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In the Central European region, there is a long tradition of breeding fish in artificially constructed ponds. As the area belongs to the temperate zone, farmed fish need to survive cold winter periods. Common carp (Cyprinus carpio L.), which is an omnivorous, bioturbating species, is well adapted to warm and cold periods and the alluvial water environment. Since the Middle Ages, a large scale, efficient carp farming methodology has been developed in the region, where production is based on natural resources (protein and fatty acid sources) of renewable water ecosystems. This summary aims to present this well-developed breedi:ng method through discussing aspects of hydrobiology and energy transfer through the food chain as well. Capabilities and effects of agro-technical treatments such as liming and organic manuring, zooplankton management and possible supplementary feedings are also reviewed. Analysing chemical processes of waters uncovers that biological production has no carbon footprint; no carbon dioxide is released into the atmosphere. In contrast, gaseous carbon dioxide diffuses into pond water containing calcium and/or magnesium, then it accumulates in algae production and, through energy migration to upper trophic levels, increases carp production. Thus, it can be declared that pond-farmed carp provides an environmentally friendly, delicious meat among products of animal origin.

Abstract Environmental negotiations are complex, and conveying the interaction between science and policy in traditional teaching methods is challenging. To address this issue, innovative educational approaches like serious gaming and role-playing games have emerged. These methods allow students to actively explore the roles of different stakeholders in environmental decision-making and weigh for instance between sometimes conflicting UN Sustainable Development Goals or other dilemmas. In this work the phosphorus negotiation game (P-Game) is for the first time introduced. We present the initial quantitative and qualitative findings derived from engaging 788 students at various academic levels (Bachelor, Master, PhD, and Postdoc) across three continents and spanning 22 different countries. Quantitative results indicate that female participants and MSc students benefitted the most significantly from the P-Game, with their self-reported knowledge about phosphorus science and negotiation science/practice increasing by 71–93% (overall), 86–100% (females), and 73–106% (MSc students in general). Qualitative findings reveal that the P-Game can be smoothly conducted with students from diverse educational and cultural backgrounds. Moreover, students highly value their participation in the P-Game, which can be completed in just 2–3 h. This game not only encourages active engagement among participants but also provides valuable insights into the complex environmental issues associated with global phosphorus production. We strongly believe that the underlying methodology described here could also be used for other topics.

Abstract The aim of this study was to evaluate how COVID-19 affected acute stroke care and outcome in patients with acute ischemic or hemorrhagic stroke. We performed a retrospective analysis on patients who were admitted with acute ischemic (AIS) or hemorrhagic (ICH) stroke from September 2020 to May 2021 with and without COVID-19. We recorded demographic and clinical data, imaging parameters, functional outcome and mortality at one year. Beside descriptive statistics we performed χ2-probe, Mann-Witney U-test, Student t-probe and multivariate testing. We found a 29%-reduction in the number of AIS cases during the pandemic. The number of the large vessel occlusions /LVOs/ (N = 83, 41.7%), from them 37 (17.7%) had mechanical thrombectomy (MT), was higher than before the COVID-19 period (p = 0.02 and p = 0.001, respectively). From all patients needing acute revascularization therapy (N = 137) 118 patients received it, among them 20 (16.9%) had COVID-19. Those positive for COVID-19 were more likely to have a higher median NIHSS score at baseline and at 24 h (p = 0.02 and p = 0.03, respectively). They also had a lower rate of favourable outcome at discharge (15% vs. 41.8%; p = 0.024) and at three months (25% vs. 52%, p = 0.02), longer median hospitalization (p

In this 21st century, HEIs are experiencing a dynamic change in technology, and they should be responsive to stay in the competition space. A recent phenomenon of the COVID-19 outbreak was an alarm that caused many HEIs to look back at their capacity in digital technology to deliver online teaching and learning. This paper presents technology-based teaching and learning at two Ethiopian higher education institutions. Two research questions were set to guide the study: -how do academics perceive tech-based teaching and learning as an element of quality? Do other Inputs, Processes, and Outputs impact the application of digital technology in teaching and learning? A quantitative research method was employed to assess the case. 188 university teachers were taken from two universities as a sample for questionnaire administration. Jamovi software was deployed for data analysis. The result shows that digital technology-assisted teaching and learning are among the important elements of quality. Teachers believe that technology-based teaching and learning improves quality. Their beliefs were similar across their qualifications, departments, university type, and gender. In contrast, their service years have made a significant difference between teachers of less than five years (5) experience and those between five to ten (5-10) years. Inputs and processes-oriented quality elements significantly affect the integration of ICT into teaching and learning. It is recommended that HEIs of Ethiopia be proactive in planning to adopt relevant and timely digital technologies to deliver quality teaching and learning. Besides this, their openness to cooperate with Ethio Telecom, the Ministry of Education, and other NGOs to work toward capacity building to integrate digital technology into their teaching and learning by minimizing the challenges related to poor digital competency, scarce resources, internet connection, and infrastructure.

Introduction: Epilepsy is a widespread disease requiring long-term drug treatment. The aim of this study was to collect information on reported suspected adverse drug reactions (sADRs) of antiseizure medications (ASMs) and study their seriousness and outcomes in various system organ classifications (SOCs). We intended to compare old and new ASMs’ ADRs.Methods: Using EudraVigilance (EV) database, we extracted line listings of reported sADRs with different ASMs over the period from January 2012 to December 2021. The list of ASMs was compiled according to the Anatomical therapeutic chemical classification system. The Medical Dictionary for Regulatory Activities version 24.0 was used for determining the SOCs of individual reported preferred terms (PTs) sADRs. In addition, we calculated the Reporting Odds Ratio (ROR), 95% confidence interval (95% CI), p-value (statistically significant if p< 0.05) and chi-square statistics.Results: A total of 276,694 reports were contained in the exported line listings which included 1,051,142 individual sADRs reported as PTs such as seizure (3.49%), drug ineffective (2.46%), somnolence (1.32%), dizziness (1.29%) and represented four SOCs: nervous system disorders (19.26%), general disorders and administration site conditions (14.39%), psychiatric disorders (11.29%) and injury, poisoning and procedural complications (9.79). Among patients, the age group between 18 and 64 years had the highest percentage (52.40%), followed by those aged over 64 years (18.75%). Of all the reported PTs, 882,706 (83.98%) had reported seriousness. Old ASMs had a significant positive association with “caused/prolonged hospitalisation”, “congenital anomaly”, “disabling”, “life threatening” and “results in death”, while new ASMS with ‘other medically important condition’. There were 386 (0.04%) PTs related to Sudden Unexpected Death in Epilepsy (SUDEP).Conclusion: In our study, we examined 10 years’ reported sADRs of ASMs in the EV international database. The majority of PTs were serious. Old ASMs were generally more commonly associated with undesired outcomes and seriousness. Considering their expected seriousness and outcomes, the safety profile of the different ASMs, can play a cardinal role in the selection of ASMs.

Introduction: Scarcity of age appropriate formulations for orally administered medicines for paediatric malignancies is a critical and ongoing issue which necessitates urgent solutions. According to JARC Survey 27 % of oral medicines were never available in child-friendly formulations (Vassal et al., 2021 [2]). Pharmacists from the European Society of Oncology Pharmacy Global (ESOP) and the European Society for Pediatric Oncology (SIOPE) have collaborated to provide a document summarising literature data on this topic and a set of practical instructions on the preparation of extemporaneous oral liquid medicines. Material and methods: Literature review was conducted for the preparation of oral medicines for paediatric cancer, through Pubmed 2.0. A table was drawn up with necessary information for medicine preparation. We adapted the classification model of the molecule stability ranking of the International database of stability for injectable drugs, Stabilis® (Class A–C). Results: A total of 126 articles were selected and analysed. All commercially available marketed liquid oral medications used in paediatric cancer were overviewed using globally accessible drug databases and compiled in a table with appropriate indications. Based on the literature review, 28 formulations for 13 different active ingredients for chemotherapy and 35 formulations for 16 different active ingredients for supportive therapy were compiled. Conclusions: Development of child-appropriate formulations of anticancer medicines by the pharmaceutical industry should be incentivised towards marketing authorisation to enhance accessibility. The results of this study could help facilitate creation of European standards for extemporaneous preparation and persuade researchers in the field of paediatric oncology on the way forward.

Abstract In this paper we give a necessary and sufficient condition for the discrete Jensen inequality to be satisfied for real (not necessarily nonnegative) weights. The result generalizes and completes the classical Jensen–Steffensen inequality. The validity of the strict inequality is studied. As applications, we first give the form of our result for strongly convex functions, then we study discrete quasi-arithmetic means with real (not necessarily nonnegative) weights, and finally we refine the inequality obtained.

The durability of a pallet affects the amount of use a pallet can withstand before functionality is lost. A reliable prediction of durability can be used to determine the effect of pallet performance on supply chain operating costs. The objective of this research was to correlate damage modes, location, severity, and frequency observed for pallet in the field, to damages observed during Virginia Tech’s FasTrack simulation system. Several 1219 mm x 1016 mm (48 x 40 inch) stringer class wooden pallets used in the field were inspected for damages, and the results were compared to historical pallet damage information from FasTrack. The pallet damage behavior did not change for different levels of damage severity, which indicates that pallets fail as the initial damage worsens due to prolonged use. Inspected pallets from the field showed high damage occurrence on the stringer notches and bottom lead deckboards. Pallets tested via FasTrack exhibited significantly more top deck and end board damage and less stringer damage than observed in the field.

Social identities, such as identification with the nation, are regarded as core variables in explanations of political attitudes and behaviors. In these accounts, increases in the importance of an identity such as “Englishness” are often seen to be accompanied by decreases in the importance of other, more inclusive, identities such as “British” or “European.” At the same time, increases in exclusive national identities like “Englishness” present challenges to democratic states because they are associated with preferences such as support for Brexit and intolerance of outgroups. Yet we know comparatively little about the relative importance to individuals of different social identities, the extent of changes in the strength of those social identities with contextual shifts, the interrelationships between different social identities, and the influences on different social identities. In this paper, we address each of these questions using a five-wave online panel study administered over two years of the COVID-19 pandemic in England from 2020 to 2022, in which we asked about the importance of eight identities—Europeanness, Britishness, Englishness, the local area, gender, age, race/ethnicity, and social class. We show that national identity is consistently less important to individuals than the social identities of gender and age, though more important than race/ethnicity and social class. We also show that there were general increases in identification with almost all these groups during COVID. We consider why and discuss the implications for our understanding of increases in the strength of national identity as a challenge to democratic states.

Hypophysation is the oldest and most widely used method of induced fish breeding. In practice, common carp (Cyprinus carpio) pituitary is one of the most commonly used agents to induce ovulation. The active ingredients of pituitary (glycoprotein) are very susceptible to fast degradation, therefore the glands must be preserved immediately after collection. Preservation is usually carried out in acetone which dehydrates and defattens the glands.The aim of our experiments was to investigate the efficacy of an extremely long-stored batch of pituitary gland collected in 1967. The biological potential of the glands was assessed through reproductive indices recorded during induced breeding of African catfish (Clarias gariepinus). The experiments were performed in October 2020. One group of females was treated with acetone-dried carp pituitary collected in 1967 and the other group was injected with pituitary collected in the year prior to the experiments. To assess the effectiveness of the pituitary treatment the following reproductive traits were determined: ratio of ovulated females, relative weight of the stripped eggs and the residual ovary, fertilization and hatching rates. The statistical methods used did not indicate a significant difference between the two groups for any of the reproductive indices, which means that the pituitary gland collected in 1967 remained effective after 53 years.

Digital disruption is not a new phenomenon in education; however, it has become more prominent during the COVID-19 pandemic due to school closures and the related emergency remote teaching (ERT) period. Our study aims to explore the different pedagogical strategies that primary school teachers adopted during this period and determine how successful these strategies were in involving and engaging students. Altogether, 4028 teachers from 343 primary schools answered our online survey from all the regions of Hungary. The sample adequately represents the Hungarian primary school teacher population in terms of gender and age. We used cluster analysis and identified four clusters of pedagogical strategies; then, we used analysis of variance to explore how teachers’ digital competence and their ability to involve students in online learning varied across different clusters. Our analysis grasps the complexity of the issue, as it shows that two rather distinct strategies were both successful in involving students, and thus, there is no single solution best suited to digital learning. Overall, digitally competent teachers loosened the originally strict structure of education and provided more feedback, which proved to be an important element in successfully involving students in digital learning during ERT. The framework validated in our research can be used by policymakers and school administrators in different national and educational contexts, enabling them to understand the complexity of online teaching and learning. Furthermore, our results can offer some practical pointers for school teachers on how to combine different pedagogical strategies.

IntroductionPeople with epilepsy have to face many challenges, including regular follow-ups, the need to take antiseizure medications (ASMs), and the fear of seizures. Pregnant women with epilepsy (PWWE) are a special group with even more challenges because they are responsible for the fetus. We aimed to evaluate the change in the frequency of pregnancies over the years and the possible role of newer types of ASMs concerning this change, the shift in medication use over three decades, and their possible impact on the outcome of the observed pregnancies.MethodsData were retrieved from the prospective Epilepsy Database of the Outpatient Clinic at our tertiary center between 1 January 1992 and 31 December 2020. Groups were formed for comparison in time and depending on whether regular care consultation was our task. Statistical analysis was carried out using Microsoft Office Excel 2021. Basic statistics and categorical variables were assessed using Pearson's χ2 test with Yates' correction. Differences were considered significant if the p-value was

South Korea is one of the leading markets for the e-commerce industry. In line with the rapid growth of the e-commerce industry, the parcel delivery volume in Korea has also proliferated. Despite the developments in the Korean e-commerce and courier industries, consumers still experience a high package damage rate. In response, many packaging engineers in Korea have raised the need for new parcel shipping environment tests that reflect the Korean ground shipping environment in order to properly optimize packages. However, only limited information on the Korean parcel shipping environment is currently available. Therefore, this study focused on measuring and analyzing the shock and drop levels that parcels experience during ground shipping in Korea. Shock data were collected from a total of sixty one-way shipments for small, lightweight packages and medium, mid-weight packages. The findings revealed that the two types of boxes do not experience significantly different numbers of shock events or drop heights in the Korean parcel delivery environment. Furthermore, the number of shock events that occur in Korea is substantially less than the international testing standard and less than in previous studies conducted in both Europe and the USA. In contrast, however, the drop heights are higher than those in the international testing standard and previous studies. Shock events were found to occur most frequently on the edges and to be concentrated around the bottoms of the packages. Most shock events happen while packages are loaded and unloaded at hub terminals and sub terminals.

South Korea has one of the largest e-commerce markets in the world. The last-mile delivery segment of e-commerce often causes critical damage to products in protective packages. Despite the rapid growth of the e-commerce market in Korea, the last-mile distribution environment has not yet been thoroughly investigated. The main aim of this study was to provide an understanding of the vibration levels that were measured from various parcel delivery routes within Seoul, Korea, using common types of parcel delivery trucks. Vibration levels of ten delivery trucks were measured and analyzed in terms of power spectral densities (PSDs) and presented as PSD spectra. The last-mile delivery vehicle vibration levels in Korea were found to be consistently lower (in the 1 to 200 Hz frequency range) than those recommended by international standards and lower than the vibration levels of parcel delivery vehicles in the U.S. and Hungary. The results also revealed that the highest intensity peak of the PSD spectrum for Korea was located in the lower frequency range (1.5 to 2 Hz) compared to the ISTA 3A pickup and delivery test profile (3 to 4 Hz) and the test profile recommended for Hungary (13 to 16 Hz). A smoothed composite spectrum was also provided to support Korean packaging engineers in optimizing their packages by simulating proper last-mile truck delivery vibration levels in lab conditions.

Introduction: Vitamin D (vitD) deficiency may have importance in some diseases, but there is a lack of data in our country to clarify the current situation. Our aim was to examine the basic characteristics of patients’ vitD status, and the ratio of vitD deficiency and its relation to certain diseases, assess seasonality and trends, and reveal the indirect impact of the COVID-19 pandemic on vitD3 supplementation at the patient population level.Methods: Anonymized data on 25(OH)D test results were obtained from the clinical data registry of a tertiary teaching hospital covering the period between 1 January 2015 and 30 June 2021. VitD consumption (pharmacy sale) data were retrieved from the database of the National Health Insurance Fund of Hungary in order to calculate the defined daily dose (DDD)/1,000 inhabitants/day. Descriptive statistics and odds ratios with their 95% confidence intervals were calculated. The two-sample t-test and F-test were used to analyze our patients’ data. Significant differences were considered if p

Soil moisture reserves are a key factor in maintaining soil fertility and all other related ecosystem services (including carbon sequestration, soil biodiversity, and soil erosion control). In semiarid blown-sand areas under aridification, water preservation is a particularly crucial task for agriculture. The international Diverfarming project (2017–2022), within the EU Horizon 2020 Program, focused on the impacts of crop diversification and low-input practices in all pedoclimatic regions of Europe. In this three-year experiment conducted in the Pannonian region, the impact of intercropping asparagus with different herbs on some provisioning and regulating ecosystem services was evaluated in the Kiskunság sand regions. Relying on findings based on a range of measured physical and chemical soil parameters and on crop yields and qualitative properties, advice was formulated for farmers. The message drawn from the experiment is somewhat ambiguous. The local farmers agree that crop diversification improves soil quality, but deny that it would directly influence farm competitiveness, which primarily depends on cultivation costs (such as fertilization, plant protection, and labour). Further analyses are needed to prove the long-term benefits of diversification through enriching soil microbial life and through the possible reduction of fertilizer use, while water demand is kept at a low level and the same crop-quality is ensured.

Common carp (Cyprinus carpio L.) as a cultivated fish species has huge importance all over the world. According to FAO statistics, carp is the third most widely bred freshwater pond fish species; only two other Cyprinids (silver carp and grass carp) are bred in higher amounts. Carp is native all over Asia and in a large part of Europe. As a result of human intervention, at present, carp are widespread all over the world, except for the Arctic region. Carp breeding was launched in the antique period, in the ancient Chinese Empire and the Roman Empire. The presently applied method of breeding of common carp has a long evolution. From the effectiveness point of view, the propagation and early-life nursing are crucial parts of carp production, as they provide seed stocks for the further growing section. Without effective propagation, there is no intensive carp production. Nowadays, more advanced propagation methods are available all over the world; however, in the current review, only the main milestones and production efficiency of the propagation and nursing method used in the ponds of Eastern Central Europe are discussed. In the historical overview of carp reproduction, first the natural reproduction, then the semi-extensive and intensive hatchery propagation are presented and investigated in detail. The analysis focuses on the advantages and disadvantages of the method. In particular, the different important milestones of the advanced hatchery method are shown and explained. The effectiveness is proven even with practical calculations. Not only the reproduction, but the pond nursing method is also presented and discussed, concentrating on the management of evolutionarily adapted natural feeds (Zooplankton) and their effect on the survival of fish larvae.

IntroductionAcute ischemic stroke (AIS) is a potentially devastating disease with high disability and mortality. Recombinant tissue plasminogen activator (rt-PA) is an effective treatment with a 2–8% possible risk for symptomatic intracranial hemorrhage (sICH). Our aim was to investigate the risk factors and long-term clinical outcomes of ICH in patients after rt-PA treatment.MethodsConsecutive patients with AIS, thrombolysed at the Department of Neurology, University of Debrecen, between 1 January 2004 and 31 August 2016 were enrolled prospectively. Risk factors, stroke severity based on the National Institute of Health Stroke Scale (NIHSS), functional outcome using the modified Rankin scale, and mortality at 1 year were compared in patients with and without ICH following rt-PA treatment. We evaluated clinical characteristics and prognosis by hemorrhage type based on the Heidelberg Bleeding Classification. Descriptive statistics, the chi-square test, the Mann–Whitney U-test, ANOVA, the Kruskal–Wallis test, a survival analysis, and logistic regression were performed as appropriate.ResultsOut of 1,252 patients with thrombolysis, ICH developed in 138 patients, with 37 (2.95%) being symptomatic. Mean ages in the ICH and non-ICH groups differed significantly (p = 0.041). On admission, the 24-h NIHSS after thrombolysis was higher in patients with ICH (p < 0.0001). Large vessel occlusion was more prevalent in patients with ICH (p = 0.0095). The ICH risk was lower after intravenous thrombolysis than intra-arterial or combined thrombolysis (p < 0.0001). Both at 3 months and 1 year, the outcome was worse in patients with ICH compared to patients without ICH group (p < 0.0001). Mortality and poor outcome were more prevalent in all hemorrhage types with a tendency for massive bleeding associated with unfavorable prognosis. At 3 months with the logistic regression model, the worse outcome was detected in patients with ICH after thrombolysis, at 1 year in patients with ICH after thrombolysis and smoking.DiscussionOlder age, higher NIHSS, large vessel occlusion, and intra-arterial thrombolysis may correlate with ICH. The unfavorable outcome is more common in patients with ICH. Precise scoring of post-thrombolysis bleeding might be a useful tool in the evaluation of the patient's prognosis. Our findings may help to identify predictors and estimate the prognosis of ICH in patients with AIS treated with rt-PA.

In this study, the inseminated sperm method (sperm injection into the ovarian lobe in externally fertilised fish species) combined with hormonal induction was conducted as a novel method to produce hybrid catfish by induced/tank spawning. In the treated group, four Clarias gariepinus ♀ were inseminated equally with Heterobranchus longifilis sperm in the ovaries at a dosage of 1 mL/fish and then introduced into four spawning cages together with four C. gariepinus ♂. Ovulation was induced by extracted carp pituitary (CPE) hormonal administration (♀; 5 mg CPE/BW kg). The hybridization rate was determined on the basis of morphological markers to distinguish between pure African catfish and hybrid in juvenile stage. A control experiment was also designed to determine this and to explore possible interactions between the two genotypes. In the control group, in vitro fertilisation (IVF) was used to produce pure progeny of C. gariepinus and the hybrid progeny between C. gariepinus ♀ × H. longifilis ♂. Exogenously fed larvae from each treatment were raised and compared after 28 days in four replications; the mixed group contained 50 C. gariepinus and 50 hybrids from IVF grown together, while every 100 larvae from each cage spawning pair were grown separately. The hybridisation rate determined based on morphological traits was 98.11 ± 1.59 (mean ± S.D.) for 28-day-old reared offspring. There were no significant differences (P > 0.05) in survival rate (%) between C. gariepinus (45.79 ± 6.82 %) and the hybrid (54.21 ± 6.82 %) in the control treatment; therefore, neither genotype had a negative effect on the other during the rearing period. From this result, we supposed that the hybridisation rate was also over 95 % at the moment of fertilisation. This approach could be an alternative method for producing hybrid catfish or other fish species without in vitro fertilisation.

Amyotrophic lateral sclerosis (ALS) is a fatal form of neuromuscular disease. The aim of this study was to assess changes in the blink reflex (BR) parameters as a valid and easy-to-use tool in ALS patients. We assessed the BR test in patients with a definitive diagnosis of ALS, healthy volunteers, and patients with diseases affecting the peripheral nervous system. The BR was studied in 29 patients who met the Awaji criteria. Latencies were compared with our healthy controls (N = 50) and other diseases of the peripheral nervous system (N = 61). The ALS Functional Rating Scale—Revised (ALSFRS-R) was used to evaluate functional status. Significantly prolonged R2i and R2c latencies were found in the ALS group compared with the healthy control group (p < 0.001). The latencies of R1, R2i, R2c were all increased in the bulbar subtype compared to the limb-onset subtype (p < 0.05). According to our results, BR examination might be a promising tool to monitor the course of the disease or serve as a prognostic biomarker in patients with ALS, but it should be assessed in further studies. The abnormalities detected through BR might help perform earlier interventions in ALS patients and might be useful in other diseases affecting the peripheral nervous system.

Successful propagation of fish depends on many factors including the optimal administration routes and delivery vehicles of spawning agents. In our experiments, the effects of different routes of administration and delivery vehicles of Ovopel (mammalian GnRH-analouge and metoclopramide) on ovulation were compared in African catfish (Clarias gariepinus). Seven females per treatment were used (BW = 606–1088 g). In experiment 1, fish in treatment 1 and 2 were given intramuscular (IM) and intraperitoneal injections (IP) of Ovopel suspended in fish physiological saline, respectively. For treatment 3 and 4, Ovopel was suspended in fish physiological saline (NaCl) and fish sperm (SP), respectively. The suspensions were introduced into the ovary of the females by a catheter. In experiment 2 (verification or clarification experiment), two treatments were administrated identically as experiment 1 for IM and SP. As a new treatment (SI) sperm was introduced into the ovary by a catheter, the Ovopel were administrated intramusculary. In both experiments, all females ovulated in all treatment groups. The relative number of stripped eggs was also similar among treatments within experimental cycles. Hatching rate was significantly lower for treatments where fish sperm was introduced to the ovary by a catheter whether it contained Ovopel (39.1 ± 18.3 %; SP, experiment 1 and 35.1 ± 21.2 %; SP, experiment 2.) or not (SI: 46.0 ± 9.2 %). While in other treatments, hatching rates were significantly higher and varied between 55.1 ± 16.1 % (IM), 66.7 ± 9.3 % (IP), and 63.4 ± 9.0 % (NaCl) in experiment 1 and 61.9 ± 12.0 % (IM) in experiment 2. The result of ovarian lavage with hormone preparations in saline have shown that the effects this novel method do not differ from the effects of reproduction with the use of traditionally injection by needle.

In this paper, we present a general framework that provides a comprehensive and uniform treatment of integral majorization inequalities for convex functions and finite signed measures. Along with new results, we present unified and simple proofs of classical statements. To apply our results, we deal with Hermite-Hadamard-Fejér-type inequalities and their refinements. We present a general method to refine both sides of Hermite-Hadamard-Fejér-type inequalities. The results of many papers on the refinement of the Hermite-Hadamard inequality, whose proofs are based on different ideas, can be treated in a uniform way by this method. Finally, we establish a necessary and sufficient condition for when a fundamental inequality of f-divergences can be refined by another f-divergence.

Controlled indoor reproduction of European eel is commonly recognized as a prospective tool to prevent extinction of this fish species. There is a little information about diversity of bacterial microflora of European eel during long maturation under controlled but changing thermal and salinity conditions. Characteristics of the composition of the bacterial microflora inhabiting the body surface of fish kept firstly in fresh and then in salt water, may help enhance the survival of spawners and spawning efficiency. Knowledge about the presence of potentially pathogenic bacterial species and their antibiotic resistance is particularly important. Methods: This study analyzed the bacterial microflora of two types of necrotic changes on the skin of eel females during artificial maturation under fresh and saltwater conditions. Results: A total of two hundred and forty bacterial strains were isolated from necrotic dermal changes on fish in freshwater and saltwater conditions. Both the bacterial number and biodiversity were greater in freshwater than in saltwater. Psychrophilic bacterial strains in freshwater were twice as abundant as in saltwater, especially among isolates which were cultured from the mucus or from ulcerative changes around the chip injection point (up to 1010 cfu/mL). 16 S ribosomal RNA gene sequencing of isolates from the freshwater conditions revealed the presence of twenty genera of bacteria, including: Pseudomonas sp., Comamonas sp., Escherichia sp., Aeromonas sp., Citrobacter sp., Burkholderia sp., Pantoea sp., Enterobacter sp., Yersinia sp., Edwardsiella sp., Serratia sp., Bordetella sp., Morganella sp. and Chromobacterium sp. In saltwater conditions, five genera of bacteria were found dominantly: Pseudomonas sp., Aeromonas sp., Yersinia sp., Vibrio sp., Edwardsiella sp. In freshwater conditions, the bacteria were mostly resistant or resistant to all tested antimicrobial drugs. Conclusions: Changes in bacterial microflora during controlled indoor reproduction of European eel predispose fish to bacterial infection especially during the first freshwater step of female maturation. New, alternative to antibiotic therapy, methods should be adopted to prevent infections and enhance spawning efficiency.

Abstract There are a lot of papers dealing with applications of the so-called cyclic refinement of the discrete Jensen’s inequality. A significant generalization of the cyclic refinement, based on combinatorial considerations, has recently been discovered by the author. In the present paper we give the integral versions of these results. On the one hand, a new method to refine the integral Jensen’s inequality is developed. On the other hand, the result contains some recent refinements of the integral Jensen’s inequality as elementary cases. Finally some applications to the Fejér inequality (especially the Hermite–Hadamard inequality), quasi-arithmetic means, and f-divergences are presented.

A more resilient adaptation to changing climate calls for crop diversification in vineyards, too. As a contribution to the H2020 collaborative project of the European Union, called Diverfarming, and part of the agroecological experiments during 2018 and 2019, grapevine biomass growth was monitored in connection with carbon storage types in soil and in the deposits removed by soil erosion. Phenometry was carried out interpreting segmented images to follow changes in biomass. It was found that crop growth could be best described by the Richards growth function. The distinction between grapevine and intercrop growth, however, requires further refinement in image analysis. In the laboratory TOC and Ntotal were measured for both the soil and the plant organs as well as for the eroded sediments. Greenhouse gas emissions and photosynthesis were monitored. Looking at the change of Leaf Area Index (LAI) over the growing period, image analysis pointed out the role of cut shoots from pruning in the C and N cycles. Maximum leaf area (at ripening) for guyot cultivation technique was extimated at 7,840 m2 ha-1. Soil loss by erosion was established by sediment traps at the end of vinestock rows. The grain size distribution analysis led to the remarkable result that as erosion proceeded, the ratio of the sand fraction increased but remained within the range for the textural class of loam. Organic matter contents grew to 38 g kg-1. The rate of soil erosion is higher in ploughed than in grassed interrows by orders of magnitude.

Diversified farming systems are promoted to improve ecosystem services in agriculture while maintaining productivity. Intercropping could improve soil quality, the stability of yields and climate resilience. Whether direct emissions of greenhouse gases from soil are reduced as well, depends on the specific measures of diversification. Here, we determined the greenhouse gas emissions from soils of two diversification experiments in the Pannonian climate of Hungary. Firstly, in an asparagus field, oat and field pea was introduced as intercrop between the asparagus berms. Secondly, grass and aromatic herbs were intercropped in a vineyard between the grape rows. The results show that especially for nitrous oxide, average treatment emissions can increase with additional legumes (+252% with intercropped field peas) but decrease with aromatic herbs (−66%). No significant changes were found for methane exchange. This shows that, while other ecosystem services can be increased by intercropping, changes in soil greenhouse gas emissions by intercropping are highly context dependent.

Introduction: Millions all over the world live with epilepsy, and they may require long-term drug treatment. The use and interest in complementary and alternative medicine (CAM) have grown over the previous years. Coadministration of herbal products with medicines may result in adverse drug reactions (ADRs) and/or unfavorable interactions. The aims of this study were to determine the prevalence of CAM use among patients with epilepsy, to compare the results to those of the patients with diabetes mellitus (DM), to reveal factors that may drive the use of CAM, and to measure outcomes and adherence. It was also our intent to have state-of-the-art information on CAM use in our region among patients with the two diseases above.Materials and Methods: We conducted a non-interventional study using a self-developed questionnaire. It was distributed among adult patients with either epilepsy or DM who also suffered from cardiovascular consequences. A database was compiled from the anonymous questionnaires filled in voluntarily by the patients. Basic statistics were used to analyze this database.Results: A total of 227 questionnaires were filled in by 127 patients (55.9%) with epilepsy and 100 patients (44.1%) with DM. Mean age was 54.54 ± 17.33 years. Of the patients, 50.2% were male. Average body weight was 80.3 ± 17.3 kg. Of the patients, 22 (9.7%) used CAM because they believed in CAM. Two of them reported ADRs. Among the patients with epilepsy, the ratio was only 7.9% compared to 12% among those with DM. While the number of CAM users was higher among younger patients with epilepsy, it was the elderly patients with DM who tended to use CAM.Conclusion: Attention should be paid to reliance on CAM during the follow-up. Our finding that health-conscious patients tend to use CAM more often (than the general population) may indicate it is necessary to discuss CAM usage sincerely. CAMs modulating cytochrome P450 (CYP) enzymes were the most common, leading to interactions with medication used and resulting in ADRs. This shows the importance of educating patients and treating team including clinical pharmacists in this field.

BackgroundFingolimod was approved and reimbursed by the healthcare provider in Hungary for the treatment of highly active relapsing-remitting multiple sclerosis (RRMS) in 2012. The present study aimed to assess the effectiveness, safety profile, and persistence to fingolimod in a real-life setting in Hungary in RRMS patients who were either therapy naïve before enrollment or have changed to fingolimod from another disease-modifying therapy (DMT) for any reason.MethodsThis cross-sectional, observational study with prospective data collection was performed nationwide at 21 sites across Hungary. To avoid selection bias, sites were asked to document eligible patients in consecutive chronological order. Demographic, clinical, safety and efficacy data were analysed for up to 5 years from 570 consenting adult patients with RRMS who had received treatment with fingolimod for at least one year.Results69.6% of patients remained free from relapses for the whole study duration; in the first year, 85.1% of patients did not experience a relapse, which rose to 94.6% seen in the 5th year. Compared to baseline at study end, 28.2% had higher, and 9.1% had lower, meanwhile, 62.7% of the patients had stable EDSS scores. Overall, the annualized relapse rate decreased from 0.804 observed at baseline to 0.185, 0.149, 0.122, 0.091, and 0.097 (77.0%, 82.1%, 85.2%, 89.7%, and 89.0% relative reduction, respectively) after 1, 2, 3, 4, and 5 years of treatment. The greatest reduction rate was seen in the group of therapy naïve patients. Treatment persistence on fingolimod after 60 months was 73.4%.ConclusionIn this nationwide Hungarian cohort, most patients under fingolimod treatment were free from relapses and disability progression. In addition, fingolimod has proven to be a well-tolerated DMT that has sustained its manageable safety profile, high efficacy, and positive benefit/risk ratio for up to 5 years in a real-life setting.

Introduction: Intracerebral hemorrhage (ICH) is a devastating disease, which may lead to severe disability or even death. Although many factors may influence the outcome, neurophysiological examinations might also play a role in its course. Our aim was to examine whether the findings of electroencephalography (EEG) and transcranial magnetic stimulation (TMS) can predict the prognosis of these patients.Methods: Between June 1 2017 and June 15 2021, 116 consecutive patients with ICH were enrolled prospectively in our observational study. Clinical examinations and non-Contrast computed tomography (NCCT) scan were done on admission for ICH; follow-up NCCT scans were taken at 14 ± 2 days and at 3 months ± 7 days after stroke onset. EEG and TMS examinations were also carried out.Results: Of the patients in the study, 65.5% were male, and the mean age of the study population was 70 years. Most patients had a history of hypertension, 50.8% of whom had been untreated. In almost 20% of the cases, excessive hypertension was measured on admission, accompanied with >10 mmol/L blood glucose level, whereas their Glasgow Coma Scale was 12 on average. Presence of blood in the ventricles or subarachnoid space and high blood and perihematomal volumes meant poor prognosis. Pathological EEG was prognostic of a worse outcome. With TMS examination at 14 days, it might be possible to estimate outcome in a univariate model and the absence, or reduction of the amplitude of the motor evoked potentials was associated with poor prognosis.Conclusion: Together with the clinical symptoms, the volume of bleeding, perihematomal edema (or their combined volume), and neurophysiological examinations like EEG and TMS play an important role in the neurological outcome of patients with ICH. This might affect the patients' rehabilitation plans in the future, since with the help of the examinations the subset of patients with potential for recovery could be identified.

Objectives: This retrospective single-center study aimed to investigate the risk factors, outcomes and complication rates in patients older vs. younger than 80 years treated with intravenous alteplase.Methods: Data of 1,253 thrombolysed patients were analyzed between January 1, 2004 and August 31, 2016. Vascular risk factors, stroke severity based on the NIHSS score, functional outcome using modified Rankin Scale (mRS), mortality and symptomatic intracerebral hemorrhage (SICH) were compared between two subgroups (

Our study concerns the factors leading to the electoral success and failure of LGBTQ candidates in the context of the changing nature of prejudices. We hypothesize that more positive views toward “respectability candidates,” as captured by familial status, has replaced explicit prejudice toward out LGBTQ candidates in societies where acceptance of sexual minorities in general has grown. In a survey experiment conducted with a sample of Canadian voters, one of the first countries to legalize marriage equality, we find suggestions that voters are more likely to reward lesbian and gay candidates who adopt heteronormative relationships (married with children vs. single) than those who do not. These patterns become more evident when we explore causal heterogeneity with controls for individual-level characteristics and attitudes that typically predict support toward lesbian and gay candidates. Here we find these predictors rewarded single lesbian and gay candidates, whereas lesbian and gay candidates with families were simply more supported across the board.

Forklift handling of palletized loads produces shock impacts that cause significant damage, affecting the durability and life cycle of pallets and unit loads. Laboratory testing processes using an incline impact tester have been developed to assess the resistance of pallets and unit loads to shock impact damage. A key element of the pallet durability test using the incline impact tester is the intensity of the impact. However, there is a lack of information on the intensity of the shock impacts during forklift handling. The objective of this research was to investigate the effects of forklift type, pallet design, entry speed, and top load on the horizontal shock responses measured during the interactions between pallets and forklifts. Two data loggers, SAVER 3X90 and 3D15, were used to measure the horizontal shock impacts experienced during the same event on both the pallet and the forklift. The results showed that the average peak acceleration of the forklift was 2.98 G; the same event resulted in a 4.4 times greater peak acceleration in the pallet. The average duration of these impacts was 10–12 ms. Pallet design and entry speed had the greatest effect on the response measured for the forklift, while the pallet was most heavily influenced by entry speed and forklift type. The paper mainly focused on measuring the severity of the impacts and did not attempt to correlate the measured impacts to damage experienced by unit loads.

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Az embereknek, mielőtt megegyeznek egy alkuban, először szükségszerűen rendezniük kell az árukért cserébe adott pénz értékét vagy árát. És ha ez körülnyírt vagy rossz pénzben történik, akkor annak megfelelően állapítják meg az áruk árát: ami szerintem az áremelkedés egyik fő oka volt, nemcsak az árukereskedelemben, de az élelmiszerek és a közemberek minden más létfenntartási szükséglete kapcsán, a legnagyobb sérelmükre. Hogy mindenki, aki a pénzünk emelése után jut a változtatás előtt megkötött szerződései alapján pénzhez, húsz százalékot kell, hogy veszítsen mindenen, amit azután megvesz, az Mr. Lowndes saját terve alapján is bemutatható.

Jelen írás a Köz-Gazdaság korábbi számaiban két részben megjelent tanulmányhoz kapcsolódik, melyet John Locke írt További megfontolások a pénz értékének emelésével kapcsolatban címmel. Ebben a műben – egyéb névvel megjelent, illetőleg anonim, a nyilvánosságnak szánt, valamint magánlevelezésben fennmaradt eszmefuttatásai után – a filozófus és gazdaságelméleti gondolkodó kifejti véleményét egy pénzzel kapcsolatos vitában. A vita tárgya, hogy a fémtartalmuk nagy részét különböző okokból, részben természetes kopásból, részben pedig nyerészkedési céllal történő körülnyírás folytán elvesztő angol ezüstérméket – melyeket immáron széleskörű egyetértés alapján mihamarább be kellett olvasztani és új érméket gyártani belőlük – milyen névértéken verjék újra, illetőleg addig is, milyen értéken fogadják el a csökkent fémtartalmú pénzt. Locke amellett érvel, hogy az új érméket az eredeti sztenderd szerint, vagyis nem emelt névértékkel, azaz nem csökkentett ezüsttartalommal kell újraverni, és addig is a körülnyírt érméket törvényi alapon csakis a tényleges súlyuk alapján lenne szabad elfogadni.

IntroductionWhile medicine shortages are complex, their mitigation is more of a challenge. Prospective risk assessment as a means to mitigate possible shortages, has yet to be applied equally across healthcare settings. The aims of this study have been to: 1) gain insight into risk-prevention against possible medicine shortages among healthcare experts; 2) review existing strategies for minimizing patient-health risks through applied risk assessment; and 3) learn from experiences related to application in practice.MethodologyA semi-structured questionnaire focusing on medicine shortages was distributed electronically to members of the European Cooperation in Science and Technology (COST) Action 15105 (28 member countries) and to hospital pharmacists of the European Association of Hospital Pharmacists (EAHP) (including associated healthcare professionals). Their answers were subjected to both qualitative and quantitative analysis (Microsoft Office Excel 2010 and IBM SPSS Statistics®) with descriptive statistics based on the distribution of responses. Their proportional difference was tested by the chi-square test and Fisher's exact test for independence. Differences in the observed ordinal variables were tested by the Mann-Whitney or Kruskal-Wallis test. The qualitative data were tabulated and recombined with the quantitative data to observe, uncover and interpret meanings and patterns.ResultsThe participants (61.7%) are aware of the use of risk assessment procedures as a coping strategy for medicine shortages, and named the particular risk assessment procedure they are familiar with failure mode and effect analysis (FMEA) (26.4%), root cause analysis (RCA) (23.5%), the healthcare FMEA (HFMEA) (14.7%), and the hazard analysis and critical control point (HACCP) (14.7%). Only 29.4% report risk assessment as integrated into mitigation strategy protocols. Risk assessment is typically conducted within multidisciplinary teams (35.3%). Whereas 14.7% participants were aware of legislation stipulating risk assessment implementation in shortages, 88.2% claimed not to have reported their findings to their respective official institutions. 85.3% consider risk assessment a useful mitigation strategy.ConclusionThe study indicates a lack of systematically organized tools used to prospectively analyze clinical as well as operationalized risk stemming from medicine shortages in healthcare. There is also a lack of legal instruments and sufficient data confirming the necessity and usefulness of risk assessment in mitigating medicine shortages in Europe.

We compared the effectiveness of the ovarian sperm injection method with that of the traditional one over the artificial propagation of jundia. Three experimental groups were set up containing seven females each. Females in Group 1 received common carp pituitary extract (CPE) homogenized in saline to induce ovulation and the stripped eggs were fertilized with the traditional dry method. In Group 2 ovulation was induced as in Group 1, however, sperm for fertilization was injected to the ovarian cavity of the females. In Group 3, CPE was first homogenized in sperm which was then injected to the ovarian cavity of females. All females received the same dose of 5.0 mg kg−1 bodyweight. Females in Group 2 and 3 were inseminated by a catheter. To fertilize the eggs, sperm samples were pooled from six males and they were used for all groups. There were no significant differences among the three Groups (P < 0.05) in the investigated parameters, such as ovulation ratio, pseudo-gonadosomatic index and fertilization rate. Our results demonstrated that the effectiveness of the sperm injection method was similar to that of the traditional one. Keywords: Rhamdia quelen, Sperm injection, Ovulation, Fertilization

Plasma and blood osmolality values show interspecies differences and are strictly regulated. The effect of these factors also has an influence on microrheological parameters, such as red blood cell (RBC) deformability and aggregation. However, little is known about the interspecies differences in RBC deformability at various blood osmolality levels (osmotic gradient RBC deformability). Our aim was to conduct a descriptive–comparative study on RBC osmotic gradient deformability in several vertebrate species and human blood. Blood samples were taken from healthy volunteers, dogs, cats, pigs, sheep, rabbits, rats, and mice, to measure hematological parameters, as well as conventional and osmotic gradient RBC deformability. Analyzing the elongation index (EI)–osmolality curves, we found the highest maximal EI values (EI max) in human, dog, and rabbit samples. The lowest EI max values were seen in sheep and cat samples, in addition to a characteristic leftward shift of the elongation index–osmolality curves. We found significant differences in the hyperosmolar region. A correlation of mean corpuscular volume and mean corpuscular hemoglobin concentration with osmoscan parameters was found. Osmotic gradient deformability provides further information for better exploration of microrheological diversity between species and may help to better understand the alterations caused by osmolality changes in various disorders.

This paper is devoted to inhomogeneous Halanay-type inequalities together with inhomogeneous linear delay differential inequalities and equations. Based on the the variation of constants formula and some results borrowed from a recent paper of the authors, sharp conditions for the boundedness and the existence of the limit of the nonnegative solutions are established. The sharpness of the results are illustrated by examples and by comparison of results in some earlier works.

Current pallet design methodology frequently underestimates the load capacity of the pallet by assuming the payload is uniformly distributed and flexible. By considering the effect of payload characteristics and their interactions during pallet design, the structure of pallets can be optimized and raw material consumption reduced. The objective of this study was to develop a full description of how such payload characteristics affect load bridging on unit loads of stacked corrugated boxes on warehouse racking support. To achieve this goal, the authors expanded on a previously developed finite element model of a simplified unit load segment and conducted a study to screen for the significant factors and interactions. Subsequently, a Gaussian process (GP) regression model was developed to efficiently and accurately replicate the simulation model. Using this GP model, a quantification of the effects and interactions of all the identified significant factors was provided. With this information, packaging designers and researchers can engineer unit loads that consider the effect of the relevant design variables and their impact on pallet performance. Such a model has not been previously developed and can potentially reduce packaging materials’ costs.

In recent years, Internet-of-Things technology (IoT) has been the subject of research in diverse fields of applications. IoT plays an essential role in transitioning enterprises towards a more interconnected paradigm of manufacturing, logistics, services, and business, known as Industry 4.0. This paper presents an operational concept for a system that implements IoT technology in pallets, which are used to move products along supply chains. These sensors will help us gain insight into the conditions experienced by products and unit loads. Having this capability will allow us to obtain the information necessary for better control of product distribution along the supply chain, and to design packaging that is more efficient and effective in protecting products during distribution. In this paper, we show how Model-Based Systems Engineering (MBSE) can be leveraged to create models that capture the required system behaviors, and we address the complexity of an IoT system within the domain of packaging and logistics applications.

Abstract We generalize cyclic refinements of Jensen’s inequality from a convex function to a higher-order convex function by means of Lagrange–Green’s function and Fink’s identity. We formulate the monotonicity of the linear functionals obtained from these identities utilizing the theory of inequalities for n-convex functions at a point. New Grüss- and Ostrowski-type bounds are found for identities associated with the obtained inequalities. Finally, we investigate the properties of linear functionals regarding exponential convexity and mean value theorems.

Chinese carps, namely silver carp (Hypophthalmichthys molitrix), bighead carp (Aristichthys nobilis) and grass carp (Ctenopharyngodon idella) have the largest annual production in freshwater aquaculture globally. Induced breeding of these species enlarged the geographical range for their culture as well as permitted more reliable seed supply. For the assessment of efficiency, long-term data from 18 spawning seasons on induced breeding of Chinese carps at a large-scale hatchery were evaluated. Assessment of ovulation was carried out by determining the ovulation ratio (number of ovulated females / number of injected females) × 100. The relative amount of stripped eggs (pseudo-gonadosomatic index, PGSI) was calculated as follows: (weight of stripped egg mass / body weight before stripping) × 100. We also analyzed the ovulation ratio and the PGSI relative to three different weight classes of females (small, medium and large).Over the 18 spawning seasons, 555 silver carp, 300 bighead carp and 1175 grass carp females were selected for propagation. Almost 80% of silver carp females selected belonged to categories between 4 and 7 kg. For grass carp and especially for bighead carp, breeders preferred higher weight categories.Ovulation ratios were similar between silver carp (80.9%), bighead carp (77.3%) and grass carp (79.1%). Mean PGSI for grass carp (9.3 ± 4.26%) was significantly lower than that for silver carp (10.5 ± 4.85%) and bighead carp (10.1 ± 3.96). In silver carp and bighead carp, there were no significant differences in ovulation ratios and mean PGSI values among different weight classes. Mean PGSI values were also similar among different weight classes of grass carp females. Ovulation ratios, however, were different among the three different weight classes in grass carp being the lowest in the “small” weight class and the highest in the “large” weight class. These results will provide guidelines for Chinese carp breeders to select optimal brood fish for ovulation induction and calculate their hatchery's larval production in advance. Keywords: Chinese carps, Induced breeding, Ovulation ratio, Pseudogonadosomatic index

A könyvben, melynek bevezetőjét és első fejezetét közöljük az alábbiakban, a szerző John Bates Clark bizonyítani kívánja, hogy társadalomban a jövedelemeloszlást a természeti törvények határozzák meg, amelyek a termelés különböző funkcióinak a teljes termékhez való hozzájárulásán alapulnak a határelemzésnek megfelelően. Ezzel összefüggésben nagy hangsúlyt fektet az igazságosság kérdésére a bérek mennyisége, a profitráta és a járadék erkölcsi igazolhatóságának szempontjából. Ebben a tekintetben a bérek kialakulására fókuszál, mivel ez a központi kérdése azoknak a vitáknak, amelyek a kizsákmányolás létezéséről, illetve a szocializmusról, mint a kizsákmányolás lehetséges megoldásáról szólnak In the book the Introduction and the first chapter of which can be found below, the author John Bates Clark intends to prove that the distribution of income in a society is determined by natural laws, which are based on the contribution of the various functions of production to the total product in compliance with marginal analysis. In connection with this he also places much emphasis upon the question of justice, on the problem as to whether the magnitudes of wages, profits interests and rents are morally justifiable. In this context he focuses on wage determination because this is the core issue of the debate on whether exploitation exists at all and, if it does, whether socialism could be a possible remedy for that.

Objective: This study was to investigate the outcome of status epilepticus (SE) associated with antiepileptic therapy during SE and in follow-up period, risk factors including age, co-morbidities, pre-existing epilepsy, and etiology in the East-Hungarian region.Methods: A prospective cross-sectional database was compiled from outpatient files between 2013 and 2017. Follow-up ended on 30.06.2018.Results: One hundred and thirty five episodes (male: 68, 50.4%) were evaluated, mean age and follow-up time being 64.1 ± 13.9 years and 39.9 ± 14.2 months, respectively. Of the 89 patients with pre-existing epilepsy, 34 failed to visit the outpatient unit regularly. Case fatality rate was 25.2% and 31 patients (30.7%) died after discharge due to co-morbidities; their mean survival time was 10.44 ± 8 months. Focal, generalized and combined type epilepsies were diagnosed in 67 patients (49.6%), 47 patients (34.8%), and 21 patients (15.6%) of SE, respectively. Nine patients had non-convulsive SE (NCSE). Mean seizure-free period was 6.8 ± 6.9 months. Patients taking carbamazepine (20.9%; OR: 0.37, 95%CI: 0.16–0.82; p = 0.018), levetiracetam (27.5%; OR: 0.51, 95%CI: 0.27–0.97; p = 0.041), or valproate (11.1%; OR: 0.18, 95%CI: 0.05–0.61; p = 0.0043) were expected to achieve seizure freedom after SE. The worst outcome was linked to advanced age, etiology, new onset status epilepticus, NCSE, and focal status epilepsy.Conclusion: This study highlights the importance of regular care and patient follow-up.

Workshop Presentation: The "Csáti Refi" Program