding with the two monsoon rains every year.The estimated average annual incidence is 175/100000 population,and it was 407.5/100000 in 2023 with a case fatality rate of 0.07%[2].展开更多
BACKGROUND The emergence of the Omicron variant(B.1.1.529)of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)raised global concerns with its highly transmissible nature.AIM To investigate the genomic,clinic...BACKGROUND The emergence of the Omicron variant(B.1.1.529)of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)raised global concerns with its highly transmissible nature.AIM To investigate the genomic,clinical,and demographic characteristics of Omicron infections within the early outbreak cluster in western part of Sri Lanka.METHODS We analyzed sequence data from January 2022 to April 2022 to understand variant dynamics,clinical presentation,and demographic associations.RESULTS Whole-genome sequencing of 85 nasopharyngeal and throat swab samples collected in western part of Sri Lanka between January and April 2022 identified 70(82.34%)of it as Omicron variants.BA.2 was the most prevalent sub-lineage(57%),followed by BA.1.1(14.20%)and majority of them were from>12 years old individuals.Phylogenetic analysis revealed clustering into four distinct clades(21I,21K,21L,and 21M),suggesting potential differences in transmission chains or evolutionary pressures.CONCLUSION This study found BA.2 to be the predominant Omicron sub-lineage in the western part of Sri Lanka during the first quarter of 2022,aligning with global trends.Phylogenetic analysis revealed diverse introductions and local transmission.Continued genomic surveillance and robust public health measures remain crucial for managing the evolving SARS-CoV-2 landscape.展开更多
Two widespread bird species in Sri Lanka’s dry zone,Pycnonotus cafer(Red-vented Bulbul,RVBB)and Pycnonotus luteolus(White-browed Bulbul,WBBB),were studied to understand their foraging dynamics and ecology.The researc...Two widespread bird species in Sri Lanka’s dry zone,Pycnonotus cafer(Red-vented Bulbul,RVBB)and Pycnonotus luteolus(White-browed Bulbul,WBBB),were studied to understand their foraging dynamics and ecology.The research was conducted from October 2022 to February 2023 in Mihintale Sanctuary(80.30′11.24″E,8.21′04.63″N)and the Faculty of Applied Sciences,Rajarata University of Sri Lanka(80.502206″E,8.353090″N).Data were obtained through focal sampling,opportunistic observations,and mist netting.Both species predominantly foraged on twigs,using gleaning as the dominant food-handling technique.RVBB foraged mostly at the canopy level,while WBBB foraged primarily at the sub-canopy level.Fruits constituted the major food type for both species.RVBB and WBBB utilized 10 and 7 plant species,respectively,with Grewia helicterifolia being the primary foraging plant.Minimal foraging was observed on Croton sp.(RVBB)and Hugonia mistax(WBBB).The correlation between nutritional components and the consumption of both species revealed a preference for foods with lower protein,higher fat,and ash content.There was no linear correlation between gape width and fruit size(r=-0.21,P=0.69)for both species.The standardized dietary niche breadth indicated both species are specialists,with a high pairwise dietary niche overlap(0.9854).These findings highlight the niche-specific foraging adaptations of RVBB and WBBB within Mihintale,emphasizing their distinct strategies in utilizing plant species,fruit sizes,and foraging heights.Understanding such ecological dynamics is essential for habitat conservation efforts and ensuring the availability of key foraging resources for these species in the dry zone.展开更多
Remembrance activities can support the Culture of Care(CoC)in Laboratory Animal Science(LAS)not only by promoting a culture of respect,gratitude and thankfulness for animal life but also by helping the emotional proce...Remembrance activities can support the Culture of Care(CoC)in Laboratory Animal Science(LAS)not only by promoting a culture of respect,gratitude and thankfulness for animal life but also by helping the emotional processing and healing of lab animal researchers and animal facility staff.Even though remembrance activities are practiced in many parts of the world,we did not come across any reported cases in Sri Lanka before 2022.Therefore,here,we report on the various remembrance activities and practices observed within our local scientific community.展开更多
The Ashy-headed Laughingthrush (Argya cinereifrons), a species endemic to Sri Lanka, has been historically considered a laughingthrush in the genus Garrulax. However, based on phylogenetic evidence, recent studies hav...The Ashy-headed Laughingthrush (Argya cinereifrons), a species endemic to Sri Lanka, has been historically considered a laughingthrush in the genus Garrulax. However, based on phylogenetic evidence, recent studies have suggested a new classification for the species under the genus Argya (true babblers). Despite the genetic signal showing affinity to true babblers Argya, as its common name suggests, the Ashy-headed Laughingthrush (AHLT) shows remarkable morphological similarities to other laughingthrushes of the Indo-Himalayan region. Here we attempted to address this incongruence in phenotypic and phylogenetic signals in this species by reconstructing the molecular phylogeny of babblers and comparing that with the key morphological, plumage, and vocal features of the two concerned groups. We hypothesized that the convergence of phenotype and vocalization of Garrulax in the wet evergreen forests of the Indian mainland and AHLT in the wet tropical rainforests of southern Sri Lanka has historically confused the taxonomists. The phylogenetic relationships were reconstructed using Bayesian inference using four mitochondrial and seven nuclear gene regions. The molecular phylogenetic tree placed the AHLT with India's Large Grey Babbler (A. malcolmi) as the sister taxon within the genus Argya. The hierarchical clustering based on body size, shape, plumage colour, and vocal properties resulted in the inconsistent placement of ALTH with babblers or laughingthrushes. Therefore, an incongruence in phenotype and genotype is observed. Our findings show that the convergent patterns of phenotypic evolution can confuse both historic and recent taxonomic delimitations in highly divergent groups such as Asian babblers.展开更多
Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the out...Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the outbreak.Methods:This retrospective study analyzed all samples tested for measles from 1st of May to 30th of November,2023 at National Measles Rubella Laboratory,Sri Lanka.According to the World Health Organization(WHO)algorithm,serum and oropharyngeal/nasopharyngeal swabs were tested with WHO recommended kits for anti-measles IgM and measles virus specific RNA,respectively.Selected RNA positive samples were sequenced at reference laboratory,India.Analysis of sequencing data and construction of phylogenetic tree were carried out at National Measles Rubella Laboratory.Data was analyzed using descriptive statistics.Results:Of the total 1132 serum samples and 497 oropharyngeal/nasopharyngeal swabs from 1326 patients,657(49.5%)patients were confirmed as measles by anti-measles IgM,measles virus specific RNA or both.Males(55.6%,n=365)and the age group from>20 to≤30 years(33.0%,n=217)predominated positive patients.All provinces reported measles positive cases.All samples sequenced(100%,n=42)were genotype D8 with 95.2%(n=40)bearing Victoria.Australia origin.Conclusions:We described resurgence of measles in an eliminated country,confirming the genotype to be D8,one of the two genotypes currently circulating globally.Further,the study strongly convinced the importance of a strengthened virological surveillance system in an eliminated country,despite its eliminated status.展开更多
Objective:To evaluate the polio laboratory surveillance carried out from January,2019 to May,2023 by the Polio Regional Reference Laboratory,Sri Lanka.Methods:This retrospective study analyzed all stool samples receiv...Objective:To evaluate the polio laboratory surveillance carried out from January,2019 to May,2023 by the Polio Regional Reference Laboratory,Sri Lanka.Methods:This retrospective study analyzed all stool samples received under the acute flaccid paralysis(AFP)and immunodeficient vaccine-derived poliovirus(VDPV)surveillance at Polio Regional Reference Laboratory,Sri Lanka from January,2019 to May,2023.The results of the testing methodologies were extracted from the laboratory data system,i.e.,poliovirus virus isolation,intra-typic differentiation/VDPV real time reverse transcriptase polymerase chain reaction(ITD/VDPV rRTPCR)and sequencing,along with the data on timing of reporting results,stool adequacy and socio-demographics.Data was analyzed using descriptive statistics.Results:A total of 2141 stool samples from 1644 cases were received for AFP surveillance from Sri Lanka(93.61%),Maldives(1.52%),and immunodeficient VDPV(4.86%)surveillance.Both polioviruses(19/1644,1.15%)and non-polio enteroviruses(73/1644,4.44%)were isolated,while Sabin-like 3 virus was detected in majority(12/19,63.15%)among the poliovirus isolated.Wild polioviruses or circulating VDPVs were not detected among the cases.During all years of the study,the non-polio AFP detection rate was>1/100000 in children aged less than 15 years,whereas stool adequacy rate was>80%.All results were reported within 14 days of receipt,ensuring timely reporting as per global guidelines.Conclusions:The Polio Regional Reference Laboratory,Sri Lanka plays a vital role in maintaining the polio-free status in the country through its robust laboratory surveillance,while adhering to the surveillance indicators.Non-detection of wild polioviruses and circulating VDPV during the study period reinforces the polio-free status in the country.展开更多
Objective:To establish Nipah virus diagnostic capabilities at the National Reference Laboratory in Sri Lanka using the NIV Pune real-time PCR kit.Methods:Strict safety precautions were adhered during testing due to th...Objective:To establish Nipah virus diagnostic capabilities at the National Reference Laboratory in Sri Lanka using the NIV Pune real-time PCR kit.Methods:Strict safety precautions were adhered during testing due to the high pathogenicity of the Nipah virus,with all diagnostics conducted in a BSL2+laboratory at the Medical Research Institute in Sri Lanka.RNA extraction was performed using the QIAamp Viral RNA Mini kit.The NIV Pune in-house real-time PCR kit was employed,following established primer/probe sequences and controls.The assay was validated using the Rotor-Gene Q Series Real-time PCR platform.Results:The validation run of the Nipah virus real-time PCR test demonstrated robust performance,with positive controls consistently detecting Nipah RNA at a Ct value of 21.50±0.01.Negative controls confirmed assay specificity with an external negative control which was also used as an extraction control and showed no interference.The internal control exhibited stable behavior,enhancing confidence in PCR results.The qPCR analysis graph illustrated the successful detection of internal and positive controls,validating the reliability of the assay.Conclusions:Establishing Nipah virus diagnostic capabilities in Sri Lanka signifies a proactive and collaborative response to the persistent global health threat.展开更多
Objective:To assess the attitude and willingness of medical students of the Faculty of Medicine,University of Jaffna,regarding gamete donation.Methods:An institutional-based descriptive cross-sectional study was condu...Objective:To assess the attitude and willingness of medical students of the Faculty of Medicine,University of Jaffna,regarding gamete donation.Methods:An institutional-based descriptive cross-sectional study was conducted at the Faculty of Medicine,University of Jaffna,from September 2022 to May 2023 among undergraduate medical students who gave their voluntary participation.A self-administered questionnaire was used as a study instrument to collect data regarding their attitude and willingness toward gamete donation.Results:A total of 345 participants were recruited and their sociodemographic data revealed that 56.8%of the participants were female,62.3%aged between 26 and 30 years,and 92.2%were unmarried.Many of them received information regarding gamete donations during their clinical appointments.Over half(67.8%)of them showed a negative attitude towards gamete donation.Regarding willingness,only 39.7%of participants had a positive approach for being a gamete donor;among them,84.7%preferred anonymous donations.Religion and ethnicity had a significant influence on their attitudes and willingness.In addition,male was also found to be more willing to donate gametes.Conclusions:Most medical students have negative views about gamete donation.Imparting awareness and knowledge of assisted reproductive technology and gamete donation within medical students'sociocultural and ethical backgrounds might facilitate a change in attitude towards gamete donation amongst future medical practitioners.展开更多
Groundwater is the main source of drinking water for the rural population in the chronic kidney disease of unknown etiology(CKDu)zone of the North Central Province(NCP)in Sri Lanka.In this study,a total of 334 groundw...Groundwater is the main source of drinking water for the rural population in the chronic kidney disease of unknown etiology(CKDu)zone of the North Central Province(NCP)in Sri Lanka.In this study,a total of 334 groundwater samples(311 dug wells,21 tube wells and 2 springs)during the wet season from two aquifers in the NCP were collected,and inves-tigated their chemical characteristics and evaluate their water quality,including ground-water chemistry,main ion sources,the corrosion and scaling potential of groundwater.The results showed that the two hydrochemical types of groundwater in the NCP were mainly of the Ca-HCO_(3),Na·Ca-HCO_(3)types,with the main HCO_(3)−,Na^(+)and Ca^(2+)ions in both types of groundwater originating from silicate and evaporite salt dissolution and influenced by alternating cation adsorption,while the presence of NO_(3)−was mainly anthropogenic.Eval-uation ofwater stability using namely Langelier saturation index(LSI),Ryznar stability index(RSI),Puckorius scaling index(PSI)and Larson-Skold index(LS),indicated that most ground-water presents corrosion potential and has corrosion behavior tendency of metals to some degrees.The water quality of Polonnaruwa was better than that of Anuradhapura in the NCP,and when the groundwater was worse than the“good”grade,which must be properly treated before it is used as drinking water.展开更多
Over recent decades, Gampaha district, Sri Lanka, has experienced significant urbanisation and industrial growth, increasing groundwater demand due to limited and polluted surface water resources. In 2013, a community...Over recent decades, Gampaha district, Sri Lanka, has experienced significant urbanisation and industrial growth, increasing groundwater demand due to limited and polluted surface water resources. In 2013, a community uprising in Rathupaswala, a village in Gampaha district, accused a latex glove manufacturing factory of causing groundwater acidity (pH < 4). This study evaluates the spatial and temporal changes in geochemical parameters across three transects in the southern part of Gampaha district to 1) assess the impact of geological formations on groundwater;2) compare temporal variations in groundwater;and 3) explain acidification via a geochemical model. Seventy-two sample locations were tested for pH, electrical conductivity (EC), and anion concentrations (sulphate, nitrate, chloride and fluoride). Depth to the water table and distance from the sea were measured to study variations across sandy, peaty, lateritic, and crystalline aquifers. Results showed pH readings around 7 for sandy and crystalline aquifers, below 7 for peaty aquifers, and below 5 for lateritic aquifers, with significant water table fluctuations near Rathupaswala area. Principal component analysis revealed three principal components (PCs) explaining 86.0% of the variance. PC1 (40.6%) correlated with pH, EC, and sulphate (saltwater intrusion), while PC2 (32.0%) correlated with nitrates and depth to the water table (anthropogenic nutrient pollution). A geochemical transport model indicated a cone of depression recharged by acidic groundwater from peat-soil aquifers, leading to acidic groundwater in Rathupaswala area. Previous attributions of acidic pH to the over-exploitation of groundwater by the latex factory have been reevaluated;the results suggest natural acidification from prolonged water-rock interactions with iron-rich lateritic aquifers. Groundwater pH is influenced by local climate, geology, topography, and drainage systems. It is recommended that similar water-rock interaction conditions may be present throughout the wet zone of Sri Lanka, warranting detailed studies to confirm this hypothesis.展开更多
Copper(Cu)is an essential micronutrient for rice.However,the current status of Cu in Sri Lankan paddy soils is not known.Therefore,the current study was conducted to determine the distribution of exchangeable Cu conce...Copper(Cu)is an essential micronutrient for rice.However,the current status of Cu in Sri Lankan paddy soils is not known.Therefore,the current study was conducted to determine the distribution of exchangeable Cu concentration and examine the interactive effects of the agro-climatic zone(ACZ),soil order,and water source in determining the exchangeable Cu concentration in lowland paddy fields in Sri Lanka.A total of 7,544 soil samples representing six ACZs,six soil orders,and three water sources were collected using a stratified random sampling approach.Soil exchangeable Cu fraction was extracted in 0.01 M CaCl_(2)and measured using Inductively Coupled Plasma Mass Spectrophotometry.Exchangeable Cu concentration was in the range of 0.04−728μg·kg^(−1)with a mean value of 62.4μg·kg^(−1).Only 5%of the soil samples tested had Cu concentration greater than 200μg·kg^(−1)indicating a widespread Cu deficiency in Sri Lankan paddy fields(i.e.critical level causing Cu deficiency;200-300μg·kg^(−1)).Among the climatic zones Wet zone had higher and the Dry zone had lower Cu concentrations.Among the soil orders,histosols had higher and alfisols had lower Cu concentrations.Water sources used for rice cultivation did not determine Cu concentration.Moreover,Cu concentration was positively correlated with soil pH.As most of the soil samples were deficient in soil exchangeable Cu,spatial maps generated in the current work could be used to develop ACZ and soil order-specific agronomic and management strategies to improve soil Cu fertility status.展开更多
Objectives:Cardiovascular disease(CVD)in low and middle-income countries(LMICs),accounts for over 80%of global CVD-related deaths.The high cost of drugs is a major concern in not of managing CVD.This study aimed to co...Objectives:Cardiovascular disease(CVD)in low and middle-income countries(LMICs),accounts for over 80%of global CVD-related deaths.The high cost of drugs is a major concern in not of managing CVD.This study aimed to conduct a comprehensive review to identify interventions for cost containment of cvD drugs and use the inter-vention scalability assessment tool(ISAT)to examine the acceptability and application of relevant interventions in the Sri Lankan context,that can also be adaptable to other LMICs.Methods:A systematic search across three databases(Medline,Web of Science and Embase)was completed to identify relevant health system interventions.The ISAT assessed the feasibility of adapting the identified interven-tions to Sri Lanka,using structured interviews with 25 Sri Lankan stakeholders representing five groups:health managers,cardiologists,pharmacists,nursing officers,and patients.Results:The search yielded nine publications.Five were conducted on a national scale,while others were con-ducted at the regional levels.Seven were published in developed countries.The identified interventions were categorised into six intervention themes:Imposing a ceiling price or reference price;introduction of the polypill;introduction of volume price contract initiatives;prescribing generic and essential drugs;one intervention pack-age including generics,essential medicine,90-day drugs,and free delivery;and a second intervention package including discounts,rebates,cost-free medicine,and bundling.Assessment of six intervention themes revealed that methods of setting ceiling prices and controlling generic drug prescribing were the most popular,while other interventions were least popular..Conclusions:The study provides a roadmap for future interventions based on successful scaling,emphasizing the importance of understanding contextual variables and encourages stakeholder participation in policy assessments and advocacy.The findings highlighted the potential for enhancing the access to affordable CVD drugs not only in Sri Lanka,but also adaptable to other LMICs.These outcomes can contribute to policy decisions,aimed at reducing the significant global burden of CVD.展开更多
Santalum album （Indian Sandalwood） is found in the mountainous regions of the intermediate zone of Sri Lanka. Few studies have been conducted on sandalwood ecology in this region, and ours is the first recorded stud...Santalum album （Indian Sandalwood） is found in the mountainous regions of the intermediate zone of Sri Lanka. Few studies have been conducted on sandalwood ecology in this region, and ours is the first recorded study of essential oil content and chemical composition of heartwood. We harvested two trees with State permission and took cross-sections for analysis. We demonstrated a difference in the heartwood formation and oil yield of the trees. The composition of the oil was found to be consistent between trees and along the trunk of the tree. Main aromatic compounds were santalols and other compounds are recorded in lesser quantities. Results of this study comply with the other published work on sandalwood elsewhere. This initial study on S. album in Sri Lanka provided promising results for the future of sandalwood agroforestry.展开更多
The demand for fresh water in Hambantota District, Sri Lanka is rapidly increasing with the enormous amount of ongoing development projects in the region. Nevertheless, the district experiences periodic water stress c...The demand for fresh water in Hambantota District, Sri Lanka is rapidly increasing with the enormous amount of ongoing development projects in the region. Nevertheless, the district experiences periodic water stress conditions due to seasonal precipitation patterns and scarcity of surface water resources.Therefore, management of available groundwater resources is critical, to fulfil potable water requirements in the area. However, exploitation of groundwater should be carried out together with artificial recharging in order to maintain the long term sustainability of water resources. In this study, a GIS approach was used to delineate potential artificial recharge sites in Ambalantota area within Hambantota. Influential thematic layers such as rainfall, lineament, slope, drainage, land use/land cover, lithology, geomorphology and soil characteristics were integrated by using a weighted linear combination method. Results of the study reveal high to moderate groundwater recharge potential in approximately 49% of Ambalantota area.展开更多
In this paper,we assess the role of investment in research and development(R&D)and economic policy uncertainty(EPU)in Sri Lanka’s economic growth experience.We do this by first determining which endogenous growth...In this paper,we assess the role of investment in research and development(R&D)and economic policy uncertainty(EPU)in Sri Lanka’s economic growth experience.We do this by first determining which endogenous growth theories best explain the evolution of total factor productivity(TFP)in the country.Using historical time series data(1980–2018),we find that semi-endogenous growth theories best explain the evolution of TFP in Sri Lanka.This evidence suggests that R&D is critical to the country’s TFP expansion.We find that,through R&D,EPU has a crucial detrimental impact on TFP growth,although it is short-lived.Our findings are robust and have important implications for R&D investment and for moderating EPU.展开更多
The sting of Giant Asian honeybee(Apis dorsata) or Bambara in Sinhala and Kanmge Kulavi in Tamil is a common environmental hazard in Sri Lanka known to cause immediate allergic reactions,which could be fatal in sensit...The sting of Giant Asian honeybee(Apis dorsata) or Bambara in Sinhala and Kanmge Kulavi in Tamil is a common environmental hazard in Sri Lanka known to cause immediate allergic reactions,which could be fatal in sensitized individuals.We reported myocardial infarction, bowel gangrene and fatal anaphylaxis in a prospectively proven case series and the association of these uncommon complications with delayed removal of stingers from the patients’skin.展开更多
文摘This study investigates the psychological and cultural motivations that underpin charitable giving in Sri Lanka,with particular attention to whether such behaviour can be considered genuinely altruistic.While charitable acts are commonly perceived as selfless,this research highlights the complex and often contradictory nature of the motivations involved.Using a qualitative approach,semi-structured interviews were conducted with individuals who regularly engage in charitable activities.Thematic analysis revealed three overarching categories of motivation.The first,obliged motives stem from social expectations and religious duty.The second,independent motives reflect personal values and intrinsic satisfaction.The third,ambivalent motives are a novel category that captures the simultaneous interplay between self-serving and other-oriented intentions.The emergence of ambivalent motives is especially significant,as it challenges binary distinctions between altruism and egoism,suggesting that charitable giving frequently serves psychological,social,and existential needs alongside prosocial goals.The findings support established psychological frameworks such as Self-Determination Theory and the Theory of Planned Behavior,while also highlighting the unique cultural dynamics of Sri Lankan society,particularly the influence of Buddhist ethics and collectivist values.These cultural factors shape both the meaning and practice of giving,embedding it within broader narratives of moral obligation,social harmony,and spiritual merit.Ultimately,the study concludes that while charitable giving in Sri Lanka may outwardly appear altruistic,it is often driven by a complex mixture of internal and external motives,suggesting that authenticity in giving is rarely absolute but rather contextually and psychologically mediated.
文摘Objective:To confirm the presence of Culex(Cx.)(Lophoceraomyia)cinctellus in Sri Lanka using morphological and molecular evidence.Methods:From October 2019 to April 2020,mosquito surveillance was conducted fort-nightly in the Banduragoda Public Health Inspector area.Larvae were collected using standard siphoning methods,while adults were sampled using Cattle Baited Trap,Gravid Traps,Light Traps,Bird-Baited Traps,Dog Baited Traps,and diurnal human landing collections.Specimens were transported to the Entomology Laboratory at the Medical Research Institute for identification.Morphological identification was performed using standard taxonomic keys.Molecular confirmation was achieved through DNA sequencing of mosquito head and thoracic regions,followed by sequence analysis using NCBI BLAST and Geneious software(version 7.1.3).Results:Adults of Cx.cinctellus were identified in Bird-Baited Traps and human bait collections.Unique morphological characteristics,including well-developed pulvilli,wing vein 1A ending before the apex of cross vein mcu,basal transverse pale bands on abdominal terga,and two labial basal setae on the proboscis,confirmed species identity.Morphometric measurements included mean thoracic length(0.58±0.02)mm,thoracic width(0.63±0.02)mm,abdominal length(2.15±0.03)mm,abdominal width(0.61±0.01)mm,and wing length(2.91±0.02)mm.Molecular analysis corroborated the morphological identification,affirming the species as Cx.cinctellus.COI sequences of the collected specimen(452 bp)were confirmed as Cx.cinctellus for sequence identity by BLAST and BOLD analysis.These sequences were subsequently deposited in GenBank under the accession number OR225623.1.Conclusions:This study documents the first occurrence of Cx.cinctellus in Sri Lanka,highlighting the need to enhance entomological surveillance to monitor its dispersal and population dynamics.
文摘The World Health Organization declared Sri Lanka a malaria eliminated country in 2016[1-3].At present,the country is in the phase of preventing the re-establishment of malaria[4].However,travelers who contract the disease overseas in malaria endemic countries continue to present a constant risk of re-establishing malaria in Sri Lanka,where malaria-transmitting mosquitos is prevalent.In this context,robust measures are being implemented in the country to prevent re-establishment of malaria and to stop travelers infected with malaria progressing into severe disease and death.
文摘Dengue fever presents a significant and persistent public health challenge in Sri Lanka.The disease,transmitted by Aedes aegypti and Aedes albopictus mosquitoes,affects individuals across all age groups,with working populations and school-aged children at higher risk due to increased outdoor exposure[1].Dengue transmission in Sri Lanka is seasonal with two high transmission waves corresponding with the two monsoon rains every year.The estimated average annual incidence is 175/100000 population,and it was 407.5/100000 in 2023 with a case fatality rate of 0.07%[2].
文摘BACKGROUND The emergence of the Omicron variant(B.1.1.529)of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)raised global concerns with its highly transmissible nature.AIM To investigate the genomic,clinical,and demographic characteristics of Omicron infections within the early outbreak cluster in western part of Sri Lanka.METHODS We analyzed sequence data from January 2022 to April 2022 to understand variant dynamics,clinical presentation,and demographic associations.RESULTS Whole-genome sequencing of 85 nasopharyngeal and throat swab samples collected in western part of Sri Lanka between January and April 2022 identified 70(82.34%)of it as Omicron variants.BA.2 was the most prevalent sub-lineage(57%),followed by BA.1.1(14.20%)and majority of them were from>12 years old individuals.Phylogenetic analysis revealed clustering into four distinct clades(21I,21K,21L,and 21M),suggesting potential differences in transmission chains or evolutionary pressures.CONCLUSION This study found BA.2 to be the predominant Omicron sub-lineage in the western part of Sri Lanka during the first quarter of 2022,aligning with global trends.Phylogenetic analysis revealed diverse introductions and local transmission.Continued genomic surveillance and robust public health measures remain crucial for managing the evolving SARS-CoV-2 landscape.
文摘Two widespread bird species in Sri Lanka’s dry zone,Pycnonotus cafer(Red-vented Bulbul,RVBB)and Pycnonotus luteolus(White-browed Bulbul,WBBB),were studied to understand their foraging dynamics and ecology.The research was conducted from October 2022 to February 2023 in Mihintale Sanctuary(80.30′11.24″E,8.21′04.63″N)and the Faculty of Applied Sciences,Rajarata University of Sri Lanka(80.502206″E,8.353090″N).Data were obtained through focal sampling,opportunistic observations,and mist netting.Both species predominantly foraged on twigs,using gleaning as the dominant food-handling technique.RVBB foraged mostly at the canopy level,while WBBB foraged primarily at the sub-canopy level.Fruits constituted the major food type for both species.RVBB and WBBB utilized 10 and 7 plant species,respectively,with Grewia helicterifolia being the primary foraging plant.Minimal foraging was observed on Croton sp.(RVBB)and Hugonia mistax(WBBB).The correlation between nutritional components and the consumption of both species revealed a preference for foods with lower protein,higher fat,and ash content.There was no linear correlation between gape width and fruit size(r=-0.21,P=0.69)for both species.The standardized dietary niche breadth indicated both species are specialists,with a high pairwise dietary niche overlap(0.9854).These findings highlight the niche-specific foraging adaptations of RVBB and WBBB within Mihintale,emphasizing their distinct strategies in utilizing plant species,fruit sizes,and foraging heights.Understanding such ecological dynamics is essential for habitat conservation efforts and ensuring the availability of key foraging resources for these species in the dry zone.
文摘Remembrance activities can support the Culture of Care(CoC)in Laboratory Animal Science(LAS)not only by promoting a culture of respect,gratitude and thankfulness for animal life but also by helping the emotional processing and healing of lab animal researchers and animal facility staff.Even though remembrance activities are practiced in many parts of the world,we did not come across any reported cases in Sri Lanka before 2022.Therefore,here,we report on the various remembrance activities and practices observed within our local scientific community.
基金funded by the University of Colombo Research Grants,Sri Lanka(AP/3/2012/CG/15 and AP/3/2017/CG/27).
文摘The Ashy-headed Laughingthrush (Argya cinereifrons), a species endemic to Sri Lanka, has been historically considered a laughingthrush in the genus Garrulax. However, based on phylogenetic evidence, recent studies have suggested a new classification for the species under the genus Argya (true babblers). Despite the genetic signal showing affinity to true babblers Argya, as its common name suggests, the Ashy-headed Laughingthrush (AHLT) shows remarkable morphological similarities to other laughingthrushes of the Indo-Himalayan region. Here we attempted to address this incongruence in phenotypic and phylogenetic signals in this species by reconstructing the molecular phylogeny of babblers and comparing that with the key morphological, plumage, and vocal features of the two concerned groups. We hypothesized that the convergence of phenotype and vocalization of Garrulax in the wet evergreen forests of the Indian mainland and AHLT in the wet tropical rainforests of southern Sri Lanka has historically confused the taxonomists. The phylogenetic relationships were reconstructed using Bayesian inference using four mitochondrial and seven nuclear gene regions. The molecular phylogenetic tree placed the AHLT with India's Large Grey Babbler (A. malcolmi) as the sister taxon within the genus Argya. The hierarchical clustering based on body size, shape, plumage colour, and vocal properties resulted in the inconsistent placement of ALTH with babblers or laughingthrushes. Therefore, an incongruence in phenotype and genotype is observed. Our findings show that the convergent patterns of phenotypic evolution can confuse both historic and recent taxonomic delimitations in highly divergent groups such as Asian babblers.
文摘Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the outbreak.Methods:This retrospective study analyzed all samples tested for measles from 1st of May to 30th of November,2023 at National Measles Rubella Laboratory,Sri Lanka.According to the World Health Organization(WHO)algorithm,serum and oropharyngeal/nasopharyngeal swabs were tested with WHO recommended kits for anti-measles IgM and measles virus specific RNA,respectively.Selected RNA positive samples were sequenced at reference laboratory,India.Analysis of sequencing data and construction of phylogenetic tree were carried out at National Measles Rubella Laboratory.Data was analyzed using descriptive statistics.Results:Of the total 1132 serum samples and 497 oropharyngeal/nasopharyngeal swabs from 1326 patients,657(49.5%)patients were confirmed as measles by anti-measles IgM,measles virus specific RNA or both.Males(55.6%,n=365)and the age group from>20 to≤30 years(33.0%,n=217)predominated positive patients.All provinces reported measles positive cases.All samples sequenced(100%,n=42)were genotype D8 with 95.2%(n=40)bearing Victoria.Australia origin.Conclusions:We described resurgence of measles in an eliminated country,confirming the genotype to be D8,one of the two genotypes currently circulating globally.Further,the study strongly convinced the importance of a strengthened virological surveillance system in an eliminated country,despite its eliminated status.
文摘Objective:To evaluate the polio laboratory surveillance carried out from January,2019 to May,2023 by the Polio Regional Reference Laboratory,Sri Lanka.Methods:This retrospective study analyzed all stool samples received under the acute flaccid paralysis(AFP)and immunodeficient vaccine-derived poliovirus(VDPV)surveillance at Polio Regional Reference Laboratory,Sri Lanka from January,2019 to May,2023.The results of the testing methodologies were extracted from the laboratory data system,i.e.,poliovirus virus isolation,intra-typic differentiation/VDPV real time reverse transcriptase polymerase chain reaction(ITD/VDPV rRTPCR)and sequencing,along with the data on timing of reporting results,stool adequacy and socio-demographics.Data was analyzed using descriptive statistics.Results:A total of 2141 stool samples from 1644 cases were received for AFP surveillance from Sri Lanka(93.61%),Maldives(1.52%),and immunodeficient VDPV(4.86%)surveillance.Both polioviruses(19/1644,1.15%)and non-polio enteroviruses(73/1644,4.44%)were isolated,while Sabin-like 3 virus was detected in majority(12/19,63.15%)among the poliovirus isolated.Wild polioviruses or circulating VDPVs were not detected among the cases.During all years of the study,the non-polio AFP detection rate was>1/100000 in children aged less than 15 years,whereas stool adequacy rate was>80%.All results were reported within 14 days of receipt,ensuring timely reporting as per global guidelines.Conclusions:The Polio Regional Reference Laboratory,Sri Lanka plays a vital role in maintaining the polio-free status in the country through its robust laboratory surveillance,while adhering to the surveillance indicators.Non-detection of wild polioviruses and circulating VDPV during the study period reinforces the polio-free status in the country.
文摘Objective:To establish Nipah virus diagnostic capabilities at the National Reference Laboratory in Sri Lanka using the NIV Pune real-time PCR kit.Methods:Strict safety precautions were adhered during testing due to the high pathogenicity of the Nipah virus,with all diagnostics conducted in a BSL2+laboratory at the Medical Research Institute in Sri Lanka.RNA extraction was performed using the QIAamp Viral RNA Mini kit.The NIV Pune in-house real-time PCR kit was employed,following established primer/probe sequences and controls.The assay was validated using the Rotor-Gene Q Series Real-time PCR platform.Results:The validation run of the Nipah virus real-time PCR test demonstrated robust performance,with positive controls consistently detecting Nipah RNA at a Ct value of 21.50±0.01.Negative controls confirmed assay specificity with an external negative control which was also used as an extraction control and showed no interference.The internal control exhibited stable behavior,enhancing confidence in PCR results.The qPCR analysis graph illustrated the successful detection of internal and positive controls,validating the reliability of the assay.Conclusions:Establishing Nipah virus diagnostic capabilities in Sri Lanka signifies a proactive and collaborative response to the persistent global health threat.
文摘Objective:To assess the attitude and willingness of medical students of the Faculty of Medicine,University of Jaffna,regarding gamete donation.Methods:An institutional-based descriptive cross-sectional study was conducted at the Faculty of Medicine,University of Jaffna,from September 2022 to May 2023 among undergraduate medical students who gave their voluntary participation.A self-administered questionnaire was used as a study instrument to collect data regarding their attitude and willingness toward gamete donation.Results:A total of 345 participants were recruited and their sociodemographic data revealed that 56.8%of the participants were female,62.3%aged between 26 and 30 years,and 92.2%were unmarried.Many of them received information regarding gamete donations during their clinical appointments.Over half(67.8%)of them showed a negative attitude towards gamete donation.Regarding willingness,only 39.7%of participants had a positive approach for being a gamete donor;among them,84.7%preferred anonymous donations.Religion and ethnicity had a significant influence on their attitudes and willingness.In addition,male was also found to be more willing to donate gametes.Conclusions:Most medical students have negative views about gamete donation.Imparting awareness and knowledge of assisted reproductive technology and gamete donation within medical students'sociocultural and ethical backgrounds might facilitate a change in attitude towards gamete donation amongst future medical practitioners.
基金supported by the National Natural Science Foun-dation of Chinathe National Science Foundation of Sri Lanka(No.21861142020)+1 种基金the Alliance of International Science Orga-nizations Collaborative Research Program(No.ANSO-CR-KP-2020-05)the Program of China Sri Lanka Joint Research and Demonstration Center for Water Technology,China-Sri Lanka Joint Center for Education and Research,CAS.
文摘Groundwater is the main source of drinking water for the rural population in the chronic kidney disease of unknown etiology(CKDu)zone of the North Central Province(NCP)in Sri Lanka.In this study,a total of 334 groundwater samples(311 dug wells,21 tube wells and 2 springs)during the wet season from two aquifers in the NCP were collected,and inves-tigated their chemical characteristics and evaluate their water quality,including ground-water chemistry,main ion sources,the corrosion and scaling potential of groundwater.The results showed that the two hydrochemical types of groundwater in the NCP were mainly of the Ca-HCO_(3),Na·Ca-HCO_(3)types,with the main HCO_(3)−,Na^(+)and Ca^(2+)ions in both types of groundwater originating from silicate and evaporite salt dissolution and influenced by alternating cation adsorption,while the presence of NO_(3)−was mainly anthropogenic.Eval-uation ofwater stability using namely Langelier saturation index(LSI),Ryznar stability index(RSI),Puckorius scaling index(PSI)and Larson-Skold index(LS),indicated that most ground-water presents corrosion potential and has corrosion behavior tendency of metals to some degrees.The water quality of Polonnaruwa was better than that of Anuradhapura in the NCP,and when the groundwater was worse than the“good”grade,which must be properly treated before it is used as drinking water.
文摘Over recent decades, Gampaha district, Sri Lanka, has experienced significant urbanisation and industrial growth, increasing groundwater demand due to limited and polluted surface water resources. In 2013, a community uprising in Rathupaswala, a village in Gampaha district, accused a latex glove manufacturing factory of causing groundwater acidity (pH < 4). This study evaluates the spatial and temporal changes in geochemical parameters across three transects in the southern part of Gampaha district to 1) assess the impact of geological formations on groundwater;2) compare temporal variations in groundwater;and 3) explain acidification via a geochemical model. Seventy-two sample locations were tested for pH, electrical conductivity (EC), and anion concentrations (sulphate, nitrate, chloride and fluoride). Depth to the water table and distance from the sea were measured to study variations across sandy, peaty, lateritic, and crystalline aquifers. Results showed pH readings around 7 for sandy and crystalline aquifers, below 7 for peaty aquifers, and below 5 for lateritic aquifers, with significant water table fluctuations near Rathupaswala area. Principal component analysis revealed three principal components (PCs) explaining 86.0% of the variance. PC1 (40.6%) correlated with pH, EC, and sulphate (saltwater intrusion), while PC2 (32.0%) correlated with nitrates and depth to the water table (anthropogenic nutrient pollution). A geochemical transport model indicated a cone of depression recharged by acidic groundwater from peat-soil aquifers, leading to acidic groundwater in Rathupaswala area. Previous attributions of acidic pH to the over-exploitation of groundwater by the latex factory have been reevaluated;the results suggest natural acidification from prolonged water-rock interactions with iron-rich lateritic aquifers. Groundwater pH is influenced by local climate, geology, topography, and drainage systems. It is recommended that similar water-rock interaction conditions may be present throughout the wet zone of Sri Lanka, warranting detailed studies to confirm this hypothesis.
基金supported by the World Bank under the Accelerating Higher Education Expansion and Development Grant(AHEAD)(Grant No.AHEAD/RA3/DOR/AGRI/PERA-No16).
文摘Copper(Cu)is an essential micronutrient for rice.However,the current status of Cu in Sri Lankan paddy soils is not known.Therefore,the current study was conducted to determine the distribution of exchangeable Cu concentration and examine the interactive effects of the agro-climatic zone(ACZ),soil order,and water source in determining the exchangeable Cu concentration in lowland paddy fields in Sri Lanka.A total of 7,544 soil samples representing six ACZs,six soil orders,and three water sources were collected using a stratified random sampling approach.Soil exchangeable Cu fraction was extracted in 0.01 M CaCl_(2)and measured using Inductively Coupled Plasma Mass Spectrophotometry.Exchangeable Cu concentration was in the range of 0.04−728μg·kg^(−1)with a mean value of 62.4μg·kg^(−1).Only 5%of the soil samples tested had Cu concentration greater than 200μg·kg^(−1)indicating a widespread Cu deficiency in Sri Lankan paddy fields(i.e.critical level causing Cu deficiency;200-300μg·kg^(−1)).Among the climatic zones Wet zone had higher and the Dry zone had lower Cu concentrations.Among the soil orders,histosols had higher and alfisols had lower Cu concentrations.Water sources used for rice cultivation did not determine Cu concentration.Moreover,Cu concentration was positively correlated with soil pH.As most of the soil samples were deficient in soil exchangeable Cu,spatial maps generated in the current work could be used to develop ACZ and soil order-specific agronomic and management strategies to improve soil Cu fertility status.
文摘Objectives:Cardiovascular disease(CVD)in low and middle-income countries(LMICs),accounts for over 80%of global CVD-related deaths.The high cost of drugs is a major concern in not of managing CVD.This study aimed to conduct a comprehensive review to identify interventions for cost containment of cvD drugs and use the inter-vention scalability assessment tool(ISAT)to examine the acceptability and application of relevant interventions in the Sri Lankan context,that can also be adaptable to other LMICs.Methods:A systematic search across three databases(Medline,Web of Science and Embase)was completed to identify relevant health system interventions.The ISAT assessed the feasibility of adapting the identified interven-tions to Sri Lanka,using structured interviews with 25 Sri Lankan stakeholders representing five groups:health managers,cardiologists,pharmacists,nursing officers,and patients.Results:The search yielded nine publications.Five were conducted on a national scale,while others were con-ducted at the regional levels.Seven were published in developed countries.The identified interventions were categorised into six intervention themes:Imposing a ceiling price or reference price;introduction of the polypill;introduction of volume price contract initiatives;prescribing generic and essential drugs;one intervention pack-age including generics,essential medicine,90-day drugs,and free delivery;and a second intervention package including discounts,rebates,cost-free medicine,and bundling.Assessment of six intervention themes revealed that methods of setting ceiling prices and controlling generic drug prescribing were the most popular,while other interventions were least popular..Conclusions:The study provides a roadmap for future interventions based on successful scaling,emphasizing the importance of understanding contextual variables and encourages stakeholder participation in policy assessments and advocacy.The findings highlighted the potential for enhancing the access to affordable CVD drugs not only in Sri Lanka,but also adaptable to other LMICs.These outcomes can contribute to policy decisions,aimed at reducing the significant global burden of CVD.
基金the financial support provided by Sadaharitha Plantations Ltdservices provided by Wescorp Sandalwood Ltd
文摘Santalum album （Indian Sandalwood） is found in the mountainous regions of the intermediate zone of Sri Lanka. Few studies have been conducted on sandalwood ecology in this region, and ours is the first recorded study of essential oil content and chemical composition of heartwood. We harvested two trees with State permission and took cross-sections for analysis. We demonstrated a difference in the heartwood formation and oil yield of the trees. The composition of the oil was found to be consistent between trees and along the trunk of the tree. Main aromatic compounds were santalols and other compounds are recorded in lesser quantities. Results of this study comply with the other published work on sandalwood elsewhere. This initial study on S. album in Sri Lanka provided promising results for the future of sandalwood agroforestry.
基金University of Moratuwa,Sri Lanka for providing the financial support for this research
文摘The demand for fresh water in Hambantota District, Sri Lanka is rapidly increasing with the enormous amount of ongoing development projects in the region. Nevertheless, the district experiences periodic water stress conditions due to seasonal precipitation patterns and scarcity of surface water resources.Therefore, management of available groundwater resources is critical, to fulfil potable water requirements in the area. However, exploitation of groundwater should be carried out together with artificial recharging in order to maintain the long term sustainability of water resources. In this study, a GIS approach was used to delineate potential artificial recharge sites in Ambalantota area within Hambantota. Influential thematic layers such as rainfall, lineament, slope, drainage, land use/land cover, lithology, geomorphology and soil characteristics were integrated by using a weighted linear combination method. Results of the study reveal high to moderate groundwater recharge potential in approximately 49% of Ambalantota area.
文摘In this paper,we assess the role of investment in research and development(R&D)and economic policy uncertainty(EPU)in Sri Lanka’s economic growth experience.We do this by first determining which endogenous growth theories best explain the evolution of total factor productivity(TFP)in the country.Using historical time series data(1980–2018),we find that semi-endogenous growth theories best explain the evolution of TFP in Sri Lanka.This evidence suggests that R&D is critical to the country’s TFP expansion.We find that,through R&D,EPU has a crucial detrimental impact on TFP growth,although it is short-lived.Our findings are robust and have important implications for R&D investment and for moderating EPU.
文摘The sting of Giant Asian honeybee(Apis dorsata) or Bambara in Sinhala and Kanmge Kulavi in Tamil is a common environmental hazard in Sri Lanka known to cause immediate allergic reactions,which could be fatal in sensitized individuals.We reported myocardial infarction, bowel gangrene and fatal anaphylaxis in a prospectively proven case series and the association of these uncommon complications with delayed removal of stingers from the patients’skin.
