In mesoscale eddies, the chemical properties and biological composition are different from those in the surrounding water due to their unique physical processes. The mechanism of physical–biological coupling in warm-core eddies is unclear, especially because no studies have examined the effects of environmental factors on bacteria and viruses. The purpose of the present study was to examine the influence of an anticyclonic warm eddy on the relationship between bacterial and viral abundances, as well as viral activity (viral production), at different depths. At the core of the warm eddy, the bacterial abundance (0.48 to 2.82 × 10⁵ cells mL⁻¹) fluctuated less than that outside the eddy (1.12 to 7.03 × 10⁵ cells mL⁻¹). In particular, there was a four-fold higher viral–bacterial abundance ratio (VBR) estimated within the eddy, below the layer of the deep chlorophyll maximum, than outside the eddy. An anticyclonic warm eddy with downwelling at its center may contribute to viruses being transmitted directly into the deep ocean through adsorption on particulate organic matter while sinking. Overall, our findings provide valuable insights into the interaction between bacterial and viral abundances and their ecological mechanisms within a warm eddy. Full article

Predicting stock market movement direction is a challenging task due to its fuzzy, chaotic, volatile, nonlinear, and complex nature. However, with advancements in artificial intelligence, abundant data availability, and improved computational capabilities, creating robust models capable of accurately predicting stock market movement is now feasible. This study aims to construct a predictive model using news headlines to predict stock market movement direction. It conducts a comparative analysis of five supervised classification machine learning algorithms—logistic regression (LR), support vector machine (SVM), random forest (RF), extreme gradient boosting (XGBoost), and artificial neural network (ANN)—to predict the next day’s movement direction of the close price of the Nepal Stock Exchange (NEPSE) index. Sentiment scores from news headlines are computed using the Valence Aware Dictionary for Sentiment Reasoning (VADER) and TextBlob sentiment analyzer. The models’ performance is evaluated based on sensitivity, specificity, accuracy, and the area under the receiver operating characteristic (ROC) curve (AUC). Experimental results reveal that all five models perform equally well when using sentiment scores from the TextBlob analyzer. Similarly, all models exhibit almost identical performance when using sentiment scores from the VADER analyzer, except for minor variations in AUC in SVM vs. LR and SVM vs. ANN. Moreover, models perform relatively better when using sentiment scores from the TextBlob analyzer compared to the VADER analyzer. These findings are further validated through statistical tests. Full article

This study examines whether Differential Object Marking (DOM) realization and word order in relative clauses (RCs) in Spanish affect processing and interpretation among monolinguals and highly proficient Catalan–Spanish bilinguals. RCs are parallel in Catalan and Spanish, but DOM is much more restricted in Catalan than in Spanish, and, interestingly, the distinction between subject and object RCs relies mainly on the presence/absence of DOM. To examine DOM optionality, we concentrate on the top portion of the animacy scale and test the human/non-human contrast. Exploring these two populations allows us to test whether they resort to different strategies for the following three reasons: (1) bilingualism places an increased burden on memory processes); (2) the partial overlap between both DOM systems might lead to the influence from Catalan into Spanish); and (3) optionality has been proposed to characterize bilingual grammars). Findings from a word-by-word non-cumulative self-paced reading task showed that DOM modulates RC processing. With [+human] obligatorily marked objects, both monolinguals and bilinguals read subject RCs faster than object RCs, suggesting a strategy favoring subject RCs. However, monolinguals solved the interpretation early while processing but bilinguals, despite the more restricted DOM character of Catalan, are sensitive to DOM albeit displaying delayed spill-over effects. With [−human] optionally marked objects, bilinguals performed faster than monolinguals. We suggest that the uneven experience with DOM in Catalan, particularly with the non-standard variety that frequently displays DOM and that our bilinguals also speak in everyday conversations, facilitates bilinguals’ adaptation to the optional marking of non-human objects in Spanish, much in the same manner that they accommodate the presence or absence of DOM with both human and non-human objects in other native language. Full article

Background: Pelvic organ prolapse (POP) is a public health problem that influences millions of women around the globe, and it has a significant impact on the quality of life. From the FDA statement regarding the complications of using mesh implants in POP surgery to studies that have shown the benefits and side effects, we conducted a systematic review investigating the complications associated with surgical mesh implantation for POP repair. Methods: Relevant studies were identified through a comprehensive search of scientific databases. Studies evaluating the use of mesh in POP surgery and reporting on associated complications were included. Results: Among 2816 studies, 28 studies met the research criteria, with a total number of 8958 patients, revealing that in laparoscopic mesh surgery, the rate of mesh exposure was lower compared to vaginal mesh surgery, among other complications. Conclusions: Laparoscopic mesh surgery is superior as a long-term approach for POP repair compared to vaginal mesh surgery, offering lower complication rates and potentially better anatomical success. However, vaginal mesh surgery remains a valuable option for patients who are unsuitable for laparoscopy due to specific factors. Future research should explore alternative techniques, like pectopexy with or without mesh, to further improve surgical outcomes and patient experience. Full article

Transcranial electrical stimulation (tES) is increasingly recognized for its potential to modulate cerebral blood flow (CBF) and evoke cerebrovascular reactivity (CVR), which are crucial in conditions like mild cognitive impairment (MCI) and dementia. This study explores the impact of tES on the neurovascular unit (NVU), employing a physiological modeling approach to simulate the vascular response to electric fields generated by tES. Utilizing the FitzHugh–Nagumo model for neuroelectrical activity, we demonstrate how tES can initiate vascular responses such as vasoconstriction followed by delayed vasodilation in cerebral arterioles, potentially modulated by a combination of local metabolic demands and autonomic regulation (pivotal locus coeruleus). Here, four distinct pathways within the NVU were modeled to reflect the complex interplay between synaptic activity, astrocytic influences, perivascular potassium dynamics, and smooth muscle cell responses. Modal analysis revealed characteristic dynamics of these pathways, suggesting that oscillatory tES may finely tune the vascular tone by modulating the stiffness and elasticity of blood vessel walls, possibly by also impacting endothelial glycocalyx function. The findings underscore the therapeutic potential vis-à-vis blood-brain barrier safety of tES in modulating neurovascular coupling and cognitive function needing the precise modulation of NVU dynamics. This technology review supports the human-in-the-loop integration of tES leveraging digital health technologies for the personalized management of cerebral blood flow, offering new avenues for treating vascular cognitive disorders. Future studies should aim to optimize tES parameters using computational modeling and validate these models in clinical settings, enhancing the understanding of tES in neurovascular health. Full article

A ~3-kb deletion-type DNA copy number variation (CNV, esv3587290) located at intron 7 of the VANGL1 gene (1p13.1, MIM*610132) has been proposed as a genetic factor in lupus nephritis (LN) development in adult systemic lupus erythematosus (SLE) patients across European-descent populations, but its replication in other ethnicities has been inconsistent and its association with LN in childhood-onset SLE (cSLE) remains unknown. Here, we performed an exploratory association study in a sample of 66 unrelated cSLE Mexican patients (11 males, 55 females; ages 7.8 to 18.6 years). Two stratified groups were compared: cSLE patients with (N = 39) or without (N = 27) LN, as diagnosed by renal biopsy (N = 17), proteinuria (N = 33), urinary protein–creatinine ratio > 0.2 (N = 34), and erythrocyturia and/or granular casts in urinary sediment (N = 16). For esv3587290 CNV genotyping, we performed an end-point PCR assay with breakpoint confirmation using Sanger sequencing. We also determined the allelic frequencies of the esv3587290 CNV in 181 deidentified ethnically matched individuals (reference group). The obtained genotypes were tested for Hardy–Weinberg equilibrium (HWE) using the χ² test. Associations between LN and esv3587290 CNV were tested by calculating the odds ratio (OR) and using Pearson’s χ² tests, with a 95% confidence interval and p ≤ 0.05. The esv3587290 CNV allele (OR 0.108, 95% CI 0.034–0.33, p = 0.0003) and the heterozygous genotype (OR 0.04, 95% CI 0.119–0.9811, p = 0.002) showed a significant protective effect against LN development. Finally, we characterized the precise breakpoint of the esv3587290 CNV to be NG_016548.1(NM_138959.3):c.1314+1339_1315-897del in our population. This report supports the notion that a broad genetic heterogeneity underlies the susceptibility for developing LN. Full article

(1) Background: Although culturally grounded health interventions (CGHI) have shown efficacy in improving Indigenous health, few CGHI for Queer and Transgender Pacific Islander (QTPI) communities exist to address their health promotion. This study explores QTPI experiences of health for cultural mechanisms to develop CGHI for QTPI health promotion. (2) Methods: Using Indigenist community-engaged research methodologies, we collaborated with the United Territories of Pacific Islanders Alliance of Washington and Guma’ Gela’ to conduct 11 exploratory semi-structured interviews with QTPI community members living in the Puget Sound area of Washington state. These interviews were analyzed using thematic analysis. (3) Results: QTPI well-being was greatly influenced by how settler colonialism impacted their connectedness to their families, communities, and cultures. We also found that inágofli’e’ and alofa, relational values in CHamoru and Sāmoan culture, played essential roles in facilitating QTPI health. Many participants fostered these values through chosen family, community care, and Indigenous mobilities. (4) Conclusions: Our findings indicate a need for CGHI that facilitate inágofli’e’ and alofa for QTPI to combat settler colonialism’s impacts on QTPI well-being. Finally, we present a community-centered conceptual model for culturally grounded health promotion in QTPI communities. Full article

Precisely assessing the vulnerability of landslides is essential for effective risk assessment. The findings from such assessments will undoubtedly be in high demand, providing a solid scientific foundation for a range of critical initiatives aimed at disaster prevention and control. In the research, authors set the ancient core district of Sichuan Moxi Ancient Town as the research object; they conduct and give the final result of the geological survey. Fault influences are commonly utilized as key markers for delineating strata in the field of stratigraphy, and the slope distance, slope angle, slope aspect, elevation, terrain undulation, plane curvature, profile curvature, mean curvature, relative elevation, land use type, surface roughness, water influence, distance of the catchment, cumulative water volume, and the Normalized Vegetation Index (NDVI) are used along roads to calculate annual rainfall. With the purpose of the establishment of the evaluation system, there are 17 factors selected in total. Through the landslide-susceptibility assessment by the coupled models of DNN-I-SVM and DNN-I-LR nine factors had been selected; it was found that the Area Under the Curve (AUC) value of the Receiver Operating Characteristic Curve (ROC) was high, and the accuracy of the model is relatively high. The coupler, DNN-I-LR, gives 0.875 of an evaluation accuracy of AUC, higher than DNN-I-SVM, which yielded 0.860. It is necessary to note that, in this region, compared to the DNN-I-SVM model, the DNN-I-LR coupling model has better fitting and prediction abilities. Full article

Babesiosis is a growing concern due to the increased prevalence of this infectious disease caused by Babesia protozoan parasites, affecting various animals and humans. With rising worries over medication side effects and emerging drug resistance, there is a notable shift towards researching babesiacidal agents. Antimicrobial peptides, specifically cathelicidins known for their broad-spectrum activity and immunomodulatory functions, have emerged as potential candidates. Aquiluscidin, a cathelicidin from Crotalus aquilus, and its derivative Vcn-23, have been of interest due to their previously observed antibacterial effects and non-hemolytic activity. This work aimed to characterize the effect of these peptides against three Babesia species. Results showed Aquiluscidin's significant antimicrobial effects on Babesia species, reducing the B. bigemina growth rate and exhibiting IC₅₀ values of 14.48 and 20.70 μM against B. ovata and B. bovis, respectively. However, its efficacy was impacted by serum presence in culture, and it showed no inhibition against a B. bovis strain grown in serum-supplemented medium. Conversely, Vcn-23 did not demonstrate babesiacidal activity. In conclusion, Aquiluscidin shows antibabesia activity in vitro and its efficacy is affected by the presence of serum in the culture medium. Nevertheless, this peptide represents a candidate for further investigation of its antiparasitic properties and provides insights into potential alternatives for the treatment of babesiosis. Full article

Thiocyanates form an important class of organic compounds commonly found in natural products that exhibit excellent antimicrobial activity. The electrophilic thiocyanation is one of the most effective methods of introducing a -SCN functional group to the parent organic molecule. In this work, we explored an eco-friendly and highly efficient method for thiocyanation of anilines and 1-(substituted benzylidene)-2-phenylhydrazines using commercially available N-bromoscuccinimide (NBS) and potassium thiocyanate (KSCN). The optimized protocol afforded thiocyanates with good regioselectivity and excellent yields in comparison to the available methods. Full article

Herbicide-resistant corn poppy (Papaver rhoeas L.) is one of the most important broadleaved weeds and the number of resistant cases is still growing. The aims of this study were to confirm the resistance of P. rhoeas from Tunisia to ALS inhibitors and auxin mimics and investigate the mechanisms of Target-Site Resistance (TSR) and Non-Target Site Resistance (NTSR) involved. Dose–response trials to determine cross-resistance patterns for ALS inhibitors and auxin mimics were conducted in a greenhouse. In this study, multiple resistance to tribenuron-methyl and dicamba but not to 2,4-D was found in P. rhoeas populations. Cross-resistance to imazamox was confirmed as well. Sequence analysis of the ALS gene detected target-site mutations in codon 197 of the ALS gene, namely, Pro197His, Pro197Thr, Pro197Leu, and Pro197Asn. In this study, the metabolism experiments with malathion (a cytochrome P450 inhibitor) showed that malathion reduced resistance to imazamox, indicating that P450 is involved in the resistance. TSR and NTSR mechanisms to ALS inhibitors likely coexist. The findings of this study revealed a significant synergistic interaction between malathion and dicamba in particular populations, suggesting that the resistance to auxin mimics can be conferred by enhanced metabolism. Full article

Due to the increasing demands of today’s society on visual quality and patient comfort, and due to the growing interest in the implantation of new and more complex intraocular lens (IOL) designs, determining the IOL position occupies an important position in current ophthalmological practice. The dynamic Purkinje meter combines the construction of static Purkinje meters, presented in recent years, with dynamic examination of the IOL position according to the optical axis of the IOL. Full article

As a consequence of climate change, temperature and rainfall regimes are being modified, threatening the survival of the current gardening concept in many areas of the world. This situation highlights the need to investigate the potential of other species, especially in more sensitive areas such as the Mediterranean Basin. The aim of this research is to study the resilience of adapted species to promote sustainable gardening. To achieve this, seven species belonging to three families (Amaranthaceae, Lamiaceae and Asteraceae) used or potentially used as ornamentals were selected to compare their tolerance at the germinative stage to different levels of temperature (10 °C to 35 °C) and water stress created by PEG 6000 (−0.10 MPa to −2.5 MPa). Germination percentage, mean germination time, base temperature, thermal time, base water potential and hydrotime were calculated. The results showed a good response to high temperature and low osmotic potential in most of the species, and germination even increased under certain stress levels. Salsola oppositifolia presented by far the best results in terms of germination under high-water-stress conditions and the second best at high temperatures. The extraordinary response of Celosia argentea, an alien species, highlighted the risk of it becoming an invasive species. Full article

The study of pear dormancy mechanisms is currently a major research area in pear production and has high economic significance for agricultural production. We selected the southern sand pear cultivar Pyrus pyrifolia ‘Huanghua’ as the test material to study the pear dormancy process through microscopic observation of pear flower buds. The endodormancy period is abbreviated as D_bud. Similarly, the endodormancy release initiation period and the ecodormancy period are referred to as DB_bud and G_bud, respectively. Meanwhile, RNA sequencing was used to obtain the gene expression profile of Pyrus pyrifolia ‘Huanghua’ flower buds. The RNA sequencing results indicated that there were 224 differentially expressed genes (DEGs) in endodormancy (D) vs. endodormancy release initiation period (DB), while 975 were identified between endodormancy and ecodormancy (G). Finally, a total of 868 DEGs were found in the DB vs. G comparison. The expression levels of the genes Pbr009498.1 (LAX1-1), Pbr012348.1 (LAX1-2), Pbr021158.1 (GH35), and Pbr031621.1 (LAX2) encoding IAA were significantly higher during the DB_bud than during the D_bud. The expression level of Pbr025864.2 (IAA13) during the D_bud was significantly higher than the DB_bud and G_bud. The Pbr041942.1 (GID1B) gene also showed a significant increase during ecodormancy. Taken together, these results suggest that these genes, annotated as LAX1, GH35, LAX2, IAA13, and GID1C, are involved in endodormancy maintenance and in the transition from endodormancy to ecodormancy in Pyrus pyrifolia ‘Huanghua’. Full article

Climate change exacerbates drought, globally impacting crop production and necessitating the adoption of sustainable strategies. This study investigates the potential synergistic effects of salicylic acid (SA) and Bacillus butanolivorans KJ40 (KJ40) on napa cabbage (Brassica rapa subsp. pekinensis) under water-deficit stress conditions by watering withheld for five days. Results demonstrate that the combined application of KJ40 and SA, particularly at concentrations of 0.5 mM and 1 mM, significantly enhances plant growth and mitigates the negative impacts of water deficit. Moreover, the combination treatment with SA (0.5 mM) and KJ40 (1 × 10⁸ cells/mL) reduces lipid oxidation and enhances antioxidant enzyme activity, indicating improved plant stress tolerance. Analysis of soil microbial profiles reveals alterations in metabolic activity and substrate utilization patterns, suggesting potential changes in rhizosphere dynamics. Additionally, this study examines the impact of SA on KJ40 population dynamics in soil, revealing concentration-dependent effects on bacterial survival. Overall, the combination of KJ40 and SA was effective in mitigating water-deficit stress in napa cabbage. These findings highlight the combination as a novel synergistic strategy to enhance plant resilience to water-deficit stress, offering insights into plant–microbe interactions and soil ecosystem dynamics. Full article

Floral scent is an essential and genetically complex trait in herbaceous peonies (Paeonia lactiflora Pall.); however, specific genes related to metabolic and regulatory networks remain scantily studied. Our study integrated metabolite profiling and RNA-sequencing to screen floral scent biosynthetic genes. Hence, the major molecules identified by headspace collection combined with cultivar-specific GC-MS analysis were geraniol, β-caryophyllene, 2-phenylethanol (2-PE), citronellol, and 1,8-cineole. Genes related to terpenoids and 2-PE biosynthesis were identified after the assembly and annotation of the P. lactiflora transcriptomes. Eight angiosperm-specific terpene synthases (TPSs) from the TPS-a and TPS-b clades, as well as enzymes linked to 2-PE synthesis such as aromatic amino acid decarboxylase (AADC), phenylacetaldehyde reductase (PAR), and geranial reductase (GER) were identified. The biochemical analysis of the enzymes encoded by PlPAR1 and PlGER1 generated 2-PE from phenylacetaldehyde (PAld). The pairwise alignment of AADC1 reveals a splice variant lacking a 124 bp fragment, thus highlighting the possible role of alternative splicing in modulating floral scent composition. This study offers insights into the molecular-level biosynthesis of terpenoids and 2-PE in Peonia taxa, and provides the basis for the functional characterization, breeding, and bioengineering of prospective candidate genes for the production of floral volatiles in the Paeonia genus. Full article

Due to the high respiration rate and ethylene production at the cut surface of bamboo (Dendrocalamus latifloxus Munro) shoots after harvesting, browning and lignification at the cut surface reduce their quality and shelf life. Due to the demand of consumers, using physical treatment to inhibit microbial growth and maintain quality has become more and more popular. In this study, bamboo shoots were treated with hot water at 70 °C for 30 s after harvesting and then stored at 1, 3, or 5 °C for 4 weeks to measure the quality change. Our results show that the L* value and h° angle at the cut surface of the bamboo shoots were significantly higher, but the respiration rate was significantly lower when stored at 1 °C compared with those at 3 and 5 °C. In terms of quality, the bamboo shoots showed lower firmness and cutting force values, and no decay was observed at 1 °C. The results from the shelf simulation test with rewarming of the cold-treated bamboo shoots at ambient temperature (25 °C) for 1 day indicated that the L* value and h° angle were significantly higher for the bamboo shoots stored at 1 °C compared with those stored at 3 and 5 °C. Taken together, browning and lignification at the cut surface were effectively inhibited, quality was maintained, and the storage life could be extended to 4 weeks at 1 °C. Full article

Scaffold-guided breast tissue regeneration (SGBTR) can transform both reconstructive and cosmetic breast surgery. Implant-based surgery is the most common method. However, there are inherent limitations, as it involves replacement of tissue rather than regeneration. Regenerating autologous soft tissue has the potential to provide a more like-for-like reconstruction with minimal morbidity. Our SGBTR approach regenerates soft tissue by implanting additively manufactured bioresorbable scaffolds filled with autologous fat graft. A pre-clinical large animal study was conducted by implanting 100 mL breast scaffolds (n = 55) made from medical-grade polycaprolactone into 11 minipigs for 12 months. Various treatment groups were investigated where immediate or delayed autologous fat graft, as well as platelet rich plasma, were added to the scaffolds. Computed tomography and magnetic resonance imaging were performed on explanted scaffolds to determine the volume and distribution of the regenerated tissue. Histological analysis was performed to confirm the tissue type. At 12 months, we were able to regenerate and sustain a mean soft tissue volume of 60.9 ± 4.5 mL (95% CI) across all treatment groups. There was no evidence of capsule formation. There were no immediate or long-term post-operative complications. In conclusion, we were able to regenerate clinically relevant soft tissue volumes utilizing SGBTR in a pre-clinical large animal model. Full article

Bone drilling is a common procedure used to create pilot holes for inserting screws to secure implants for fracture fixation. However, this process can increase bone temperature and the excessive heat can lead to cell death and thermal osteonecrosis, potentially causing early fixation failure or complications. We applied a three-dimensional dynamic elastoplastic finite element model to evaluate the propagation and distribution of heat during bone drilling and assess the thermally affected zone (TAZ) that may lead to thermal necrosis. This model investigates the parameters influencing bone temperature during bone drilling, including drill diameter, rotational speed, feed force, and predrilled hole. The results indicate that our FE model is sufficiently accurate in predicting the temperature rise effect during bone drilling. The maximum temperature decreases exponentially with radial distance. When the feed forces are 40 and 60 N, the maximum temperature does not exceed 45 °C. However, with feed forces of 10 and 20 N, both the maximum temperatures exceed 45 °C within a radial distance of 0.2 mm, indicating a high-risk zone for potential thermal osteonecrosis. With the two-stage drilling procedure, where a 2.5 mm pilot hole is predrilled, the maximum temperature can be reduced by 14 °C. This suggests that higher feed force and rotational speed and/or using a two-stage drilling process could mitigate bone temperature elevation and reduce the risk of thermal osteonecrosis during bone drilling. Full article

Degenerative disc disease (DDD) is a pervasive condition that limits quality of life and burdens economies worldwide. Conventional pharmacological treatments primarily aimed at slowing the progression of degeneration have demonstrated limited long-term efficacy and often do not address the underlying causes of the disease. On the other hand, orthobiologics are regenerative agents derived from the patient’s own tissue and represent a promising emerging therapy for degenerative disc disease. This review comprehensively outlines the pathophysiology of DDD, highlighting the inadequacies of existing pharmacological therapies and detailing the potential of orthobiologic approaches. It explores advanced tools such as platelet-rich plasma and mesenchymal stem cells, providing a historical overview of their development within regenerative medicine, from foundational in vitro studies to preclinical animal models. Moreover, the manuscript delves into clinical trials that assess the effectiveness of these therapies in managing DDD. While the current clinical evidence is promising, it remains insufficient for routine clinical adoption due to limitations in study designs. The review emphasizes the need for further research to optimize these therapies for consistent and effective clinical outcomes, potentially revolutionizing the management of DDD and offering renewed hope for patients. Full article

Nonsense mutations are genetic mutations that create premature termination codons (PTCs), leading to truncated, defective proteins in diseases such as cystic fibrosis, neurofibromatosis type 1, Dravet syndrome, Hurler syndrome, Beta thalassemia, inherited bone marrow failure syndromes, Duchenne muscular dystrophy, and even cancer. These mutations can also trigger a cellular surveillance mechanism known as nonsense-mediated mRNA decay (NMD) that degrades the PTC-containing mRNA. The activation of NMD can attenuate the consequences of truncated, defective, and potentially toxic proteins in the cell. Since approximately 20% of all single-point mutations are disease-causing nonsense mutations, it is not surprising that this field has received significant attention, resulting in a remarkable advancement in recent years. In fact, since our last review on this topic, new examples of nonsense suppression approaches have been reported, namely new ways of promoting the translational readthrough of PTCs or inhibiting the NMD pathway. With this review, we update the state-of-the-art technologies in nonsense suppression, focusing on novel modalities with therapeutic potential, such as small molecules (readthrough agents, NMD inhibitors, and molecular glue degraders); antisense oligonucleotides; tRNA suppressors; ADAR-mediated RNA editing; targeted pseudouridylation; and gene/base editing. While these various modalities have significantly advanced in their development stage since our last review, each has advantages (e.g., ease of delivery and specificity) and disadvantages (manufacturing complexity and off-target effect potential), which we discuss here. Full article

The prevalence of Helicobacter pylori (H. pylori), a pathogen, has decreased globally in the last decade. To date, the management of H. pylori has focused on a reactive approach, whereby those diagnosed are treated with antimicrobials and acid suppression in combination. This review article provides an overview of the shift in the management of H. pylori from a reactive approach towards a proactive ‘screen and treat’ approach; the article reflects the current pharmacological landscape for H. pylori treatment by exploring similarities such as the first-line prescription of quadruple therapy in most countries and provides a summary table of the best practice guidance from Europe, Asia, and North America. It explores significant ongoing challenges in management, such as rising antimicrobial resistance rates, and explores a potential ‘work smart’ approach to antimicrobial susceptibility testing. We explore the role of registry databases in providing data on treatment efficacy and safety and how they can support a strategic approach to H. pylori treatment. We question if such a database’s availability, update, and regular audit should serve as a key quality indicator in a population screening programme. Despite a call for vaccination against H. pylori and decades of research, not many have made it to a phase-three clinical trial. We explore the challenges that have complicated the development of such a vaccine, such as the genetic diversity of H. pylori, immunotolerance, and limitations of mouse models in research; we reflect on how these challenges are contributing to a low likelihood of having a vaccine in the short–medium term. Lastly, it explores the heterogeneity in research on probiotics and their role as an adjunct in the management of H. pylori. Full article