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To assess the prevalence, types, sociodemographic factors, and reported dangerous activities of sleep-related behaviors likely representing NREM parasomnia episodes, as well as their association with adverse childhood experiences in Hungary. Cross-sectional survey of 1000 adults (aged ≥18 years) representing the Hungarian population, using a non-probability quota sampling with a random walk method and a structured face-to-face interview. A multi-criterion weighting procedure was applied to correct bias along the main sociodemographic variables to the data available. Binary logistic regression estimated the odds of NREM parasomnia-related behaviors associated with sociodemographic factors and adverse childhood experiences. The prevalence of NREM parasomnia-related behaviors was 2.7 %, and self-reported sleep-eating was 0.1 % of the population (4.6 % of parasomnia-like activities). For middle-aged adults, the odds of sleep ambulation were significantly lower than for younger adults (OR 0.3; P = 0.03). A participant's family occurrence of reported parasomnia-like activity increased their odds of having it by more than 7 times (OR 7.1; P < 0.001). Nine participants out of those 27 people reporting NREM parasomnia-related behavior episodes, reported childhood adverse experiences, increasing the odds of parasomnia-related behavior by more than six times (OR 6.2; P < 0.001) compared to those not reporting it. This is the first population survey in Hungary on adult sleep-related behaviors likely representing NREM parasomnia episodes and the potential association with childhood traumatic events preceding them. The related dangerous behaviors call for safety measures and prevention. The significant association between adverse childhood events and NREM parasomnia-related behaviors needs further analysis. • In the Hungarian population, the sum prevalence of NREM parasomnias was 2.7 %; the prevalence of sleep-eating was 0.1 %. • Potentially injurious behaviors associated to 18 % of reported NREM parasomnia-cases. • People reporting NREM parasomnias had 6.2 times higher odds compared to non-parasomnia population, of reporting adverse childhood experiences. [ABSTRACT FROM AUTHOR]

We aimed to assess the psychometric performance and added value of 9 existing bolt-ons (breathing problems, cognition, hearing, self-confidence, skin irritation, sleep, social relationships, tiredness, and vision) for the EQ-5D-5L in a general population sample. The EQ-5D-5L, 9 bolt-ons, SF-6Dv1, Patient-Reported Outcomes Measurement Information System (PROMIS)-29+2, PROMIS Global Health, and Satisfaction with Life Scale were completed in an online cross-sectional survey among a general adult population sample in Hungary (n = 1587). The following psychometric properties were tested for the EQ-5D-5L + bolt-on(s): ceiling, divergent and convergent validity, structural validity, known-group validity, and explanatory power. Adding sleep (30%), tiredness (24%), or vision (21%) substantially reduced the ceiling of the EQ-5D-5L (41%). Cognition, sleep, social relationships, and tiredness correlated with corresponding PROMIS and SF-6D items (r s = ǀ0.32ǀ − ǀ0.73ǀ). All bolt-ons, except cognition and self-confidence, loaded on a different factor from the EQ-5D-5L dimensions. Breathing, hearing, skin irritation, and vision significantly improved known-group validity in relevant health condition groups. The sleep bolt-on improved known-group validity in 9 of 13 chronic health conditions. Tiredness had the largest impact on explaining EQ VAS score variance in 8 of 13 conditions. Hearing and vision improved the ability of the EQ-5D-5L to capture declining health with age, whereas self-confidence and social relationships were valuable for mental health assessment. This study established the validity of multiple bolt-ons for the EQ-5D-5L and highlights the usefulness of including relevant bolt-ons in population-based and patient surveys. Our findings inform the further development of these bolt-ons and the bolt-on item selection for clinical studies. • Bolt-ons are additional dimensions that can be attached to the EQ-5D to capture aspects of health-related quality of life not sufficiently covered by the 5 core dimensions. Over the past 3 decades, numerous bolt-ons have been proposed for the EQ-5D. There is a need for high-quality psychometric evidence regarding bolt-ons to determine their added value. • We provide a comprehensive analysis of the psychometric performance of 9 existing EQ-5D-5L bolt-ons (breathing problems, cognition, hearing, self-confidence, skin irritation, sleep, social relationships, tiredness, and vision) in a general population sample. The inclusion of bolt-ons led to a reduced ceiling and improved discriminatory power of the EQ-5D-5L across prevalent chronic health conditions (eg, cardiovascular diseases, depression, diabetes), age, and self-perceived health status groups. • Relevant bolt-ons, offering a more comprehensive assessment of health-related quality of life, may be useful both in population-based studies and patient surveys. Our findings serve as a guide for selecting suitable bolt-ons in clinical studies and inform decisions for future instrument development endeavors, also beyond the EQ-5D. [ABSTRACT FROM AUTHOR]

This study aimed to provide subjective well-being (SWB) population norms in Hungary and explore the contribution of explanatory factors of SWB inequality among the Hungarian adult general population. The data originated from a large representative internet-based cross-sectional survey in Hungary, which was conducted in 2020. We applied validated multi-item instruments for measuring SWB, namely Satisfaction With Life Scale (SWLS) and World Health Organization-Five Well-Being Index (WHO-5). Multiple linear regressions were used to examine the relationship between demographic-socioeconomic-health status and both well-being instruments. The concentration index (CI) was used to measure the degree of income-related inequality in well-being. A total of 2001 respondents were enrolled with the means ± SD WHO-5 scores and SWLS scores of 0.51 ± 0.21 and 0.51 ± 0.23, respectively. Higher household income, higher educational level, better general health status, and absence of chronic morbidity were significant positive predictors for both WHO-5 and SWLS scores. The CI of WHO-5 scores was lower than that of SWLS scores in the total sample (0.0480 vs 0.0861) and in subgroups by gender (male, 0.0584 vs 0.1035; female, 0.0302 vs 0.0726). The positive CI values implied a slight pro-rich SWB inequality in this population. The regression analyses showed a positive association of SWB with having a higher household income and a better general health status. This is the first representative study in Hungary to compare population norm of 2 well-being instruments and analyze well-being inequality. Slight pro-rich inequality was found consistently with both SWB measures. Our findings support the need for health and social policies that effectively tackle inequalities in Hungary. • This is the first study to explore the degree of income-based SWB inequality in the representative Hungarian population. • The concentration indices and the concentration curves for both well-being scores implied a slight pro-rich distribution. • The Hungarian health economic guideline prioritizes quality of life as a primary measure of health technology outcomes; however, it is imperative to recognize that public health interventions can have broader implications on various facets of well-being beyond just health. Therefore, in decision-making processes concerning funding allocations, it is essential to consider the holistic impact of interventions. [ABSTRACT FROM AUTHOR]

[Display omitted] • Meningococcus colonisation rate was investigated for the first time in Hungary. • High meningococcus carriage rate (34.8 %) was found, with a peak at 17–19 years. • Carriage rate was significantly higher among high school students and among males. • Most carried meningococci were non-typable. • From capsulated meningococci, MenB was the most prevalent, followed by MenC and MenY. Neisseria meningitidis causes life-threatening invasive meningococcal disease (IMD) with high mortality worldwide. Asymptomatic pharyngeal meningococcus colonisation is an important reservoir for the spread of the bacterium. The aim of this study was to determine N. meningitidis colonisation rates in asymptomatic high school and university students and to identify risk factors for carriage. Oropharyngeal swab samples and data from a self-reported questionnaire were obtained from overall 610 students, among them 303 university students and 307 high school students, aged between 15 and 31 years in Budapest, Hungary, between November 2017 and December 2018. Meningococcal carriage and serogroup of N. meningitidis were determined by RT-PCR from DNA extracted directly from the specimen. N. meningitidis was identified in 212 (34.8 %) of the participants. Significantly higher carriage rate was found among high school students (48.9 %) compared to university students (20.5 %). Peak of colonisation rate was among 17–19-year-old students (48.7 %). Most carriage isolates were non-typable (87.3 %). From the 212 meningococcus carriers, 19 were colonised by serogroup B (9 %), 5 by serogroup C (2.4 %), and 1 had serogroup Y (0.5 %). Significantly higher colonisation rate was found among males (42.4 %) than in females (33.1 %). Antibiotic use in the past 2 months has decreased the rate of meningococcal colonisation. Recent respiratory infection, active or passive smoking and attending parties have not influenced meningococcal colonisation rate significantly. In conclusion, we have found high asymptomatic meningococcus carriage rate among high school students and young adults, however, the majority of the colonizing meningococci were non-typable. [ABSTRACT FROM AUTHOR]

This study aimed to investigate vaccine promotion messages, examine the heterogeneous effects of these messages and provide experimental evidence to help evaluate the efficiency of COVID-19 vaccine promotion campaigns in Hungary. This study presents the results of three randomised survey experiments that were embedded in cross-sectional, representative, public opinion studies of Hungarian adults based on in-person interviews. Simple randomisation and blinding were applied to assign participants into the control group (no message) or treatment groups (vaccine promotion messages). The first experiment (March 2021) aimed to test vaccination promotion messages from politicians (N = 331) and medical experts (N = 342) by comparing experimental groups' trust in vaccines and conspiratorial beliefs with the control group (N = 327). The second experiment (September 2022) tested the impact of two communication strategies ([1] highlighting the safety and effectiveness of vaccines, N = 104; and [2] highlighting the wide variety of vaccines available, N = 110) on increasing vaccine uptake among those who were still unvaccinated (control group, N = 89). The third experiment (September 2022) tested one message aiming to increase COVID-19 booster uptake among those who received only the first round of vaccination (N = 172; control group, N = 169). The outcome variable in the second and third experiments was intent to get vaccinated. Robust regressions, logit models, Mann–Whitney U-tests and model-based recursive partitioning were run. The inference criteria (p < 0.05) was set in pre-registration of the experiments. All treatment effects were insignificant, but exploratory research found significant conditional treatment effects. Exposure to vaccine promotion by medical professionals was associated with a higher level of trust in Russian and Chinese COVID-19 vaccines in older age cohorts (weighted robust regressions, 50–59 years old, Russian vaccine: +0.769, interaction term [i.t.] p = 0.010; Chinese vaccine: +0.326, i.t. p = 0.044; and ≥60 years old, Russian vaccine +0.183, i.t. p = 0.040; Chinese vaccine +0.559, i.t. p = 0.010) and with a lower level of trust in these vaccines among younger adults (<30 years old, Russian vaccine: −1.236, i.t. p = 0.023; Chinese vaccine: −1.281, i.t. p = 0.022). Receiving a vaccine promotion message from politicians led to a higher level of trust in Chinese vaccines among the oldest respondents (≥60 years: +0.634, i.t. p = 0.035). Short-term persuasion attempts that aimed to convince respondents about COVID-19 vaccination were ineffective. Booster hesitancy, similar to primary vaccine hesitancy, was resistant to vaccine promotion messages. Significant conditional effects suggest that COVID-19 vaccine promotion by medical experts and politicians may have had adverse effects for some demographic groups in Hungary. [Display omitted] [ABSTRACT FROM AUTHOR]

Hungary was among the few countries where suicidality increased in the first year of the COVID pandemic. In this study, we sought to investigate whether that elevated suicide mortality had changed by 2021, when the number of fatalities due to COVID-19 was much higher than in 2020. We used an interrupted time-series analysis with (quasi-) Poisson regression, controlling for linear trend and seasonal effects, to estimate the effect of the pandemic on the suicide rates of various subpopulations. For both pandemic years the changes in risk of suicide were compared to the period between 2015 and 2019. Although the pandemic had a significant adverse effect on suicidality in 2020 in the Hungarian total population and in males, by 2021 this effect had vanished. In the total population, those aged 25 years and older had elevated suicidality in 2020 but neither age group in the total population had elevated suicidality in 2021. In the total population, increased risks of suicide death could be observed among residents of the capital city (in 2020 and 2021), villages (in 2020), and - in terms of regions - "Central Hungary" (in 2020 and 2021). Only the risk of violent suicides was significantly higher for both the total and male populations (and only in 2020). We used non-individual level data. The increased suicidality in 2020 had abated by 2021. In the paper, we discuss the possible explanations for our findings. • It was feared that national suicide rates would increase during COVID-19 pandemic. • In the majority of countries the number of suicides was not higher than expected. • Hungary was among the few countries where suicidality increased in 2020. • We found that the increased suicidality of 2020 had abated by 2021. [ABSTRACT FROM AUTHOR]

This paper presents a previously misidentified antler tool from Esztergom-Várhegy-Kőbánya (North Hungary), which was found in the late medieval kitchen residue of the archbishopric palace. The arrow shaft plane, an implement used together with a knife for smoothing the wooden bolts of (cross)bows, is a rare type of tool whose role was misinterpreted by several authors in the past although its ethnographic parallels made from both antler and wood in Siberia has been described already by the turn of 19th to 20th century. This work aims to summarise all the published arrow shaft planes from Hungary and abroad by presenting their origin, context, and individual features. [ABSTRACT FROM AUTHOR]

We aimed to compare measurement properties of the 5-level version of EQ-5D (EQ-5D-5L) and 2 Patient-Reported Outcomes Measurement Information System (PROMIS) short forms, PROMIS-29+2 and PROMIS Global Health (PROMIS-GH-10), and of EQ-5D-5L and PROMIS-preference scoring system (PROPr) utilities. A cross-sectional survey was conducted in a general population sample in Hungary (N = 1631). We compared the following measurement properties at the level of items, domains, and utilities, the latter using corresponding US value sets: ceiling and floor, informativity (Shannon's indices), agreement, convergent, and known-group validity. For the analyses, PROMIS items/domains were matched to EQ-5D-5L domains that cover similar concepts of health. The majority of PROMIS items showed enhanced distributional characteristics, including lower ceilings and higher informativity than the EQ-5D-5L. Good convergent validity was established between EQ-5D-5L and PROMIS domains capturing similar aspects of health. Mean EQ-5D-5L utilities were substantially higher than those of PROPr (0.864 vs 0.535). EQ-5D-5L utilities correlated moderately or strongly with PROPr (r = 0.61), PROMIS-GH-10 physical (r = 0.68), and mental health summary scores (r = 0.53). EQ-5D-5L utilities decreased with age, whereas PROPr utilities slightly increased with age. EQ-5D-5L utilities discriminated significantly better in 12/28 (ratio of F-statistics) and 18/26 (area under the receiver-operating characteristics curve ratio) known groups defined by age, self-perceived health status, and self-reported physician-diagnosed health conditions, including hypertension, diabetes, coronary heart disease, chronic kidney disease, and stroke. This study provides comparative evidence on the measurement properties of EQ-5D-5L, PROMIS-29+2, and PROMIS-GH-10 and informs decisions about the choice of instruments in population health surveys for assessment of patients' health and for cost-utility analyses. • It is important to compare the measurement performance of existing generic health status measures to support the choice of instrument. • We provide a comparative analysis of the measurement properties of 5-level version of EQ-5D (EQ-5D-5L), Patient-Reported Outcomes Measurement Information System (PROMIS)-29+2, and PROMIS Global Health. The PROMIS measures show lower ceiling and higher informativity, whereas EQ-5D-5L utilities are more effective in differentiating between known groups of respondents defined by sociodemographic and health-related characteristics. • Both EQ-5D-5L and PROMIS-preference scoring system utilities may be used to derive quality-adjusted life-years in cost-utility analyses. Nevertheless, EQ-5D-5L utilities are systematically higher than those of PROMIS-Preference scoring system and therefore the 2 measures cannot be used interchangeably. [ABSTRACT FROM AUTHOR]

• Previous empirical evidence on the impact of universal preschool on cognitive skills is ambiguous. • Preschool and primary school enrollment age may be correlated, which can lead to a negative impact of earlier preschool enrollment. • We estimate the impact of earlier preschool enrollment on 6th, 8th, and 10th grade mathematics and reading test scores, while controlling for any indirect impact through primary school enrollment age. • Preschool enrollment has a significant positive impact on test scores, especially among students with less advantaged backgrounds, as long as it does not lead to earlier school enrollment. • These results explain some of the variation seen in previous evidence, support the beneficial impact of preschool, and present an important policy consideration for planned preschool expansion. Previous empirical evidence is mixed regarding the impact of universal preschool on cognitive skills. We show that preschool enrollment can impact test scores positively if it does not lead to earlier school enrollment. We examine rich student data and use different enrollment cutoff dates in Hungary to separate the beneficial direct effect of earlier preschool enrollment from a negative indirect effect that may occur through earlier school enrollment. We find significant direct impacts: 6th-grade reading (math) test scores increase by 9.0 (6.3) percent of a standard deviation for children who enroll in preschool a year earlier. This impact persists through 10th grade and is larger among disadvantaged children. The findings support the importance of universal preschool for improving cognitive skills and equity. They highlight a key consideration for policy evaluation and design and help reconcile ambiguities in the previous empirical evidence. [ABSTRACT FROM AUTHOR]

This study experimentally verified a new design of the bilateral unit of a PV/T photovoltaic-thermal collector that utilises water and air as a coolant under weather conditions in Gödöllő, Hungary. This study examined the behaviour of three cases with different thermal configurations. The cases were classified based on the absorber design fixed to the air channels used for heat extraction from the back surface of the solar cell. The first was a copper flat-plate absorber used to configure an air-cooled unit (AC-PVT). The second soldered a new fin shape (louvered fins) and a water serpentine-shaped tube on a flat plate collector (LFS-PV/T). The last was similar to the second but without water flow (ALF-PV/T). The experimental results verified the achievement of the fabricated module, LFS-PV/T. The thermal and electrical efficiencies of the three examined systems were 19.4 and 6.09% for the AC-PV/T system, 89.1 and 7.66% for the LFS-PV/T system, and 45.1 and 6.91% for the ALF-PV/T system. Along with the efficiencies, the surface temperature of the solar cells of the LFS-PV/T module was 31.7% lower than that of the AC-PV/T module and 25.4% lower than that of the ALF-PV/T module. [Display omitted] • A novel design of louvered fins, first used in the PV/T module, is investigated. • The performance of a bi-fluid PV/T integrated with Louvered fins is investigated. • A thermodynamic nodal analysis of fabricated PV/T layers is conducted. • Louvered fins increase the electrical and thermal efficiency of the PV/T collector. [ABSTRACT FROM AUTHOR]

Leaf litter decomposition in solution is an important part of the carbon cycle. When leaf litter is deposited in water, the decomposition process takes place, releasing carbon dioxide into the atmosphere. In Hungary, the goldenrod and bulrush are spreading over increasing areas along lakes and rivers, including the shores of Lake Balaton. The primary role of the Kis-Balaton wetland is to retain inorganic nutrients, thereby improving the water quality of Lake Balaton. As the water movement in this area is not very intensive and the water retention time is long, carbon dioxide emissions of parts of decomposing plants can be higher in this area. We set up a microcosm experiment in a climate chamber to determine the carbon dioxide emissions from the decomposition of goldenrod and bulrush leaves and stems in winter when information about the process is limited. Due to short investigation time, the difference in the impact of temperatures on decomposition of the studied plants was restricted to leaves only. In the study, significant difference was obtained for the plant species and the plant parts. The carbon dioxide increments ranged from 46.7 (p<0.001) to 54.5% (p<0.001) in every plant treatment related to control one. Changes in water temperature are reflected in carbon dioxide release with a minor time delay. The results showed that the decomposition of plant parts in water during winter contributes to the increase of carbon dioxide emissions from shallow water bodies, such as the Kis-Balaton wetland. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has posed unprecedented challenges for societies. Emerging data have indicated that the younger population are the most vulnerable group to the development of mental health problems during this pandemic. The present study aimed to examine the effects of the changes in health behaviors on mental health problems to identify an at-risk group among adolescents and young adults. In the present cross-sectional study, secondary school students (N = 2556) ages 15–21 years participated in Hungary. A self-report questionnaire was developed to measure the changes in health behaviors. Mental health problems were measured by the Beck Hopelessness Scale and the 20-item UCLA Loneliness Scale. A significant proportion of the students showed moderate/severe hopelessness or high loneliness which were more pronounced among adolescent females. An at-risk group was identified among adolescents and young adults. Students who have a lower number of friends, spend less time in front of a screen, and feel lonely often/very often are more likely to have moderate/severe hopelessness with high loneliness. All data were collected online, and students completed the questionnaires voluntarily. Cross-sectional, non-preregistered study. Loneliness and hopelessness were prevalent in the young population during the COVID-19 pandemic. The at-risk group of adolescents characterized by moderate/severe hopelessness with high loneliness highlights the need for follow-up mental health to avoid future poor mental and physical health. It is also recommended to develop effective interventions targeted to gender and age, with the promotion of resiliencies and buffers against vulnerabilities of negative life events. • More than half of the students reported mild hopelessness and moderate loneliness. • Moderate/severe hopelessness or loneliness were more frequent in younger females. • An at-risk group can be identified in adolescents during distance learning education. • The at-risk group was described by moderate/severe hopelessness with high loneliness. • It is an urge to develop effective interventions targeted to gender and age. [ABSTRACT FROM AUTHOR]

COVID-19 may unfavourably affect the mental health of individuals in various ways. Accordingly, the concern has been raised that national suicide rates will increase in the wake of the outbreak of the pandemic. In the current study, we tested this conjecture in three age groups (<25; 25–64; ≥65) of the Hungarian total population and the male and female populations. In addition, we assessed whether the pandemic had different effects on counts of suicides committed by violent or non-violent methods. Finally, by comparing the monthly suicide rates in 2020 and the corresponding monthly rates in 2019, we also investigated the "pulling together" hypothesis that postulates that a temporary decrease in suicides may occur after large-scale catastrophic events. With regard to the total population only the suicide counts of individuals aged 25–64 rose significantly (p < 0.05) during the COVID months of 2020. Similar patterns, but at lower levels of significance (0.05 < p < 0.1), were found in those members of the total population aged 65 or older and among males aged between 25 and 64. Furthermore, we found that the number of violent suicides increased significantly (p < 0.05) during the COVID months. Finally, our results have not confirmed the existence of a "pulling together" phenomenon in association with the COVID-19 pandemic in Hungary. We used non-individual level data and were therefore unable to control suicide risk factors at the level of individuals. The number of suicides rose significantly in some subgroups of the Hungarian population during the COVID months of 2020. • COVID-19 has deleterious effects on mental health. • There are concerns that suicide rates will also increase during the pandemic. • We tested the possible effects of COVID-19 on suicidality in Hungary. • The suicide counts of subjects aged 25–64 rose significantly. • The number of violent suicides also increased significantly. [ABSTRACT FROM AUTHOR]

Clinical data and cost-effectiveness analyses from several countries support the use of low-dose computed tomography (LDCT) to screen patients with high risk of lung cancer (LC). This study aimed to explore the economic value of screening LC with LDCT in Hungary. Cohorts of screened and nonscreened subjects were simulated in a decision analytic model over their lifetime. Five steps in the patient trajectory were distinguished: no LC, nondiagnosed LC, screening, diagnosed LC, and post-treatment. Patient pathways were populated based on the Hungarian pilot study of screening, the Nederlands–Leuvens Longkanker Screenings Onderzoek (NELSON) LC screening trial, and local incidence and prevalence data. Healthcare costs were obtained from the National Health Insurance Fund. Utility data were obtained from international sources and adjusted to local tariffs. Scenarios according to screening frequency, age bands (50-74, 55-74 years), and smoking status were analyzed. Annual LDCT-based screening compared with no screening for 55- to 74-year-old current smokers showed 0.031 quality-adjusted life-year (QALY) gains for an additional €137, which yields €5707 per QALY. Biennial screening for the same target population showed that purchasing 1 QALY would cost €10 203. The least cost-effective case was biennial screening of the general population aged 50 to 74 years, which yielded €37 931 per QALY. Screening LC with LDCT for a high-risk population could be cost-effective in Hungary. For the introduction of screening with LDCT, targeting the most vulnerable groups while having a long-term approach on costs and benefits is essential. • Over the years, Hungary has traditionally been reported among the highest incidence and mortality rates of lung cancer in Europe. There are data on the effectiveness of screening: 2 pilot clinical sites have initiated screening with low-dose computed tomography. Cost-effectiveness has not been assessed yet. Research from other countries indicates that cost-effectiveness largely varies by target population for screening. • To the best of our knowledge, this is the first health-economic model to analyze the cost-effectiveness of screening in a Central-Eastern European context. Rather than restricting screening to heavy smokers, the analysis investigates cost-effectiveness for the general population as well. • Low-dose computed tomography in Hungary proves to be cost-effective in the high-risk population segments, especially cohorts with a current smoker population. Cost-effectiveness depends both on the target population and the frequency of screening: selecting the appropriate risk group and setting up adequate logistics are paramount. The introduction of screening programs must be treated with a mid- to long-term focus given that initial budget impact would be high. [ABSTRACT FROM AUTHOR]

• In COPD, it is very important to take the COVID-19 vaccine, as they are much more likely to develop serious complications. • The vaccines are effective in reducing the risk of developing COVID-19 and protect against the development of long COVID. • In vaccinated patients, we detected significantly better quality of life and fewer severe and moderate exacerbations. Coronavirus infection is a particular risk for patients with chronic obstructive pulmonary disease (COPD), because they are much more likely to become severely ill due to oxygen supply problems. Primary prevention, including COVID-19 vaccination is of paramount importance in this disease group. The aim of our study was to assess COVID-19 vaccination coverage in COPD patients during the first vaccination campaign of the COVID-19 pandemic. A cross-sectional observational study (CHANCE) has been conducted in COPD patients in the eastern, western and central regions of Hungary from 15th November 2021. The anthropometric, respiratory function test results and vaccination status of 1,511 randomly selected patients were recorded who were aged 35 years and older. The median age was 67 (61–72) years, for men: 67 (62–73) and for women: 66 (60–72) years, with 47.98 % men and 52.02 % women in our sample. The prevalence of vaccination coverage for the first COVID-19 vaccine dose was 88.62 %, whereas 86.57 % of the patients received the second vaccine dose. When unvaccinated (n = 172) and double vaccinated (n = 1308) patients were compared, the difference was significant both in quality of life (CAT: 17 (12–23) vs 14 (10–19); p < 0.001) and severity of dyspnea (mMRC: 2 (2–2) vs 2 (1–2); p = 0.048). The COVID-19 infection rate between double vaccinated and unvaccinated patients was 1.61 % vs 22.67 %; p < 0.001 six months after vaccination. The difference between unvaccinated and vaccinated patients was significant (8.14 % vs 0.08 %; p < 0.001) among those with acute COVID-19 infection hospitalized. In terms of post-COVID symptoms, single or double vaccinated patients had significantly fewer outpatient hospital admissions than unvaccinated patients (7.56 vs 0 %; p < 0.001). The COVID-19 vaccination coverage was satisfactory in our sample. The uptake of COVID-19 vaccines by patients with COPD is of utmost importance because they are much more likely to develop severe complications. [ABSTRACT FROM AUTHOR]

Objectives: The EQ-5D has 2 composite domains: pain/discomfort (PD) and anxiety/depression (AD). This study aims to explore how respondents use the composites to self-report health and what the meaning of discomfort is in the EQ-5D for the general public.Methods: Both qualitative and quantitative data were collected in an online cross-sectional survey involving a nationally representative general population sample in Hungary (n = 1700). Respondents completed the 5-level version of EQ-5D, followed by the composites split into individual subdomains. Open-ended questions were asked to explore respondents' interpretations and experiences of discomfort.Results: Six different response behaviors were identified in the composites: "uniform" (21%-32%), "most severe" (30%-34%), "least severe" (16%-23%), "average" (2%-4%), "synergistic" (4%-5%), and "inconsistent" (13%-15%). Compared with the individual subdomains, many respondents under-reported their problems on both composites (PD 16%-22% and AD 6%-13%, P < .05). In respondents who scored differently in the 2 separate domains, mainly problems with the first subdomain determined responses in the composites (PD 66% and AD 61%). The discomfort subdomain in the EQ-5D captured more than 100 different problems, including pain, nonpain physical discomfort (eg, tiredness, dizziness, and nausea), and psychological discomfort (eg, anxiety, nervousness, and sadness). Women, older adults, and those in worse general health status more often considered discomfort as pain (P < .05).Conclusions: We found empirical evidence of measurement error in the composite responses on the EQ-5D, including under- and inconsistent reporting, ordering effects, potential differential item functioning, and interdomain dependency. Our findings contribute new knowledge to the development of new and refinement of existing self-reported health status instruments, also beyond the EQ-5D. [ABSTRACT FROM AUTHOR]

Despite being soon-to-be voters, adolescents globally exhibit a declining interest in news consumption and hardships in recognizing fake information. Our study examined potential protective and vulnerability factors related to the detection of fake news. A diverse Hungarian sample (N = 1582) from 25 high schools participated in our research. Our findings indicate that higher levels of analytic thinking and need for cognition, lower bullshit receptivity, ethnic majority status, and higher parental education are associated with lower susceptibility to fake news among adolescents - with cognitive reflection and bullshit receptivity exerting a more substantial influence on the acceptance of fake news compared to socioeconomic variables. Our study underscores the crucial role of cognitive factors in shaping adolescents' perceptions of fake information, even outweighing socioeconomic and ethnic minority status. [ABSTRACT FROM AUTHOR]

• Pressure-based cropland condition reflects patterns of relative bird species richness. • The proportion of semi-natural areas is the most important condition variable. • The proportion of maize is more important than average parcel size. • Model goodness and variable importance vary spatially. As the world is struggling to halt the rapid decline of biodiversity, the assessment and mapping of ecosystem condition is getting ever increasing attention. Croplands are artificial ecosystems, but as they occupy a large portion of land, they significantly influence biodiversity. Yet, there is a knowledge gap about their suitability to support and maintain wildlife on a national scale. Large-scale condition mapping is meant to address this gap; the good condition of croplands includes their ability to support biodiversity. However, the lack of suitable databases is often a challenge when creating such maps. As there is a strong causal relation between pressures on the ecosystem and its condition, pressure indicators can be used as proxies to approximate condition when more direct indicators are lacking. The validation of condition maps based on pressure proxies is a key but challenging step. In this study, we tested a previously designed pressure-based cropland condition map for Hungary using bird census data. Besides validating the composite condition indicator, we also tested some key elements of the mapping process, such as the choice of variables and thresholds. Using multiple comparisons of means by Tukey's contrast and Random Forest modelling, we examined the relationship of (1) the continuous pressure-based cropland condition variables, (2) their rescaled, ordinal version (called sub-indicators), and (3) the composite cropland condition indicator (sum of the sub-indicators) with a biodiversity measure, the standardised relative richness of characteristic farmland bird species (rRRCS). To get a picture of the spatial patterns of the examined relationships across Hungary, individual Random Forest models were constructed for all the spatial units of the bird census database, using focal analysis with a 30 km radius moving window. We found significant differences in the mean rRRCS for nearly all sub-indicator categories, signifying that the literature-derived thresholds were mostly sound. Categories with higher (better) condition scores had higher mean rRRCS; the differences are significant in the mid-range but not in the extreme categories, indicating a need for a meaningful simplification of the categories. The goodness-of-fit (R2) of the Random Forest models was found to be high, but it is spatially heterogeneous (ranged from 0.69 to 0.89, with a median value of 0.81), similarly to the variable importance. The proportion of semi-natural areas proved to be the most important condition variable. The proportion of maize and alfalfa were more important than parcel size. Our results show that condition maps based on pressure proxies can reflect patterns of biodiversity surprisingly well. They also highlight the spatial context dependence of the uncertainty of condition maps. [ABSTRACT FROM AUTHOR]

• Phenological processes of 30 apricot cultivars were investigated for 26 years. • Differences in the rate of generative processes were significant among cultivars. • Meteorological parameters explained large portion of yearly variations. • During 26 years trend-like changes were detected in microsporogenesis. Apricot microsporogenesis, flowering and ripening are the result of a long development process lasting almost a year. These phenological stages are essentially genetically regulated, but they are strongly influenced by various environmental factors including the prevailing meteorological conditions. To better understand the nature of the relationships between different meteorological parameters and generative developmental processes, long-term field observations were carried out to study the microsporogenesis, flowering and ripening time of 30 apricot cultivars in the central part of Hungary over 26 years with full meteorological characterization (1994–2020). Both year and genotype had a significant effect on developmental processesThe effect of year was much stronger on microsporogenesis and flowering time, while genotype was the dominant factor in determining ripening time. The strongest grouping factor for genotypes was the speed of flower bud development, and flowering time that divided them into three main groups, but subgroups were formed within the main groups based on maturation time. Significant relationships were identified between weather conditions and microsporogenesis, which were used to establish the most likely model of meteorological parameters and were found to be developmental stage specific. The parameters were only partially overlapping, indicating that there are remarkable differences in the meteorological requirements of the consecutive phases of microsporogenesis and blooming. Over 26 years, trend-like changes have been detected in both meteorological parameters and phenological processes. In addition to a gradual increase in ambient temperature, genotype-dependent opposite trends between the beginning of string and beginning of tetrad stages were identified, which may have a significant negative impact on locally adapted developmental patterns in the medium-early flowering genotype group. These trend-like changes are expected to intensify due to global climate warming. As the establishment and profitable management of production orchards covers a period more than 10 years, the appropriate choice of cultivars more suitable to the changing ecological conditions is becoming especially essential. Our research results will help to understand the changes in the generative development of apricot cultivars in the light of climate change and contribute to improving crop safety. [ABSTRACT FROM AUTHOR]

Restructuring rural spaces brings about essential changes in the everyday lives of rural societies. Rural restructuring shapes and alters the image, identity, and, ultimately, the content and physical environment of the countryside. The trajectories of change vary widely, although the globalisation of rurality severely challenges some parts of rural areas, too. Peripheries, deprived, and remote settlements suffer from the effects and processes of restructuring, and their spatial representation also changes. In Central and Eastern European rural areas, the globalisation of the countryside started right after the political transition, in which these areas were left with a declining population, a collapsed economy, and inadequate infrastructure. In many cases, these disadvantaged settlements could not cope with the challenges of a market-based economy; furthermore, their geographical location and inability to join the labour market created disconnected spaces with low spatial and social mobility. As a result of such a vicious circle, residents in these areas experienced the destruction of local societies and a deteriorating physical environment, supplemented by an ageing population, and because of all these consequences, different spatial representations emerged in and about rurality. This paper focuses on a disadvantaged, isolated rural area in Hungary, the Baranyai-Hegyhát micro-region. We assume that the changing nature of such rural areas affects local inhabitants' spatial imagination and representation. We surveyed to define values of spatial representation and social status, among other variables. In the evaluation, we compared survey indices and attempted to ascertain the types of spatial representation, social status, and their connections in the research area. As a main result, we found that spatial representations do not depend on spatial position but are strongly associated with social backgrounds. • Processes of marginalisation can lead to perforation of rural settlement networks. • Spatial representation in a deprived, isolated area is not necessarily negative. • Low social status does not lead to negative representations of space. • Negative spatial representation is always compared with lower social status. • Settlements with low social status and low levels of representation are perforated. [ABSTRACT FROM AUTHOR]

• The quality of obstetric care for Roma women was found to be poorer than for non-Roma in Hungary. • Roma women in Hungary experience higher rates of hospital-dictated delivery positions during vaginal births. • The presence of a private obstetrician, family support and residence in Central Hungary reduce the likelihood of giving birth in a fixed position. • Roma ethnicity has a negative impact on the quality of care, but it is also significantly influenced by adverse socio-economic and regional factors. This study aims to identify discrimination in maternity care experienced by Roma women in Hungary, due to ethnic and socio-economic factors. We used data from the Cohort'18 Hungarian Birth Cohort Study, covering births in 2018–2019 (n = 7805). Face-to-face interviews were conducted by health visitors during pregnancy and six months postpartum. Differences in obstetric care were tested using Welch's ANOVA. Logistic regression models estimated the influence of Roma ethnicity on birth position, adjusting for socio-economic variables. Odds ratios with 95 % confidence intervals and adjusted predictions were calculated. Roma mothers had a lower rate of caesarean section due to fewer planned interventions (13.3% vs. 19.1% for non-Roma mothers). Roma women were less likely than non-Roma women to have a birth attended by a private obstetrician (15% vs. 52.6%) and less likely to have a family member present at the birth (40% vs. 65.5%). For vaginal births, 61.3% of Roma women had their birth position dictated by hospital staff, compared with 40.6% of non-Roma women. Ethnic background significantly influenced the choice of birth position, but these associations were attenuated after adjustment for socio-economic and territorial factors. Variables such as the presence of a private obstetrician, family support, and residence in Central Hungary reduced the likelihood of giving birth in a fixed position. Roma women face significant disadvantages in maternity care in Hungary. Ethnic background has a negative impact on the quality of care, but it is also significantly influenced by adverse socio-economic and regional factors. [ABSTRACT FROM AUTHOR]

The pursuit of a secure, efficient healthcare system responsive to patient needs remains a crucial goal for developed countries. Governments, grappling with rising healthcare demands, are increasingly turning to technological innovation as a transformative solution. Healthcare 4.0, integrating cutting-edge industrial technologies, aims to enhance patient experience, promote health, control costs, and boost clinical satisfaction. The COVID-19 pandemic has catalysed investments in digitalisation, but the promises of Healthcare 4.0 are still seemingly unrealized. This is especially true in the Central-Eastern European (CEE) region, particularly in Hungary, where substantial Industry 4.0 innovation potential intersects with shrinking financial resources, a challenging political environment, a transitioning healthcare system hindering the widescale transition to Healthcare 4.0. Thus, this paper aims to explore the macro-environmental factors influencing Healthcare 4.0 adoption in Hungary. Leveraging qualitative content analysis of interviews with 21 Hungarian healthcare technology startup founders, we aim to map the catalysts and barriers of a Healthcare 4.0 transition using a PESTLE framework. This explorative study contributes to the literature with valuable insights from the innovators' perspective, serving as a foundation for future policy interventions in the quest for widespread Healthcare 4.0 implementation. • Unveiling catalysts and barriers of Healthcare 4.0 transformation in CEE with PESTLE providing a comprehensive framework. • Identifying key barriers: declining government healthcare spending, regulatory obstacles and social acceptance. • Featuring key catalysts: rising healthcare demand, efficiency effects of innovations and potentials of systemic data sharing. • Prioritizing healthtech entrepreneurs' perceptions is vital for supportive healthcare policies. [ABSTRACT FROM AUTHOR]

Abstract The rapid development of information technology has partially been reversed, and may become a tool for manipulation, which is incompatible with librarians' social mission. Making information available, connecting databases, and making them accessible result in people becoming more and more exposed. Customisation and effectively filtered information sources create filter bubbles. Although new systems of collaboration would be suitable for sharing reliable knowledge, they often lead to the spread of fake news. Despite worrying trends, we seek an encouraging future. Therefore, in this paper we analyse the relationship between information technology, market economy, and the librarian profession from the perspective of Hungarian LIS education, and emphasise the importance of active and creative information provision based on interdisciplinarity. Based on our experiences we believe that current and future readers can be reached through intriguing collages of credible information. The use of collages can compensate for the effects of filter bubbles, and librarians may become the masters of creating digital information collages. [ABSTRACT FROM AUTHOR]

This article deals with a unique topic related to railway infrastructure, civil and geotechnical engineering, and modern materials. In the past 20–30 years, more and more synthetic materials have been applied in engineering and everyday life. Geogrid and geotextile products are adequate for substituting lacking abilities of the soils, and granular materials, mainly low tensile and shear strength, etc. This paper aims to introduce the result of the author's research dealing with investigating the behavior of geogrid-reinforced railway ballast based on a long-term field test in the busiest main railway line in Hungary. The duration of the test is more than eleven years. Five different types of geosynthetics were installed in the superstructure of the No. 1 main railway line (Kelenföld – Hegyeshalom state border) in Hungary in 2010. More than eleven years have elapsed since the installation. The experiences are formulated in this paper. Mathematical-statistical analysis was performed to compare the (sub)sections with each other and with the designated reference sections where no geogrids were applied. As a result of the examination, the author summarized the main differences in the behavior of railway track geometry, and the geometrical deterioration rates, considering the different types of reinforcement products. • Five geogrid types were examined in same railway circumstances. • More than 11-year geometrical deterioration process was analyzed. • Water pockets and drainage problems were also considered. • Mathematical statistical methods were applied to compare the geogrids. • The paper focused on engineering design and maintenance aspects. [ABSTRACT FROM AUTHOR]

The role of networks has been growing attention in recent decades in explaining political behaviour. Political nexus aspects also get on the agenda in studying various resources of status attainment. Despite the general realization of these relevant network implications, some conceptual and measurement issues are still debatable. In this paper, we introduce a new tool for measuring political acquaintanceship networks, the Party Nexus Position Generator (PNPG). We will show how one of the most widely used SNA-instruments, the technique of position generator, could be transformed to apply for the measurement of political networks. We tested the tool in two countries, Germany and Hungary, with surveys administered by different methods: online and face-to-face. The presentation of findings on German and Hungarian political networks may help us understand how the broader settings affect the composition of political networks and their influences on political behavior. Results from two different countries may also contribute to assess the validity of the PNPG tools introduced by our study. • We introduce a new tool for measuring political acquaintanceship networks, the Party Nexus Position Generator (PNPG). • The PNPG tool measures two aspects of ego-network political networks, political nexus diversity, and political homophily. • In this paper, we present some basic and more advanced indices extracted from PNPG. • Studying our indices in a joint framework present a research direction of interest with various comparative perspectives. [ABSTRACT FROM AUTHOR]

Gossip is universal, and multiple studies have demonstrated that it can have beneficial group-level outcomes when negative reports help identify defectors or norm-violators. Gossip, however, seldom happens in a social vacuum. Instead, it is enmeshed in a fabric of positive and negative relationships that creates opportunities, constraints, and also motives to gossip. This article studies the importance of friendships and antipathies among the three concerned parties (sender, receiver, target) for negative gossip among adolescents. We contrast two theoretical accounts. According to the first, gossip brings closer individuals who have "enemies" in common. Based on this, we infer that gossip appears in triads where both the sender and receiver share their antipathy against the target. The second position argues that gossip is used to compromise different opinions of friends towards the target. Thus, what predicts gossip is direct antipathy against the target or being friends with someone who dislikes the target (indirect antipathy) rather than the combination of the two antipathies. We test these two lines of reasoning with sociometric data from 17 classroom observations (13 unique classrooms in different time points) in Hungary. Bayesian Exponential Random Graph Models yield support for direct antipathy in 13 (nine unique) classrooms and indirect antipathy in five. No evidence for shared antipathy is found. Results suggest that, at least among adolescents, negative gossip is not about bonding with potential allies but more about consensus-making between friends. Also, results reveal that negative gossip concentrates on the two ends of the reputational echelon, hinting that, in the classroom, high reputation might be contested instead of rewarded. • We investigate how multiplex ties (friendships and antipathies) relate to the occurrence of negative gossip among adolescents. • Discrepancies between friends regarding their relationship with a third classmate explain gossip, not shared antipathy. • Influencing friends' opinions and conforming with theirs seem more important for gossip than bonding with enemies' enemies. • Although negative gossip is not concentrated on a few targets only, it zeroes in on the two ends of the reputational echelon. [ABSTRACT FROM AUTHOR]

The study aimed to investigate the academic adaptation experiences of international students from post-Soviet countries in Hungary. Semi-structured interviews were conducted with 42 international students from Kazakhstan, Azerbaijan, Georgia, and Moldova, studying at an institute of higher education in Hungary. We used reflexive thematic analysis to explore the adaptation experiences of the international students and to analyze a relatively large dataset. Three themes were generated: (1) From the post-Soviet to the "Western world"; (2) Comparison and contrast; and (3) Managing in an unknown academic environment. The results show that push-pull factors affected the international students' decision to study abroad. International students consider Hungary as a "transit" country — an "affordable stepping stone" from which to look for future educational or job opportunities in other Western countries. Our findings also emphasize the importance of cultural distance in the institutional context of post-Soviet countries and Hungary. [ABSTRACT FROM AUTHOR]

The evaluation of the governance of the implementation of the European LEADER approach was carried out in six case studies in France, Spain and Hungary using an analytical grid cross-referencing two complementary theoretical frameworks: the analysis of overages (i.e. the identification of the diverse effects of public policy) and learning phenomena. It was shown that the overages (especially institutional) of the LEADER approach were greater when the governance and management learning subsystems converged. Conversely, the overages remain more limited when the two systems diverge, which is often the case when the program is used as a tool by certain political or economic actors. Overall, these results underline some of the limitations of bottom-up and integrated programs such as LEADER, which are characterized by a relative non-linearity in their implementation. • Governance learning effects play a major role in the implementation of European territorial policies. • Efficiency can be maximized when governance and management learning subsystems converge. • Learning is weak if territorial policy is exploited by only some of the local actors. • Cooperative actions are very sensitive to the learning effects. • European public policies implementation could be non-linear in case of monopolization of information by some actors. [ABSTRACT FROM AUTHOR]

Despite continuous population decline or stagnation, many Central and Eastern European cities experience urban sprawl and expansion, accompanied by excessive land take and land use change. This paper investigates recent trends in land take and land use change in Hungarian cities, aiming to identify the drivers of these processes. The study utilizes the Urban Atlas (UA) databases from 2006 and 2018 to analyze land use change in selected Hungarian cities, employing QGIS software to compile the database and MS Excel to conduct the statistical analysis. A linear trajectory model is employed to project land use change by 2026, based on 2006–2018 UA data. Additionally, via the in-depth analysis of Debrecen, the study highlights the recent acceleration of land use change to compare the projected trend with the forecasted one. Local climate strategies focus on addressing environmental concerns, including changes in land use at the city level. Therefore, this study reviews the relevant documents associated with each city to assess its commitment to reducing land take. The results indicate that despite its declining population, Hungary has seen a significant expansion in artificial surfaces, primarily due to industrialization and population policies introduced by the central government, which is likely to continue in the coming years. Unfortunately, local climate strategies have been insufficient in preventing cities from experiencing urban sprawl and expansion and preserving local ecosystem services. This underscores the inability of municipalities to defend local interests against central government directives. The findings of this study indicate that the current central policies are the main drivers of land take and urban sprawl and expansion. Prioritizing the compact city model and brownfield developments could effectively mitigate these issues. Finally, the paper advocates that complete jurisdiction over land use decisions be restored to local governments, enabling them to reject investments that may jeopardize local environmental goals. • Land take and land use change have dramatically accelerated in Hungarian cities. • The expansion of the urban fabric is taking place with declining populations. • Industrialization and population policies are propelling land take and land use change. • Local climate strategies are ineffective tools to halt land take and land use change. [ABSTRACT FROM AUTHOR]

The Earth's climate is projected to warm significantly in the 21st century, and this will affect human societies in many ways. Since sleep is a basic human need and part of everyone's life, the question of how temperature affects human sleep naturally arises. This paper examines the effect of daily mean temperature on sleep duration using nationally representative Hungarian time use surveys between 1976 and 2010. Compared to a day with an average temperature of 5–10 °C, colder temperatures do not influence sleep duration. However, as daily mean temperatures rise, sleep duration starts to strongly decline. The effect of a hot (>25 °C) day is −13.3 minutes, but if preceded by a few other hot days, the effect is even stronger, −24.7 minutes. The estimated sleep loss is especially large on weekends and public holidays, for older individuals, and men. Combining the estimated effects with temperature projections of twenty-four climate models shows that the warming climate will substantially decrease sleep duration. The projected impacts are especially large when taking into account the effects of heatwave days. This study also shows that different groups in society are likely to be affected in significantly different ways by a warming climate. • This paper examines the effect of temperature on sleep duration. • Exposure to heat reduces the amount of time spent sleeping. • The effect of heat wave days is much stronger. • The sleep loss is especially large on weekends. • The effects are stronger for older people, people with less education and men. [ABSTRACT FROM AUTHOR]

• Technology startups move HQ abroad but keep business functions in home countries. • Push, pull and retention factors shape startups' virtual relocation. • Arguments against the reduced location boundness of resources in the digital era. • With scaling, the virtualness of the HQ office will gradually fade. Some of the best technology startups born in CEE moved their headquarters to a foreign jurisdiction before scaling. These ventures became 'foreign' companies but kept the principal business functions in the countries of origin. We theorize about this phenomenon, referred to as virtual relocation, and consider what it conveys for the asserted reduced relevance of location-bound advantages and constraints in the digital era. We take a process approach and investigate the cases of 34 technology startups from Poland, Hungary, and Romania. We find that CEE startups' choice of a 'virtual' type of relocation can be traced back to the tension between the retention factors and the push/pull factors influencing their locational decision. We show that the factors that push CEE startups away from their home countries, pull them to the destination country, and make them retain specific business functions in their home countries are equally location bound. If virtually relocated startups manage to seize the assumed opportunities in the destination country and scale, the virtualness of the HQ office will gradually fade: employment starts growing also at the HQ location. [ABSTRACT FROM AUTHOR]

• Hungary's geothermal potential offers a path to reduce gas consumption by 40–50%. • Deployment of renewables in Székesfehérvár can cut CO2 emissions by up to 9,200 t. • Scenario B presents savings, decreased import dependence, and lower emissions. Hungary boasts exceptional geothermal capabilities, with an Earth's crust thermal gradient nearly double the global average. However, the current utilization of these resources is often one-sided and lacks careful consideration. This comprehensive study offers updated insights into Hungary's geothermal potential and its current energy utilization. By presenting a practical example and employing scenario-based analyses, this study demonstrates how basic calculations can guide investment decisions in geothermal infrastructure. The aim is to address the prevailing issue of cities and towns prioritizing fossil fuel-based energy sources, thereby overshadowing renewable energy alternatives, despite advancing technology. Notably, in the case of Székesfehérvár, it was determined that annual natural gas consumption could be reduced by an impressive 40–50%, leading to a substantial reduction of 5,000–9,200 tons of CO 2 emissions, depending on the specific scenarios examined. [ABSTRACT FROM AUTHOR]

Paprika is a spice whose composition and characteristics vary with its geographical origin and additionally is illegally adulterated with dyes to improve its appearance. This work proposes a strategy based on Fourier-transform near infrared (FT-NIR) analysis and chemometric tools for its authentication and detection of fraud. A total of 115 paprika samples were analyzed, including paprika with protected designation of origin (PDO) labels from Spain, France and Hungary, and samples from China and Zambia. The proposed orthogonal partial least squares-discriminant analysis (OPLS-DA) models allow to distinguish paprika according to its PDO and variety, as well as to identify adulteration with Sudan dyes or Congo red. Partial least squares regressions allow to quantify the adulterant in paprika from 0.1 to 5 %. Chemometric models achieved high classification success rates and suitable linearities. The proposed strategy is presented as a comprehensive and effective tool to ensure paprika quality and authenticity, including the detection and quantification of adulteration with commercial dyes. • Paprika geographical origin and variety are established. • FT-NIR analysis and chemometric tools allow authentication and detection of fraud. • Protected Designation of Origin paprika from Spain, France and Hungary are analyzed. • Partial least squares regressions allow to quantify dye adulteration up to 5 %. [ABSTRACT FROM AUTHOR]

Ervin Bauer (1890–1938) made historical contributions to contemporary biology, provided a new definition of life, defined the contents of theoretical biology. He worked in different countries, perturbed by deep historical events. These historical events necessarily impacted his fate and finally led to the violent loss of his life and the life of his wife. His work and with it his theory of life had a no less complicated history than the history of his personal life. Bauer's main work "Theoretical Biology" was published in 1935 in Russian. The author and his wife Stefánia became victims of the Great Purge. They were executed in 1938, all their publications were banned and most copies of "Theoretical Biology" destroyed. Ervin and Stefánia Bauer were rehabilitated in 1956 but renewed publication of Bauer's works was delayed. The first reprint edition of "Theoretical Biology" of 1967 was not in Russian, but was a translation into Hungarian, the native language of Bauer. The first Russian reprint of "Theoretical Biology", in which the original Russian chapters are followed by short English summaries, was published in Hungary in 1982. This edition was prepared by Hungarian and Russian scientists. The best-known Russian edition of "Theoretical Biology" was published in 2002 in St. Petersburg. A complete English translation of Bauer's main work "Theoretical Biology" is still outstanding. [ABSTRACT FROM AUTHOR]

Aquatic vegetation species at the genus level in an oxbow lake were identified in Hungary based on a multispectral Uncrewed Aerial System (UAS) survey within an elongated oxbow lake area of the Tisza River under continental climate. Seven and 13 classes were discriminated using three different classification methods (Support Vector Machine [SVM], Random Forest [RF], and Multivariate Adaptive Regression Splines [MARS]) using different input data in ten combinations: original spectral bands, spectral indices, Digital Surface Model (DSM), and Haralick texture indices. We achieved a high (97.1%) overall accuracies (OAs) by applying the SVM classifier, but the RF performed only <1% worse, as it was represented in the first places of the classification rank before the MARS. The highest classification accuracies (>84% OA) were obtained using the most important variables derived by the Recursive Feature Elimination (RFE) method. The best classification required DSM as an input variable. The poorest classification performance belonged to the model that used only texture indices or spectral indices. On the class level, Stratiotes aloides exhibit the lowest degree of separability compared to the other classes. Accordingly, we recommend using supplementary input data for the classifications besides the original spectral bands, for example, DSM, spectral, and texture indices, as these variables significantly improve the classification accuracies in the proper combinations of the input variables. [Display omitted] • Dividing genus to phenophases does not provide better classification accuracy. • Recursive Feature Elimination method improves classification performance. • Involving Digital Surface Model relevantly improves classification accuracy. • Stratoites aloides has the poorest separability among the other classes. [ABSTRACT FROM AUTHOR]

The expansion of urban areas threatens biodiversity and disrupts ecological relationships, thereby impeding key ecosystem services. To avert irreversible consequences, there is a focus on improving the biodiversity value of domestic gardens. We employ machine learning and network analysis and examine gardening practices and garden owners' environmental consciousness in Hungary through a questionnaire-based study to untangle the interplay among socio-demographic factors, garden management and -characteristics. We found that the activities determined as biodiversity-positive were widespread among respondents, but ubiquitous pesticide use (62.14%), lack of undisturbed areas (49.52%), and frequent mowing (32.06%) were also present. Middle-aged respondents demonstrated more biodiversity-supporting activities than those over 55, who had long-term gardening experience and were predominantly conventional gardeners. Respondents of towns showed the least biodiversity-positive activities, whereas those living in cities and the countryside fared better. Additionally, multiple interconnected garden characteristics revealed various types of gardens distinguished by care practices and use, such as gardens for food self-provisioning, ornamental gardens, or those prioritizing biodiversity support. Our results show that garden owners use pesticides independently of socio-demographic parameters, gardening practices, or garden characteristics, suggesting widespread pesticide use in Hungary. Our findings suggest that strategies to promote biodiversity-friendly gardening may not be equally suitable for all gardener owners with different cultural backgrounds, environmental consciousness and gardening habits. Factors like differences between societal groups underscore the preference for in-person programs over online information transfer in several cases, for instance, among the elderly and those living in the countryside. We offer fresh perspectives on the intricate connections between garden diversity, characteristics, and practices, and it lays the groundwork for future research into the sociological drivers of gardening practices in Eastern Europe. Our work emphasises that optimizing gardens for multiple ecosystem services, including biodiversity conservation and enhancing human well-being, requires a nuanced understanding of both ecological and socio-demographic factors. [Display omitted] • Biodiversity-friendly domestic gardens are key for urban sustainability. • Gardening practices of Hungarian gardeners varied with socio-demographic factors. • Lack of undisturbed areas, frequent mowing and pesticide use were the most harmful. • Elderly gardeners showed less biodiversity support and environmental awareness. • Tailored strategies are crucial for enhancing Eastern European garden biodiversity. [ABSTRACT FROM AUTHOR]

In 2022, energy prices in the European Union reached record highs, accompanied by a significant increase in fuel prices. In response, the Hungarian government imposed a price cap on retail fuel prices from November 15, 2021 to December 6, 2022. This study empirically examines the effect of the elimination of the price cap on fuel prices. The aim is to determine whether the removal of the price cap resulted in subsequent price increases. The study employed a synthetic control method, comparing actual observed prices with prices estimated by the synthetic control after the intervention. In the ten-month period following the removal of the price cap (December 2022 to September 2023), the actual price was on average 12 % higher than the price projected by the synthetic control. The largest difference was observed in January 2023, with a price premium of 16 %. There was a moderation in the difference between February and September, but even during these months, the gap remained slightly higher than 11 %. This difference may be attributed to distortions of competition due to the price cap. • The Hungarian government imposed a price cap on retail fuel prices from November 2021 to December 2022. • The impact of the removal of the price cap on fuel prices was empirically investigated. • The results show that the actual price was, on average, 12 % higher than the price projected by the synthetic control. • The higher prices may be due to several factors, including changes in market structure and incentives for tacit collusion. • These negative effects should be taken into account when considering a price cap policy. [ABSTRACT FROM AUTHOR]

• Water-filled tree holes (dendrotelms) are important microhabitats. • Little is known about the microclimates near this microhabitat type. • Dendrotelms create cooler and more humid microclimates than closed forests per se. • Their microclimate is largely independent from local stand structure. • Their microclimatic refugia role will likely increase due to climate change. The relevance of forests in mitigating biodiversity loss and the negative effects of climate change on the biota is largely shaped by below-canopy microclimatic conditions, which are buffered, cooler and more humid compared to adjoining open habitats. Water-filled tree holes (dendrotelms, DTs) are special tree-related microhabitats that host semi-aquatic communities and are important substrates or water sources for numerous taxa (e.g., birds, mammals, insects, fungi, bryophytes). Despite their microrefugia-role might be more pronounced under climate change-induced drought events, little is known about their microclimate and its potential drivers. In an abandoned Turkey oak-dominated coppice stand in Hungary, the microclimates of 80 paired dendrotelms and adjacent forest plots were measured in the summer of 2021. Compared to nearby open areas, under closed forests, air temperature maxima were up to 5 °C cooler, DTs had an additional negative offset of 2.5 °C and increased air humidity by 15 percentage points (5% vs. 20 %). The local microclimate of DTs and the adjacent closed forest differed significantly in means and extremes of air temperature, relative humidity and vapour pressure deficit, which was mainly driven by DT entrance area and water volume and seemed independent from local stand structure. On the contrary, nearby below-canopy microclimate was shaped by the distance from forest edge, incoming light and tree density. Water volume in DTs also influenced local forest microclimates up to 0.5–1 m from the entrances. As the frequency and severity of extreme weather events such as heatwaves are likely to intensify due to climate change, the importance of microhabitats and habitat trees for invertebrates and vertebrates will increase further, and will additionally contribute to the microclimatic refugia role of forests. Active protection of veteran trees under the scheme of continuous cover forestry or conservation-oriented management is essential facing climate change to mitigate its negative effects on forest biodiversity. [Display omitted] [ABSTRACT FROM AUTHOR]

Pollinators are declining rapidly, largely due to land conversion and intensification of agriculture. To mitigate their crisis, low-disturbance habitats, such as sown wildflower plantings, could promote pollinators by restoration of their resources. However, comprehensive knowledge is lacking on how landscape context, spatial configuration and age of wildflower plantings, seasonality and flower composition affect pollinator communities, especially from East-Central Europe. To understand these effects, we established diverse native wildflower plantings within heterogeneous and homogeneous agricultural landscapes, by two spatial configurations: one large field or three smaller strips, in Hungary. We sampled floral resources and wild pollinator insects (wild bees, hoverflies, butterflies), in early and mid-summer, for two years after establishment. Flower resources of the sown plant species increased continuously, and were complemented at high rate by flowering plant species from the soil seed bank, especially in the first year. Both flower abundance and diversity increased the abundance of pollinators, highlighting the important role of using diverse seed mixtures. Wild bee abundance and species richness increased year by year and season by season, while butterfly abundance also demonstrated a yearly increase after establishment. Hoverfly abundance and species richness, however, showed an opposite trend, possibly due to the inter-annual variation. Wild bee and butterfly abundance was higher in the heterogeneous than in the homogeneous landscapes. We did not observe any significant local effects of spatial configuration itself on pollinator populations. Wildflower plantings were particularly attractive for wild bees in flower-poor (homogeneous) landscapes during the flower-poor (mid-summer) period of the year. This can be explained by the increased contrast in flower resources between the wildflower plantings and the surrounding landscape, and highlights the importance of wildflower plantings in such conditions. Our results emphasise that to support pollinators effectively, future wildflower plantings should be maintained for multiple years, aim to maximise floral diversity and ensure continuously available flower resources throughout the entire season. They can be facilitated by i) using diverse seed mixtures of native flowering plants, ii) particularly focusing on plants that bloom during the crucial mid-summer period, iii) allowing the plant species to grow and bloom from the soil seed bank, and iv) using management techniques, which help to extend the flowering season. Further results from the upcoming years and similar long-term and landscape-scale experimental studies are needed to understand all the benefits and ecological processes of diverse native wildflower plantings especially in understudied European regions. • Sown native diverse wildflower plantings increased wild bee & butterfly abundance. • Plant species from the soil seed bank dominated flower resources in the first year. • Both flower abundance and species richness increased the abundance of pollinators. • Heterogeneous landscapes affected wild bee and butterfly abundance positively. • Plantings had special importance for wild bees in flower-poor seasons and landscapes. [ABSTRACT FROM AUTHOR]

In this study, a picornavirus and a nidovirus were identified from a single available nasopharyngeal swab (NPS) sample of a freshly deceased sheep, as the only vertebrate viruses found with viral metagenomics and next-generation sequencing methods. The sample was originated from a mixed feedlot farm in Hungary where sheep and cattle were held together but in separate stalls. Most of the sheep had respiratory signs (coughing and increased respiratory effort) at the time of sampling. Other NPS were not, but additional enteric samples were collected from sheep (n = 27) and cattle (n = 11) of the same farm at that time. The complete/nearly complete genomes of the identified viruses were determined using RT-PCR and Nanopore (MinION-Flonge) / Dye-terminator sequencing techniques. The results of detailed genomic and phylogenetic analyses indicate that the identified picornavirus most likely belongs to a type 4 genotype of species Bovine rhinitis B virus (BRBV-4, OR885914) of genus Aphthovirus , family Picornaviridae while the ovine nidovirus (OvNV, OR885915) – as a novel variant – could belong to the recently created Bovine nidovirus 1 (BoNV) species of genus Bostovirus , family Tobaniviridae. None of the identified viruses were detectable in the enteric samples using RT-PCR and generic screening primer pairs. Both viruses are well-known respiratory pathogens of cattle, but their presence was not demonstrated before in other animals, like sheep. Furthermore, neither BRBV-4 nor BoNVs were investigated in European cattle and/or sheep flocks, therefore it cannot be determined whether the presence of these viruses in sheep was a result of a single host species switch/spillover event or these viruses are circulating in not just cattle but sheep populations as well. Further studies required to investigate the spread of these viruses in Hungarian and European sheep and cattle populations and to identify their pathogenic potential in sheep. • Bovine rhinitis B virus 4 and a novel ovine nidovirus were detected in sheep. • Both viruses were detected from a nasopharyngeal swab of a deceased sheep. • Complete/nearly complete genomes were determined and analyzed in detail. • Cattle-sheep host species switch/spillover of these viruses is plausible. [ABSTRACT FROM AUTHOR]

Although the Pannonian Basin in Hungary boasts significant geothermal potential, most geothermal wells in the region suffer from reinjection issues. The aim of this study is to examine the impact of the sedimentary architecture of a paralic lacustrine succession on the static connectivity of a geothermal aquifer. This problem was examined for a case-study geothermal doublet drilled in Mezőberény, southeast Hungary, which experienced injectivity problems shortly after commencing operations in 2012, ultimately leading to shut-in of the wells. A characterization of the architecture of the deltaic aquifer has been undertaken through a novel workflow that combines sedimentological and sequence stratigraphic analysis of the well-doublet and stochastic 3D modelling techniques to assess the likely static connectivity between the production and injection wells. Planform dimension of aquifer-forming mouth-bar elements and fluvial channel bodies were estimated from geological analogues, selected based on the thickness values of such sedimentary bodies interpreted on the gamma-ray logs of the well doublet and nearby hydrocarbon wells. In total five mouth-bar and two fluvial channel input geometry groups were selected, and fifty object-based realizations were constructed to analyse the static connectivity of different geological scenarios. The internal lithology of mouth-bar and fluvial-channel elements were modelled by sequential indicator simulations (ten realizations). Results of connected volume analysis indicate that the sandstone content of the aquifer is located within vertically segmented fluvial-channel and mouth-bar elements separated by mud-prone prodelta and lower delta-front deposits. This architectural configuration, in combination with low net-sandstone content suggests limited connectivity between the wells. Across the set of stochastic realizations, the volume of sandstone connecting the injection and production wells is ∼4% of the total aquifer volume, on average. Results of this study shows that simplified reservoir models can lead to over-estimation of connectivity of geothermal doublets. The proposed workflow combines sedimentological analysis and 3D modelling supported by geological analogues to predict sandstone reservoir connectivity of deltaic geothermal reservoirs. The described workflow can be carried out in target areas using existing boreholes to assist borehole planning. • Simplified reservoir models can result in overestimated well-doublet performance. • Assessment of sedimentary architecture can help predict performance problems. • Geological analogues can be utilized to estimate aquifer sandstone connectivity. • A new workflow, linking sedimentary analysis and geological analogues is proposed. • The Mezőberény site has low net-reservoir volume negatively impacting injectivity. [ABSTRACT FROM AUTHOR]

The Suidae from the late Miocene of Alsótelekes (northeastern Hungary, Borsod-Abaúj-Zemplén county) are described and assigned to Propotamochoerus palaeochoerus (Suinae) and cf. Parachleuastochoerus (Tetraconodontinae). The co-occurrence of these two taxa agrees with a reference to the early Vallesian (MN 9), as previously indicated from biochronological correlation of the small mammal fauna, and suggests the presence of woodland environments, with abundance of below-ground resources and direct access to water. This fits well with the diverse wetlands and riparian forests that characterized Lake Pannon ∼10 Ma, as documented in the geographically close site of Rudabánya. The convoluted taxonomy of European Tetraconodontinae is discussed. [ABSTRACT FROM AUTHOR]

The evaluation of forensic DNA expert opinions (in some countries expert witness testimonies) and the way it affects criminal judgement is of paramount importance. We have selected one of the largest challenges when it comes to the evaluation of forensic DNA evidence, contamination of DNA samples, and examined how it influences the decisions judges make about the credibility of DNA evidence in Hungary. [ABSTRACT FROM AUTHOR]

Background: In recent decades, a series of ecological studies from various countries have attempted to reveal whether there is an association between trace amounts of lithium in drinking water and suicide mortality. With some notable exceptions, results have indicated that there is an inverse association between these two variables. Since Hungary had extremely high rates of suicide with a persistent spatial pattern, we consider that our country is ideal to investigate this research question.Methods: We carried out our research on Hungarian data at the level of districts (n = 197). The dependent variable was the age- and gender-standardized mortality ratio for suicide (sSMR). Our main explanatory variable was the tap water lithium level (Li) from public drinking water supply systems using their own water source (n = 1 325). Those data, which give full national coverage, were aggregated to the level of districts. Confounding factors were religiosity, alcohol consumption and income. Various regression models were used for statistical calculations.Results: Findings from our most appropriate regression model - adjusted for relevant confounding variables and able to handle spatial autocorrelation and heteroscedasticity - suggest a significant (p < 0.05) and a trend-like (p < 0.1) negative association between Li and sSMR in the total population and among males, respectively. However, such an association was not found between these two variables among females.Conclusion: In line with the majority of findings from other countries, our results indicate that the intake of lithium with drinking water may have a gender-dependent suicide-protective effect. [ABSTRACT FROM AUTHOR]

• We analyzed mortality data of 11,968 patients who died of COVID-19 in order to find the prevalence of epilepsy. • The risk factors for COVID-19 mortality in young adults may be different than in the general population. • Epilepsy is overrepresented among young patients who died from COVID-19. : Studies examining epilepsy as a COVID-related death risk have come to conflicting conclusions. Our aim was to assess the prevalence of epilepsy among COVID-related deaths in Hungary. Each COVID-19 infection case is required to be reported on a daily basis to the National Public Health Center of Hungary. This online report includes the beginning and end of the infection, as well as information on comorbidities. Death during infection is regarded as COVID-related. The anonymized data of each deceased patient are published on an information website (www.koronavirus.gov.hu) and provides up-to-date information on each patient with the date of death, the patient's sex, age, and chronic illness. There were 11,968 patients who died of COVID-19 in Hungary between 13 March 2020 and 23 January 2021. Among 11,686 patients with no missing values for comorbidities, 255 patients had epilepsy (2.2%). Epilepsy was much more common among those who died at a young age: 9.3% of those who died under the age of 50 had epilepsy, compared with only 1.3% in those over the age of 80. The younger an age group was, the higher was the prevalence of epilepsy. Patients who died of COVID-19 under the age of 50 were 10 to 20 times more likely to have epilepsy than what would have been expected from epidemiological data. Our results highlight the need for increased protection of young people with epilepsy from COVID-19 infection and the development of a vaccination strategy accordingly. [ABSTRACT FROM AUTHOR]

• We explore changes in homogeneity within personal networks using two cross-sectional surveys conducted in 2001 and 2017. • We observe higher homogeneity rates in terms of education, age and family status. • Changes are only partly explained by socio-demographic changes. • Results mostly consistent with those of other studies in Hungary and the USA. This article explores the evolution of homogeneity within personal networks in France over time and across several relational contexts, using two cross-sectional surveys conducted in 2001 (n = 399) and 2017 (n = 663). Personal networks have changed relatively little overall, but with a tendency toward more homogeneity among the most educated, 26–45 and 61−75 year-olds, singles, and childless individuals. Differences in rates of personal network homogeneity are only partly explained by demographic shifts in French society. These findings are mostly consistent with those of other studies in Hungary and the USA. We argue that the effects of rising education levels, the segmentation of social contexts in terms of age, and the transformation of family models – which can be observed in most western countries – reinforce relational spheres characterized by relatively similar lifestyles. [ABSTRACT FROM AUTHOR]

A case study approach was used to investigate the adaptation experiences of Turkish international students (TIS), which may vary according to the host culture, in two different cultures: Hungary (n = 14) and the United States (US) (n = 12). The findings of the data analysis yielded four broad overlapping categories: (1) experiences in academic setting, (2) interaction with others in the host country, (3) political reflections in the host country, and (4) everyday matters in the host country. According to findings, depending on the factors in the institutional, social and physical environment, and societal contexts, both the psychological and sociocultural adaptation experiences of the participants in Hungary and the US differed. The study revealed that studying in Hungary, which offers english mediuim instruction programs, poses some serious difficulties for TIS compared to their co-nationals studying in an English-speaking country, such as in-school separation from local students. However, due to a shared historical background between Hungarians and Turks, TIS in Hungary have experienced many cultural similarities in their relations and daily lives unlike TIS in the US. Additionally, the positive attitudes of some Hungarian politicians toward Turkey and Turkish ethnicity have contributed to TIS' perceived low cultural distance and positively affected their cross-cultural adaptation process. Whereas, TIS in the US experienced stress that hindered adaptation due to certain political developments in the US and their political relations with Turkey. [ABSTRACT FROM AUTHOR]

Objectives: The ICEpop CAPability measure for Adults (ICECAP-A) was developed to assess the capability well-being of adults for use in economic evaluations. Currently, ICECAP-A tariffs are available only for the UK population. The objectives of this study were to develop a Hungarian tariff set for the ICECAP-A instrument and to explore intercountry differences between the Hungarian and the UK value sets.Methods: A survey was conducted by computer-assisted personal interviews on a sample representative of the Hungarian adult population (N = 1000) to elicit their preferences regarding ICECAP-A attributes with the use of a best-worst scaling choice task. A latent class multinomial logit model with continuous variance scale was used to estimate the weights for each of the 4 capability levels of all 5 ICECAP-A attributes, namely, attachment, stability, achievement, enjoyment, and autonomy.Results: The model identified 2 preference classes with approximately equal share. The first class had a stronger relative preference for autonomy and achievement, whereas the second class had a strong preference for attachment. Multivariate analysis of the classes revealed that women, pensioners, people who are married or living in a partnership, and people with poorer health status are characteristics associated with the latter class membership (preference for attachment). Population tariffs were estimated from the model. Overall, attachment was found to be the most important attribute, followed by stability, enjoyment, achievement, and autonomy.Conclusions: Hungarian tariffs are largely consistent with those found for the United Kingdom; nevertheless, autonomy seems to be less important in Hungary compared with the United Kingdom. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to investigate and compare the preferences that citizens of four Visegrad countries hold concerning the communication between patient and provider.Methods: The patient-practitioner orientation scale was used on a general population in our research, which consists of the Sharing and Caring subscales and assesses patient-centered or doctor-centered orientation toward communication. The statistical analysis included 4000 respondents of citizens from the Czech Republic, Slovakia, Poland and Hungary. When comparing the various demographic data and the four countries with each other univariate and multivariate logistic regressions were performed.Results: Being female, middle aged, having a higher education and a poor health status were associated with significantly higher Sharing and Caring scores. Also, Hungarian citizens had a significantly higher Caring score compared to the other three countries.Conclusions: Key demographic variables were identified that affect how citizens perceive the communication between patient and provider. With the exception of Caring among Hungarian citizens, no differences were observed among the Visegrad countries.Practice Implications: These findings have potential implications for understanding the preferences of the citizens and thus better promote a more patient-centered communication. [ABSTRACT FROM AUTHOR]

Background: Studies examining epilepsy as a COVID-related death risk have come to conflicting conclusions. Our aim was to assess the prevalence of epilepsy among COVID-related deaths in Hungary.Methods: Each COVID-19 infection case is required to be reported on a daily basis to the National Public Health Center of Hungary. This online report includes the beginning and end of the infection, as well as information on comorbidities. Death during infection is regarded as COVID-related. The anonymized data of each deceased patient are published on an information website (www.koronavirus.gov.hu) and provides up-to-date information on each patient with the date of death, the patient's sex, age, and chronic illness.Results: There were 11,968 patients who died of COVID-19 in Hungary between 13 March 2020 and 23 January 2021. Among 11,686 patients with no missing values for comorbidities, 255 patients had epilepsy (2.2%). Epilepsy was much more common among those who died at a young age: 9.3% of those who died under the age of 50 had epilepsy, compared with only 1.3% in those over the age of 80. The younger an age group was, the higher was the prevalence of epilepsy.Conclusion: Patients who died of COVID-19 under the age of 50 were 10 to 20 times more likely to have epilepsy than what would have been expected from epidemiological data. Our results highlight the need for increased protection of young people with epilepsy from COVID-19 infection and the development of a vaccination strategy accordingly. [ABSTRACT FROM AUTHOR]