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Synaptic connectivity between neocortical neurons is highly structured. The network structure of synaptic connectivity includes first-order properties that can be described by pairwise statistics, such as strengths of connections between different neuron types and distance-dependent connectivity, and higher order properties, such as an abundance of cliques of all-to-all connected neurons. The relative impact of first- and higher order structure on emergent cortical network activity is unknown. Here, we compare network structure and emergent activity in two neocortical microcircuit models with different synaptic connectivity. Both models have a similar first-order structure, but only one model includes higher order structure arising from morphological diversity within neuronal types. We find that such morphological diversity leads to more heterogeneous degree distributions, increases the number of cliques, and contributes to a small-world topology. The increase in higher order network structure is accompanied by more nuanced changes in neuronal firing patterns, such as an increased dependence of pairwise correlations on the positions of neurons in cliques. Our study shows that circuit models with very similar first-order structure of synaptic connectivity can have a drastically different higher order network structure, and suggests that the higher order structure imposed by morphological diversity within neuronal types has an impact on emergent cortical activity.

To compete effectively, living organisms must adjust the allocation of available energy resources for growth, survival, maintenance, and reproduction throughout their life histories. Energy demands and allocations change throughout the life history of an organism, and understanding their energy allocation strategies requires determination of the relative age of individuals. As most scleractinian corals are colonial, the relationship between age and mass/size is complicated by colony fragmentation, partial mortality, and asexual reproduction. To overcome these limitations, solitary mushroom corals, Herpolitha limax from Okinawa, Japan and Fungia fungites from Okinawa and the Great Barrier Reef (GBR), Australia, were used to investigate how energy allocation between these fundamental processes varies as a function of age. Measurements of the relative growth, biochemical profiles, fecundity of individuals of different sizes, and the settlement success of their progeny have revealed physiological trade-offs between growth and reproduction, with increasing body mass ultimately leading to senescence. The importance of energy allocation for reproduction led us to examine the reproductive strategies and sex allocation in the two studied species. In the present study, the smallest individuals of both species studied were found to invest most of their energy in relative growth, showing higher lipid and carbohydrate content than the later stages. In medium-sized corals, this pattern was overturned in favour of reproduction, manifesting in terms of both the highest fecundity and settlement success of the resulting brooded larvae. Finally, a phase of apparent senescence was observed in the largest individuals, characterized by a decrease in most of the parameters measured. In addition, complex reproductive plasticity has been revealed in F. fungites in the GBR, with individual females releasing eggs, embryos, planulae, or a combination of these. These data provide the most direct estimates currently available for physiological, age-related trade-offs during the life history of a coral. The unusual reproductive characteristics of the GBR F. fungites indicate previously unknown layers of complexity in the reproductive biology of corals and have implications for their adaptive potential across a wide geographical scale.

Plankton show preferential swimming towards fluorescent cues compared to non-fluorescent targets in both the laboratory and the sea. Further, green fluorescence enhances predation success, suggesting a prey-luring effect of fluorescence in corals.

High-latitude habitats have become increasingly recognized as a potential climate refuge for coral communities, supporting both tropical and sub-tropical corals. Despite the increasing interest in the ecology of high-latitude corals, our current knowledge of their temporal dynamics is limited, especially within urbanized settings. Here, we examined the entire history of a high-latitude coral reef ecosystem in an urbanized setting. We surveyed Holocene fossil and modern coral communities along a water quality gradient in Moreton Bay, southeast Queensland, Australia, representing near-river (Wellington Point), intermediate (Peel Island) and near-oceanic (Myora Reef) environmental conditions. Reef accretion occurred during three discrete episodes from 7,400 to 5,800, 4,900 to 3,000, and 2,100 to 300 years BP, each separated by roughly 1,000-year hiatuses, where conditions were probably not favorable enough for reef accretion to occur. Episodic reef initiation and termination suggests strong environmental controls over reef development. Eastern Australian Holocene reef growth and cessation has been linked previously to sea level fluctuations and climatic regimes (e.g., ENSO). Within each reef building episode, there were few changes in coral assemblages over time. The fast growing and branching Acropora had a relative abundance greater than 90% in ten of the 13 sediment cores and all the submerged terrace excavations. However, substantial modification of adjacent coastal catchments from European colonization in the mid 1800’s resulted in increased sediment and nutrient discharge into the bay. This perturbation coincided with a greater abundance of stress-tolerant coral species (e.g., Dipsastraea, Goniastrea, and Goniopora) and the near extirpation of Acropora in the modern coral communities of near-river and intermediate sites due to poor water quality. In contrast, the modern coral assemblage at the near-oceanic site (Myora Reef) continues to be dominated by Acropora, likely due to the consistent oceanic input, resulting in lower sediment loading and higher water quality. In order for conditions for reef growth to improve, especially within the near-river portions of the bay, further sediment and nutrient runoff from anthropogenic land-use changes need to be mitigated. Given the historical abundance of Acropora, we recommend this genus be used as an indicator of natural resource management success in the bay.

Measurement(s) Point in Time Date and Time Data Type • Spawning Technology Type(s) Observation • digital curation Sample Characteristic - Organism Scleractinia Sample Characteristic - Environment ocean Sample Characteristic - Location Pacific Ocean • Indian Ocean region Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.13100552

The distinction between shallow coral reefs and mesophotic coral ecosystems (MCEs) has not been fully clarified yet. The original definition of MCEs, by depths of 30–150 m, fixes their bathymetrical limits and fails to accommodate environmental and biological variation. Recent studies have indicated that water transparency and light availability may explain why MCEs do not occur at fixed depths but vary among localities. This study aimed to evaluate the presence and distribution of MCEs, along the central coast of Oaxaca, through optical depths and the associated benthic community. Using MODIS-Aqua satellite data (Kd490), we estimated the mesophotic optical depths monthly (z10%, z1%, z0.1%), over the last four years. In addition, to characterize benthic community structure, we conducted underwater photo quadrat surveys at two locations on the southern Mexican Pacific coast from 10 to 55 m depth. Significant differences between depths and locations were found in benthic communities. Furthermore, the lower distribution of photosynthetic taxa was different between the two locations but indicative to the z10% and z1% in both cases. Those differences were associated with the upwelling season, which reduces, drastically and differentially, the light availability for benthic communities between the two locations and limits the development of MCEs on the central coast of Oaxaca.

Introduction: Soft contact lenses may be a good alternative for early‐stage keratoconus (KC) patients who do not tolerate rigid gas permeable (RGP) lenses due to ocular discomfort or complications. This prospective study compared outcomes obtained after 2 weeks of wearing two types of soft silicone hydrogel contact lenses for keratoconus that varied in their diameter and central thickness (cc). Methods: Patients with Amsler–Krumeich grades I or II KC were fitted with small‐diameter (14.2 or 14.8 mm) SoftK (SD‐SoftK, cc = 0.48 mm) and large‐diameter (17 mm) SoftK (LD‐SoftK, cc = 0.60 mm) lenses, each worn for 2 weeks in a crossover design. Low (10%;10VA) and high (100%;100VA) contrast visual acuity, contrast sensitivity (CS, Pelli‐Robson), higher order aberrations (HOAs, Visionix Vx130), the number of trial lens modifications during fitting and the subjectively preferred lens were compared using Friedman tests with post‐hoc analysis. Results: Forty eyes (N = 20, 10 males, mean age: 39.0 ± 9.9 years, range: 23–55 years) were examined. Their habitual median (interquartile1, interquartile3) 10VA (LogMAR), 100VA (LogMAR) and CS (LogCS) were 0.52 (0.30, 0.50), 0.14 (0.10, 0.15) and 1.35 (1.35, 1.50), respectively. For the SD‐SoftK condition, the values were 0.23 (0.17, 0.30), 0.02 (0.00, 0.05) and 1.50 (1.50, 1.65), respectively. For the LD‐SoftK condition, the respective values were 0.36 (0.27, 0.44), 0.09 (0.05, 0.13) and 1.50 (1.50, 1.60). SD‐SoftK lenses significantly improved 10VA compared with habitual and LD‐SoftK. SD‐SoftK also significantly improved CS compared with habitual, but not LD‐SoftK. LD‐SoftK significantly improved spherical aberration compared with uncorrected (0.03 ± 0.10 μ vs. 0.07 ± 0.13 μ) but not SD‐SoftK (0.04 ± 0.07 μ). Both lenses required a mean of 1.5 modifications prior to final lens fitting. Fewer adverse events were seen with SD‐SoftK (N = 3) compared with LD‐SoftK (N = 8), and 75% of participants preferred SD‐SoftK lenses. Conclusion: SD‐SoftK lenses were preferred by 75% of subjects, were associated with fewer adverse events and significantly improved 10VA compared with LD‐SoftK lenses. SD‐SoftK lenses also significantly improved CS compared with the habitual correction, but this did not differ significantly from the LD‐SoftK lenses. [ABSTRACT FROM AUTHOR]

Population size structure provides information on demographic characteristics, such as growth and decline, enabling post-hoc assessment of spatial differences in susceptibility to disturbance. Nevertheless, very few studies have quantified size data of scleractinian corals along a shallow-mesophotic gradient, partly because of previously inaccessible depths. Here, we report the coral size-frequency distributions at the morphology level (six growth forms) and at the species level for ten representative locally abundant species along a broad depth gradient (5–100 m) in the Gulf of Eilat/Aqaba (GoE/A). A total of 18,865 colonies belonging to 14 families and 45 genera were recorded and measured over four reef sites. Colonies were found to be 11.2% more abundant at mesophotic (40–100 m; 55.6%) depths compared with shallow (5–30 m; 44.4%). The coral taxa exhibited heterogeneity in their size-structure, with marked differences among depths, morphological growth forms, and species. Branching and corymbose corals were more prevalent in shallow waters, while encrusting and laminar forms comprised the majority of mesophotic corals. Nevertheless, massive morphology was the most abundant growth form across all sites and depths (39%), followed by laminar (26%) and encrusting (20%). Corymbose corals (primarily Acroporidae) revealed constrained size at all depths; with the lack of small-size groups indicating populations at risk of decline. Depth-generalist species belonging to massive and laminar morphologies generally exhibited a larger colony size at the mesophotic depths, but were typified by a higher number of small colonies. Furthermore, we refute the widely and long-accepted assertion that Stylophora pistillata is the most abundant coral in the northern GoE/A, and assert that Leptoseris glabra is the one. Here, we provide a baseline for future monitoring of coral population structures, insights to recent ecological dynamics, retrospective assessment of coral community recovery following disturbances and grounds for conservation assessments and management actions.

Purpose: Astigmatism blurs the retinal image of a circular spot along a particular orientation rendering it an elliptical shape. Astigmatic patients demonstrate adaptation to residual astigmatic blur that may affect their discrimination between oval and circular targets. The Wilkins Egg and Ball Test (WEBT) was created to detect altered visual perception due to residual astigmatic blur by discriminating a circle within a row of oval elements. This prospective, cross-sectional study examined the utility of WEBT in detecting uncorrected residual astigmatism on the perception of form symmetry in astigmatic and keratoconic participants as well as normal participants with induced astigmatism at four primary meridians. Methods: The mean search time (sT) and number of errors (noE) of 33 non-astigmatic controls (mean age: 24± 5, range: 18– 43, 6 males), 23 astigmatic participants (mean age: 36± 12, range: 18– 43, 6 males) and 13 keratoconic participants (N=22 eyes, mean age: 36± 12, range: 18– 58, 6 males) were measured under baseline, and 2.00 DC induced cylinder at four primary meridians, and for uncorrected, spherical-correction only, and fully corrected conditions, respectively. Mean sT and noE were converted to Z-scores, combined for each condition, and compared using repeated measures ANOVA with post-hoc analysis. Results: Combined Z-scores for the controls were significantly worse (p< 0.001) for all induced cylinder conditions. The induced 180° condition was significantly better than 45° and 90° conditions (p=0.04), but not the 135° condition. For both astigmatic and keratoconic cohorts, Z-scores of the uncorrected condition were significantly worse than the fully corrected condition (both p< 0.01), but the fully corrected and spherical-only conditions did not differ significantly (p=0.06 and p=0.05, respectively). Conclusion: In accommodating young adults, WEBT detected altered visual perception due to overall blur, and moderate-high amounts of uncorrected induced astigmatism and keratoconus, but is not useful as a tool for detection of altered visual perception due to small residual astigmatic blur. [ABSTRACT FROM AUTHOR]

Abstract Light quality is a crucial physical factor driving coral distribution along depth gradients. Currently, a 30 m depth limit, based on SCUBA regulations, separates shallow and deep mesophotic coral ecosystems (MCEs). This definition, however, fails to explicitly accommodate environmental variation. Here, we posit a novel definition for a regional or reef‐to‐reef outlook of MCEs based on the light vs. coral community–structure relationship. A combination of physical and ecological methods enabled us to clarify the ambiguity in relation to the mesophotic definition. To characterize coral community structure with respect to the light environment, we conducted wide‐scale spatial studies at five sites along shallow and MCEs of the Gulf of Eilat/Aqaba (0–100 m depth). Surveys were conducted by technical‐diving and drop‐cameras, in addition to one year of light spectral measurements. We quantify two distinct coral assemblages: shallow (

In an endeavor to study natural systems at multiple spatial and taxonomic resolutions, there is an urgent need for automated, high-throughput frameworks that can handle plethora of information. The coalescence of remote-sensing, computer-vision, and deep-learning elicits a new era in ecological research. However, in complex systems, such as marine-benthic habitats, key ecological processes still remain enigmatic due to the lack of cross-scale automated approaches (mms to kms) for community structure analysis. We address this gap by working towards scalable and comprehensive photogrammetric surveys, tackling the profound challenges of full semantic segmentation and 3D grid definition. Full semantic segmentation (where every pixel is classified) is extremely labour-intensive and difficult to achieve using manual labeling. We propose using label-augmentation, i.e., propagation of sparse manual labels, to accelerate the task of full segmentation of photomosaics. Photomosaics are synthetic images generated from a projected point-of-view of a 3D model. In the lack of navigation sensors (e.g., a diver-held camera), it is difficult to repeatably determine the slope-angle of a 3D map. We show this is especially important in complex topographical settings, prevalent in coral-reefs. Specifically, we evaluate our approach on benthic habitats, in three different environments in the challenging underwater domain. Our approach for label-augmentation shows human-level accuracy in full segmentation of photomosaics using labeling as sparse as 0.1%, evaluated on several ecological measures. Moreover, we found that grid definition using a leveler improves the consistency in community-metrics obtained due to occlusions and topology (angle and distance between objects), and that we were able to standardise the 3D transformation with two percent error in size measurements. By significantly easing the annotation process for full segmentation and standardizing the 3D grid definition we present a semantic mapping methodology enabling change-detection, which is practical, swift, and cost-effective. Our workflow enables repeatable surveys without permanent markers and specialized mapping gear, useful for research and monitoring, and our code is available online. Additionally, we release the Benthos data-set, fully manually labeled photomosaics from three oceanic environments with over 4500 segmented objects useful for research in computer-vision and marine ecology.

Mesophotic ecosystems (MEs) are characterized by the presence of light-dependent organisms, found at depths ranging from ~30 to 150 m in temperate, subtropical and tropical regions. These communities occasionally create massive reef structures with diverse but characteristic morphologies, which serve as the framework builders of those ecosystems. In many localities, MEs are physically linked with shallow and deep-sea habitats, and while taxa from both environments share this space, a unique and endemic biodiversity is also found. The main MEs studied to date are the mesophotic coral ecosystems (MCEs) and the temperate mesophotic ecosystems (TMEs), which have received increased attention during the last decade. As shallow coral reef ecosystems are among the most threatened habitats on Earth, the potential of MEs to act as refugia and contribute to the resilience of the whole ecosystem has been a subject of scrutiny. New technologies and methods have become more available to study these deeper parts of the reef ecosystems, yielding many new discoveries. However, basic gaps in knowledge remain in our scientific understanding of the global diversity of MEs, limiting our ability to recognize biogeographic patterns and to make educated decisions for the management and conservation of these ecosystems.

Corals and their photosymbionts experience inherent changes in light along depth gradients, leading them to have evolved several well-investigated photoacclimation strategies. As coral calcification is influenced by light (a process described as LEC—‘light-enhanced calcification’), studies have sought to determine the link between photosynthesis and calcification, but many puzzling aspects still persist. Here, we examine the physiology of Euphyllia paradivisa, a coral species found at a wide range of depths but that is strictly mesophotic in the Red Sea; and also examines the coupling between photosynthesis and LEC by investigating the response of the coral under several controlled light regimes during a long-term experiment. E. paradivisa specimens were collected from 40 to 50 m depth and incubated under three light conditions for a period of 1 year: full-spectrum shallow-water light (approx. 3 m, e.g. shallow-light treatment); blue deep-water light (approx. 40 m, e.g. mesophotic-light treatment) or total darkness (e.g. dark treatment). Net photosynthesis remained similar in the shallow-light-treated corals compared to the mesophotic-light-treated corals, under both low and high light. However, calcification increased dramatically with increasing light intensity in the shallow-light-treated corals, suggesting a decoupling between these processes. Photoacclimation to shallow-water conditions was indicated by enhanced respiration, a higher density of zooxanthellae per polyp and lower chlorophyll a content per cell. The dark-treated corals became completely bleached but did not lower their metabolism below that of the mesophotic-light-treated corals. No Symbiodinium clade shift was found following the year-long light treatments. We conclude that E. paradivisa, and its original symbiont clade, can adapt to various light conditions by controlling its metabolic rate and growth energy investment, and consequently induce LEC.

The recognition of the microbiota complexity and their role in the evolution of their host is leading to the popularization of the holobiont concept. However, the coral holobiont (host and its microbiota) is still enigmatic and unclear. Here, we explore the complex relations between different holobiont members of a mesophotic coral Euphyllia paradivisa. We subjected two lines of the coral—with photosymbionts, and without photosymbionts (apo-symbiotic)—to increasing temperatures and to antibiotics. The different symbiotic states were characterized using transcriptomics, microbiology and physiology techniques. The bacterial community’s composition is dominated by bacteroidetes, alphaproteobacteria, and gammaproteobacteria, but is dependent upon the symbiont state, colony, temperature treatment, and antibiotic exposure. Overall, the most important parameter determining the response was whether the coral was a symbiont/apo-symbiotic, while the colony and bacterial composition were secondary factors. Enrichment Gene Ontology analysis of coral host’s differentially expressed genes demonstrated the cellular differences between symbiotic and apo-symbiotic samples. Our results demonstrate the significance of each component of the holobiont consortium and imply a coherent link between them, which dramatically impacts the molecular and cellular processes of the coral host, which possibly affect its fitness, particularly under environmental stress.

This document is a response to a letter regarding the publication titled "Optimizing the Wilkins Egg and Ball Test: Overcoming Limitations for Accurate Astigmatism Detection." The authors of the response conducted a study to evaluate the effectiveness of the Wilkins' Egg and Ball Test in identifying uncorrected residual astigmatism and its impact on form symmetry perception. The study found no significant differences in the test results between two sessions for normal participants. The authors acknowledge the limitations of the test and suggest that further investigations are needed to improve its usefulness. [Extracted from the article]

Intrathoracic esophageal perforation is a devastating event bearing high mortality rates. Prompt recognition and aggressive treatment are key. Traditionally, most patients required surgical treatment, but recently, endoscopic techniques, mainly endoscopic vacuum-assisted closure (EVAC), have been recognized as a valuable alternative in selected patients. Herein, we describe a novel technique in which a nasogastric tube (NGT) was placed endoscopically into a mediastinal abscess and covered with a self-expanding metal stent to treat esophageal defects in three patients. [ABSTRACT FROM AUTHOR]

Purpose: Assess the refractive states of donkeys and goats. Methods: Forty‐two donkeys and 28 goats were enrolled. The mean ± SD ages were 7.68 ± 7.33 years for donkeys and 4.26 ± 2.33 years for goats. Seven donkeys and one goat were <6 months old. Retinoscopy was performed in alert animals, following cycloplegia in goats but not in donkeys. Normality was determined using the Kolmogorov–Smirnov test. The two primary meridians and two eyes were compared using Pearson's correlation and paired Student's t–tests. The association between refractive states and age was examined using one‐way ANOVA in donkeys and a paired Student's t‐test in goats. One‐sample t‐tests were conducted to assess if the refractive error distributions were significantly different from "0". Results: The mean ± SD spherical equivalent (SE) refractive errors of the right and left donkey eyes were −0.80 ± 1.03 D and −0.35 ± 0.95 D, respectively. The majority (86%) of the donkeys had an astigmatic refraction and eight (19%) had anisometropia. The mean SE refractive errors of the right and left goat eyes were −0.15 ± 1.1 D and −0.18 ± 1.2 D, respectively. The majority (54%) of the goat eyes had an astigmatic refraction and five (18%) had anisometropia. The right and left eye SE refractive errors were positively correlated in both species (both p =.9). Age was not correlated with refractive error in both donkeys (p =.09) and goats (p =.6). Conclusions: Both goats and donkeys are emmetropic. [ABSTRACT FROM AUTHOR]

The growth in human population along coastal areas is exposing marine environments to increasing anthropogenic light sources. Despite the potential effects of this modern phenomenon, very few studies have examined its implications for corals. Here, we present a long-term study of coral early life stages under light pollution conditions at night. Coral larvae were collected from Stylophora pistillata colonies, and then settled and grown under experimental conditions of two different common city lighting methods (fluorescent or LED). Effects of the artificial lighting on the coral settlement success, survivorship, growth rate, photosynthetic efficiency, and calcification rate were examined over a period of one year. The control exhibited ~30% higher settlement success compared to the two light treatments, while under the light treatments corals showed higher survivorship, growth, and calcification rates. In addition, an indication of damage to the photosynthetic system was found in the light-polluted corals, which was reflected in their photosynthesis efficiency parameters: i.e., lower maximum light utilization coefficient (α), lower maximum potential photosynthetic rate (Pmax), and lower photosynthetic maximal quantum yield (Fv/Fm). Our findings provide evidence of the potential adverse effects of artificial lighting methods on the natural environment of coral reefs. We conclude that the use of the LED lighting method has high interference potential for the early life stages of corals.

The profound mutualistic symbiosis between corals and their endosymbiotic counterparts, Symbiodiniaceae algae, has been threatened by the increase in seawater temperatures, leading to breakdown of the symbiotic relationship—coral bleaching. To characterize the heat-stress response of the holobiont, we generated vital apo-symbiotic Euphyllia paradivisa corals that lacked the endosymbiotic algae. Using RNA sequencing, we analyzed the gene expression of these apo-symbionts vs. symbiotic ones, to test the effect of the algal presence on the tolerance of the coral. We utilized literature-derived lists of “symbiosis differentially expressed genes” and “coral heat-stress genes” in order to compare between the treatments. The symbiotic and apo-symbiotic samples were segregated into two separate groups with several different enriched gene ontologies. Our findings suggest that the presence of endosymbionts has a greater negative impact on the host than the environmental temperature conditions experienced by the holobiont. The peak of the stress reaction was identified as 28 °C, with the highest number of differentially expressed genes. We suggest that the algal symbionts increase coral holobiont susceptibility to elevated temperatures. Currently, we can only speculate whether coral species, such as E. paradivisa, with the plasticity to also flourish as apo-symbionts, may have a greater chance to withstand the upcoming global climate change challenge.

Many neurodegenerative diseases are associated with the death of specific neuron types in particular brain regions. What makes the death of specific neuron types particularly harmful for the integrity and dynamics of the respective network is not well understood. To start addressing this question we used the most up-to-date biologically realistic dense neocortical microcircuit (NMC) of the rodent, which has reconstructed a volume of 0.3 mm3 and containing 31,000 neurons, ∼37 million synapses, and 55 morphological cell types arranged in six cortical layers. Using modern network science tools, we identified hub neurons in the NMC, that are connected synaptically to a large number of their neighbors and systematically examined the impact of abolishing these cells. In general, the structural integrity of the network is robust to cells' attack; yet, attacking hub neurons strongly impacted the small-world topology of the network, whereas similar attacks on random neurons have a negligible effect. Such hub-specific attacks are also impactful on the network dynamics, both when the network is at its spontaneous synchronous state and when it was presented with synchronized thalamo-cortical visual-like input. We found that attacking layer 5 hub neurons is most harmful to the structural and functional integrity of the NMC. The significance of our results for understanding the role of specific neuron types and cortical layers for disease manifestation is discussed. [ABSTRACT FROM AUTHOR]

The resistance of Helicobacter pylori isolated in Israel to metronidazole, clarithromycin, tetracycline, amoxicillin and cefixime was tested in 138 isolates, including 28 from treatment failures. No resistance to tetracycline was detected. Resistance to amoxicillin was found in one isolate (MIC = 1.5 mg/L) from an untreated patient, and resistance to cefixime in two isolates from each group (P = 0.18). Resistance to metronidazole and clarithromycin was much higher in the isolates from treated than from untreated patients: 60.7% and 38.2% for metronidazole (MIC >or= 8 mg/L) (P = 0.03); 46.4% and 8.2% for clarithromycin (MIC >or= 2 mg/L) (P < 0.001). Therapeutic outcome would benefit from susceptibility testing, especially after treatment failure. [ABSTRACT FROM AUTHOR]