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Article ; Online: Development of metaphors to explain cognitive behavioural principles for patients with medically unexplained symptoms in Sri Lanka.

Sumathipala, Athula

The International journal of social psychiatry

2014 Volume 60, Issue 2, Page(s) 117–124

Abstract: Background: Medically unexplained symptoms (MUS) are common in primary care across cultures, accounting for high consultations with multiple providers and unnecessary investigations. Cognitive behavioural therapy (CBT) is efficacious for MUS and reduces ...

Abstract	Background: Medically unexplained symptoms (MUS) are common in primary care across cultures, accounting for high consultations with multiple providers and unnecessary investigations. Cognitive behavioural therapy (CBT) is efficacious for MUS and reduces physical symptoms, psychological distress and disability. Two intervention trials by the author and his group remain the only reported trials from the developing world. Material: A treatment package was designed by modifying a CBT model. The modifications were innovative use of locally relevant appropriate language and strategies that were simple enough while conforming to the CBT principles. The aim was to convey the principles of CBT to people using simple techniques--using metaphor. These are described in the paper as generic metaphors that could be used to explain the CBT principles and specific ones for patients with MUS. Discussion: Metaphor is an effective clinical tool. The author's clinical experience and patients' feedback suggest that these metaphors are helpful in conveying the CBT principles to patients. To develop metaphors appealing to the client and effective clinically, carrying out qualitative research among patients' explanatory model is an important prerequisite. The generic and MUS-specific metaphors reported here should be tried in other cultural and clinical settings and evaluated. Further systematic work including qualitative work for consensus evaluation among CBT experts as well as opinion on user-friendliness of these techniques tested among CBT practitioners will be needed.
MeSH term(s)	Cognitive Therapy/methods ; Developing Countries ; Humans ; Metaphor ; Somatoform Disorders/psychology ; Somatoform Disorders/therapy ; Sri Lanka ; Surveys and Questionnaires ; Treatment Outcome
Language	English
Publishing date	2014-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3062-4
ISSN	1741-2854 ; 0020-7640
ISSN (online)	1741-2854
ISSN	0020-7640
DOI	10.1177/0020764012467897
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Article: Contextualizing protein representations using deep learning on protein networks and single-cell data.

Li, Michelle M / Huang, Yepeng / Sumathipala, Marissa / Liang, Man Qing / Valdeolivas, Alberto / Ananthakrishnan, Ashwin N / Liao, Katherine / Marbach, Daniel / Zitnik, Marinka

bioRxiv : the preprint server for biology

2024

Abstract: Understanding protein function and developing molecular therapies require deciphering the cell types in which proteins act as well as the interactions between proteins. However, modeling protein interactions across diverse biological contexts, such as ... ...

Abstract	Understanding protein function and developing molecular therapies require deciphering the cell types in which proteins act as well as the interactions between proteins. However, modeling protein interactions across diverse biological contexts, such as tissues and cell types, remains a significant challenge for existing algorithms. We introduce Pinnacle, a flexible geometric deep learning approach that is trained on contextualized protein interaction networks to generate context-aware protein representations. Leveraging a human multi-organ single-cell transcriptomic atlas, Pinnacle provides 394,760 protein representations split across 156 cell type contexts from 24 tissues and organs. Pinnacle's contextualized representations of proteins reflect cellular and tissue organization and Pinnacle's tissue representations enable zero-shot retrieval of the tissue hierarchy. Pretrained Pinnacle's protein representations can be adapted for downstream tasks: to enhance 3D structure-based protein representations for important protein interactions in immuno-oncology (PD-1/PD-L1 and B7-1/CTLA-4) and to study the effects of drugs across cell type contexts. Pinnacle outperforms state-of-the-art, yet context-free, models in nominating therapeutic targets for rheumatoid arthritis and inflammatory bowel diseases, and can pinpoint cell type contexts that predict therapeutic targets better than context-free models (29 out of 156 cell types in rheumatoid arthritis; 13 out of 152 cell types in inflammatory bowel diseases). Pinnacle is a graph-based contextual AI model that dynamically adjusts its outputs based on biological contexts in which it operates.
Language	English
Publishing date	2024-01-18
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.07.18.549602
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Article ; Online: Under-representation of low and middle income countries (LMIC) in the research literature: Ethical issues arising from a survey of five leading medical journals: have the trends changed?

Woods, William Aidan / Watson, Matthew / Ranaweera, Sandali / Tajuria, Gulshan / Sumathipala, Athula

Global public health

2023 Volume 18, Issue 1, Page(s) 2229890

Abstract: Despite many initiatives taken by funding bodies and health care organisations, the 10/90 gap in health care and health system research between low and middle-income countries (LIMC) and high income countries is still widely recognised. We aimed to ... ...

Abstract	Despite many initiatives taken by funding bodies and health care organisations, the 10/90 gap in health care and health system research between low and middle-income countries (LIMC) and high income countries is still widely recognised. We aimed to quantify the contribution of LMIC in high impact medical journals and compare the results with the previous survey conducted in 2000. Research articles were anaylsed to determine the origin of data and authorship affiliated countries in a calendar year (2017) for five journals: British Medical Journal, The Lancet, New England Journal of Medicine (NEJM), Annals of Internal Medicine and the Journal of the American Medical Association. Contributing countries were categorised into four regions; USA, UK, Other Euro-American countries (OEAC) and rest of the world (RoW). A total of 6491 articles were categorised where USA, UK and OEAC contributed 39.7%, 28.5% and 19.9% respectively. RoW countries contributed 11.9% of articles surveyed. The Lancet and NJEM had the highest numbers from RoW with 22.1% and 17.3% respectively. After 17 years, the trend remained comparable with the original survey carried out in 2000. RoW contributions increased from 6.5% to only 11.9% of the published articles from countries accounting for 88.3% of the world's population.
MeSH term(s)	Humans ; Developing Countries ; Periodicals as Topic ; Authorship ; Income
Language	English
Publishing date	2023-07-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2234129-8
ISSN	1744-1706 ; 1744-1706
ISSN (online)	1744-1706
ISSN	1744-1706
DOI	10.1080/17441692.2023.2229890
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Article ; Online: Posttraumatic stress and co-occurrence of mental health problems in Sri Lankan adolescents.

Ponnamperuma, Thyagi / Sumathipala, Athula / Siribaddana, Sisira

Asian journal of psychiatry

2020 Volume 54, Page(s) 102444

Abstract: A significant minority (5 %) of adolescents develop posttraumatic stress disorder (PTSD) after trauma exposure. These adolescents are likely to experience many other mental health problems and have related impaired functioning. This study examined the co- ...

Abstract	A significant minority (5 %) of adolescents develop posttraumatic stress disorder (PTSD) after trauma exposure. These adolescents are likely to experience many other mental health problems and have related impaired functioning. This study examined the co-occurrence of Emotional and Behavioral Problems (EBP) with PTSD symptoms and investigated the effect of PTSD symptoms on EBP-related impaired functioning. The initial sample (T1) comprised 729 Sri Lankan adolescents, age 12-16 years, living in an area impacted by the 2004 tsunami. In 2008, participants (T1) completed measures of trauma exposure, PTSD symptoms, EBP and related functional impairment. Sixteen months later a subsample of 90 adolescents (T2) underwent diagnostic interview for PTSD and co-occurrence of mental health morbidity. In the 58.2 % of the T1 sample reporting any trauma exposure, 23.7 % met criteria for full or partial PTSD. Among all participants, 13.4 % had borderline to abnormal levels of EBP. EBP was significantly higher among PTSD-positive participants compared to PTSD-negative and non-traumatized subgroups (p < 0.001). In the T2 sample, all four cases with diagnosed PTSD had coexisting psychological problems. Further, PTSD symptoms exacerbated the impact of EBP on functional impairment. Findings support the conclusion that researchers and practitioners should be alert to EBP among trauma-exposed adolescents, because such general psychological problems are common and, in combination with PTSD symptoms, are associated with even greater impairment. Moreover, identifying the presence of these trauma associated problems is of crucial clinical importance.
MeSH term(s)	Adolescent ; Child ; Humans ; Mental Health ; Problem Behavior ; Stress Disorders, Post-Traumatic/epidemiology ; Tsunamis
Language	English
Publishing date	2020-10-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2456678-0
ISSN	1876-2026 ; 1876-2018
ISSN (online)	1876-2026
ISSN	1876-2018
DOI	10.1016/j.ajp.2020.102444
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Article ; Online: All you Need is Trust? Public Perspectives on Consenting to Participate in Genomic Research in the Sri Lankan District of Colombo.

Jayasinghe, Krishani / Chamika, W A S / Jayaweera, Kaushalya / Abhayasinghe, Kalpani / Dissanayake, Lasith / Sumathipala, Athula / Ives, Jonathan

Asian bioethics review

2023 Volume 16, Issue 2, Page(s) 281–302

Abstract: Engagement with genomic medicine and research has increased globally during the past few decades, including rapid developments in Sri Lanka. Genomic research is carried out in Sri Lanka on a variety of scales and with different aims and perspectives. ... ...

Abstract	Engagement with genomic medicine and research has increased globally during the past few decades, including rapid developments in Sri Lanka. Genomic research is carried out in Sri Lanka on a variety of scales and with different aims and perspectives. However, there are concerns about participants' understanding of genomic research, including the validity of informed consent. This article reports a qualitative study aiming to explore the understanding, knowledge, and attitudes of the Sri Lankan public towards genomic medicine and to inform the development of an effective and appropriate process for informed consent in that setting. Purposive sampling was employed. Participants were recruited from a sub-group of the public in Colombo, Sri Lanka who had either consented or refused to donate genetic material for a biobank. Data were collected using face-to-face semi-structured interviews. Interview data were transcribed verbatim and translated into English. Conventional content analysis was used. The analysis developed three key themes: a) 'Scientific literacy' describes an apparent lack of scientific knowledge that seems to affect a participant's ability to understand the research, b) 'Motivation' describes narratives about why participants chose (not) to take part in the research, despite not understanding it, and c) 'Trust' describes how trust served to mitigate the apparent ethical deficit created by not being fully informed. In this article, we argue that informed trust is likely an acceptable basis for consent, particularly in settings where scientific literacy might be low. However, researchers must work to be worthy of that trust and ensure that misconceptions are actively addressed.
Language	English
Publishing date	2023-11-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2602378-7
ISSN	1793-9453 ; 1793-8759
ISSN (online)	1793-9453
ISSN	1793-8759
DOI	10.1007/s41649-023-00269-y
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Article ; Online: Prevalence of mental health conditions amongst people living with human immunodeficiency virus in one of the most deprived localities in England.

Gill, A / Ranasinghe, Awip / Sumathipala, A / Fernando, K A

International journal of STD & AIDS

2020 Volume 31, Issue 7, Page(s) 619–626

Abstract: Mental health conditions (MHCs) are often unrecognised which can result in detrimental physical health outcomes and poor quality of life. This can be compounded by the impact of deprivation. People living with human immunodeficiency virus (PLWH) are more ...

Abstract	Mental health conditions (MHCs) are often unrecognised which can result in detrimental physical health outcomes and poor quality of life. This can be compounded by the impact of deprivation. People living with human immunodeficiency virus (PLWH) are more likely to be affected by MHCs which if untreated, may result in both clinical and psychosocial adversities. To ascertain the prevalence of and factors associated with MHCs in the human immunodeficiency virus cohort of Stoke-on-Trent, which is the 13th most deprived locality in England, we conducted a cross-sectional service evaluation using electronic records of 302 PLWH attending the service between October 2018 and January 2019. The prevalence of MHCs amongst PLWH was 33.4% (101/302). Depression was the most prevalent MHC affecting 17.2% (52/302). Those of white ethnicity were at higher risk (odds ratio [OR] = 3.14; p < 0.01) of MHCs compared to black Asian and minority ethnic groups. Women were at higher risk of having an MHC (OR = 3.15; p < 0.01), and recreational drug use was also a significant factor (OR = 16.18; p = 0.01) associated with MHCs. There is sub-optimal access and heterogeneity in the modes of referral to mental health support services. Commissioning constraints will further detrimentally affect our ability to provide support in an already deprived area, thus widening health inequalities affecting the most vulnerable.
MeSH term(s)	African Americans ; Anti-HIV Agents/therapeutic use ; Asian Continental Ancestry Group ; England/epidemiology ; Ethnic Groups ; European Continental Ancestry Group ; Female ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV Infections/psychology ; Health Services Accessibility/statistics & numerical data ; Humans ; Male ; Mental Disorders/drug therapy ; Mental Disorders/epidemiology ; Mental Disorders/psychology ; Poverty Areas ; Prevalence ; Psychotropic Drugs/therapeutic use ; Quality of Life/psychology ; Referral and Consultation ; Risk-Taking ; Sex Factors ; Socioeconomic Factors ; Treatment Outcome
Chemical Substances	Anti-HIV Agents ; Psychotropic Drugs
Language	English
Publishing date	2020-05-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1018089-8
ISSN	1758-1052 ; 0956-4624
ISSN (online)	1758-1052
ISSN	0956-4624
DOI	10.1177/0956462420904299
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Article: Context-dependent hyperactivity in

Sumathipala, Sureni H / Khan, Suha / Kozol, Robert A / Araki, Yoichi / Syed, Sheyum / Huganir, Richard L / Dallman, Julia E

bioRxiv : the preprint server for biology

2023

Abstract: Background and aims: SYNGAP1 disorder is a prevalent genetic form of Autism Spectrum Disorder and Intellectual Disability (ASD/ID) and is caused by : Methods: We used CRISPR/Cas9 to introduce frameshift mutations in the : Results: We show that ... ...

Abstract	Background and aims: SYNGAP1 disorder is a prevalent genetic form of Autism Spectrum Disorder and Intellectual Disability (ASD/ID) and is caused by Methods: We used CRISPR/Cas9 to introduce frameshift mutations in the Results: We show that CRISPR/Cas9 indels in zebrafish Conclusions: Our data support mutations in zebrafish
Language	English
Publishing date	2023-09-21
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.09.20.557316
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Article: The aftermath of war; mental health, substance use and their correlates with social support and resilience among adolescents in a post-conflict region of Sri Lanka.

Dissanayake, Lasith / Jabir, Sameeha / Shepherd, Thomas / Helliwell, Toby / Selvaratnam, Lavan / Jayaweera, Kaushalya / Abeysinghe, Nihal / Mallen, Christian / Sumathipala, Athula

Child and adolescent psychiatry and mental health

2023 Volume 17, Issue 1, Page(s) 101

Abstract: Background: Armed conflicts impact on the health and well-being of everyone, but its effect on adolescent mental health is a significant, yet under-explored area in global health. Mental health disorders which develop during adolescence often lead to ... ...

Abstract	Background: Armed conflicts impact on the health and well-being of everyone, but its effect on adolescent mental health is a significant, yet under-explored area in global health. Mental health disorders which develop during adolescence often lead to behavioural problems, risky decision-making, under-age substance use and can adversely impact on educational attainment. This study aimed to estimate the prevalence of common mental disorders, substance use and their correlates with social support and resilience among adolescents (age 12-19 years) in Vavuniya; a post-conflict region of Sri Lanka. Methods: A population-based cross-sectional study was conducted, with a modified cluster sampling method used for participant selection. Eight culturally adapted instruments were used for data collection. A total of 585 adolescents participated in the study. Analyses were performed using SPSS Version 23 statistical software package. All statistical tests were two-sided (p < 0.05) and p-values less than 0.05 were considered significant. Chi-square tests were used to explore associations between variables of interest. Spearman rank order correlation was used to examine correlations among depression, hopelessness, quality of life, social support, and resilience. Results: The mean age of participants was 15.02 (± 2.13) years. Ninety-one (15.6%) participants reported being exposed to one or more war-related events, and 85 (93.4%) participants in this group reported being internally displaced due to war. Fifty-two (8.9%) had dropped out of school and the prevalence of depression (3.9%) and substance use (7%) were low. Correlational analyses revealed that depression and hopelessness were significantly negatively correlated with social support, resilience, and quality of life (p < 0.01). Linear regression analysis suggested that 40% of the variance in resilience of the participants can be explained by perceived social support. Conclusion: The low prevalence of hopelessness and depression highlights the resilience of this group in the face of adversity. Furthermore, significant negative correlations between hopelessness and depression with perceived social support and resilience suggest that social support and resilience could be protective factors against mental health issues in these adolescents. However, the prevalence of school dropouts calls for a focus on academic attainment to promote better educational outcomes in the adolescents of this conflict-affected region.
Language	English
Publishing date	2023-08-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2379599-2
ISSN	1753-2000
ISSN	1753-2000
DOI	10.1186/s13034-023-00648-1
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Article: Cyfip2 controls the acoustic startle threshold through FMRP, actin polymerization, and GABA

Deslauriers, Jacob C / Ghotkar, Rohit P / Russ, Lindsey A / Jarman, Jordan A / Martin, Rubia M / Tippett, Rachel G / Sumathipala, Sureni H / Burton, Derek F / Cole, D Chris / Marsden, Kurt C

bioRxiv : the preprint server for biology

2024

Abstract: Animals process a constant stream of sensory input, and to survive they must detect and respond to dangerous stimuli while ignoring innocuous or irrelevant ones. Behavioral responses are elicited when certain properties of a stimulus such as its ... ...

Abstract	Animals process a constant stream of sensory input, and to survive they must detect and respond to dangerous stimuli while ignoring innocuous or irrelevant ones. Behavioral responses are elicited when certain properties of a stimulus such as its intensity or size reach a critical value, and such behavioral thresholds can be a simple and effective mechanism to filter sensory information. For example, the acoustic startle response is a conserved and stereotyped defensive behavior induced by sudden loud sounds, but dysregulation of the threshold to initiate this behavior can result in startle hypersensitivity that is associated with sensory processing disorders including schizophrenia and autism. Through a previous forward genetic screen for regulators of the startle threshold a nonsense mutation in
Language	English
Publishing date	2024-02-05
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.12.22.573054
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Article: Advancing good governance in data sharing and biobanking - international aspects.

Fernando, Buddhika / King, Mandella / Sumathipala, Athula

Wellcome open research

2019 Volume 4, Page(s) 184

Abstract: Ethical and effective data-sharing among countries can be achieved by considering the interests of all relevant parties: research participants, researchers and funders. Fears of exploitation, however, both of research participants and researchers from ... ...

Abstract	Ethical and effective data-sharing among countries can be achieved by considering the interests of all relevant parties: research participants, researchers and funders. Fears of exploitation, however, both of research participants and researchers from low- and middle-income countries (LMIC), can undermine the free flow of data necessary for scientific advancement. In this Open Letter, two case studies presented at the 2018 Global Forum on Bioethics in Research meeting on the Ethics of data sharing and biobanking in Cape Town, South Africa, function as the focal point for a reflection on the attributes of an ideal model of good data governance and how it can help support ethical best practices in biobanking and data sharing. Consideration of the case studies as well as the literature indicate three broad principles that need to be reflected in an ideal data governance framework: (i) collaboration - both among researchers as well as between researchers and participants, (ii) fairness - ensuring that all parties in international collaborations, the data provider, primary data gathering LMIC researcher and the high income country (HIC) institution/funder are treated fairly, and (iii) working towards a level playing field - neither collaboration nor fairness can be effectively achieved with the existing power differential between HIC and LMIC researchers/institutions; it is therefore necessary to work towards achieving a more level playing field between partners in research collaborations. Promoting good governance of data through fair, efficient and accountable governance frameworks can help build trust and ensure continued international data sharing.
Language	English
Publishing date	2019-11-22
Publishing country	England
Document type	Journal Article
ISSN	2398-502X
ISSN	2398-502X
DOI	10.12688/wellcomeopenres.15540.1
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