Search Results (1,188)

Background/Objectives: Monitoring human papillomavirus (HPV) vaccine coverage worldwide can provide valuable insight into cervical cancer prevention. The aim of this manuscript was to assess the HPV vaccination coverage among the primary target cohort (9–14-year-old girls) in the world from 2010 to 2024. Methods: A descriptive epidemiological study (with an ecological study design) was carried out. Trends in HPV vaccination coverage were examined using the joinpoint regression analysis. Results: The HPV vaccination was introduced into the national schedule of 147 countries in 2024. Globally, coverage with the first dose of the HPV vaccine in the primary target cohort (9–14-year-old girls) was estimated at 56.9% in 2024. The growth trend in HPV vaccination coverage was significant mainly in the most developed countries (e.g., such as the USA, Canada and Germany), while trends were 10 times faster in other countries such as Armenia, Indonesia and Tanzania. A decline in trends of HPV vaccination coverage was significant in some developing countries (e.g., such as Panama, Sri Lanka, and Suriname) and in one of the most developed countries—the United Kingdom. Conclusions: A better understanding of changes in HPV vaccination coverage worldwide and further efforts to improve coverage to the target of 90% may contribute to more effective disease prevention. Full article

Late-stage cancer diagnoses of prevalent cancers are increasing in the Northern Province of Sri Lanka, a region currently rebuilding its healthcare system after a prolonged civil war. In this region, cancer prevention services are limited. We describe a community-centric approach to cancer education and prevention as a strategy to cancer control in this rural, post-conflict region. Nursing students were trained as Community Cancer Educators (CCEs), equipping them with essential knowledge about cancer symptoms, risk factors, and the importance of early detection. The training also included creative methods such as dance and drama to help CCEs communicate cancer-related messages in an engaging and culturally relevant manner. These CCEs supported the oncologist-led community health camps in delivering cancer education and screening directly to community members within their community. We planned the health camps in collaboration with the existing community-based public health system for better outreach. Feedback from community participants and healthcare providers suggests that this community-centric approach can improve cancer awareness, encourage participation in population screening, and support early cancer detection. This approach could strengthen community engagement and contribute to more equitable access to prevention and screening services in rural, post-conflict settings with limited healthcare infrastructure. Full article

This paper compares national hydrogen (H₂) infrastructure plans in Canada, the United States (the USA), Singapore, and Sri Lanka, four countries with varying geographic and economic outlooks but shared targets for reaching net-zero emissions by 2050. It examines how each country approaches hydrogen production, pipeline infrastructure, policy incentives, and international collaboration. Canada focuses on large-scale hydrogen production utilizing natural resources and retrofitted natural gas pipelines supplemented by carbon capture technology. The USA promotes regional hydrogen hubs with federal investment and intersectoral collaboration. Singapore suggests an innovation-based, import-dominant strategy featuring hydrogen-compatible infrastructure in a land-constrained region. Sri Lanka maintains an import-facilitated, pilot-scale model facilitated by donor funding and foreign collaboration. This study identifies common challenges such as hydrogen embrittlement, leakages, and infrastructure scalability, as well as fundamental differences based on local conditions. Based on these findings, strategic frameworks are proposed, including scalability, adaptability, partnership, policy architecture, digitalization, and equity. The findings highlight the importance of localized hydrogen solutions, supported by strong international cooperation and international partnerships. Full article

This paper examines the quotative system of Sri Lankan English. Quotatives are identified in face-to-face conversations in the Sri Lankan component of the International Corpus of English. The use of kiyala indicating and following quoted material has been transferred from Sinhala, one of the indigenous languages of the country, into Sri Lankan English. Together with the occurrence of complementising that, the localisation of the Sri Lankan English quotative system is evident. Special emphasis is given to the choice between BE like and SAY, the by far most frequent quotative forms in the informal spoken data analysed. They are annotated with established structural (e.g., content of the quote or tense) and sociobiographic variables (e.g., age and gender of the speaker) apparent from earlier quotative research, but also with new ones (e.g., quote length or speakers’ stays abroad or media exposure to particular varieties of English). Via a generalised linear mixed-effects model tree implementing the latest methodological suggestions for classification trees, it is found that BE like is favoured over SAY in Sri Lankan English with younger speakers—particularly when the conversation took place after 2015 and events are narrated using the historical present. Full article

With the intensification of global climate change, extreme weather events increasingly threaten water resources and agricultural systems. This study focuses on the Naoli River Basin, employing the Standardized Precipitation Actual Evapotranspiration Index (SPAEI), the Standardized Runoff Index (SRI), and the Standardized Surface Moisture Index (SSMI) to assess the spatiotemporal variability of meteorological, hydrological, and agricultural droughts. Drought events are identified based on travel time theory, and joint distributions of drought characteristics are modeled using optimized two- and three-dimensional copula functions. Lagged correlation and Bayesian conditional probability analyses are used to explore drought propagation processes. Key findings include (1) the SWAT model showed strong runoff simulation performance (R² > 0.75, NSE > 0.97), while the PLUS model achieved high land use simulation accuracy (overall accuracy > 0.93, Kappa > 0.85); (2) future projections suggest continued forest expansion and farmland decline, with water areas increasing under SSP245 and urban areas expanding under SSP585; (3) five CMIP6 models with high skill (r = 0.80, RMSE = 26.15) were selected via a Taylor diagram for scenario simulation; (4) copula-based joint drought probabilities vary temporally, with meteorological drought risks increasing under long-term moderate-emission scenarios, while hydrological and agricultural droughts show contrasting trends; (5) and under extreme meteorological drought, the conditional probability of extreme agricultural drought doubles from 0.12 (SSP245) to 0.24 (SSP585), indicating heightened vulnerability under high-emission pathways. These results offer critical insights for regional drought risk assessment and adaptive management under future climate scenarios. Full article

Dispute resolution significantly enhances construction performance as it facilitates effective time, cost, quality and scope management, which may be disrupted in the presence of conflicts and disputes. Quantity Surveyors (QSs) play multiple roles in construction and act as contract administrators. Yet, dispute resolution was not formally adapted into the profession of QS in the Sri Lankan green construction sector to a considerable extent. Therefore, this study explores the extent to which construction companies have adopted ADR (Alternative Dispute Resolution) methods, human skills required for QSs in effective dispute resolution, and the impact of QSs involvement in ADR on the organizational performance, following a quantitative analysis. The research outcomes mainly discovered possibilities of utilizing ADR for the purpose of reducing carbon emissions and energy consumption in Sri Lankan green building construction through QSs involvement. While identifying essential human skills and competencies required for QSs in handling disputes, this study further exposed a slightly significant traditional gender domination in the QSs’ involvement towards ADR, common occurrences of disputes in green building projects, and a significant relationship between QSs’ experience and their involvement in disputes. The recommendations include enhancement of QSs’ involvement in ADR for green construction through developing policies and formalities, providing sufficient ADR- and green construction-related training, encouraging female participation in green construction, and collaborative dispute resolution. Full article

Background/Objectives: This study aimed to assess whether income was associated with dental caries experience and dental care levels among 12-year-old children in two contrasting economic contexts, Sri Lanka (lower-middle-income) and Wales (high-income), regardless of national income status. Methods: An ecological study design was used with published data. For Sri Lanka, the income parameters used included household income, mean per capita income, and the Gini coefficient. For Wales, the Welsh Index of Multiple Deprivation was used. Dental caries was assessed using the DMFT index and its components (DT, MT, FT), while dental care was assessed using the care index, restorative index, and treatment index. Pearson correlations were used to explore associations between income measures and both caries experience and dental care indices across districts in Sri Lanka and unitary authorities in Wales. Results: The mean DMFT for 12-year-old children was 0.6 in both Sri Lanka and Wales, with caries prevalence of 30.4% and 29.6%, respectively. In Sri Lanka, both mean household income and per capita income showed moderate, statistically significant positive correlations with DMFT (r = 0.47, p = 0.01). Income inequality, measured by the Gini coefficient, was positively associated with caries experience (r = 0.42, p = 0.03). In Wales, higher deprivation (lower income) was moderately associated with increased DMFT, in areas within the 20% (r = 0.54, p < 0.01), 30% (r = 0.53, p < 0.01), and 50% (r = 0.61, p < 0.01) deprived quintiles. The dental care indices showed no clear association with income in either of the countries. Conclusions: Income-related disparities in dental caries were evident in both countries. Prevention strategies should focus on higher-income groups in Sri Lanka and on deprived populations in Wales. However, as this was an ecological study, the results are subject to ecological fallacy and should therefore be interpreted with caution. Full article

Mangroves in Sri Lanka provide critical ecosystem services, yet they have undergone significant changes due to anthropogenic and natural drivers. This study presents the first national-scale assessment of mangrove dynamics in Sri Lanka using remote sensing techniques. A total of 4670 Landsat images from Landsat 5, 7, 8, and 9 were selected to detect mangrove distribution, changes in extent, and structure and stability patterns from 1987 to 2022. A Random Forest classification model was applied to elucidate the spatial changes in mangrove distribution in Sri Lanka. Using national-scale data enhanced mapping accuracy by incorporating region-specific spectral and ecological characteristics. The average overall accuracy of the maps was over 96.29%. The total extent of mangroves in 2022 was 16,615 ha, representing 0.25% of the total land of Sri Lanka. The results further indicate that, at the national scale, mangrove extent increased from 1989 to 2022, with a net gain of 1988 ha (13.6%), suggesting a sustained and continuous recovery of mangroves. Provincial-wise assessments reveal that the Eastern and Northern Provinces showed the largest mangrove extents in Sri Lanka. In contrast, the Colombo, Gampaha, and Kalutara districts in the Western Province showed persistent declines. The top mangrove spatial structure and stability districts were Jaffna, Trincomalee, and Gampaha, while the most degraded mangrove districts were Batticaloa, Colombo, and Kalutara. This study offers critical insights into sustainable mangrove management, policy implementation, and climate resilience strategies in Sri Lanka. Full article

Objective: Stroke is one of the leading causes of death and disability worldwide. Compared to developed countries, the prognosis of stroke is less favourable in developing countries. The objective of this study is to identify inter-ethnic variation in risk profiles and stroke outcomes amongst Bangladeshi, Indian, Nepalese, Pakistani, and Sri Lankan expatriates living in Qatar. Methods: Data from the Qatar Stroke Registry were retrospectively analyzed from April 2014 to June 2025. A total of 8825 patients were included. The chi-square test was used to analyze sociodemographic variables, while the Kruskal–Wallis test was used to analyze continuous variables. Post hoc analysis was performed. Multivariate logistic regression and multivariate multiple regression were used to identify the predictors associated with poor clinical outcomes and mortality at 90 days. Results: Ischemic stroke was the predominant stroke type in all groups, with Nepalese patients presenting with stroke at a younger age, whilst Pakistanis tended to be older (p < 0.001). In terms of stroke outcomes, Nepalese patients had the highest proportion of a poor functional outcome at 90 days as well as NIHSS at discharge (p < 0.05). However, Bangladeshis had the highest proportion of mortality at 90 days compared to the other cohorts. Multivariable logistic regression revealed that undiagnosed dyslipidemia, Nepalese ethnicity, and moderate and severe NIHSS admission scores were independent predictors of a poor functional outcome at 90 days, whilst male sex and prior antidiabetic therapy were protective factors (p < 0.001). In terms of mortality at 90 days, only a severe NIHSS admission score (>10) was a significant predictor (p < 0.001). A severe NIHSS admission score was also the only predictive factor of mortality and poor functional outcome at 90 days (p < 0.05). Conclusions: There was a significant variation in stroke presentation and outcomes among South Asian subpopulations in Qatar, suggesting the importance of tailored public health strategies as a uniform approach to stroke care is insufficient for this diverse population. Full article

This study develops and operationalizes a multi-dimensional framework for sustainable building retrofit that aligns with national 2050 net-zero objectives. First, we conduct a scoping review of international standards (e.g., ISO), sustainability reporting guidelines (GRI G4), and peer-reviewed studies to define an indicator system spanning three pillars—environmental (carbon neutrality, resource circulation, pollution management), social (habitability, durability/safety, regional impact), and economic (direct support, deregulation). Building on this structure, we propose a transparent 0–3 rubric at the sub-indicator level and introduce the Sustainable Building Retrofit Index (SRI) to enable cross-case comparability and over-time monitoring. We then apply the framework to seven countries (United States, Canada, United Kingdom, France, Germany, Japan, and South Korea), score their retrofit systems/policies, and synthesize results through radar plots and a composite SRI. The analysis shows broad emphasis on carbon neutrality and habitability but persistent gaps in resource circulation, pollution management, regional impacts, and deregulatory mechanisms. For South Korea, policies remain energy-centric, with relatively limited treatment of resource/pollution issues and place-based social outcomes; economic instruments predominantly favor direct financial support. To address these gaps, we propose (i) life-cycle assessment (LCA)–based reporting that covers greenhouse gas and six additional impact categories for retrofit projects; (ii) a support program requiring community and ecosystem-impact reporting with performance-linked incentives; and (iii) targeted deregulation to reduce uptake barriers. The paper’s novelty lies in translating diffuse sustainability principles into a replicable, quantitative index (SRI) that supports benchmarking, policy revision, and longitudinal tracking across jurisdictions. The framework offers actionable guidance for policymakers and a foundation for future extensions (e.g., additional countries, legal/municipal instruments, refined weights). Full article

Background: Metabolic diseases, like type 2 diabetes mellitus and obesity, show a growing public health concern in Sri Lanka. Genetic predisposition and diet contribute to metabolic disease risk, but there are limited investigations into the impact of gene–diet interactions on metabolic disease risk in the Sri Lankan population. In this study, we examined whether a metabolic genetic risk score (GRS), constructed from 10 single nucleotide polymorphisms (SNPs), interacts with dietary factors to influence metabolic health indicators in Sri Lankan adults. Methods: This cross-sectional study included 105 generally healthy adults aged 25–50 years from the GOOD (Genetics of Obesity and Diabetes) study. Anthropometric, biochemical, and dietary data using food frequency questionnaires were collected using validated methods. Genotyping was performed using the KASP^® assay. The unweighted GRS was calculated by summing risk alleles across 10 SNPs in the TCF7L2, CAPN10, FTO KCNJ11, and MC4R genes. Gene–diet interaction analysis was conducted using regression models adjusted for confounders. Results: A statistically significant interaction was identified between the 10-SNP metabolic GRS and polyunsaturated fatty acid (PUFA) intake on waist circumference (P_{(interaction)} = 0.00009). Participants with a high GRS (≥6 risk alleles) and higher PUFA intake (≥3.1 g/day) exhibited significantly lower waist circumference (p = 0.047). Conclusions: This study provides novel insights to understand gene–diet interactions affecting metabolic traits in Sri Lankans. The findings suggest that higher PUFA intake may mitigate genetic susceptibility to central obesity, highlighting the importance of personalized dietary recommendations for metabolic disease prevention. Further studies in larger cohorts are warranted to confirm this finding. Full article

Rice is a staple crop for over half the world’s population, and accurate, timely information on its planted area and production is crucial for food security and agricultural policy, particularly in developing nations like Sri Lanka. However, reliable rice monitoring in regions like Sri Lanka faces significant challenges due to frequent cloud cover and the fragmented nature of smallholder farms. This research introduces a novel, cost-effective method for mapping rice-planted area and yield at field scales in Sri Lanka using optical satellite data. The rice-planted fields were identified and mapped using a phenologically tuned image classification algorithm that highlights rice presence by observing water occurrence during transplanting and vegetation activity during subsequent crop growth. To estimate yields, a random forest regression model was trained at the district level by incorporating a satellite-derived chlorophyll index and environmental variables and subsequently applied at the field level. The approach has enabled the creation of two decades (2000–2022) of reliable, field-scale rice area and yield estimates, achieving map accuracies between 70% and over 90% and yield estimates with less than 20% error. These highly granular results, which are not available through traditional surveys, show a strong correlation with government statistics. They also demonstrate the advantages of a rule-based, phenology-driven classification over purely statistical machine learning models for long-term consistency in dynamic agricultural environments. This work highlights the significant potential of remote sensing to provide accurate and detailed insights into rice cultivation, supporting policy decisions and enhancing food security in Sri Lanka and other cloud-prone regions. Full article

The common krait (Bungarus caeruleus) and the endemic Sri Lankan krait (B. ceylonicus) are two species of krait responsible for envenomings in Sri Lanka that result in progressive neuromuscular paralysis. We characterised the in vitro neurotoxicity of B. ceylonicus and B. caeruleus venoms and studied their neutralisation by two commercially available Indian polyvalent antivenoms (i.e., VINS and BHARAT), Thai banded krait antivenom and Australian polyvalent antivenom using the chick biventer cervicis nerve-muscle preparation. Both venoms displayed concentration-dependent neurotoxicity, showing equipotent pre-synaptic neurotoxicity at 0.03 μg/mL. At a higher concentration (1 μg/mL), both venoms showed post-synaptic neurotoxicity, with B. ceylonicus venom being more potent. VINS was unable to neutralise the neurotoxicity of B. ceylonicus venom, but neutralised both pre- and post-synaptic neurotoxicity of B. caeruleus venom. BHARAT neutralised in vitro pre- and post-synaptic activity of both B. ceylonicus and B. caeruleus venoms. Banded krait antivenom and Australian polyvalent antivenoms were unable to fully neutralise the neurotoxicity of either venom at tested concentrations. In conclusion, B. ceylonicus venom shows pre- and post-synaptic neurotoxicity similar to B. caeruleus venom. BHARAT effectively neutralises both pre- and post-synaptic neurotoxicity of B. ceylonicus venom. Both Indian polyvalent antivenoms effectively neutralise neurotoxicity induced by B. caeruleus venom. Full article

This article explores the relationship between corporate financial performance (CFP) and commitment to ESG (environmental, social and governance) practices, using a sample of companies listed on the S&P 500 and TSX 60 indices. By employing a linear regression model, the study examines how financial indicators such as Earnings Before Interest, Taxes, Depreciation and Amortization (EBITDA), return on assets (ROA), Assets and Debt influence ESG scores. The results show that financial indicators such as EBITDA, ROA and Assets are positively associated with increased ability to commit resources to ESG practices, except in some cases like when costs associated with ESG initiatives can reduce the competitiveness and profitability of companies in the short term, where ROA is negatively correlated with the adoption of ESG criteria. Also, with regard to the size of companies, thanks to their greater resources, larger companies are more inclined to adopt ESG criteria. These findings enhance the understanding of financial conditions that enable or constrain ESG adoption and provide managerial insights for strategic resource allocation in the pursuit of sustainability goals. Full article

A comprehensive analysis of the molecular epidemiology of SARS-CoV-2 in the Kandy District of Sri Lanka from November 2020 to March 2022 was conducted to address the limited genomic surveillance data available across the country. The study investigated the circulating SARS-CoV-2 lineages, their temporal dynamics, and the associated mutational profiles in the study area. A total of 280 SARS-CoV-2-positive samples were selected, and 252 complete genomes were successfully sequenced using Oxford Nanopore Technology. Lineage classification was performed using the EPI2ME tool, while phylogenetic relationships were inferred through maximum likelihood and time-scaled phylogenetic trees using IQ-TREE2 and BEAST, respectively. Amino acid substitutions were analyzed to understand lineage-specific mutation patterns. Fifteen SARS-CoV-2 lineages were identified, and of those B.1.411 (36%) was the most prevalent, followed by Q.8 (21%), AY.28 (9.5%), and the Delta and Omicron variants. The lineage distribution showed a temporal shift from B.1.411 to Alpha, Delta, and finally the Omicron, mirroring the global trends. Time to the most recent common ancestor analyses provided estimates for the introduction of major variants, while mutation analysis revealed the widespread occurrence of D614G in the spike protein and lineage-specific mutations across structural, non-structural, and accessory proteins.Detection of the Epsilon variant (absent in other national-level studies) in November 2020, highlighted the regional heterogeneity viral spread. This study emphasizes the importance of localized genomic surveillance to capture the true diversity and evolution of SARS-CoV-2, to facilitate containment strategies in resource-limited settings. Full article