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Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Although the number of point-of-care ultrasound devices available in Hungarian primary care practices are increasing due to government funding, their use in day-to-day patient care is limited and unregulated. Our study aimed to evaluate the attitudes and needs of general practitioners (GPs) and patients in Hungary regarding the introduction of bedside ultrasonography in primary care practices. Methods: As a part of a cross-sectional study, an anonymous, self-administered questionnaire was distributed to GPs and patients on a social media platform. Data collection was carried out from August 2023 to October 2023. Chi-square test was used to determine the associations between categorical variables. Results: The survey was completed by 415 GPs (mean age 53.8 ± 11.1 years, 54.9% female, mean 19.5 ± 11.9 years of practice) and 693 patients (mean age 45.5 ± 12.3 years, 95.2% female). There was a statistically significant increase in interest in PoCUS among young and middle-aged GPs (age 28–59; p = 0.02). In addition, this population of GPs was also more likely to undertake training in PoCUS than their older colleagues (p < 0.0001). An inverse relationship was found between the duration of practice and training willingness (p = 0.0011). Even with the government's financial support, only 8.2% of GPs currently use PoCUS in a daily basis, and 59.5% of GPs are unfamiliar with the indications and the ways of using it. Patients would even pay to have the examination done in a primary care setting, even though only 45.9% of patients would pay a GP who is not certified in PoCUS, but the willingness to pay increased to 99.4% for those with formal training (p = 0.024). Conclusion: Our findings indicate a significant interest in adapting PoCUS in primary care from both GPs and patients. Based on the fact that a significant proportion of Hungarian GPs are unaware of PoCUS and its indications, it is particularly important to develop educational frameworks, and practical guidelines for the effective incorporation of PoCUS in Hungary. [ABSTRACT FROM AUTHOR]

The article thoroughly investigates the relationships between terrain features and tree measurements derived from aerial laser scanning (ALS) data and field surveys in a 1067-hectare forested area. A digital elevation model (DEM) was generated from ALS data, which was then used to derive additional layers such as slope, aspect, topographic position index (TPI), and landforms. The authors developed a mathematical procedure to determine the radii for the topographic position index. The canopy height model was created, and individual trees were segmented using a novel voxel aggregation method, allowing for the calculation of tree height and crown size. Accuracy assessments were conducted between ALS-derived data and field-collected data. Terrain variability within each forest unit was evaluated using characteristics such as standard deviation, entropy, and frequency. The relationships between tree height and the derived topographic features within forest subcompartments, as well as the correlation between the height yield map for the entire area and the TPI layer, were analysed. The authors found strong correlation between the topographic position index and tree heights in both cases. The presented remote-sensing-based methodology and the results can be effectively used in digital forest site mapping, complemented by field sampling and laboratory soil analyses, and, as final goal, in carbon stock assessment. [ABSTRACT FROM AUTHOR]

Novel soil datasets and the application of pedotransfer functions provide soil hydraulic input data for modelling hydrological processes at different scales. We aimed to evaluate the reliability of soil hydraulic parameters derived by indirect methods in simulation of soil moisture time series and water budgets at profile level of three sites (Forest, Orchard and Grassland) from a Central European catchment (Lake Balaton, Hungary). Five soil-vegetation-atmosphere model variants were set up with the Hydrus-1D model for each site, differing only in the parametrization of input soil data: i) a calibrated reference, ii) measured values, iii) values predicted from measured basic soil properties, iv) values predicted from national soil map information, v) values derived from the 3D soil hydraulic dataset of Europe. Calibrated soil parameters led to Nash-Sutcliffe efficiency 0.50, 0.54 and 0.71 for the Forest, Orchard and Grassland Site respectively. The outcomes for model efficiency of soil moisture underline the superiority of local databases over regional ones and the need for more detailed vertical discretization during modelling. The model performance according to soil moisture and water budget accuracy led to different rank order of model variants. Water budget comparisons indicated moderate differences between the hydrologic fluxes simulated by the different model variants, emphasizing the uncertainties associated with soil hydraulic parametrization either at local or at watershed scale. [ABSTRACT FROM AUTHOR]

Sunflower is considered a plant with extraordinary adaptability. However, the conditions of growing sunflower function as a limiting factor in its production. The hybrids used in production tolerate weather variability to a different level and utilise the nutrient and water resources of the soil, while the yield is also affected by the number of plants per hectare. In this study, the authors attempted to observe the environmental effects influencing sunflower cultivation, the heterogeneous productivity zones of the given production site and the correlation of the number of seeding plants used under various farm practices. The average rainfall of 2021 and the dry weather of 2022 created suitable conditions for examining the yearly weather effect. In the selected experimental areas, three distinguishable zones were defined in terms of productivity. In each productivity zone, three crop density steps were used in four replicates. Based on the performed comparative tests, the rainy year of 2021 resulted higher yield than the drier year of 2022 in the average- and high productivity zones, while in the low-productivity zone, higher yields were harvested under the drier conditions of 2022 than in the rainy year of 2021. In 2021, with the improvement in productivity, the obtained yield was also higher. However, in 2022, this clarity could not be demonstrated. In the zones with low productivity, identical yield results were observed in both weather conditions. Based on the examination of the obtained results, it was shown that the effect of weather conditions and the given number of plants have a smaller influence on the yield results of low-productivity zones, while these factors have a greater influence on the yields of high-productivity zones. [ABSTRACT FROM AUTHOR]

Potentiodynamic and galvanostatic experiments have been used to investigate the electrodeposition of Zn and to develop a reliable recovery method from a purified spent pickling liquor (SPL) of hot dip galvanization. The main bjective was to find the suitable conditions to deposit high-grade Zn from the purified ZnCl2–HCl–NaCl solution in a conventional electrowinning cell holding the stationary electrolyte. The effects of pH (1.5–4.5) in and Zn concentration (30–150 g/dm3) in the stationary electrolytes were studied first by the potentiodynamic method to reveal the major characteristics of the cathodic process and to give reference for further practical examinations by the galvanostatic technique. The electrowinning experiments pointed out the effects of these major parameters, beside other practical factors, like apparent current density (c.d.) and additional NaCl concentration. The long-term galvanostatic experiments proved that the current efficiency (c.e.) increases significantly as the pH and the Zn concentration are increased. A c.e. of ~ 99% can be reached with an electrolyte of pH ~ 5, Zn concentration ~ 50 g/dm3 applying a c.d. in the 300–600 A/m2 range. Increasing the Zn concentration could considerably improve also the deposit morphology. The addition of NaCl can practically improve the c.e. if the Zn concentration is at least around 50 g/dm3. In contrast, this improvement is largely off-set by the negative effects of strong H2 evolution at low (e.g. < 10 g/dm3) Zn concentrations. Extremely high Cl− ion concentrations, however, inhibit the cathodic reaction by stronger chloro-complex formation. In this case the intensive H+ reduction causes hydroxide precipitation.Article Highlights: The evolution of hydrogen and the reduction of Zn2+ are reflected in polarization curves and the development of surface irregularities at the cathode. The current efficiencies and the surface morphologies were determined with different electrolyte compositions in a wide range of apparent current densities. A pH values in the range of 2–5 and apparent current densities of 600–1200 A/m2 were found suitable to avoid excessive hydrogen evolution and hydroxide precipitation. Sodium chloride addition enhances chloro-complexation of zinc, promotes hydroxide precipitation and hydrogen evolution. [ABSTRACT FROM AUTHOR]

Background/Objectives: Autoimmune pancreatitis (AIP) is a diagnosis-challenging disease that often mimics pancreatic malignancy. Pancreatic resection is considered to be a curative treatment for pancreatic ductal adenocarcinoma (PDAC). This meta-analysis aims to study the incidence of AIP in patients who have undergone pancreatic resection for clinical manifestation of cancer. Methods: A comprehensive search was conducted in three databases, PubMed, Embase and the Cochrane Library, using the terms 'autoimmune pancreatitis' and 'pancreatic resection' and supplemented by manual checks of reference lists in all retrieved articles. Results: Ten articles were included in the final analysis. 8917 pancreatic resections were performed because of a clinical suspicion of pancreatic cancer. AIP accounted for 140 cases (1.6%). Type 1 AIP comprised the majority of cases, representing 94% (132 cases), while type 2 AIP made up the remaining 6% (eight cases) after further classification. AIP accounted for almost 26% of all cases of benign diseases involving unnecessary surgery and was overrepresented in males in 70% of cases compared to 30% in females. The mean age for AIP patients was 59 years. Serum CA 19 − 9 levels were elevated in 23 out of 47 (49%) AIP patients, where higher levels were detected more frequently in patients with type 1 AIP (51%, 22 out of 43) than in those with type 2 AIP (25%, 1 out of 4). The sensitivity of IgG4 levels in type 1 AIP was low (43%, 21/49 patients). Conclusion: Even with modern diagnostic methods, distinguishing between AIP and PDAC can still be challenging, thus potentially resulting in unnecessary surgical procedures in some cases. Serum CA 19 − 9 levels are not useful in distinguishing between AIP and PDAC. Work must thus be done to improve diagnostic methods and avoid unnecessary complicated surgery. [ABSTRACT FROM AUTHOR]

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Clear-cutting is the most robust intervention in a forest ecosystem, causing marked changes in ecosystem processes. Although the effects of forest harvesting have been widely investigated, comparative studies can provide vital supplementary information concerning specific fields, including changes in soil microbiota structure and functioning. Our study examined the soil bacterial community composition, diversity, and activity of a mixed pedunculate oak stand over three years after clear-cutting based on 16S rRNA sequencing and substrate-induced respiration data. In addition, we conducted a yearly comparison with a control oak stand already in the regeneration phase. According to our results, the forest harvest caused only limited changes in the diversity, structure, and activity of the soil bacterial community of the oak stand, suggesting that soil parameters influence the soil bacterial community structure and functioning more significantly than the cessation of forest cover. [ABSTRACT FROM AUTHOR]

Background and Objectives: The overall- and progression-free survival rates of Hodgkin's lymphoma patients have improved. Our goal was to examine the changes in our treatment results and their causes depending on the daily diagnostic and therapeutic practice. Materials and Methods: We analysed data of 776 classical Hodgkin lymphoma patients treated between 1980 and 2019. Patient data were investigated in ten-year periods (first period: 1980–1989, second period: 1990–1999, third period: 2000–2009, and fourth period: 2010–2019). Results: Radiotherapy alone as a first-line treatment was used progressively less often, and in the 4th period it was no longer used before or without chemotherapy. The use of combined chemo- and radiotherapy decreased in the last period, and the number of those patients who received only chemotherapy increased significantly. The 10-year overall survival improved significantly from 1990 to 1999 compared to 2010 to 2019 (74.9% vs. 86.9%). About 30% of patients relapsed after or were refractory to first-line therapy in each period. The incidence of relapse in the last period did not increase after two years, but there was no significant difference between the periods. Conclusions: Overall survival rates of HL patients have improved significantly in recent decades, which is due to improved diagnostic methods and modern therapies. Progression-free survival is unchanged; one-third of patients relapse or are refractory to first-line treatment within the first two years. Early recognition of R/R patients, the early application of newer and already available innovative therapies, and the finding of additional new and effective therapies are of particular importance. [ABSTRACT FROM AUTHOR]

Distal arthrogryposis (DA) is a skeletal muscle disorder that is characterized by the presence of joint contractures in various parts of the body, particularly in the distal extremities. In this study, after a systematic review of the literature, we present a case report of a non-consanguineous family. In our case, the first-trimester ultrasound was negative, and the presence of the affected mother was not enough for the parents to consent to us performing invasive amniotic fluid sampling. The second-trimester ultrasound showed clear abnormalities suggestive of arthrogryposis. Whole-exome sequencing was performed and an autosomal dominantly inherited disease-associated gene was identified. In our case, a pathogenic variant in the TNNT3 gene c.188G>A, p.Arg63His variant was identified. The mother, who had bilateral clubfoot and hand involvement in childhood, carried the same variant. The TNNT3 gene is associated with distal arthrogryposis type 2B2, which is characterized by congenital contractures of the distal limb joints and facial dysmorphism. In the ultrasound, prominent clubfoot was identified, and the mother, who also carried the same mutation, had undergone surgeries to correct the clubfoot, but facial dysmorphism was not detected. Our study highlights the importance of proper genetic counseling, especially in an affected parent(s), and close follow-up during pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the rate of residual disease in the Potsic staging system for congenital cholesteatomas. Methods: A protocol registration was published on PROSPERO (CRD42022383932), describing residual disease as a primary outcome and hearing improvement as secondary. A systematic search was performed in four databases (PubMed, Embase, Cochrane Library, Web of Science) on December 14, 2022. Articles were included if cholesteatomas were staged according to the Potsic system and follow-up duration was documented. Risk of bias was evaluated using the Quality In Prognosis Studies (QUIPS) tool. In the statistical synthesis a random effects model was used. Between-study heterogeneity was assessed using I2. Results: Thirteen articles were found to be eligible for systematic review and seven were included in the meta-analysis section. All records were retrospective cohort studies with high risk of bias. Regarding the proportions of residual disease, analysis using the χ2 test showed no statistically significant difference between Potsic stages after a follow-up of minimum one year (stage I 0.06 (confidence interval (CI) 0.01–0.33); stage II 0.20 (CI 0.09–0.38); stage III 0.06 (CI 0.00–0.61); stage IV: 0.17 (CI 0.01–0.81)). Postoperative and preoperative hearing outcomes could not be analyzed due to varied reporting. Results on cholesteatoma location and mean age at staging were consistent with those previously published. Conclusion: No statistically significant difference was found in the proportions of residual disease between Potsic stages, thus the staging system's applicability for outcome prediction could not be proven based on the available data. Targeted studies are needed for a higher level of evidence. [ABSTRACT FROM AUTHOR]

Background: Donor-specific antibodies (DSAs) are common following lung transplantation (LuTx), yet their role in graft damage is inconclusive. Mean fluorescent intensity (MFI) is the main read-out of DSA diagnostics; however its value is often disregarded when analyzing unwanted post-transplant outcomes such as graft loss or chronic lung allograft dysfunction (CLAD). Here we aim to evaluate an MFI stratification method in these outcomes. Methods: A cohort of 87 LuTx recipients has been analyzed, in which a cutoff of 8000 MFI has been determined for high MFI based on clinically relevant data. Accordingly, recipients were divided into DSA-negative, DSA-low and DSA-high subgroups. Both graft survival and CLAD-free survival were evaluated. Among factors that may contribute to DSA development we analyzed Pseudomonas aeruginosa (P. aeruginosa) infection in bronchoalveolar lavage (BAL) specimens. Results: High MFI DSAs contributed to clinical antibody-mediated rejection (AMR) and were associated with significantly worse graft (HR: 5.77, p < 0.0001) and CLAD-free survival (HR: 6.47, p = 0.019) compared to low or negative MFI DSA levels. Analysis of BAL specimens revealed a strong correlation between DSA status, P. aeruginosa infection and BAL neutrophilia. DSA-high status and clinical AMR were both independent prognosticators for decreased graft and CLAD-free survival in our multivariate Cox-regression models, whereas BAL neutrophilia was associated with worse graft survival. Conclusions: P. aeruginosa infection rates are elevated in recipients with a strong DSA response. Our results indicate that the simultaneous interpretation of MFI values and BAL neutrophilia is a feasible approach for risk evaluation and may help clinicians when to initiate DSA desensitization therapy, as early intervention could improve prognosis. [ABSTRACT FROM AUTHOR]

The period of extreme weather anomalies in recent years has challenged farmers, and this has encouraged greater adaptability in farming practices. In the last decade, conventional tillage systems have been complemented by more biologically based cropping systems. The research evaluated the impact of drought on soil physical parameters in maize production by testing different conventional and non-conventional tillage systems to ensure optimal soil physical parameters. In the analysis of the prevailing weather conditions, rainfall values were divided into two parts, the pre-growing season and the growing season. We studied different climatic seasons. In 2021, the soil moisture content in the upper shallow 15 cm soil layer during the sowing period in April in the case of conventional tillage was significantly lower than in reduced tillage, conservation tillage and strip tillage. The most significant difference was measured between conventional and conservation tillage, with a difference of 11.25 v/v%. The 2022 crop year was extremely dry. In June, the highest moisture value in the soil was measured in the case of strip tillage with a value of 21.64 v/v%, which was more than 60% higher than in the case of conventional and conservation tillage. In conventional tillage, a very pronounced compacted layer was observed in the lower part of the ploughed layer. This zone reached a compaction of 6.9 MPa between 28 and 34 cm, which is agronomically harmful. No compacted soil layer was found in the experiment site under conservation tillage. In the severe drought year of 2022, only the strip-till system provided the proper water management conditions for the maize stand. [ABSTRACT FROM AUTHOR]

This special issue of the Journal of Optimization Theory & Applications focuses on the work of Professors Cornelis Roos and Florian A. Potra in the field of optimization. The issue includes a biographical sketch of both professors, highlighting their achievements. The papers in the special issue cover various topics such as conic optimization, interior point methods, proximal methods, convex optimization, and stochastic optimal control. The authors of the papers have close connections to Professors Roos and Potra, either as students, visitors, or co-authors. The document is a compilation of research papers on interior-point methods (IPMs) and their applications in optimization and conic programming. The papers cover theoretical developments of IPMs, algorithms for linear complementarity problems (LCPs), weighted LCPs, and sufficient linear complementarity problems. There are also papers on new computational approaches for IPMs, applications of IPMs in different fields such as mechanics and support vector machines, and the theory and application of conic optimization. The document also includes papers on proximal methods for convex and non-convex problems, as well as papers on convexity and convex optimization. The volume concludes with acknowledgments to the authors, reviewers, and editor-in-chief. [Extracted from the article]

This paper investigates various aspects of sufficient matrices, one of the most relevant matrix classes introduced in connection with linear complementarity problems. We summarize the most important theoretical results and properties related to sufficient matrices. Based on these, we propose different construction rules that can be used to generate new matrices that belong to this class. A nonnegative number can be assigned to each sufficient matrix, which is called its handicap and works as a measure of sufficiency. The handicap plays a crucial role in proving convergence and complexity results for interior point algorithms for linear complementarity problems. For a particular sufficient matrix, called Csizmadia's matrix, we give the exact value of the handicap, which is exponential in the size of the matrix. Another important topic that we address is deciding whether a matrix is sufficient. Tseng proved in 2000 that this decision problem is co-NP hard. We investigate three different algorithms for determining the sufficiency of a given matrix: Väliaho's algorithm, a linear programming-based algorithm, and an algorithm that facilitates nonlinear programming reformulations of the definition of sufficiency. We tested the efficiency of these methods on our recently launched benchmark data set that consists of four different sets of matrices. In this paper, we give the description and most important properties of the benchmark set, which can be used in the future to compare the performance of different interior point algorithms for linear complementarity problems. [ABSTRACT FROM AUTHOR]

We propose new short-step interior-point algorithms (IPAs) for solving P ∗ (κ) -linear complementarity problems (LCPs). In order to define the search directions, we use the algebraic equivalent transformation (AET) technique of the system describing the central path. A novelty of the paper is that we introduce a whole, new class of AET functions for which a unified complexity analysis of the IPAs is presented. This class of functions differs from the ones used in the literature for determining search directions, like the class of concave functions determined by Haddou, Migot and Omer, self-regular functions, eligible kernel and self-concordant functions. We prove that the IPAs using any member φ of the new class of AET functions have polynomial iteration complexity in the size of the problem, in starting point's duality gap, in the accuracy parameter and in the parameter κ . [ABSTRACT FROM AUTHOR]

Soil bacterial communities play a remarkable role in nutrient cycling, significantly affecting soil organic material content, soil fertility, and, in an indirect way, plant succession processes. Conversely, vegetation type influences microbial soil life. The present study compared the bacterial microbiome composition, diversity and catabolic activity profile of topsoil samples collected under three different forest types (a twice-coppiced black locust stand, a young, naturally reforested, and a middle-aged mixed pedunculate oak stand) planted on former arable land in the early 20th century. Diversity indices determined during 16S ribosomal RNA sequencing-based metagenome analysis indicated that the black locust stand had the highest soil bacterial community diversity. At the phylum level, Acidobacteriota, Actinobacteriota, Proteobacteria, Verrucomicrobiota, Bacteroidota, and Gemmatimonadota were the most abundant taxa in the forest soils. Concerning soil parameters, redundancy analysis revealed that pH had the highest impact on bacterial community structure and pH, and soil organic carbon content on the samples' respiration patterns. As for catabolic activity, the recently clearcut oak forest showed the lowest substrate-induced respiration, and citrate was the main driver for the inter-stand variability of microbial activity. Our results confirm that soil parameters and forest type influence the composition and functioning of the soil bacterial microbiome. [ABSTRACT FROM AUTHOR]

In this study, we detected and compared changes in the annual and daily captures of the Eurasian (Certhia familiaris) and Short-toed Treecreeper (C. brachydactyla) in the timing of their post-breeding movements, in the length of minimum stopover duration (MSD) in the area, and also in biometrics in western Hungary. The birds were captured and ringed, or recaptured from the end of July to the first weekend of November in all years from 2001 to 2023. The annual captures of both species indicated stable populations in this period, with milder February months having a positive effect on annual captures. There were similarities and differences in the movement strategies and habitat selection of the species. During the post-breeding season, the Eurasian Treecreeper was more strongly associated with the scrubland and forest edge than the Short-toed Treecreeper. There were two autumn capture waves in September and October for the Eurasian Treecreepers and just one in September for the Short-toed Treecreepers, which were primarily consisted of birds captured only once. There were no significant differences in wing length of the three capture intervals (July-August, September, October-November) in either species, which suggests that the dynamics of post-breeding movements cannot be explained on the bases of possible differences in the behavior of sexes, ages, or populations. The proportion of birds captured only once was about double of that of stopovers in both species each year. The average real length of stopover duration in the area for Eurasian Treecreepers was 94.25 days, and 84.31 days for Short-toed Treecreepers. The length of MSD in the area was not significantly associated with wing length and body mass in either species. Individuals of both species did not gain fat stores significantly during post-breeding season. [ABSTRACT FROM AUTHOR]

Introduction: Parkinson's disease (PD) has a complex genetic background involving both rare and common genetic variants. Although a small percentage of cases show a clear Mendelian inheritance pattern, it is much more relevant to identify patients who present with a complex genetic profile of risk variants with different severity. The ß-glucocerebrosidase coding gene (GBA1) is recognized as the most frequent genetic risk factor for PD and Lewy body dementia, irrespective of reduction of the enzyme activity due to genetic variants. Methods: In a selected cohort of 190 Hungarian patients with clinical signs of PD and suspected genetic risk, we performed the genetic testing of the GBA1 gene. As other genetic hits can modify clinical features, we also screened for additional rare variants in other neurodegenerative genes and assessed the APOE-ε genotype of the patients. Results: In our cohort, we identified 29 GBA1 rare variant (RV) carriers. Out of the six different detected RVs, the highly debated E365K and T408M variants are composed of the majority of them (22 out of 32). Three patients carried two GBA1 variants, and an additional three patients carried rare variants in other neurodegenerative genes (SMPD1, SPG11, and SNCA). We did not observe differences in age at onset or other clinical features of the patients carrying two GBA1 variants or patients carrying heterozygous APOE-ε4 allele. Conclusion: We need further studies to better understand the drivers of clinical differences in these patients, as this could have important therapeutic implications. [ABSTRACT FROM AUTHOR]

The co-occurrence of myasthenia gravis (MG) and paroxysmal nocturnal hemoglobinuria (PNH) is rare; only one case has been published so far. We report a 63-year-old Caucasian female patient who was diagnosed with MG at the age of 43. Thymoma was also detected, and so it was surgically resected, which resulted in reasonable disease control for nearly 20 years. Slight hemolysis began to emerge, and then myasthenia symptoms progressed, so immunosuppressive therapy was started. Due to progressive disease and respiratory failure, the patient underwent plasmapheresis, and ventilatory support was stopped. Marked hemolysis was present, and diagnostic tests confirmed PNH with type III PNH cells. Her myasthenia symptoms aggravated, mechanical ventilation had to be started again, and due to the respiratory acidosis, massive hemolysis occurred. After two plasmapheresis sessions, the patient received eculizumab at 600 mg, resulting in prompt hemolysis control. After the second dose of the treatment, the patient was extubated. Still, due to their inability to cough, she developed another respiratory failure and pneumonia–sepsis, resulting in the patient's death. This case highlights the rare association between these two serious diseases and similar immune-mediated pathophysiology mechanisms involving the complement system. [ABSTRACT FROM AUTHOR]

Since the ingestion of both natural and anthropogenic microfibers produces a deleterious effect on aquatic organisms, it is crucial to explore the emission of these pollutants by WWTPs into the receiving water bodies, such as rivers. Cellulose- and petroleum-based microfibers, as well as microplastic particles, were collected from the effluent of a municipal WWTP operating with activated sludge technology in Budapest, Hungary. During two sampling campaigns organized in February and April of 2023 on different working days and at different times of the day, 123–145 L of effluent was sieved and filtered. The organic matter was removed by hydrogen-peroxide treatment. All fibers and particles larger than 10 µm were counted, and using a fluorescence microscope, the fibers were geometrically characterized in terms of length and diameter. Each fiber was individually identified by transflection-FT-IR method. The fiber concentration varied in the range of 1.88–2.84 and 4.25–6.79 items/L during the 7th and the 16th week of 2023, respectively. In February and April, the proportion of microfibers in the solid particles was 78.3 and 94.7%, respectively. In the effluent the cellulose-based microfibers were dominant (53–91%), while among the petroleum-based microfibers, polyester occurred most often. The median length of cellulose-based fibers was considerably higher in April than in February (650 vs. 1250 µm), and simultaneously the median diameter also increased from 21 to 29 µm. This behaviour was also seen, albeit to a lesser extent, in connection to microfibers derived from petroleum. The treated wastewater’s daily microfiber transport to the Danube River varied between 0.44 − 0.69 and 0.94–1.53 billion in February and April 2023, respectively. [ABSTRACT FROM AUTHOR]

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This review aims to explore advancements in perioperative ischemic stroke risk estimation for asymptomatic patients with significant carotid artery stenosis, focusing on Circle of Willis (CoW) morphology based on the CTA or MR diagnostic imaging in the current preoperative diagnostic algorithm. Functional transcranial Doppler (fTCD), near-infrared spectroscopy (NIRS), and optical coherence tomography angiography (OCTA) are discussed in the context of evaluating cerebrovascular reserve capacity and collateral vascular systems, particularly the CoW. These non-invasive diagnostic tools provide additional valuable insights into the cerebral perfusion status. They support biomedical modeling as the gold standard for the prediction of the potential impact of carotid artery stenosis on the hemodynamic changes of cerebral perfusion. Intraoperative risk assessment strategies, including selective shunting, are explored with a focus on CoW variations and their implications for perioperative ischemic stroke and cognitive function decline. By synthesizing these insights, this review underscores the potential of non-invasive diagnostic methods to support clinical decision making and improve asymptomatic patient outcomes by reducing the risk of perioperative ischemic neurological events and preventing further cognitive decline. [ABSTRACT FROM AUTHOR]

In this paper, the design and research of a sensor-based personal air-quality monitoring device are presented, which is retrofitted into different personal protective face masks. Due to its small size and low power consumption, the device can be integrated into and applied in practical urban usage. We present our research and the development of the sensor node based on a BME680-type environmental sensor cluster with a wireless IoT (Internet of Things)-capable central unit and overall low power consumption. The integration of the sensor node was investigated with traditional medical masks and a professional FFP2-type mask. The filtering efficiency after embedding was validated with a head model and a particle counter. We found that the professional mask withstood the embedding without losing the protective filtering aspect. We compared the inner and outer sensor data and investigated the temperature, pressure, humidity, and AQI (Air Quality Index) relations with possible sensor data-fusion options. The novelty is increased with the dual-sensor layout (inward and outward). It was found that efficient respiration monitoring is achievable with the device. With the analysis of the recorded data, characteristic signals were identified in an urban environment, enabling urban altimetry and urban zone detection. The results promote smart city concepts and help in endeavors related to SDGs (Sustainable Development Goals) 3 and 11. [ABSTRACT FROM AUTHOR]

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The beekeeping sector plays an important role in maintaining biodiversity and the ecosystem, in addition to its production function. The European beekeeping sector is facing a number of constraints that make it difficult to operate, and the Covid-19 pandemic has posed new challenges for beekeepers. The purpose of the study is to examine the resilience of beekeeping businesses to the most important problems affecting beekeepers and the Covid-19 pandemic. The research analyses the role of marketing and profitability and how they influence the resilience. Variables obtained from online questioning of a representative sample of Hungarian beekeepers (N = 297). Cluster analysis was used to validate the results. Using a Two-step clustering model, three clusters of beekeepers were identified: a non-resilient; a resilient, but not proactive and not very profitable and a resilient, proactive and profitable cluster. According to the research, the resilience of beekeepers is shaped by several factors. Well-trained, long-established beekeepers who seek to differentiate their products from their competitors' overcome the difficulties caused by the pandemic and other beekeeping problems much more easily. Very important factors resulting in remarkable business resilience are the number of used subsidies and the number of cooperations. [ABSTRACT FROM AUTHOR]

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Introduction: Erdheim-Chester disease (ECD) is a rare disease that belongs to the group of Dendritic and histiocytic neoplasms. Only 2000 cases have been reported worldwide. It can present with a wide range of symptoms, making a differential diagnosis especially difficult. The primary and most important diagnostic tool is a biopsy of the affected organ/tissue. Nowadays the analysis of different mutations affecting the BRAF and MAPK pathways makes it possible to use targeted treatments, such as vemurafenib, dabrafenib, or cobimetinib. Objective: Our aim is to present the results of three male patients treated in our hematology department. Results: Our BRAF mutation-positive patient presented with retroperitoneal tissue proliferation and diabetes insipidus. The initial therapy of choice was dabrafenib. After 3 months of treatment, 18F-fluoro-deoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) scans showed regression, and after 2 years of treatment, no disease activity was detected. In our second patient, a recurrent febrile state (not explained by other reasons) and diabetes insipidus suggested the diagnosis. A femoral bone biopsy confirmed BRAF-negative ECD. The first-line therapy was interferon-alpha. After 3 months of treatment, no response was observed on 18FDG-PET/CT, and treatment with cobimetinib was started. The control 18FDG-PET/CT imaging was negative. Our third patient was evaluated for dyspnea, and a CT scan showed fibrosis with hilar lymphadenomegaly. A lung biopsy confirmed BRAF-negative ECD. We started treatment with interferon-alpha, but unfortunately, no improvement was observed. Second-line treatment with cobimetinib resulted in a partial metabolic response (PMR) according to control 18FDG-PET/CT. Conclusions: Our results demonstrate that an appropriately chosen treatment can lead to a good therapeutic response, but dose reduction may be necessary due to side effects. With advanced targeted therapeutic treatment options, survival and quality of life are significantly improved. [ABSTRACT FROM AUTHOR]

The Mór Wine Region (MWR) is one of the smallest ones in Hungary. Its area decreased continuously to only 724 hectares till 2022. Nevertheless, a spatial concentration of farms can be observed, like it has happened in other wine-growing regions of Hungary. Our principal aim is to investigate the sale channels with special consideration of the personal, market and online forms in the light of sustainability. The pandemic time is over, the online sales are in vain, the personal relationship between the winemaker and the customer is currently enjoying a revival period. Within the framework of mixed methods approach, we surveyed 28 winegrowers and wineries to fill in our semi-structured questionnaires, as main method in this article. After evaluating the questionnaires, we can say that some young wineries, thanks to good marketing activities, are able to take advantage of modern community-based media and are able to reach semi-wealthy social groups that usually consume wine. Unfortunately, the majority of wineries are not able to do so. Furthermore, there is a lack of cooperation between suppliers that can initiate smaller wineries to process and store grapes, and at least appear on the domestic market. [ABSTRACT FROM AUTHOR]

In patients with sickle cell disease (SCD), transfusions pose risks like delayed hemolytic transfusion reaction (DHTR) and hyperhemolytic syndrome (HHS). We present the case of a 61-year-old Nigerian male patient with SCD, developing hyperhemolytic syndrome (HHS) post-orthopedic surgery due to alloimmunization from blood transfusions. Surgery induced massive hemorrhage, requiring RBC transfusions. Postoperatively, he developed HHS with jaundice, hemoglobinuria, and fever. Despite additional transfusions, his condition worsened, leading to hematological consultation on postoperative day +9. Laboratory findings showed positive DAT and multiple alloantibodies. The diagnosis of HHS was established and treatment involved high-dose methylprednisolone, intravenous immunoglobulin (IVIG), and erythropoietin. The patient was discharged on postoperative day +24 with stable hemoglobin levels, tapering doses of methylprednisolone, and continuous administration of hydroxyurea prescribed. HHS pathogenesis involves extensive intravascular hemolysis, exacerbated by alloimmunization. Diagnostic challenges and therapy selection complexity underscore the need for cautious transfusion strategies in HHS, reserving them for hemodynamic instability or hypoxia. This case highlights promptly recognizing and managing HHS in SCD for improved outcomes and avoiding unnecessary transfusions. [ABSTRACT FROM AUTHOR]

The Semmelweis Study is a prospective occupational cohort study that seeks to enroll all employees of Semmelweis University (Budapest, Hungary) aged 25 years and older, with a population of 8866 people, 70.5% of whom are women. The study builds on the successful experiences of the Whitehall II study and aims to investigate the complex relationships between lifestyle, environmental, and occupational risk factors, and the development and progression of chronic age-associated diseases. An important goal of the Semmelweis Study is to identify groups of people who are aging unsuccessfully and therefore have an increased risk of developing age-associated diseases. To achieve this, the study takes a multidisciplinary approach, collecting economic, social, psychological, cognitive, health, and biological data. The Semmelweis Study comprises a baseline data collection with open healthcare data linkage, followed by repeated data collection waves every 5 years. Data are collected through computer-assisted self-completed questionnaires, followed by a physical health examination, physiological measurements, and the assessment of biomarkers. This article provides a comprehensive overview of the Semmelweis Study, including its origin, context, objectives, design, relevance, and expected contributions. [ABSTRACT FROM AUTHOR]

Neuropathy is a serious and frequent complication of type 2 diabetes (T2DM). This study was carried out to search for genetic factors associated with the development of diabetic neuropathy by whole exome sequencing. For this study, 24 patients with long-term type 2 diabetes with neuropathy and 24 without underwent detailed neurological assessment and whole exome sequencing. Cardiovascular autonomic function was evaluated by cardiovascular reflex tests. Heart rate variability was measured by the triangle index. Sensory nerve function was estimated by Neurometer and Medoc devices. Neuropathic symptoms were characterized by the neuropathy total symptom score (NTSS). Whole exome sequencing (WES) was performed on a Thermo Ion GeneStudio S5 system determining the coding sequences of approximately 32,000 genes comprising 50 million base pairs. Variants were detected by Ion Reporter software and annotated using ANNOVAR, integrating database information from dbSNP, ClinVar, gnomAD, and OMIM. Integrative genomics viewer (IGV) was used for visualization of the mapped reads. We have identified genetic variants that were significantly associated with increased (22–49-fold) risk of neuropathy (rs2032930 and rs2032931 of recQ-mediated genome instability protein 2 (RMI2) gene), rs604349 of myosin binding protein H like (MYBPHL) gene and with reduced (0.07–0.08-fold) risk (rs917778 of multivesicular body subunit 12B (MVB12B) and rs2234753 of retinoic acid X receptor alpha (RXRA) genes). The rs2032930 showed a significant correlation with current perception thresholds measured at 5 Hz and 250 Hz for n. medianus (p = 0.042 and p = 0.003, respectively) and at 5 Hz for n. peroneus (p = 0.037), as well as the deep breath test (p = 0.022) and the NTSS (p = 0.023). The rs2032931 was associated with current perception thresholds (p = 0.003 and p = 0.037, respectively), deep breath test (p = 0.022), and NTSS (p = 0.023). The rs604349 correlated with values measured at 2000 (p = 0.049), 250 (p = 0.018), and 5 Hz (p = 0.005) for n. medianus, as well as warm perception threshold measured by Medoc device (p = 0.042). The rs2234753 showed correlations with a current perception threshold measured at 2000 Hz for n. medianus (p = 0.020), deep breath test (p = 0.040), and NTSS (p = 0.003). There was a significant relationship between rs91778 and cold perception threshold (p = 0.013). In our study, genetic variants have been identified that may have an impact on the risk of neuropathy developing in type 2 diabetic patients. These results could open up new opportunities for early preventive measures and might provide targets for new drug developments in the future. [ABSTRACT FROM AUTHOR]

In the last decade, intense research has been witnessed on developing compact, terahertz (THz) driven electron accelerators, producing electrons with a sub-MeV—few tens of MeV energy. Such economical devices could be used in scientific and material research and medical treatments. However, until now, the extremely high-energy THz pulses needed by the THz counterparts of the microwave accelerators were generated by optical rectification (OR) of ultrafast Ti:sapphire or Yb laser pulses. These lasers, however, are not very effective. Because of this, we use numerical simulations to investigate the possibility of generating high-energy THz pulses by the OR of pulses produced by CO2 lasers, which can have high plug-in efficiency. The results obtained supposing optical rectification (OR) in GaAs demonstrate that consideration of the self-phase-modulation (SPM) and the second-harmonic-generation (SHG) processes is indispensable in the design of CO2 laser-based THz sources. More interestingly, although these two processes hinder achieving high laser-to-THz conversion efficiency, they can still surpass the 1.5% value, ensuring high system efficiency and making the CO2 laser OR system a promising THz source. Our finding also has important implications for other middle-infrared laser-pumped OR-based THz sources. [ABSTRACT FROM AUTHOR]

The ever-shorter product life cycle entails a shortening of the life cycle of the production site and production systems as well. One of the biggest advantages of flexible production systems is that new products can be introduced to them continuously, so that their life cycle can be significantly extended. Flexible manufacturing systems, on the other hand, also require flexible control, the logic of which must be defined already in the design phase. The main elements of the design methodology of the production and logistics layout that make up the research are the information relationship chart and the related decision tables, which are suitable for speeding up the design and later for facilitating the creation of a digital twin and control logic programming. The paper covers an extended layout planning method which can be used to design flexible manufacturing lines. [ABSTRACT FROM AUTHOR]

(1) Background: Microinjection of zebrafish (Danio rerio) embryos offers a promising model for studying the virulence and potential environmental risks associated with Pseudomonas aeruginosa. (2) Methods: This work aimed to develop a P. aeruginosa infection model using two parallel exposition pathways on zebrafish larvae with microinjection into the yolk and the perivitelline space to simultaneously detect the invasive and cytotoxic features of the examined strains. The microinjection infection model was validated with 15 environmental and clinical strains of P. aeruginosa of various origins, antibiotic resistance profiles, genotypes and phenotypes: both exposition pathways were optimized with a series of bacterial dilutions, different drop sizes (injection volumes) and incubation periods. Besides mortality, sublethal symptoms of the treated embryos were detected and analyzed. (3) Results: According to the statistical evaluation of our results, the optimal parameters (dilution, drop size and incubation period) were determined. (4) Conclusions: The tested zebrafish embryo microinjection infection model is now ready for use to determine the in vivo virulence and ecological risk of environmental P. aeruginosa. [ABSTRACT FROM AUTHOR]

UTIs (urinary tract infections) are common bacterial infections with a non-negligible hospitalization rate. The diagnosis of UTIs remains a challenge for prescribers and a common source of misdiagnosis. This retrospective observational study aimed to evaluate whether recorded diagnosis by clinicians and empirical antibiotic therapy met the EAU (European Association of Urology) guideline in patients hospitalized with UTI. The study was conducted at an internal medicine unit of a tertiary care medical center in Hungary. The diagnosis was assessed based on clinical presentation, physical examination, and laboratory (including microbiological) results, considering all the potential risk factors. Diagnosis was considered misdiagnosis when not confirmed by clinical presentation or clinical signs and symptoms. Evaluation of empirical antibiotic therapy was performed only for confirmed UTIs. Empirical treatment was considered guideline-adherent when complying with the relevant recommendations. Out of 185 patients, 41.6% failed to meet EAU-based UTI diagnosis criteria, of which 27.6% were misdiagnosed and 14.1% were ABU (asymptomatic bacteriuria). The diagnosis of urosepsis recorded at admission (9.7%, 18/185) was not confirmed either by clinical or microbiological tests in five (5/18) cases. The initial empirical therapies for UTI showed a relatively low rate (45.4%) of guideline adherence regarding agent selection. The most common guideline-non-adherent therapies were combinations with metronidazole (16.7%). Dosage appropriateness assessments showed a guideline adherence rate of 36.1%, and underdosing due to high body weight was common (9.3%). Overall (agent, route of administration, dose, duration) guideline adherence was found to be substantially low (10.2%). We found a relatively high rate of misdiagnosed UTIs. Written protocols on the ward may be crucial in reducing misdiagnosis and in optimizing antibiotic use. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 pandemic had a major impact on most medical services. Our aim was to assess the outcome of acute cholecystitis during the nationwide lockdown period. All patients admitted to our emergency department for AC were analysed. Patient characteristics, performance status, AC severity, treatment modality and outcome of AC were assessed during the lockdown period (Period II: 1 April 2020–30 November 2021) and compared to a historical control period (Period I: 1 May 2017–31 December 2018). AC admissions increased by 72.8% in Period II. Patients were younger (70 vs. 74 years, p = 0.017) and greater in number in the CCI 1 group (20.4% vs. 11.2%, p = 0.043) in Period II. The unplanned readmission rate (6.3 vs. 0%, p = 0.004) and the gallbladder perforation (GP) rate was higher (18.0 vs. 7.3%, p = 0.006) in Period II. Percutaneous transhepatic gallbladder drainage (PTGBD) was more frequent (24.1 vs. 12.8%, p = 0.012) in Period II. In addition to a drop in patient age and CCI, a significant rise in the prevalence of acute cholecystitis, GP and unplanned readmissions was observed during the nationwide lockdown due to the COVID-19 pandemic. PTGBD was more frequent during this period, whereas successful conservative treatment was less frequent. [ABSTRACT FROM AUTHOR]

Plasmonic metallic nanoparticles, like Au, can be used to tune the optical properties of photonic nanoarchitectures occurring in butterfly wing scales possessing structural color. The effect of the nanoscale Au depends on the location and the amount deposited in the chitin-based photonic nanoarchitecture. The following three types of Au introduction methods were compared regarding the structural and optical properties of the resulting hybrid bio-nanocomposites: (i) growth of Au nanoparticles inside the nanopores of butterfly wing scales by a light-induced in situ chemical reduction of HAuCl4 in aqueous solution containing sodium citrate, as a new procedure we have developed, (ii) drop-drying of the aqueous Au sol formed during procedure (i) in the bulk liquid phase, and (iii) physical vapor deposition of Au thin film onto the butterfly wing. We investigated all three methods at two different Au concentrations on the wings of laboratory-bred blue-colored male Polyommatus icarus butterflies and characterized the optical properties of the resulting hybrid bio-nanocomposites. We found that the drop-drying and the in situ growth produced comparable redshift in the spectral position of the reflectance maximum associated with the chitin-based photonic nanoarchitecture in the wing scales, while the 5 nm or 15 nm thick Au layers vacuum deposited onto the butterfly wing behaved like an optical filter, without inducing spectral shift. The in situ growth in the photonic nanoarchitecture under intense illumination produced uniform Au nanoparticles located in the pores of the biological template, which is more advantageous for further applications. An additional benefit of this method is that the Au nanoparticles do not aggregate on drying, like in the case of drop-drying of preformed Au nanoparticles from the citrate-stabilized sol. [ABSTRACT FROM AUTHOR]

Electric vehicles are becoming increasingly popular to reduce environmental impact and to make logistics systems more cost-effective. This trend is affecting not only passenger cars but also public transport, especially in developed countries. For electric buses, the recycling of high-capacity batteries is becoming an increasingly important issue, as no generally applicable recycling model has yet been developed in this area. The paper presents a literature analysis in this field and identifies the main trends in battery recycling. In essence, it opens the way for future research, i. e. the elaboration of different operational models. [ABSTRACT FROM AUTHOR]

The paper focuses on modelling and optimizing the distribution of material flows in a first version. Furthermore, the focus is on electrical energy flows, considering different energy sources and types of consumers. The most commonly used energy sources are nuclear, thermal, renewable and geothermal. The main categories of consumers include industry, residential, commercial and, increasingly, electric transportation. A first model is proposed which uses matrices for the various time constraints and uses graph theory to represent the flow of energy between sources and consumers. Variables and constraints are established to ensure that the flow remains within maximum capacities and meets minimum demands. In addition, a first version of mathematical model is proposed to minimize total energy supply costs. [ABSTRACT FROM AUTHOR]

Maintenance, Refurbishment and Network Upgrading Systems occupy a prominent place among service systems, especially due to their dispersed location and large territorial extent. For the efficient opertaion of these systems, it is essential to apply Project Oriented Management (POM), which aims at optimizing logistic processes and meeting project specific requirements. [ABSTRACT FROM AUTHOR]

Introduction: Circulating microRNAs are promising biomarkers for multiple sclerosis (MS). Our aim was to correlate serum microRNA levels with various magnetic resonance imaging (MRI) parameters. Methods: We recruited 50 MS patients and measured cervical spine and cerebral white matter lesions together with regional brain volumes. Microstructural changes in the white matter were investigated with diffusion tensor imaging. Magnetic resonance spectroscopy was performed to measure cerebral metabolites. Functional connectivity within the default mode network was examined with resting-state functional MRI. On the day of the MRI measurements, we collected serum samples and carried out quantitative analysis of ten pre-selected microRNAs using droplet digital PCR. Results: Serum level of miR-143.3p could differentiate between MS subtypes and had lower levels in progressive MS types. We found significant associations between microRNA levels and MRI measures: (1) higher miR-92a.3p and miR-486.5p levels were associated with greater total white matter lesion volumes within the cervical spine, (2) decreased miR-142.5p levels was associated with reduced total creatinine concentration and (3) miR-92a.3p, miR-142.5p and miR-486.5p levels were associated with functional connectivity strengths between specific nodes of the default mode network. Specifically, we found a negative association between miR-92a.3p and miR-486.5p levels and connectivity strength between the lateral temporal cortex and posterior inferior parietal lobule, and a positive association between miR-142.5p level and connectivity strength between the retrosplenial cortex and temporal pole. However, miRNA levels were not associated with regional brain volumes. Conclusion: We provide here further evidence that circulating microRNAs may show correlation with both structural and functional neuroimaging outcomes in patients with MS. [ABSTRACT FROM AUTHOR]