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The beneficial effects of balneotherapy have been proven by numerous clinical studies on locomotor disorders. To date, there is only scant data on changes in the microbiome system of the skin during balneotherapy. The aim of this study was to compare the effects of thermal water and tap water on the skin’s microbiome in healthy volunteers. 30 healthy female volunteers participated in the study. The experimental group (of 15 women) spent 30-min 10 times, in Gabriella Spring’s thermal baths (i.e., mineral water containing sodium hydrogen carbonate).The controlled group (15 women) had the same, but in tap water. The results of this study have proven that there is a difference in the influencing effects of tap water and medicinal water on the microbiome of the skin. After bathing in the thermal water of Lakitelek, Deinococcus increased significantly at the genus level, and the tendency for Rothia mucilaginosa bacteria also increased. At the species level, Rothia mucilaginosa increased significantly, while Paracoccus aminovorans and the tendency for Paracoccus marcusii decreased. When the values of the two trial groups after bathing at the genus level were compared, Rothia bacteria increased significantly, while Haemophilus tended to increase, Pseudomonas tended to decrease, Neisseria tended to increase significantly, and Flavobacterium tended to decrease. At the species level, Geobacillus vulcani decreased significantly, and the tendency for Burkholderia gladioli decreased. The growth of Rothia mucilaginosa and the decrease in the tendency of Paracoccus, Pseudomonas, Flavobacteroium, and Burkholderia gladioli confirm the beneficial effect of balneotherapy. In this study, trends are represented by the uncorrected p value. The main result was that the thermal water changed certain bacteria of the skin, both on the genus and species levels, but there were no significant changes in the tap water used, either at the genus or species level. We first compared the worlds of thermal water and tap water’s microbiome systems. The thermal water decreased the number of certain inflammatory infectious agents and could enhance some of their positive effects, which have been proven at the molecular level. Our results can provide an important clue in the treatment of certain skin diseases. The research of the skin microbiome during balneotherapy can be one of the most intriguing and exciting topics of the future and can bring us closer to understanding the mechanism of action of balneotherapy.

Abstract 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

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.

In this paper, novel application possibilities of CuO nanoparticles were investigated in SAC0307 solder alloy for composite soldering purposes. CuO nanoparticles in 0.25 and 0.5 wt% were mixed into the solder paste to produce composite solder joints. Solder joints were manufactured using standard surface mounting technology from different solder pastes. The solder joints were loaded in an 85 °C/85RH% temperature and humidity test for 4000 h. It was found that the CuO composite solder joints showed improved mechanical quality due to the microstructural refinement, which was studied using scanning electron microscopy (SEM) and focused ion beam (FIB) analysis. On the other hand, the corrosion resistance of CuO joints decreased, as they suffered localized corrosion extensively, which produced longer and more Sn whiskers on their surface than on the reference SAC0307. Density functional theory (DFT) calculations proved that CuO can bond to Sn, but CuO is not chemically inert in the solder bulk. CuO can start a cyclic reaction with the dispersed Cu6Sn5 intermetallics, which produces SnO2 in the solder bulk, ultimately enhancing corrosion. Therefore, CuO nanoparticles are suggested to be applied only in non-corrosive environments, such as space applications.

Abstract 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 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

Abstract 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.

Castleman disease is a rare and atypical lymphoproliferative disorder characterized by diverse clinical manifestations. It has both unicentric and multicentric forms, the latter with further subdivisions, i.e., human herpesvirus 8-associated and idiopathic forms. The diagnosis of Castleman disease is often delayed, as it is rare, and because it shares clinical features with different autoimmune, inflammatory, and malignant lymphoproliferative disorders. The first-line treatment in unicentric form is mainly surgical, while in idiopathic Castleman disease, anti-interleukin-6 treatment is the therapy of choice. In virus-associated diseases, antiretroviral therapy and rituximab are recommended. In Hungary, only a few cases of Castleman disease have been published. This report presents our two decades of experience in the challenging diagnosis and management of this rare disorder, most properly underdiagnosed in Hungary. We provide insights into seven unicentric and five idiopathic multicentric Castleman disease cases, the latter ones especially highlighting the diagnostic and therapeutic challenges due to the variable and unique clinical features both of patients and diseases, e.g., bronchiolitis obliterans, stage IV diabetic renal failure, anti-HBc positivity, siltuximab treatment period, respectively.

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 Background Premature ovarian insuffiency (POI) is one of the main cause behind infertility. The genetic analysis of POI should be part of the clinical diagnostics, as several genes have been implicated in the genetic background of it. The aim of our study was to analyse the genetic background of POI in a Hungarian cohort. Methods The age of onset was between 15 and 39 years. All patients had the 46,XX karyotype and they were prescreened for the most frequent POI associated FMR1 premutation. To identify genetic alterations next-generation sequencing (NGS) of 31 genes which were previously associated to POI were carried out in 48 unrelated patients from Hungary. Results Monogenic defect was identified in 16.7% (8 of 48) and a potential genetic risk factor was found in 29.2% (14 of 48) and susceptible oligogenic effect was described in 12.5% (6 of 48) of women with POI using the customized targeted panel sequencing. The genetic analysis identified 8 heterozygous damaging and 4 potentially damaging variants in POI-associated genes. Further 10 potential genetic risk factors were detected in seven genes, from which EIF2B and GALT were the most frequent. These variants were related to 15 genes: AIRE, ATM, DACH2, DAZL, EIF2B2, EIF2B4, FMR1, GALT, GDF9, HS6ST2, LHCGR, NOBOX, POLG, USP9X and XPNPEP2. In six cases, two or three coexisting damaging mutations and risk variants were identified. Conclusions POI is characterized by heterogenous phenotypic features with complex genetic background that contains increasing number of genes. Deleterious variants, which were detected in our cohort, related to gonadal development (oogenesis and folliculogenesis), meiosis and DNA repair, hormonal signaling, immune function, and metabolism which were previously associated with the POI phenotype. This is the first genetic epidemiology study targeting POI associated genes in Hungary. The frequency of variants in different POI associated genes were similar to the literature, except EIF2B and GALT. Both of these genes potential risk factor were detected which could influence the phenotype, although it is unlikely that they can be responsible for the development of the disease by themselves. Advances of sequencing technologies make it possible to aid diagnostics of POI Since individual patients show high phenotypic variance because of the complex network controlling human folliculogenesis. Comprehensive NGS screening by widening the scope to genes which were previously linked to infertility may facilitate more accurate, quicker and cheaper genetic diagnoses for POI. The investigation of patient’s genotype could support clinical decision-making process and pave the way for future clinical trials and therapies.

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.

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.

Internal and external food safety audits and inspections are commonly implemented in food service establishments to uphold and enhance food safety standards. While the processes for various types of inspections are similar, each has distinct roles and implications. Self-checking involves inspections conducted by local staff within the food business. However, experts question the efficacy of this process, as it often fails to uncover food safety issues.This indicative study aimed to investigate whether self-checking can reveal food safety risks associated with primary and additional activities and identify which activities, if any, are misjudged by internal staff. An in-depth survey was conducted over four months in 10 school kitchens using a food safety control checklist, which was completed monthly by internal staff, an internal auditor, and an external auditor.The evaluations from external auditors consistently rated the kitchens lower than those from internal auditors and local catering managers. The most divergent judgments centered on personal hygiene practices, storage procedures, cleaning methods, and disinfection processes.Based on this data, food handlers tend to perceive their adherence to food safety practices as more robust than it is.

AbstractThis current study delves into the quality of consumer perception regarding brand channel integration that adopts the omnichannel approach. It specifically explores the impact of process consistency, breadth of the channel service choice, transparency of the channel service configuration, and content consistency, on customers’ inclination towards alternatives. The research incorporates the mediating role of retailer uncertainty and introduces the moderating factor of web-rooming. The analysis, based on data from 319 customers engaged with various omnichannel brands, revealed that the breadth of channel-service choice and process consistency emerged as the most influential factors. These factors contribute significantly to reducing retailer uncertainty and deterring customers from exploring alternative options. The implications of these findings are particularly valuable for industry practitioners, offering insights to shape effective omnichannel business strategies. By prioritizing the breadth of channels and ensuring process consistency, retailers can mitigate uncertainties in customers’ minds, thereby fostering retention and satisfaction.

Signaling pathways of Retinoblastoma (Rb) protein, Akt-kinase, and Erk-kinase (extracellular signal-regulated kinase) have an important role in the pathogenesis of acute myeloid leukemia. Constitutive activation of these proteins by phosphorylation contributes to cell survival by regulation of cell cycle, proliferation and proapoptotic signaling processes. According to previous data phosphorylated forms of these proteins represent a worse outcome for cancer patients. We investigated the presence of phosphorylated Rb (P-Rb), Akt (P-Akt) and Erk (P-Erk) proteins by Western blot technique using phospho-specific antibodies in bone marrow or peripheral blood samples of 69 AML patients, 36 patients with myelodysplastic syndrome (MDS) and 10 healthy volunteers. Expression level of PTEN (Phosphatase and tensin homolog) and PHLPP (PH domain and leucine-rich repeat Protein Phosphatase) phosphatases, the negative regulators of Akt kinase pathway were also examined. We tested the effect of these proteins on survival and on the correlation with known prognostic features in AML. We found 46.3% of AML patients had detectable P-Rb, 34.7% had P-Akt and 28.9% had P-Erk protein. 66.1% of patients expressing PTEN, 38.9% PHLPP, 37.2% both PTEN and PHLPP and 32.2% neither PTEN nor PHLPP phosphatases. Compared to nucleophosmin mutation (NPMc) negative samples P-Erk was significantly less in nucleophosmin mutated patients, P-Rb was significantly less in patients’ group with more than 30 G/L peripheral leukocyte count by diagnosis. PHLPP was significantly present in FAB type M5. The expression of P-Rb represented significant better overall survival (OS), while P-Akt represented significantly worse event-free survival (EFS) in unfavorable cytogenetics patients. The presence of both PHLPP and PTEN phosphatases contributes to better OS and EFS, although the differences were not statistically significant. We confirmed significant positive correlation between P-Akt and PHLPP. Assessing the phosphorylation of Rb, Akt and Erk may define a subgroup of AML patients who would benefit especially from new targeted treatment options complemented the standard chemotherapy, and it may contribute to monitoring remission, relapse or progression of AML.

The linear feedback shift register (LFSR) and Gold codes are used in telecommunications, Global Positioning System (GPS), satellite navigation, wireless systems, and code division multiple access (CDMA) dependent channel schemes for numerous radio communication technologies Gold codes are distinguished by their capacity to provide various orthogonal sequences. • The objective of the article is to focus on the design and simulation of the LFSR-based gold code generator chip in Xilinx ISE 14.7 software with the logic synthesis in Virtex-5 field programmable gate array (FPGA) and check the switching behavior with large frequency support applicable in fast-switching optical, and wireless electronics systems. • The methodology comprises design, functional simulation with different test inputs, and FPGA synthesis. The chip design is verified for the 10-bit seeding sequence of LFSRs to result in 1023-bit code with the frequency support of 310 MHz, and 9.285 ns delay. • The chip design is simulated based on seed data and different tap points of LFSR registers from which the bits are considered to generate the feedback. The design is scalable and has greater potential to extend to a larger extent. The behavior of the gold code depends on the maximum length sequence, absolute cross-correlation, and size of LFSR.

Background: Industrial, e.g. food industrial and domestic wastewaters contain huge amount of compounds causing eutrophication, and should be removed with high cost during wastewater treatment. However, these compounds could be utilized as fertilizers too. Biochar can remove a wide range of pollutants from water, such as ammonium, which can be found in relatively high concentration in dairy wastewaters. However, adsorption performance may be affected by the presence of other wastewater pollutants. Thus, this study aims to determine the efficiency of biochar as an adsorbent of ammonium in aqueous solutions in the presence of some selected organic compounds of typical dairy wastewaters such as bovine serum albumin (BSA), lactose, and acetic acid. Methods: The biochar was produced from banana leaves at 300 °C, modified with NaOH, and characterized by Scanning Electron Microscope – Energy Dispersive X-Ray Spectroscopy (SEM-EDX), Fourier-transform infrared spectra (FTIR) analysis, and specific surface area measurements. Batch experiments were carried out to investigate the ammonium adsorption capacity and the ion competitive adsorption mechanism. Significant Findings: Results show that the surface structure of the biochar derived from banana leaves is different from other biochars previously studied; although the specific surface area is not very considerable and despite having nitrogen within the elemental composition, the biochar studied is capable of adsorbing 2.60 mg NH4+/m2, the highest ammonium removal in 2 h occurs at pH 9 and 500 mg biochar dose. Langmuir model in the monolayer phase analysis fits better for all scenarios and the maximum NH4+ adsorption capacity was 0.97 mg/g without organic compounds. In the multilayer adsorption phase, the isotherm model that best fits the data obtained is the Harkins-Jura model without organic compounds. The presence of organic compounds in the aqueous solution significantly impacts the adsorption of ammonium by biochar since it improves the adsorption capacity (1.132 mg/g BSA, 0.975 mg/g lactose, and 1.874 mg/g acetic acid). The Aranovich-Donohue isotherm model fitted the data obtained during ion competitive adsorption experiments well.

During vapour phase reflow soldering used in electronics manufacturing, the process control of ovens is usually based on temperature measurements, which can be insufficient due to the saturation differences in the temperature and the vapour concentration. Therefore, the ovens use extended cycle times for process identification to ensure the proper formation of solder joints. This study offers a solution to eliminate the idle time by investigating the hydrostatic pressure conditions in the process zone. A pressure measurement system was developed for vapour phase soldering ovens which can monitor the vapour pressure changes by a gauge-type pressure sensor with fused temperature measurement. It works as an IoT-enabled node for data logging and subsequent control. The fusion of the hydrostatic pressure values with the temperature values allowed us to identify and reduce the idle time by approximately 60 s, which is 15–20% of the total soldering cycle time. This increases the oven's yield by 15–20%, reduces the system's power consumption by 15–20%, and reduces time above liquidus of the solder by ∼35%. The presented method could enhance the more sustainable electronics production according to the Sustainability Development and could improve the quality and reliability of the lead-free solder joints.

Abstract 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 There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p

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.

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.

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.

Second language (L2) motivation research has been thriving for the past decades by emphasizing L2 motivation theories and describing the motivated learner, while relatively few studies have dealt with how to motivate students in a systematic way. Approaches in these studies either included investigations into the role of different motivational strategies that teachers can use to motivate their students (Dörnyei & Csizér, 1998; Guilloteaux & Dörnyei, 2008) or the impact of various intervention methods (Chan, 2014; Mackay, 2014; Magid, 2014). Even though more situated and classroom-room related projects have been completed recently (Henry, Sundqvist & Thorsen, 2019), there is a need to provide further systematic analyses of how to maximize learner's L2 motivation in the 21st century. To fulfill this aim, the present theoretical investigation first summarizes the most important L2 motivation theories and their contributions to learner motivation, then outlines the challenges that make motivating students difficult in the 21stcentury. These areas comprise the role of English as a lingua franca, students' plurilingual identities and the relationship between student motivation and autonomy as a user. Among the main results and implications of the investigation features the finding that student motivation can be increased by engaging learners on their own terms and by involving their reality and creativity in the language learning process. Methods and activities which enable students to act as L2 users in the language class include translation and literature. In addition, the classroom as a venue of genuine communication can have a positive impact on student motivation in the practice of language teaching.