High Resistance Research Articles

Construction and validation of a machine learning-based immune-related prognostic model for glioma.

Glioma stands as the most prevalent primary brain tumor found within the central nervous system, characterized by high invasiveness and treatment resistance. Although immunotherapy has shown potential in various tumors, it still faces challenges in gliomas. This study seeks to develop and validate a prognostic model for glioma based on immune-related genes, to provide new tools for precision medicine. Glioma samples were obtained from a database that includes the ImmPort database. Additionally, we incorporated ten machine learning algorithms to assess the model's performance using evaluation metrics like the Harrell concordance index (C-index). The model genes were further studied using GSCA, TISCH2, and HPA databases to understand their role in glioma pathology at the genomic, molecular, and single-cell levels, and validate the biological function of IKBKE in vitro experiments. In this study, a total of 199 genes associated with prognosis were identified using univariate Cox analysis. Subsequently, a consensus prognostic model was developed through the application of machine learning algorithms. In which the Lasso + plsRcox algorithm demonstrated the best predictive performance. The model showed a good ability to distinguish two groups in both the training and test sets. Additionally, the model genes were closely related to immunity (oligodendrocytes and macrophages), and mutation burden.The results of in vitro experiments showed that the expression level of the IKBKE gene had a significant effect on the apoptosis and migration of GL261 glioma cells. Western blot analysis showed that down-regulation of IKBKE resulted in increased expression of pro-apoptotic protein Bax and decreased expression of anti-apoptotic protein Bcl-2, which was consistent with increased apoptosis rate. On the contrary, IKBKE overexpression caused a decrease in Bax expression an increase in Bcl-2 expression, and a decrease in apoptosis rate. Tunel results further confirmed that down-regulation of IKBKE promoted apoptosis, while overexpression of IKBKE reduced apoptosis. In addition, cells with down-regulated IKBKE had reduced migration in scratch experiments, while cells with overexpression of IKBKE had increased migration. This study successfully constructed a glioma prognosis model based on immune-related genes. These findings provide new perspectives for glioma prognosis assessment and immunotherapy.

Molecular Detection of Carbapenemases in Acinetobacter baumannii Strains of Portugal and Association With Sequence Types, Capsular Types, and Virulence

Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important nosocomial pathogen. The capsular type (K-type) is considered a major virulence factor, contributing to the evasion of host defenses. The global spread and dissemination dynamics between K-types, sequence types (ST), antibiotic resistance genes, and virulence factors remain largely unknown in Portugal. A collection of 96 CRAB clinical samples collected between 2005 and 2019 in the northern region of Portugal were tested for antimicrobial susceptibility profile and screened by polymerase chain reaction for resistance genetic determinants. A subset of 26 representative isolates was subjected to whole-genome sequencing to assess K types, ST types, and genomic relatedness. The pathogenicity of distinct K-types was also tested using Galleria mellonella model. For the 96 CRAB isolates analyzed, high antimicrobial resistance (>90%) was observed to the carbapenems, fluoroquinolones, and miscellaneous agents. Greater antimicrobial susceptibility (∼30%-57%) was observed for aminoglycosides, particularly tobramycin, and amikacin. Genotypically, 75 strains (78.5%) carried blaOXA-23-like, 18 strains (18.8%) carried blaIMP-like, and 11 strains (14.9%) carried blaOXA-40-like carbapenem resistance genes, respectively. Associations between OXA and ST/capsular locus (KL) types were observed over the years (eg, OXA-40-like/ST46Past/KL120 and OXA-23-like/ST2Past/KL2). ST2Past of clonal complex II was present in most strains, a dominant drug-resistant lineage in the United States and Europe. KL7 was also the most prevalent KL-type (38.5%), followed by KL2 (34.6%), KL120 (23.1%), and KL9 (3.8%). Virulence assessment for different K-types in a Galleria mellonella model revealed a significantly increased virulence for KL120 when compared with KL7, KL9, and KL2. There are specific CRAB serotypes circulating in Portugal, accounting by the low diversity of acquired carbapenemase genes (OXA-23-like and OXA-40-like), ST types (ST2 and ST46) and KL types (KL2, KL7, KL9, and KL120) identified. The high prevalent of ST2, especially when associated with KL2 and blaOXA-23-like, suggest that antibiotic resistance has been driven by clonal expansion of clonal complex II. Such findings provide useful information on the diversity of multidrug-resistant bacterium that might be relevant for antibacterial interventions.

Covalent Organic Frameworks Interfacial Modification of Ceramic Electrolytes for Enhanced Electrochemical Performance

AbstractThe interface instability between inorganic ceramic electrolytes and lithium metal anodes seriously affects the cycling behavior of high‐performance lithium‐metal batteries. Herein, an in situ interfacial modification strategy is proposed to build the precise hybrid organic/inorganic lithium‐ion conducting layer where the Li1.3Al0.3Ti1.7(PO4)3 (LATP) particle surface is anchored by ion‐conducting covalent organic frameworks (COF) with affluent poly(ethylene glycol) (PEG) moieties. This interlayer features ion transport regulation to avoid high interfacial resistance and enhances interfacial stability by building a functional COF‐based shield against electrons. These as‐prepared particles are employed to fabricate flexible quasi‐solid electrolyte membranes interconnected by polytetrafluoroethylene binder based on the dry process. The obtained membranes perform two‐fold increase in ion conductivity at 30 °C of 2.55 × 10−3 S cm−1 and the prolonged lithium deposition up to 1000 h compared to the pristine, which are attributed to synergistic effects in the inorganic/organic phase. Moreover, an integrated cathode/electrolytes design is proposed and exhibits excellent cycling performance with capacity retention of 98.8% after 200 cycles at 1 C. The corresponding pouch cells can light up LED after bending and recovery. This research provides new insights into the great potential of fabricating soft ceramic‐based membranes in a low‐cost and green way for highly‐stable lithium‐metal batteries.

Changes In Sympathovagal Balance Following High Load Resistance Exercise Compared To Blood Flow Restriction

Changes In Sympathovagal Balance Following High Load Resistance Exercise Compared To Blood Flow Restriction

High creep resistance in amorphous/crystalline dual-phase nanostructured CoCrFeNiMn high entropy alloys

Amorphous/crystalline dual-phase metallic materials received great attention owing to their synergistic combination of strength and ductility. However, the mechanisms governing creep deformation in these dual-phase materials are largely elusive. In the present letter, the creep deformation of amorphous/nanocrystalline CoCrFeNiMn high-entropy alloy (HEA) films is investigated through nanoindentation creep testing. It is suggested that dual-phase HEAs exhibit reduced creep strain compared to their monophase counterparts, and even surpass the performance of coarse-grained variants. This behavior arises from diffusion processes within the amorphous phase and the capacity for nucleation/annihilate of dislocations at amorphous/nanocrystalline interfaces. Furthermore, it is proposed that the presence of glass shell significantly influences the creep behavior of dual-phase HEAs.

Mechanics and Cutting Performance of Multilayer Nanostructured TiAlN/TiSiN/ZrN Coatings

The aerospace industry has made extensive use of titanium alloy material due to its exceptional qualities, which include high strength, low weight, and resistance to corrosion. However, these qualities also pose challenges for the material’s processing. This article examined the coated end mills for Ti6Al4V milling. First, an analysis was conducted on the solubility of Ti and Si elements. It was discovered that W and Co elements were far more soluble in Ti than Si and Zr elements, which could effectively stop element diffusion. Next, the base’s composition was planned. It was discovered that when the amount of Al increased, the base’s surface roughness increased, while its hardness and elastic modulus decreased. The binding force between the substrate and the base was greater at a 50:50 Ti:Al ratio. The H3/E2 was about 0.23 and the surface roughness was about 0.15 μm. TiSiN and TiSiN/ZrN functional layer properties were also examined. When Zr was added to TiSiN/ZrN coating, it improved the coating’s hardness and elastic modulus, increased density, and decreased surface roughness and friction coefficient when compared to TiSiN coating. There was an increase in hardness by 8.09% and an increase in elastic modulus by 9.65%. The average coefficient of friction decreased from 0.315 to 0.299. Lastly, an analysis of the initial and intermediate tool wear was done using the Ti6Al4V milling experiment. It was discovered that adding Zr element could successfully extend the tool’s cutting life by preventing adhesive wear.

Development of a highly stable IrO2-RuO2-Ta2O5 / Ti with fluorine doped nanotube interlayer

Fluorine-doped titanium oxide nanotubes were studied as a coating interlayer for IrO2-RuO2-Ta2O5/Ti to retard the passivation of titanium substrates and enhance anode life and corrosion characteristics. Nanotubes were produced by anodizing the substrate at 10, 20, and 40V in HF, and their effect on the microstructure of the coating was assessed using FE-SEM. Additionally, EIS and ALT measurements were conducted to investigate this coating's electrochemical behavior. Results showed that titanium oxide nanotubes with a smaller diameter would improve the performance and increase the life of the anode (IrO2-RuO2-Ta2O5/Ti). Likewise, the diameter of the nanotubes demonstrates a direct relationship with anodizing voltage. Furthermore, high voltages during anodizing resulted in an etched surface that was not ideal for an interlayer. All an all, it was concluded that the layer anodized at 10V, with smaller-diameter tubes and a higher number of walls, could result in a product with high corrosion resistance and 80% excess lifetime compared to a bare titanium substrate. This study provides valuable insights for engineering applications, demonstrating the potential for enhanced anode design in corrosion-sensitive environments in electrochemical engineering, water treatment, or fuel cells and electrolyzers where durability of the anodes are crucial.

Sustainability in Enterprise Architecture: From Optional to Essential

This study investigates the integration of sustainability into Enterprise Architecture (EA) and its impact on organizational performance. It examines how sustainable EA practices influence efficiency, compliance with environmental regulations, stakeholder engagement, and innovation within organizations. The research employs a structured Likert scale questionnaire targeting professionals in various industries. Findings reveal a positive correlation between sustainable EA practices and improved organizational performance, regulatory compliance, and innovation. However, challenges such as high costs and organizational resistance persist, particularly for Small and Medium-sized Enterprises (SMEs). The study highlights the importance of leadership support and technological readiness in overcoming these barriers. This research contributes to understanding the strategic role of sustainability in EA, offering insights for enhancing organizational resilience and competitiveness. Keywords: Enterprise Architecture (EA); Sustainability; Sustainable EA practices; Small and Medium-sized Enterprises (SMEs)

A micro-channel cooling system with two-phase looped thermosyphon for a supercritical CO2 Brayton cycle

The supercritical Carbon Dioxide (sCO2) closed Brayton cycle is a promising power generation technology, while the efficient cooling of CO2 and precise control of Compressor Inlet Temperature (CIT) is crucial for the high cycle efficiency and stable compressor operation due to the acute variation of thermophysical properties in the near-critical region. In conventional indirect cooling scheme, an intermediate single-phase water circuit is used to transfer heat from CO2 to water at the precooler, and then from water to the environment at the cooling tower, having the disadvantage of large pumping work consumption and high thermal resistance. In this work, a self-driven two-phase looped thermosyphon that significantly enhances the heat transfer by internal evaporation and condensation, is proposed to replace the water circuit. An experimental ultra-compact cooling system, consisting of a looped thermosyphon combined with micro-channel evaporator and condenser, filled with R134a coolant, is designed, fabricated, and tested. Visualized observation of the two-phase flow pattern and simultaneous measurement of the temperature, pressure and mass flow rates are conducted. A nodal analysis method is adopted, and a MATLAB code is developed for analyzing the internal fluid flow and the coupled sCO2-R134a-Air heat transfer, which is validated by experiment data. The results show that, the CO2 temperature could be accurately maintained at a specified near-critical point with a fluctuation of less than 1 K, and the average heat-releasing temperature can be reduced, while considerable pumping work, usually accounting for 2–5 % of the rated power output can be saved, thus contributing to increased cycle efficiency and system compactness.

Numerical study of proton exchange membrane water electrolyzer performance based on catalyst layer agglomerate model

In this work, a two-dimensional two-phase model of proton exchange membrane water electrolyzer (PEMWE) is developed, in which the catalyst layer (CL) is represented using agglomerate model. The effects of CL composition, porous transport layer (PTL) material properties and operating conditions on PEMWE performance are investigated. The results indicate that small size of catalyst agglomerate around 0.25 μm would benefit PEMWE performance. Appropriate increase of catalyst loading, porosity and ionomer volume fraction in the CL improves PEMWE performance, but their further increment leads to high mass transfer resistance, limiting the improvement of electrolyzer performance. The porosity and ionomer volume fraction of the catalyst layer are suggested to be lower than 0.5 and 0.6, respectively. The catalyst loading should be lower than 1.5 mg cm−2 when the CL porosity is higher than 0.3. The PTLs with high permeability, porosity and low contact angle help gas–liquid two-phase flow and avoid overheating and water shortage in the electrolyzer. Increasing the inlet velocity accelerates the bubble removal process, but results in a significant drop in temperature, degrading the PEMWE performance. The most suitable temperature of inlet liquid is around 353.15 K. The results provide important fundamental guidance for the optimization design of high performance PEMWE.

Unveiling the potency of tetrahydropalmitine as a green anticorrosion material for 2024 aluminum alloy in acid-chloride environments

2024 aluminum alloy has garnered attention from researchers because of its numerous applications in the oil and gas, aerospace, and marine sectors. However, its constituent high Cu content (the primary alloying element) poses a significant challenge to its use, particularly in applications that demand high corrosion resistance. This is particularly troubling in oxygen-containing chloride systems. Herein, we developed a protection strategy for 2024 Al alloy in an acid-chloride environment (composed of 0.5M NaCl and 0.25M H2SO4) using natural tetrahydropalmitine (THP) isolated from Corydalis yanhusuo. THP was effectively characterized from its 1H-NMR, 13C-NMR, and FTIR spectra, and its anticorrosion potentials were methodically investigated by electrochemical, gravimetry and theoretical experiments. Upon the addition of THP to the test system, EIS measurements revealed a steady increase in the Nyquist semicircles, as well as the Bode impedance and phase angle plots, attaining an optimum inhibition efficiency of 91.5% at 2.0g/L THP. Tafel plots manifested mixed-type anticorrosion effects with dominant cathodic properties, ascribed to the ordered shielding effect of both the hydrogen evolution reaction and the oxidation of oxide-free ions. According to gravimetric corrosion assessment, the 2024 Al alloy mainly retained its protection over time in the presence of THP, exhibiting only minor decline in its protectability. This is attributed to the combined effect of stable oxide film formation and the adsorbed THP on the alloy surface. SEM afforded the proof of THP adsorption on 2024 Al while XPS offered clarity into its anticorrosion mechanism. Conceptual DFT parameters, molecular electrostatic potential and molecular dynamics simulation were used to comprehend the inhibition process of THP on Al surface. Generally, THP was proven to be a viable and sustainable bio-based anticorrosion material for the protection of 2024 Al alloy.

Experimental and simulation studies to optimize the mechanical alloying process of ODS-FeCrAl alloy powder

Oxide dispersion strengthened (ODS) FeCrAl alloy exhibits superior mechanical qualities at high temperatures and resistance to neutron irradiation, making it a highly promising material for accident-tolerant fuel cladding. The preparation of ODS-FeCrAl alloy powder by mechanical alloying can mix Y2O3 and FeCrAl alloy powder uniformly and promote the uniform dispersion of nanoscale oxide particles in the alloy matrix. The preparation of ODS-FeCrAl alloy powder by the mechanical alloying method is greatly influenced by the rotational speed. Therefore, this study uses a combination of experiments and numerical simulation to investigate the effects of different rotational speeds on the microscopic morphology, particle size and force of alloy powder during the ball milling process. The mechanically alloyed powder was subjected to XRD inspection to determine the optimum ball milling time at each rotational speed by means of the maximum lattice distortion, and then the powder micromorphology and particle size were analyzed. Then the forces on the powder and grinding ball during the ball milling process were analyzed by numerical simulation, and it was found that the collision force and normal force played a dominant role in the ball milling process. The combined experimental and simulation results determined that the ODS-FeCrAl alloy powder obtained by ball milling at 300 rpm for 35 h had the largest lattice distortion, fine grain size and uniform particle size, which achieved the best mechanical alloying effect.

In vitro corrosion mechanism of biodegradable Mg-Zn-Gd alloy

The corrosion mechanisms of a high-anticorrosive Mg-Zn-Gd alloy have been unveiled. Numerous particles were observed and identified as anodic W phase. Nevertheless, due to a small potential difference between the secondary phase and Mg matrix, and the nanoscale size and dispersed distribution of the particles, no serious pitting would occur. The segregation of Zn in the MgO layer was found to be favorable for the compactness of the whole corrosion layer. The preferential corrosion of W phase should be partly responsible for this segregation. A new method has been presented to develop Mg alloys with high corrosion resistance by alloying.

Fetal Heart Rate During Moderate To High Intensity Resistance Exercise In Pregnant Individuals

Fetal Heart Rate During Moderate To High Intensity Resistance Exercise In Pregnant Individuals

Enhancing oxidation resistance of silicon nitride using a Ca2+ stabilizer

Silicon nitrides are widely used in ceramic heaters for combustion engines due to their high strength and wear resistance. However, their poor oxidation resistance at elevated temperatures limits their reliability. Oxidation products, such as silica and intermediate compounds from sintering additives, often suffer from microcracks due to phase transformation and volume expansion mismatch during thermo-mechanical cycles. Use of cation dopants to chemically stabilize the transformation of the oxidation front is proposed. This study investigated the effect of Ca2+ treatment on Si3N4 with MgO and Y2O3 sintering aids. The Si3N4 samples were coated with CaO and the phase composition, microstructure, and chemical distribution of the oxidation products were analyzed using XRD, SEM, TEM, STEM, and EDS. The oxidation coupon tests revealed that the CaO coating effectively protected Si3N4 from oxidation at 1300 ºC for 40h. Moreover, the microstructure analysis showed that CaO coating created more favorable microstructures which reduced oxidation reactions.

Bridging the gap between high-entropy alloys and metallic glasses: Control over disorder and mechanical properties of coatings

High-entropy alloys (HEAs) and high-entropy metallic glasses (HEMGs) represent two intensively researched classes of materials with high technological interest for applications as functional coatings with high strength, hardness, toughness, and corrosion resistance. The distinctive structural difference between single-phase crystalline solid solutions for HEAs and liquid-like disorder for HEMGs generates a seemingly insuperable contrast. In this work, we demonstrate that we can deliberately choose between crystalline or glassy properties by introducing structural disorder in HfMoNbTiZr thin films of identical composition. Using pulsed laser deposition (PLD) at different growth conditions, we reproducibly tune the structure of HfMoNbTiZr coatings from crystalline to fully amorphous. We show that the level of disorder has a profound impact on the mechanical properties of the coatings using the hardness derived from nanoindentation measurements as an example. While the hardness of polycrystalline HfMoNbTiZr layers already exceeds the single-phase bulk value, the amorphous HfMoNbTiZr is even clearly harder, demonstrating a distinctive improvement with introducing disorder. Our findings bridge the two seemingly different concepts of HEAs and HEMGs and demonstrate that structural disorder is not a given material property. Instead, disorder can serve as a useful design parameter for customizing the properties of functional coatings.

Effect of Metal Oxide Deposition on the Sensitivity and Resolution of E-Beam Photoresist.

Organic-inorganic hybrid resists offer a solution to the issue of low sensitivity in organic photoresists like poly(methyl methacrylate) (PMMA). In this study, an organic-inorganic hybrid resist (PMMA-Al2O3) with high sensitivity and resolution was prepared by depositing metal oxides into PMMA using sequential infiltration synthesis (SIS). PMMA-Al2O3 was prepared by precisely controlling the number of SIS cycles (<23) in various atomic layer deposition (ALD) processes to facilitate the growth of metal oxides within PMMA pores. The impact of different metal oxide contents and distributions on the sensitivity and resolution of electron beam exposure was investigated. Numerical simulations of the deposit formation within the PMMA pores were performed by solving the pore-scale ALD governing equations fed by the reactor-scale boundary conditions. The gradual pore constriction with SIS cycles was predicted and validated by the experimental charaterizations. The results demonstrated that PMMA-Al2O3 was prepared using 20 SIS cycles, which corresponds to the numerically predicted occurrence of the pore blockage at the upper region of the PMMA layer, exhibiting optimal electron beam (e-beam) resolution while enabling line exposure with a width of 50 nm. While the corresponding sensitivity was lower than those of the samples prepared using 5 and 10 SIS cycles, the degradation of the PMMA structure was affected under exposure. The pattern transfer results showed that the line width was well retained for 20 cycles of deposition because of the high etching resistance of Al2O3. This research is expected to provide an effective approach to developing next-generation high-performance photoresists.

Synthesis of low-temperature NH3-SCR catalysts for MnOx with high SO2 resistance using redox-precipitation method with mixed manganese sources

It remains a big challenge to enhance the SO2 resistance of catalyst in low-temperature NH3-SCR reduction. In this work, a series of MnOx-a%Mn (a = 0, 1, 3, 5, 10) catalysts were prepared by introducing manganese acetylacetonate during the reaction between lactic acid and KMnO4, based on the molar ratio of manganese acetylacetonate to KMnO4. Notably, MnOx-5 %Mn exhibited more than 95 % NO conversion and 100 % N2 selectivity at 80–240 °C. Moreover, the catalyst demonstrated excellent sulfur resistance by sustaining over 90 % NO conversion at 140 °C at the presence of 100 ppm SO2 for more than 6 h. Furthermore, XPS characterization indicated that adding manganese acetylacetonate enhanced electron transfer efficiency and improved the reduction capacity of the catalyst due to the interconversion between Mn3+ and Mn4+, which improved electron transfer efficiency. The enhanced reduction capacity of the catalyst promoted the formation of oxygen vacancies and surface-adsorbed oxygen species (Oα), avoiding over-oxidation of NH3. The results elucidated that manganese acetylacetonate could optimize the overall performance by modulating the synergistic effect between the oxidizing ability and surface acidity of the catalyst. Therefore, the MnOx-5 %Mn catalyst possessed a broad operational temperature window (40–240 °C) and SO2 resistance in the NH3-SCR reaction, indicating its potential for practical application.

2D-convolutional neural network based fault detection and classification of transmission lines using scalogram images

The reliable operation of power transmission systems is essential for maintaining the stability and efficiency of the electrical grid. Rapid and accurate detection of faults in transmission lines is crucial for minimizing downtime and preventing cascading failures. This research presents a novel approach to fault detection and classification in transmission lines employing 2D Convolutional Neural Networks (2D-CNN).The proposed methodology leverages the inherent spatial characteristics of fault signals, converting them as 2D scalogram images for input to the CNN model. By converting fault signals into scalogram representations, the network can capture both temporal and frequency domain features, enabling a more comprehensive analysis of fault patterns. The 2D-CNN architecture is designed to automatically learn hierarchical features, allowing for effective discrimination between different fault types. To evaluate the performance of the proposed approach, extensive simulations and experiments were conducted using MATLAB/SIMULINK modeled transmission line data. The results demonstrate the superior fault detection accuracy and classification capabilities of the 2D-CNN model. The performance of the proposed model is evaluated using 10-fold cross-validation, and its effectiveness is assessed by comparing it with current state-of-the-art techniques. Proposed 2D-CNN model has evidenced an accuracy of 99.9074 with ideal dataset for 12- class fault classification and performing consistently in presence of noise, having an accuracy of 99.629 %,99.72 % and 99.814 % in 20.30 and 40 dB noises respectively. The proposed model also verified in high resistance fault condition. The model exhibits robustness to noise and is capable of generalizing well to various fault scenarios. The proposed methodology offers a scalable and efficient solution for transmission line fault analysis, paving the way for the integration of advanced machine learning techniques into the operation and maintenance of power transmission infrastructure.

Genetic Determinants of Clarithromycin and Fluoroquinolones Resistance in Helicobacter pylori in Serbia

Background/Objectives: Stomach infections by Helicobacter pylori can cause acute or chronic gastritis, peptic ulcers, and gastric cancer. The rise in antibiotic resistance is a significant health issue highlighted by the World Health Organization. The increasing number of treatment failures underscores the necessity for antibiotic susceptibility testing (AST). The study aimed to investigate the current prevalence and resistance to fluoroquinolones and clarithromycin with their detected mutations. Methods: Stomach biopsies from symptomatic patients were subjected to molecular testing by GenoType Helico DR kit (Hain Lifescience GmbH, Nehren, Germany). Results: Positive findings on the presence of H. pylori were detected in 42.4% of symptomatic patients, with the significant majority of patients (69%) having previously failed treatments. The resistance rates to fluoroquinolones and clarithromycin were 53.9% and 58.5%, respectively, with significantly higher rates in secondary resistant strains. The main resistance markers in fluoroquinolones and clarithromycin were N87K (27.4%) and A2147G (78.6%), respectively. Hetero-resistance or mixed genotypes were detected in over 20% of tested patients. During the study period, a significant increase in trends in both fluoroquinolones and clarithromycin resistance rates was observed. Conclusions: Results indicate the need for the implementation of the latest Maastricht VI Consensus recommendations for both AST whenever possible and the use of tailored guided therapy options due to high resistance rates and possible treatment failures. The GenoType Helico DR kit is a useful tool for AST, especially in cases of mixed H. pylori genotypes.