Intermediate Reference Research Articles

Diffuse instability of slightly disordered quasi rate-independent anisotropic viscoplastic FCC-polycrystals

Geometry and kinematics of intragranular as well as intergranular plastic deformation of polycrystals are briefly discussed. Elastic strain is covered by the effective medium homogenization method inside a representative volume element (RVE). Evolution equation formed by tensor representation is derived from very simple micro-evolution equation. It has an incremental quasi rate-independent (QRI) form obtained by Vakulenko’s concept of thermodynamic time. The rate dependence takes place by means of stress rate dependent value of the initial yield stress. In accordance with Zorawski’s communication about free macro rotations in intermediate reference configuration, strain geometry is based on constrained micro rotation within a representative volume element (RVE). The theory is applied to slightly disordered fcc-polycrystals. A comparison between QRI and classic diffuse instability equations is presented for transversely isotropic polycrystals.

Prevalence of rifampicin-resistant pediatric tuberculosis by cartridge-based nucleic acid amplification test at the intermediate reference laboratory under revised national tuberculosis control program India: A multidimensional approach

Background: Tuberculosis (TB) still remains the major public health threat in India. Early diagnosis, so as to initiate early treatment is a priority as any delay, may complicate the prognosis further leading to the failure of an effective control. India accounts for 6% incidence of pediatric TB cases in a population that has 40% as estimated latent TB cases. Implementation of cartridge-based nucleic acid amplification tests (CBNAATs) in diagnosis of pediatric TB has augmented the detection rates. The study involves a retrospective multidimensional analysis of the increased pediatric TB case detection by CBNAAT at the Intermediate Reference laboratory, State TB Demonstration and Training Centre in West Bengal, India. A total of 14,088 samples from pediatric patients coming from all the districts were tested from May 2014 to April 2018. This included pulmonary (sputum, bronchoalveolar lavage, gastric lavage, and gastric aspirate) and extrapulmonary (cerebrospinal fluid [CSF], pus, ascitic fluid, pericardial fluid, lymph node aspirate) samples. Although detection levels showed variation in the nature of the samples, the study explored percentage contribution of the types of samples and the proportion positive rates among them. Percentage-wise propensity with regard to age, clinical presentations, type of samples, and smear result were observed. The predominant geographical location in terms of incidences and periodic prevalence were studied. The resistant cases were retested with line probe assay by MTBDRplus and V2 Hains for concordance analysis. This was done based on the parameters in the erstwhile evaluations. Methods: Pulmonary and extrapulmonary pediatric samples were tested on CBNAAT by Xpert Mycobacterium tuberculosis rifampicin (RIF) (Cepheid) based on the manufacturer's instruction. All necessary aseptic measures were taken. The data were captured in the Xpert software automatically during the tests and exported to the Microsoft Excel sheets for further analysis. A defined study design against each and every objective was set up. Results: It was found that a point prevalence of 6%–7% of pediatric TB exists among the tested specimens every quarter. The periodic prevalence was found to be 5%, the incidence rates ranged from 4.5% to 5%. RIF resistance detection showing a seasonal variation ranged from 13% to 15% among the CBNAAT-positive cases. Gastric lavage showed a major detection in children below 6 months of age of whom collecting sputum samples were difficult. This prompted suboptimal detection levels due to the dearth of sample collection modalities at the peripheries. CSF accounted for 2.37% of positivity. Conclusions: The study concluded that more skilled collection centers for biological specimens are required to address the undetected pulmonary TB cases among the pediatric age group, especially below the 6 months of age. About 5% prevalence and around 4.9% incidence is an alarming situation in the TB control scenario of West Bengal. Focus on the universal drug-susceptibility testing is a prerequisite.

I Am Not Sidney Poitier By Percival Everett As A Film Adaptation: Intermedial Approach

The paper examines the features of selective adaptation – "novelization" in the novel by Percival Everett "I'm not Sidney Poitier" from the intermedial perspective. “Screen to book adaptation” or novelization is viewed as a phenomenon of the recent history of cinema-literature relationship. In his novel Percival Everett "I'm not Sidney Poitier" created a hybrid genre in which selective adaptation serves as a component. It has been found out that the writer uses the technique of intermedial reference as a means of intermedialisation. The author widely uses direct and hidden references to the primary movie source to produce the effect of immediate recognition and as a means of creating a parody and comic effect. In movie-related sections of the novel the author employs certain cinematographic techniques, namely organizing narration in units resembling scenes, that take place in a single location; quick change of these locations, brief and precise characterization, script-like style layout of conversation.The novel incorporates the plot elements and events borrowed from a number of movies from the acting career of the iconic figure of American cinema Sidney Poitier. Characteristic features of the main character of the novel are traced against the background of the typologized image of a positive African-American from the acting career of Sidney Poitier. It is concluded that the movie career of a well-known actor is being novelized in the novel.

Genetic polymorphism of rare mutations in Mycobacterium tuberculosis-infected patients in Delhi

Background: There is a wide variation in existing Mycobacterium tuberculosis strains across the globe, and false results in line probe assay (LPA) can occur due to the presence of unique genetic mutations in different settings. Objectives: An attempt was made to observe uncommon mutations in multidrug-resistant tuberculosis (MDR-TB) strains and determination of genetic diversity by spoligotyping and to study the treatment outcome in patients with uncommon mutations. Materials and Methods: Band pattern analysis of LPA strips was performed as per manufacturer's instructions. DNA sequencing was performed to confirm the presence of uncommon mutations in Intermediate Reference Laboratory in Delhi state. Results: Four uncommon mutations were recognized along with 12 unique spoligotype patterns which serve as an update to worldwide databases. The noteworthy presence of a spoligotype previously rarely seen in India was the SIT53/T1 pattern. Central Asian (CAS) spoligotype was highly associated with MDR followed by Beijing type. During follow-up, the treatment outcomes of cases showing uncommon mutations were considered as cured, after completion of their treatment. Conclusion: The rifampicin resistance appears to be an effective marker of MDR-TB. The presence of uncommon mutations confirms genetic polymorphism that may require treatment targeted at both drug-resistant and drug-susceptible phenotypes for the better management of patients with MDR-TB.

Sound, Vision, and Embodied Performativity in Beyoncé Knowles’ Visual Album Lemonade (2016)

In 2016, Beyonce published Lemonade, a work of art that exists in various manifestations: as a music album that includes twelve songs, as live performances (including her world tour and her appearance at the Superbowl halftime show), and as a “visual album,” an art film that consists of the music video clips for each individual song and visually and auditorily complex “chapters” which feature the poetry by Warsan Shire. This article focuses on the visual album as intermedial artwork that can be described as a soundscape in which the intermedial constellations fulfill a number of functions: Firstly, intermedial references are a means of cohesion that are responsible for the unified character of the visual album. Secondly, intermedial references result in a transcultural signature of the artwork. Thirdly, through intermedial references Beyonce locates Lemonade within the cultural history of the United States and American music history in particular. Finally, intermediality acquires cultural-critical functions which in particular pertain to race relations and structural forms of discrimination against people of color in contemporary America.

Drug resistance patterns among extra-pulmonary tuberculosis cases in a tertiary care centre in North India.

xtra-pulmonary tuberculosis (EPTB) is a growing public health concern, and data on drug resistance are limited. Specimens from 2468 clinically diagnosed EPTB patients received at the Intermediate Reference Laboratory (IRL) of a tertiary centre in India were subjected to Ziehl-Neelsen staining, Xpert® MTB/RIF testing, liquid culture and drug susceptibility testing (DST) using automated BACTEC MGIT™ 960™. Line-probe assay (LPA) was performed on all culture-positive isolates. Gene sequencing was performed on rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB) and phenotypic/genotypic discrepant isolates. The culture positivity rate was 18.9% (483/2553). The sensitivity and specificity of Xpert in diagnosing EPTB were respectively 70.8% (95%CI 66.5-74.8) and 97.7% (95%CI 96.9-98.3), with liquid culture as the reference standard. Prevalence of RR/MDR-TB was 10.1% (49/483). Prevalence of pre-extensively drug-resistant TB (pre-XDR-TB) was 18.4% (09/49), whereas the prevalence of XDR-TB among MDR-TB patients was 2% (01/49). The sensitivity of genotypic DST for the detection of rifampicin resistance was 92.7% (95%CI 81.1-98.5) and specificity was 99.3% (95%CI 97.5-99.9), with 100% concordance between Xpert and LPA. The burden of drug resistance, including M/XDR-TB, among EPTB patients is high. Novel molecular tests can help in early diagnosis and treatment to prevent disease progression and amplification of resistance.

The Art of Illustrating the Impossible: Marcel Proust’s A la recherche du temps perdu through the eyes of Kees van Dongen

Since the publication of Marcel Proust’s A la recherche du temps perdu (1913-1927), multiple artists have taken up the challenge of visualizing his modernist magnum opus. In this article, I will discuss the interpretation of Dutch artist Kees van Dongen, who created 77 illustrations for a luxury edition published by Gallimard in 1947. By looking at the way Van Dongen visualized different forms of art, I will argue that Van Dongen’s interpretation is more artistically interesting than has been asserted before, as there are many intertextual and even intermedial references and practices to be found in Van Dongen’s aquarelles.

Investigations of the first-wall erosion of DEMO with the CELLSOR code

Fusion reactor systems codes (SCs) are 0.5d codes used for optimization studies towards the design of a tokamak demonstration power plant (DEMO). These codes usually comprise a description of the core plasma physics, technology aspects and reactor economy, while only a coarse description of plasma-wall interaction (PWI) aspects is included. Therefore, the new systems code extension CELLSOR (Code to Estimate the Lifetime Limited by Sputtering Of a Reactor wall) was developed in order to allow inclusion of PWI effects into reactor optimization studies. CELLSOR is foreseen to be used as a secondary tool for PWI evaluations, taking design point parameters from the European PROCESS systems code as input. CELLSOR consists of an analytical treatment of the plasma in the scrape-off layer (SOL) for fuel ions (D, T), solving the 1.5d continuity equation in fluid approximation to obtain perpendicular flux and ion density in the SOL, and a fast Monte-Carlo description of the neutral particle (D, T) behavior. The Monte Carlo (MC) implementation of the new code extension was successfully benchmarked with results from the EIRENE code. The trajectories of eroded neutral W were computed within CELLSOR ERO, an add-on code used for calculations of prompt re-deposition and self-sputtering. The damage by ions was calculated analytically for fuel (D, T), ash (He), seeding gas (N) and wall material (W), including the acceleration by a sheath in front of the wall, assuming radially constant impurity concentrations.Six exemplary DEMO SOL test-cases were defined, covering the range of predicted diffusive and convective transport strength within the SOL, and of upstream separatrix density levels sufficient for detached diverter conditions. The damage by ions (D, T, He, N, W) and by hot neutrals (D, T), being born by charge-exchange within the hot pedestal region (ΔT=−300eV/cm), was compared for the six cases. The results indicated, that in the investigated low density and weak transport cases, the recharged neutrals caused the major threat to the FW due to bad SOL screening ability, i.e. deeper plasma penetration for neutrals. In the other cases, N ions were the dominant driver for erosion due to their high concentration levels and strong sheath acceleration.Furthermore, the net erosion, incl. prompt re-deposition and self-sputtering, was investigated for variations of the wall clearance ΔSOL, which was identified as the main control parameter to keep the FW erosion in the main chamber below acceptable levels. Within the intermediate reference case, i.e. medium transport (D⊥=0.5m2s−1, v⊥=5ms−1), the net erosion rate was acceptable, if the wall clearance was at least ΔSOL ≥ 14 cm, whereas a clearance of ΔSOL ≈ 25cm was sufficient within all 6 investigated test-cases.

The Sound of a (New) Generation? Intermedial References to Pop Music in Judith Hermann's Prose

The Sound of a (New) Generation? Intermedial References to Pop Music in Judith Hermann's Prose

Band pattern analysis of mutations in rifampicin resistance strain of Mycobacterium tuberculosis by Line Probe assay in patients from Delhi, India

BackgroundThe GenoType MTBDRplus, a commercial Line Probe Assay (LPA) kit from Hain Lifescience, Germany, is endorsed by India's RNTCP Program for diagnosis of DRTB cases among smear-positive sputum samples. Although the LPA has been studied in several laboratories, there is a wide variation in existing M. tuberculosis strains across the globe, and false results can occur due to the presence of unique genetic mutations in different settings. Aim and objectiveAn attempt was made to carry out band pattern analysis using LPA and also to observe uncommon mutations in MDR strains. Materials and methodsSputum samples were collected from MDR suspects and transported to intermediate reference laboratory (IRL) at New Delhi Tuberculosis Centre in Delhi. Sputum decontamination, DNA extraction, amplification, hybridization, and band pattern analysis of Line Probe assay strips was performed as per manufacturer's instructions. ResultsAmong the 3000 samples with interpretable LPA strips, rifampicin drug resistance with or without isoniazid was observed in 600 samples. The most common mutation detected by LPA in the rpoB gene was Ser516Leu (29.0%). Novel mutations reported in this study include mutation from CAG (Gin) to CAT (His) at codon 517, AGC (Ser)-AGG (Arg) at codon 512, ACA (Thr) to GCA (Ala) at codon 526, TTG (Leu)-CTG (Leu)s at codon 524. ConclusionHigh frequencies of uncommon mutations in rpoB gene by LPA were observed, highlighting possibility of those in-silico detected mutations that may not impart phenotypic resistance further.

The Uhlenbeck-Ford model: Exact virial coefficients and application as a reference system in fluid-phase free-energy calculations.

The Uhlenbeck-Ford (UF) model was originally proposed for the theoretical study of imperfect gases, given that all its virial coefficients can be evaluated exactly, in principle. Here, in addition to computing the previously unknown coefficients B11 through B13, we assess its applicability as a reference system in fluid-phase free-energy calculations using molecular simulation techniques. Our results demonstrate that, although the UF model itself is too soft, appropriately scaled Uhlenbeck-Ford (sUF) models provide robust reference systems that allow accurate fluid-phase free-energy calculations without the need for an intermediate reference model. Indeed, in addition to the accuracy with which their free energies are known and their convenient scaling properties, the fluid is the only thermodynamically stable phase for a wide range of sUF models. This set of favorable properties may potentially put the sUF fluid-phase reference systems on par with the standard role that harmonic and Einstein solids play as reference systems for solid-phase free-energy calculations.

Estudio de variabilidad genética en aislamientos de Leptospira spp., en sistemas bovinos de carne y doble propósito

A partir de riñón y orina de bovinos, se aislaron en campo serovares de Leptospira spp., en los departamentos de Cundinamarca y Meta, Colombia. Los aislamientos fueron clasificados mediante análisis filogenético y ribotipificación, utilizando como marcador el gen 16S ADNr. El análisis filogenético permitió clasificar los aislamientos en dos de las tres genomoespecies reconocidas: patógeno e intermedio, siendo este último de gran importancia, dado que no se conoce su patrón de comportamiento inmunológico ante un huésped, lo que podría generar respuestas variables. En la ribotificación se obtuvieron ribopatrones de cuatro aislamientos de leptospira y cinco cepas de referencia con mayor identidad y su análisis mostró la presencia de dos perfiles predominantes dentro de los cuatro aislamientos. Un perfil coincidió con la cepa de referencia intermedia y otro perfil fue similar a la cepa de referencia patógena serovares Copenhageni y Lai. El análisis filogenético del aislamiento, fue agrupado dentro de leptospiras tipo intermedio y su patogenicidad se encuentra todavía en estudio. Los análisis filogenéticos de especies de leptospiras basados en secuencias comparativas del gen 16S ADNr, permiten confirmar e identificar tres grupos según su estatus de patogenicidad (patógeno, saprofítico e intermedio), donde el propósito taxonómico de los marcadores genera resultados consistentes en obtener secuencias del gen 16S ADNr agrupados en un árbol filogenético.

Rapid detection of extensively drug-resistant (XDR-TB) strains from multidrug-resistant tuberculosis (MDR-TB) cases isolated from smear-negative pulmonary samples in an Intermediate Reference Laboratory in India

BackgroundDirect sputum smear microscopy is commonly used for diagnosing tuberculosis (TB). The objectives of the study were first, to determine the recovery of Mycobacterium tuberculosis in smear-negative sputum samples through liquid culture (using MGIT 960) and solid culture (using LJ slant) and second, to screen multidrug-resistant isolates through line probe assay and further third, to identify XDR isolates through MGIT second-line DST from these positive MDR cultures in Delhi region. MethodsIn this study, the sample size was 717 (sputum smear AFB negative and culture positive for M. tuberculosis complex by both solid and liquid culture methods) MDRTB suspects who were enrolled from January 2014 to December 2014 at the Intermediate Reference Laboratory in New Delhi Tuberculosis Centre, New Delhi. Rapid line probe assay was performed on all culture-positive samples, which were direct smear-negative specimens, and LPA-confirmed MDR samples were tested on MGIT 960 second-line DST for identification of XDR strains. ResultsAn overall increase in the culture positivity (9.4%) among these smear-negative cases shows a good sign of recovery from M. tuberculosis infection in these samples. 717 (9.4%) positive cultures (MGIT+LJ) were subjected to line probe assay. Out of these 717 cultures, 9 (1.2%) were confirmed as NTM, 50 (7%) were MDR, 4 (0.6%) were mono-rifampicin resistant and 654 (91.2%) cultures were sensitive to both drugs Rif and Inh, respectively. Out of these 54 (50 MDR +4 mono-RIF resistant) cultures as screened by LPA, 1 (1.8%) was XDR, 10 (18.6%) were mono-ofloxacin resistant and 1 (1.8%) was mono-Kanamycin resistant. Sensitivity to both drugs KAN and OFX was seen in 42 (77.8%) cultures. ConclusionsSince the bacterial load in direct smear-negative suspected MDR samples is less, it is important to recover mycobacteria by rapid liquid culture method in such samples. Initial screening for MDRTB is to be done in such cases by performing rapid molecular genotypic drug susceptibility test such as LPA. Baseline second-line DST is also done to rule out the XDR cases among them for rapid and better management of XDRTB patients.

Multi-reference combinatorial strategy towards longer long-term dense motion estimation

This paper addresses the estimation of accurate long-term dense motion fields from videos of complex scenes. With computer vision applications such as video editing in mind, we exploit optical flows estimated with various inter-frame distances and combine them through multi-step integration and statistical selection (MISS). In this context, managing numerous combinations of multi-step optical flows requires a complexity reduction scheme to overcome computational and memory issues. Our contribution is two-fold. First, we provide an exhaustive analysis of available single-reference complexity reduction strategies. Second, we propose a simple and efficient alternative related to multi-reference frames multi-step integration and statistical selection (MR-MISS). Our method automatically inserts intermediate reference frames once matching failures are detected to re-generate the motion estimation process and re-correlates the resulting dense trajectories. By this way, it reaches longer accurate displacement fields while efficiently reducing the complexity. Experiments on challenging sequences reveal improved results compared to state-of-the-art methods including existing MISS schemes both in terms of complexity reduction and accuracy improvement.

Development of medians generators for the calculation of MoM for the first-trimester Down syndrome maternal serum markers.

The Down syndrome risk calculation software, Fast Screen pre I plus, from Thermo Fisher Scientific, converts the First-trimester maternal serum markers concentrations (PAPP-A and hCGβ) into degrees of extreme (DoE). To meet the requirements of the French legislation as well as those of the certified biologists for Down syndrome screening, a conversion tool for DoE into multiple of the median (MoM), intermediate reference value for the screening, was developed. In absence of any median polynomial allowing to obtain MoM easily, the calculations were made first on the basis of the polynomials centiles from the software. The subsequent reviews of the risk algorithms showed the fragility of this approach based on the Gaussian hypothesis. Medians generators, calculated from the data of the Kryptor club's biologists, were established.

Remaking a European, Post-catastrophic Atmosphere in 2000s China: Jia Zhangke’s Still Life, Iconology and Ruins

Jia Zhangke’sStill Life(Sānxiá hǎorén, 2006) was shot in Fengjie, shortly before its flooding brought about by the construction of the Three Gorges Dam, the world’s largest hydropower station in terms of capacity. The film remakes the post-apocalyptic atmosphere found in European films made after the Second World War. From a web of cinephilic, intermedial and intertextual references, which inscribesStill Lifein a local and global history of art and of film, this text compares the way Jia films his characters in a disappearing Fengjie with sequences from Roberto Rossellini’sGermany Year Zero(Germania anno zero, 1948) and Michelangelo Antonioni’sRed Desert(Il deserto rosso, 1964). While remaking the composition of ruins framing Edmund, in the first case, and in the second, a complex relation between background and figure in a deserted industrial landscape,Still Lifecreates a strange temporality, combining the imminence of a future catastrophe with the memory of past ones.

Injury prediction in veteran football players using the Functional Movement Screen™

ABSTRACTThe Functional Movement Screen™ (FMS™) is aimed at assessing fundamental movements and is often used to identify players’ injury risk. The purpose of this study was to determine whether the FMS™ can be used to predict injuries in veteran footballers (aged > 32 years). Eighteen veteran football teams (n = 238) were recruited and prospectively followed for 9 months. The players (44 ± 7 years; 178 ± 7 cm, 84 ± 11 kg) performed the FMS™ at the start of the study period. Players’ exposure hours and injuries were recorded. The difference of FMS™ overall score between injured and uninjured players was not significant (11.7 ± 2.9 vs 12.2 ± 2.8 points; Mann-Whitney U-test P = 0.17). Players scoring <10 (score < 1 standard deviation [SD]) below the mean) had a significantly higher injury incidence (z-statistics P < 0.05) compared to an intermediate reference group (mean ± 1 SD; scores of 10–14). No lower injury incidence for players with scores of >14 (score > 1 SD above the mean) was found. Further analyses of potential risk factors suggest higher age, lower body mass and a longer football career to be risk factors for injuries. The findings of this study suggest that the suitability of the FMS™ for injury prediction in veteran footballers is limited.

A study on outcome of standardized treatment in multi-drug resistance tuberculosis patients

Background: Programmatic management of Multi-drug resistance Tuberculosis (MDR-TB) using a standardized treatment regimen (STR) is being implemented under the Revised National Tuberculosis Control Programme (RNTCP) in India. Our study was undertaken to analyze the outcomes of MDR-TB patients treated at the Drug resistance centre (also known as Dots Plus Centre, DR-TB) Bellary, with the RNTCP recommended 24-27months STR, under programmatic conditions. Methods: Patients confirmed to have MDR-TB by Line Probe Assay (LPA) method, from Intermediate reference laboratory (IRL) Bangalore, were treated with the RNTCP’s STR in a prospective field trial on a predominantly ambulatory basis. Forty three patients were enrolled to the trial from December 2012 to April 2013. Results: At the end of treatment, 19 (44.2%) were cured, 12 defaulted, 9 died, 1 failure and 2 were under XDR TB evaluation. Thirty two (74.2%) patients reported adverse drug reactions (ADRs) which required dose reduction or termination of the offending drug. No patient had XDR-TB initially, but 3 cases emerged for XDR-TB evaluation during treatment. Before start of treatment mean body mass index (BMI) was 17.67±3.627 kg/mt 2 . 34 patients had far advanced lesions on chest x-ray. Outcome was better in those patients, whose tubercular bacilli resistant both to rifampicin and isoniazid and who had good adherence in the past tubercular treatment. Conclusions: Outcomes of this small group of MDR-TB patients treated with the RNTCP’s STR is encouraging in this setting. Close attention needs to be paid to ensure adherence, and to the timely recognition and treatment of ADRs.

Associations between serum lipid levels and suicidal ideation among Korean older people

IntroductionThere have been inconsistent reports on the relationships between lipids and suicidality, and studies conducted in older adults are rare. This study examined associations between serum lipid levels and suicidal ideation in an older population. MethodsThis study used data obtained from a representative Korean sample of 4265 people age 65 years or older who completed a self-administered questionnaire about suicidal ideation over the last year. The fasting serum concentrations of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were measured and categorized into lower, intermediate (reference), and upper quartiles. A complex sample logistic regression stratified by gender was performed to determine the associations between serum lipid levels and suicidal ideation after controlling for covariates including age, education, marital status, current smoking, alcohol drinking, body mass index, hypertension, diabetes, diagnosed depression, antidepressant use, and lipid-lowering therapies. ResultsIn this study, the prevalence of suicidal ideation in an older Korean population was 22.9% (SE=0.9%). The prevalence was significantly higher in women than in men, 27.7% (1.2%) vs. 15.9% (1.1%) respectively. After adjusting for covariates, lower triglyceride levels were significantly associated with a decreased risk of suicidal ideation (OR=0.65; 95% CI=0.43–0.99) among men but no significant associations were observed among women. Additionally, there were no significant associations between any other measure of cholesterol levels and suicidal ideation in either men or women. LimitationsCross-sectional design cannot infer temporality or the effects of changes in variables. ConclusionsThese results support the association between lower triglyceride levels and a reduced risk of suicidal ideation among Korean men over 65. Further studies are necessary to investigate gender difference and the biological mechanism.

Detecting mutation pattern of drug-resistant Mycobacterium tuberculosis isolates in Himachal Pradesh using GenoType® MTBDRplus assay

Context: Tuberculosis (TB) is a major public health problem in India and a principal cause of death in adults, especially among the economically productive age group. India accounts for one-fifth of the global burden of TB. It is estimated that about 40% of Indian population is infected with TB bacillus. The GenoType® MTBDRplus molecular method allows rapid diagnosis of the clinical samples and detection of the most common mutations in the genes associated with rifampicin (R) and isoniazid (H) resistance. Aims: To study the drug resistance and mutational patterns in multidrug-resistant (MDR) suspects clinical strains using GenoType® MTBDRplus assay. Subjects and Methods: A total of 770 sputum samples of the MDR-TB suspects were included in this study, which were received at Intermediate Reference Laboratory, Government TB Sanatorium, Dharampur, Solan, Himachal Pradesh from the Designated Microscopy Centres of Himachal Pradesh for the culture and susceptibility testing. All the 521 Mycobacterium tuberculosis complex (MTBC) strains were subjected to GenoType® MTBDRplus (HAIN Lifescience) assay to detect molecular resistance pattern to first line anti-tubercular drugs (isoniazid and rifampicin). Results: Of 770 samples, 556 (72.20%) were from male and 214 (27.80%) were from female. Among the 521 MTBC strains, 19.76% were found to be MDR and mono-resistance to isoniazid and rifampicin was detected in 8.63% and 6.14% strains respectively. About 74.81%, 76.35% and 5.40% strains harboured known mutation in rpoB, katG and inhA genes respectively. Conclusions: In rpoB gene, the most common mutation is associated with S531 L region. The GenoType® MTBDRplus assay is a rapid test for the detection of the most common mutations in MDR-TB strains. In our study, unknown rpoB gene mutations were found in 25.18% strains that may further be detected by gene sequencing.