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BackgroundThe evidence on long-lasting effects of certain specific aspects of birth circumstances on the maternal mental health later during pregnancy in offspring is scares.AimThis study aimed to investigate the association between birth circumstances and prenatal maternal mental health in offspring.MethodIn this retrospective survey, 380 pregnant women completed the Hungarian translation of Wijma Delivery Expectancy/Experience Questionnaire A, Beck Depression Inventory-Short Form, Beck Anxiety Inventory to measure prenatal fear of childbirth (FOC), depression, and anxiety, respectively. Information on peri and postnatal events were obtained from participants’ biological mothers through Mother’s Birth Circumstances Questionnaire. This included questions regarding mode of birth, administered medical interventions during labor, early life care, and breastfeeding during infancy. Multiple Linear regression was performed for statistical analysis.ResultsAfter adjusting for potencial confounders, administration of Oxytocin (OT) induction during labor was significantly associated with higher levels of prenatal FOC (B = 7.64; 95% CI, 0.55, 14.73), depression (B = 1.60; 95% CI, 0.47, 2.73), and anxiety (B = 3.80; 95% CI, 0.55, 6.99). Moreover, having been breastfed for more than 12 months was significantly associated with lower level of prenatal FOC in offspring (B= -10.45; 95% CI,-18.79,-2.11).ConclusionPoor prenatal mental health might be rooted in administered OT induction as a common medical practice during labor while long duration of breast feeding can have a positive effect on improving prenatal maternal mental health in offspring. Further studies of prospective design are on demand to explore the biological trajectories of these findings in humans.

Összefoglaló. Bevezetés: A magyarországi vesetranszplantáció 2013 óta az Eurotransplant (ET) keretein belül zajlik. A debreceni vesetranszplantációs centrumhoz évente kb. 200 kadáverdonorvese-felajánlás érkezik, melyek 37%-a kerül a megismert adatok alapján elfogadásra. Nem minden elfogadott vese kerül beültetésre, aminek számos oka lehet. Célkitűzés: A debreceni szakmai gyakorlat elemzése és bemutatása reprezentatív mintán. Módszer: A debreceni centrumhoz 2016. november és 2020. március között 624 vesefelajánlás érkezett. A felajánlott vesék 37%-a (n = 229) került előzetesen elfogadásra, később az elfogadott vesék 63%-a (n = 144) került beültetésre. Centrumunkban az ún. 'standard criteria', azaz tökéletes minőségű donorvesék szignifikánsan magasabb arányban kerültek elfogadásra, majd beültetésre, mint az 'extended criteria', azaz kompromisszummal vállalhatók. Az elfogadott és nem elfogadott veséket vizsgálva a KDPI (kidney donor profile index) és a KDRI (kidney donor risk index) értéke szignifikánsan magasabb volt az elutasított donorok esetében (p0,001). Eredmények: Elemeztük, hogy a felajánlott, de a centrum által nem beültetett donorveséket más ET-centrumban elfogadták-e. Látható, hogy a felajánlott 624 donorvese közül 144 Debrecenben, 313 pedig más ET-centrumban került beültetésre, viszont 167 vese beültetése egyik ET-centrumban sem történt meg (discarded organ). A 36-85 KDPI-értékkel rendelkező csoportból került beültetésre a legtöbb donorvese (180 vese) más ET-centrumban. A Debrecenben beültetett kadáverdonor-vesék KDPI- és KDRI-értéke szignifikánsan alacsonyabb volt a nekünk felajánlott, majd máshol beültetett vesékhez képest. Következtetés: Összességében elmondható, hogy a debreceni centrumban a magas rizikócsoportba tartozó donorszervek elutasításra kerültek, miközben más centrumban a nagy részüket beültették. Ez alapján a 36-85 KDPI-értékű csoport a transzplantációs esetszám bővítésének lehetséges forrása a recipiens ismeretében. Orv Hetil. 2021; 162(26): 1022-1028.Kidney transplantation in Hungary is carried out via Eurotransplant (ET). Our centre in Debrecen receives around 200 kidney offers a year, of which 37% are accepted. Not all accepted kidneys are transplanted, which can be a result of a number of causes. Obejctive: A debreceni szakmai gyakorlat elemzése és bemutatása reprezentatív mintán.Between November 2016 and March 2020, the centre of Debrecen received 624 kidney offers. 37% (n = 229) of the offered kidneys got preliminarily accepted, of which 63% (n = 144) were transplanted later. In our centre, standard criteria donor kidneys were accepted and transplanted in significantly higher rate, than extended criteria donor kidneys. Looking at accepted and rejected kidneys, KDPI and KDRI values were significantly higher in the case of the refused ones (p0.001).Part of our assessment is to analyze whether kidneys offered to and refused by us got accepted in other transplant centres. In the examined period, of the 624 kidneys offered to our centre 144 were transplanted in Debrecen, 313 were transplanted in other ET centres, while 167 were not transplanted at all (discarded organ). The majority of transplanted kidneys in other ET centres had KDPI values between 36 and 85 (180 kidneys.) KDPI and KDRI values of kidneys transplanted in our centre were significantly lower than those that were offered to us, but got transplanted elsewhere.To summarize, we can say that high-risk donor organs are refused in the transplant centre of Debrecen, while the majority of them are being transplanted in other centres. Based on this, kidneys of KDPI value between 36 and 85 are a possible source of expanding the number of transplantations, with regards to the recipient. Orv Hetil. 2021; 162(26): 1022-1028.

Research on the efficacy of hypnosis applications continues to grow, but there remain major gaps between the science and clinical practice. One challenge has been a lack of consensus on what applications of hypnosis are efficacious based on research evidence. In 2018, six major hypnosis organizations collaborated to form a Task Force for Establishing Efficacy Standards for Clinical Hypnosis. This paper describes a Guideline for the Assessment of Efficacy of Clinical Hypnosis Applications developed by the Task Force which makes ten specific recommendations. The guideline is intended to be a tool for those who want to assess the quality of existing evidence on the efficacy of clinical hypnosis for any particular indication. The paper also discusses methodological issues in the interpretation and implementation of these guidelines. Future papers will report on the other products of the Hypnosis Efficacy Task Force, such as best practice recommendations for outcomes research in hypnosis, and an international survey of researchers and clinicians on current practice and attitudes about hypnosis.

Background:The evidence on long-lasting effects of certain specific aspects of birth circumstances on the maternal mental health later during pregnancy in offspring is scares. Aim: This study aimed to investigate the association between birth circumstances and prenatal maternal mental health in offspring. Method: In this retrospective survey, 380 pregnant women completed the Hungarian translation of Wijma Delivery Expectancy/Experience Questionnaire A, Beck Depression Inventory-Short Form, Beck Anxiety Inventory to measure prenatal fear of childbirth (FOC), depression, and anxiety, respectively. Information on peri and postnatal events were obtained from participants’ biological mothers through Mother’s Birth Circumstances Questionnaire. This included questions regarding mode of birth, administered medical interventions during labor, early life care, and breastfeeding during infancy. Multiple Linear regression was performed for statistical analysis.Results: After adjusting for potencial confounders, administration of Oxytocin (OT) induction during labor was significantly associated with higher levels of prenatal FOC (β= 0.14; 95% CI, 0.59, 14.70), depression (β= 0.18; 95% CI, 0.47, 2.73), and anxiety (β= 0.15; 95% CI, 0.50, 6.95). Moreover, being breast fed for more than 12 months was significantly associated with lower level of prenatal FOC in offspring (β= -0.12; 95% CI, -18.42, -1.36). Conclusion: Poor prenatal mental health might be rooted in administered OT induction as a common medical practice during labor while long duration of breast feeding can have a positive effect on improving prenatal maternal mental health in offspring. Further studies of prospective design are on demand to explore the biological trajectories of these findings in humans.

Background: The purpose of our study was to analyze body composition and spiroergometric data of young (14-15 years) elite level ball sport players. We suggested that three-ball sports (handball, soccer, and basketball) share common performance indicators, as each ball sport is primarily characterized by rapid intermittent movements. Methods: We selected one-hundred and ten, handball (n=30), basketball (n=40) and soccer (n=40) players male and female from local clubs in Hungary. To measure their performance to develop high-quality training programs adequately age was differing from 14 to 15, they represented the elite level of their sports. They participated in performance analysis, the protocol included a body composition analysis and spiroergometric tests. We measured body composition and physiological parameters utilizing an In Body 720 device, and a standard Bruce treadmill protocol. Although we were aware of the limitations of the Bruce protocol in elite athletes, we choose this protocol as a safer alternative for younger inexperienced athletes. Results and conclusions: We concluded that in young male soccer and basketball players mean peak /load (W), peak/VE (l), peak/Vtex (l), peak/VO2 (ml/min), peak/VCO2 (ml/min), and peak/ O2 pulse (ml) data is a reliable indicator of the sport-specific performance. We may also suggest, that in our population of male basketball and handball players peak/Vtex (l) is the only variable, which is significantly different. Between groups of male handball and soccer players, peak/VO2/kg (ml/min) may be a valid performance indicator too. Among female basketball and handball players we found a significant difference in three performance variables: peak/Vtex (l), peak/VO2 (ml/min) and peak/ O2 pulse (ml). Although we must be careful when interpreting results, prior experiences with exercise testing, biological maturation differences must be considered. Trial registration: All examinations involving human subjects were approved by the Hungarian Ethical Committee ETT TUKEB:15117-4/2018/EÜIG.

TiO2 and ZnO single and multilayers were deposited on hydroxyl functionalized multi-walled carbon nanotubes using atomic layer deposition. The bare carbon nanotubes and the resulting heterostructures were characterized by TG/DTA, Raman, XRD, SEM-EDX, XPS, TEM-EELS-SAED and low temperature nitrogen adsorption techniques, and their photocatalytic and gas sensing activities were also studied. The carbon nanotubes (CNTs) were uniformly covered with anatase TiO2 and wurtzite ZnO layers and with their combinations. In the photocatalytic degradation of methyl orange, the most beneficial structures are those where ZnO is the external layer, both in the case of single and double oxide layer covered CNTs (CNT-ZnO and CNT-TiO2-ZnO). The samples with multilayer oxides (CNT-ZnO-TiO2 and CNT-TiO2-ZnO) have lower catalytic activity due to their larger average densities, and consequently lower surface areas, compared to single oxide layer coated CNTs (CNT-ZnO and CNT-TiO2). In contrast, in gas sensing it is advantageous to have TiO2 as the outer layer. Since ZnO has higher conductivity, its gas sensing signals are lower when reacting with NH3 gas. The double oxide layer samples have higher resistivity, and hence a larger gas sensing response than their single oxide layer counterparts.

This study aims to assess the effectiveness of psychosocial techniques to decrease postoperative pain and improve perioperative clinical care in orthopedic surgery. A systematic review and meta-analysis was performed to evaluate the effects of psychosocial methods among adults undergoing orthopedic surgeries. The systematic review included both randomized and nonrandomized trials, but only randomized controlled clinical trials (RCTs) were included in the meta-analysis. Key outcomes were postoperative pain, analgesic requirement, perioperative anxiety, quality of life, and recovery. After searching the databases from January 1980 to September 2016, a total of 62 RCTs were included with a pooled sample size of 4,908. Psychosocial interventions significantly reduced postoperative pain (Hedges’ g = 0.31 [95% confidence interval = 0.14, 0.48]), and preoperative and postoperative anxiety (g = 0.26 [0.11, 0.42] and g = 0.4 [0.21, 0.59], respectively). Furthermore, psychosocial interventions improved recovery (g = 0.38 [0.22, 0.54]). However, no significant effects were found for postoperative analgesic use (g = 0.16 [−0.01, 0.32]) and quality of life (g = 0.14 [−0.05, 0.33]). Patient education and relaxation techniques produced the most consistent positive effects, showing benefits on pain, anxiety, and recovery. Cognitive or behavioral techniques improved recovery. Furthermore, larger effects were found for studies that included acute surgeries compared to elective surgeries. The results indicate that psychosocial interventions, especially patient education and relaxation training, may reduce perioperative side effects and improve recovery in patients undergoing orthopedic procedures, but the quality of evidence is generally low. More well-powered, high-quality studies are needed to increase confidence. Perspective In this meta-analysis of RCTs in orthopedic surgeries, significant benefits in postoperative pain, perioperative anxiety, and recovery were found, suggesting that psychosocial interventions, especially patient education and relaxation techniques, are useful in improving clinical care.

It is increasingly clear that oxytocin and cortisol play an intricate role in the regulation of behavior and emotions impacting health, relationships, and well-being. Their long-term, cross-generational effect makes them an important focus of the present study. This exploratory research examined changes in oxytocin and cortisol levels and their correlations with different phenomenological measures in both hypnotist and subject during active-alert hypnosis. The level of oxytocin increased whereas the level of cortisol decreased in the hypnotist. When comparing the oxytocin changes of subjects with their hypnotizability, those with low hypnotizability scores experienced an increase in oxytocin, and those with medium and high hypnotizability scores showed no change or decrease. This could explain why clients' hypnotizability is not considered an important factor during hypnotherapy.

Shifts in hemispheric dominance were previously proposed to play a role in hypnosis. Participants (N = 32) were exposed to an active–alert hypnosis induction and a music-control condition while electrodermal activity was registered bilaterally, providing information on alterations in hemispheric dominance. The results suggest that highly hypnotizable participants show a shift to right-sided and low hypnotizable participants demonstrated a shift to left-sided electrodermal dominance in response to the induction, whereas no change in laterality is present in the control condition. Additionally, the authors found that self-reported hypnosis experiences were also associated with a shift in laterality. These results underline the importance of the shift to right hemispheric activity in hypnosis and underscore the importance of hemispheric changes in shaping subjective experience. (Less)

Management of reed beds primarily includes controlling water levels and removing vegetation by mowing, burning, or grazing. Although recent studies have demonstrated increased diversity and abundance of wetland specialists after reed bed management, documenting demographic benefits to individual species would add additional support to the advantages of appropriate management. Here, we explore the effects of reed management on the philopatry of Great Reed Warblers (Acrocephalus arundinaceus) over 7 yr. Reed beds were managed in the winter by occasional burning at mining ponds and large canals, infrequent burning in marshes, and frequent mowing of small canals. Based on resightings and recaptures of 1,243 adult and 1,428 nestlings individually marked at 57 sites in 6 different reed habitats, we built Cormack-Jolly-Seber models to estimate the apparent annual survival and encounter probabilities of birds banded as nestlings or as adults. Apparent survival varied in time for both age groups and both ...

Suggestions can be used without formal hypnosis, especially with critically ill patients, due to their spontaneous trance state. In this paper we outline data on the effectiveness of therapeutic suggestions. We interpret the possible mechanism of therapeutic suggestions in the context of stress cognition. Basic principles of formulating suggestions are discussed and some recommended versions of non-pharmacological pain control are provided. Case vignettes are given of how suggestions are used with critically ill ICU patients.

Hypnotizability is related to the Val158Met polymorphism of the COMT gene. The authors' aim was to find associations between candidate genes and subjective dimensions of hypnosis; 136 subjects participated in hypnosis and noninvasive DNA sampling. The phenomenological dimensions were tapped by the Archaic Involvement Measure (AIM), the Phenomenology of Consciousness Inventory (PCI), and the Dyadic Interactional Harmony Questionnaire (DIH). The main results were that the "Need of dependence" subscale of AIM was associated with the COMT genotypes. The GG subgroup showed higher scores, whereas AA had below average scores on the majority of the subjective measures. An association between the 5-HTTLPR polymorphism and the intimacy scores on the DIH was also evident. The effects are discussed in the social-psychobiological model of hypnosis.

Buday György grafikus, fametsző, díszlettervező, a Szegedi Fiatalok Művészeti Kollégiumának vezetője és Bauer Lilla pályakezdő mozdulatművész 1933 augusztusában találkoztak először Szegeden. 1937-ig tartó szerelmük Buday fametszőművészetében új, intenzív korszakot nyitott. Bauer Lilla – kisebb megszakításokkal – 1934-től haláláig Angliában élt, így személye és művészete itthon kevéssé ismert. Az életrajzi vázlat – Buday hozzá írott levelei és a korabeli sajtó segítségével – pályafutásának rövid hazai szakaszát mutatja be.

Morphine and its derivatives play inevitably important role in the μ-opioid receptor (MOR) targeted antinociception. A structure-activity relationship study is presented for novel and known orvinol and thevinol derivatives with varying 3-O, 6-O, 17-N and 20-alkyl substitutions starting from agonists, antagonists and partial agonists. In vitro competition binding experiments with [3H]DAMGO showed low subnanomolar affinity to MOR. Generally, 6-O-demethylation increased the affinity toward MOR and decreased the efficacy changing the pharmacological profile in some cases. In vivo tests in osteoarthritis inflammation model showed significant antiallodynic effects of thevinol derivatives while orvinol derivatives did not. The pharmacological character was modelled by computational docking to both active and inactive state models of MOR. Docking energy difference for the two states separates agonists and antagonists well while partial agonists overlapped with them. An interaction pattern of the ligands, involving the interacting receptor atoms, showed more efficient separation of the pharmacological profiles. In rats, thevinol derivatives showed antiallodynic effect in vivo. The orvinol derivatives, except for 6-O-desmethyl-dihydroetorfin (2c), did not show antiallodynic effect.

Twin studies provide evidence for the heritability of social attitudes, e.g. competitiveness, however, there are no psychogenetic association results linking competitive attitudes to genetic polymorphisms. Candidate gene studies report association with competitiveness-related phenotypes, risk taking for example was linked with the 7-repeat allele of the dopamine D4 receptor gene. This polymorphism has been studied extensively with novelty seeking and certain psychiatric disorders, as it plays a crucial role in molecular genetic mechanisms driving behavioral responses to the environment, especially modulating behavior through the reward circuitry. In the present study, we examined association of the DRD4 48-bp VNTR and competitiveness using self-report data from 399 non-related Caucasians. We found an interesting gene-sex interaction: 7-carrier males were more hypercompetitive as compared to non-carriers, while 7-carrier females were less hypercompetitive as compared to non-carriers. This finding remained significant after Bonferroni correction for multiple testing. Interestingly, among females we observed a significant positive correlation between hypercompetitiveness and mood characteristic variables, however, no such relationship could be detected in males. In 7-carrier females the association of hypercompetitiveness and anxiety or depression was more robust as compared to non-carrier females. These results highlight the importance of cultural influences in interpreting gene-sex interaction effects. Our results underlies interaction between genes and the environment; suggesting that the 7-repeat allele plays an important role in adaptivity, enabling sex-specific behavior to social expectations.

This study aimed to assess fear of childbirth (FOB) among Hungarian pregnant women and determine predictors based on WDEQ-A subscales. This cross-sectional study was conducted among 423 healthy pregnant women during their third trimester. A socio-demographic and obstetrics characteristics, the Hungarian version of WDEQ-A, Beck Depression Inventory-Short Form and Beck Anxiety Inventory were used. The analysis was performed using multivariate linear regression. Among four WDEQ-A subscales, Fear (19%) and Lack of positive emotion (13%) obtained the largest and smallest percentages of cases with severe FOB. The nulliparous obtained significantly higher mean score in subscales Isolation and Lack of positive emotion compared to the multiparous. Anxiety was the most common predictor for all subscales in both groups. In the nulliparous group, significant predictors included economic hardship for Moment of birth, being a housewife for Fear, and wanted pregnancy for Lack of positive emotion. In the multiparous women, the strongest significant predictors were being married, previous elective caesarean section and being a housewife for subscales Isolation, Moment of birth, and Fear, respectively. Assessing FOB using WDEQ-A among Hungarian women revealed different mean scores and predisposing factors for each subscale. The topic should be further explored relative to its constituent factors.

Hip and knee replacement surgery is very demanding for patients. Medication consumption is further increased by perioperative anxiety. Besides pain killer and anxiolytic medications, patients' recovery can be enhanced by applying therapeutic suggestions, which are easily applicable during the patient-physician communication.In our prospective, randomized, controlled study we examined the effects of positive suggestions on patients undergoing hip or knee arthroplasty in spinal anaesthesia. Members of the suggestion group received the therapeutic suggestions during a pre-surgery physician visit, and by listening to an audio recording during surgery.Compared to the control group (n = 50), in the suggestion group (n = 45) the need of medication (pain killer and adjuvant pain medication) during the surgery was lower (p = 0.037), the mean change from baseline in the well-being of the patients was better on the 2nd [1.31 (0.57; 2.04); p0.001] and 4th [0.97 (0.23; 1.7); p = 0.011] postoperative day and less transfusion had to be administered (OR: 2.37; p = 0.004). However, there was no difference between the two groups in the postoperative need of medications, in the length of hospitalisation and in the frequency of complications. Conslusion: Our results indicate that the administration of therapeutic suggestions in the perioperative period may be beneficial for orthopaedic surgery patients. Orv Hetil. 2018; 159(48): 2011-2020.Absztrakt: Bevezetés és célkitűzés: A csípő- és térdprotézisműtétek jelentős megterheléssel járnak a betegek számára. A műtétek körüli gyógyszeres fájdalomcsillapítás és szorongásoldás mellett a betegek gyógyulása az orvos–beteg kommunikáció során könnyen alkalmazható terápiás szuggesztiókkal is segíthető. Módszer: Prospektív, randomizált, kontrollált tanulmányunkban csípő- és térdprotézisműtéten spinalis anesztéziában átesett betegeken vizsgáltuk a pozitív szuggesztiók hatását. A szuggesztiós csoport tagjai műtét előtti beszélgetés során, valamint műtét alatt hangfelvételről kapták a szuggesztiókat. Eredmények: A kontrollcsoporthoz (n = 50) képest a szuggesztiós csoportban (n = 45) alacsonyabb volt a műtét alatti fájdalomcsillapítók és adjuváns szerek iránti összesített igény (p = 0,037), jobb volt a betegek közérzetének átlagos változása a műtét utáni 2. [1,31 (0,57; 2,04); p0,001], illetve 4. [0,97 (0,23; 1,7); p = 0,011] napon, és kevesebb transzfúzió adására (OR: 2,37; p = 0,004) volt szükség. Ugyanakkor nem mutatkozott különbség a műtét utáni gyógyszerek iránti igényben, a hospitalizáció időtartamában és a szövődmények gyakoriságában. Következtetés: Eredményeink igazolják, hogy a terápiás szuggesztiók alkalmazása a műtét körüli időszakban kedvezően befolyásolja a gyógyulási folyamatot. Orv Hetil. 2018; 159(48): 2011–2020.

Background:. Surviving critical illness often creates a lasting psychological impact, including depression, anxiety, and post-traumatic stress. Memories of frightening and delusional experiences are the largest potentially modifiable risk factor, but currently, there is no proven intervention to improve these inciting factors. Psychological support based on positive suggestion is a psychotherapeutic approach that can be provided even to patients in altered cognitive states and is therefore a viable psychotherapy intervention throughout the ICU stay. Traditional ICU care team members have limited time and training to provide such psychological support to patients. Doulas are trained supportive companions who have been effectively used to provide patient advocacy and emotional support in other clinical settings and may address this need. Our aim was to train and implement a psychological support based on positive suggestion program for the critically ill using doulas, and measure acceptance of this intervention through stakeholder feedback. Methods:. Doula training included three objectives: an introduction to ICU practice structure and policies; education about fundamental aspects of critical care conditions and procedures; and didactic and hands-on learning experiences in effective use of psychological support based on positive suggestion in the critically ill. Doulas were evaluated at the end of their training and during subsequent clinical activities using competency-based assessments as well as through survey-based questions and interviews with key stakeholders. Results:. The ICU doulas performed psychological support based on positive suggestion on 43 critically ill patients in the ICU setting. Stakeholder feedback from nurses, patients, and patient families was positive. The majority (28/32) of surveyed bedside ICU nurses reported that the doulas’ involvement was helpful for both patients and nurses alike. All interviewed family members offered positive comments about the ICU doula presence and of the 40 patients who recalled the intervention 37 found it comforting. Conclusions:. Our program successfully trained two doulas to work effectively in the ICU setting performing patient-centered psychological support based on positive suggestion interventions. Their training improved their skill sets and was reported as beneficial by patients, families, and critical care nursing. This training program offers a proof of concept that could be applied in other medical centers, bringing doulas more commonly into the ICU practice to help humanize the experience for patients, families, and medical teams.

We describe a case of infectious spondylodiscitis of the lumbar spine complicated by epidural and bilateral psoas abscesses which started with subtle symptoms and a non-specific clinical picture. Diagnosis is based on clinical, laboratory and radiological features. It can be difficult and often delayed due to the rarity of the disease and the high frequency of low back pain in the general population. Our aim is to raise awareness for the possibility of specific low back pain which requires quick and indispensable action from the physician.

This study examined whether positive suggestions applied without a hypnotic induction in the perioperative period reduces the need for red blood cell transfusions in patients who underwent total hip or knee arthroplasties with spinal anesthesia. No hypnotic assessment was performed. Ninety-five patients were randomly assigned to the suggestion group (n = 45) and to the control group (n = 50). Patients in the suggestion group received verbal suggestions before and audiotaped suggestions during the surgery for reducing blood loss, anxiety, postoperative pain, and fast recovery. Our study showed that using positive suggestions in the perioperative period significantly decreases the necessity for transfusion.

Aims Pain and anxiety are commonly reported among those undergoing orthopaedic surgery. Improvement in anxiety and pain control might be achieved by supplementing standard care with psychological interventions. However, the effectiveness of adjunctive psychosocial interventions in anxiety and pain control have not been addressed sufficiently by previous systematic reviews in orthopaedic surgeries. The present study aimed to assess the effectiveness of adjunctive psychosocial techniques to improve perioperative clinical care in orthopaedic surgery, to identify the most effective intervention types and to evaluate potential moderators. Methods We will perform a systematic review and meta-analysis to address the study aims. PubMed, PsycINFO, CINAHL and ProQuest Dissertations & Theses will be searched between 1980 and 2015. Prospective controlled clinical trials completed in adults, contrasting standard care and standard care supplemented with psychosocial methods, will be eligible for inclusion. Effectiveness will be assessed through the outcomes of postoperative pain intensity, analgesic requirement, perioperative anxiety, quality of life and postoperative recovery. The results of a random-effect meta-analysis will be reported. To aid implementation of best practice, moderating effects of the type and timing of psychosocial intervention, type of surgical intervention and type of anaesthesia will be evaluated through meta-regression. Sensitivity analyses and subgroup contrasts will follow as necessary. Discussion Recommendations will be made to improve medical care in orthopaedic procedures. The quality of evidence will be rated using GRADE criteria. Copyright © 2016 John Wiley & Sons, Ltd.

In this study we explored the linkage between wing size of Great Reed Warbler males (Acrocephalus arundinaceus) and their habitat selection and relate these linkages to differences in reed habitat quality. We measured the wing sizes of males nesting in 6 different reed habitats. To explain reed habitat selection, we modeled male wing size as a function of 7 predictor variables describing reedbeds: proportion of managed reed; densities of mixed, old, and fresh reed; reed stem diameter; water depth; and fluctuation of water level. Mean wing size was greatest for males at large canals, intermediate at mining ponds and smaller canals, and lowest at marshes and very small canals. The proportion of managed reed and fluctuation of water level were negatively related to wing size, and water depth was positively related to wing size, which suggests that males with larger wings preferred reed habitats with little management in deep water with little fluctuation in water level. We concluded that the availab...

Traditionally, electrodermal research measurements were taken from the non-dominant hand. This was considered a valid measurement of arousal for the whole body. Some, however argue for a complex and asynchronous electrodermal system in terms of lateral and dermatome differences in emotional responding. The present study measured skin conductance responses to emotionally laden musical stimuli from the left and right index and middle fingers, as well as the left and right plantar surface of right handed participants (N = 39). The 7-s musical segments conveyed four emotional categories: fear, sadness, happiness and peacefulness. Our results suggest, that the electrodermal system responds to emotional musical stimuli in a lateralized manner on the palmar surfaces. Fear, sadness and peacefulness prompted right hand dominance while happiness elicited left hand dominant response. Lateralization of the palmar and plantar surfaces differed significantly. Moreover, an association between lateralization of the electrodermal system in response to fear and state anxiety was found. Results of the present study suggest that the electrodermal system displays lateral preferences, reacting with varying degree of intensity to different emotions. Apart from lateral differences, music induced emotions show dermatome differences as well. These findings fit well with Multiple Arousal Theory, and prompt for revaluating the notion of uniform electrodermal arousal.

Abstract: Introduction and aim: Hip and knee replacement surgery is very demanding for patients. Medication consumption is further increased by perioperative anxiety. Besides pain killer and anxiolytic medications, patients’ recovery can be enhanced by applying therapeutic suggestions, which are easily applicable during the patient–physician communication. Method: In our prospective, randomized, controlled study we examined the effects of positive suggestions on patients undergoing hip or knee arthroplasty in spinal anaesthesia. Members of the suggestion group received the therapeutic suggestions during a pre-surgery physician visit, and by listening to an audio recording during surgery. Results: Compared to the control group (n = 50), in the suggestion group (n = 45) the need of medication (pain killer and adjuvant pain medication) during the surgery was lower (p = 0.037), the mean change from baseline in the well-being of the patients was better on the 2nd [1.31 (0.57; 2.04); p

Exploring autonomic nervous system (ANS) changes during hypnosis is critical for understanding the nature and extent of the hypnotic phenomenon and for identifying the mechanisms underlying the effects of hypnosis in different medical conditions. To assess ANS changes during hypnosis, electrodermal activity and pulse rate variability (PRV) were measured in 121 young adults. Participants either received hypnotic induction (hypnosis condition) or listened to music (control condition), and both groups were exposed to test suggestions. Blocks of silence and experimental sound stimuli were presented at baseline, after induction, and after de-induction. Skin conductance level (SCL) and high frequency (HF) power of PRV measured at each phase were compared between groups. Hypnosis decreased SCL compared to the control condition; however, there were no group differences in HF power. Furthermore, hypnotic suggestibility did not moderate ANS changes in the hypnosis group. These findings indicate that hypnosis reduces tonic sympathetic nervous system activity, which might explain why hypnosis is effective in the treatment of disorders with strong sympathetic nervous system involvement, such as rheumatoid arthritis, hot flashes, hypertension, and chronic pain. Further studies with different control conditions are required to examine the specificity of the sympathetic effects of hypnosis.

We surveyed five reed habitats (mining pond, sand pit, large canal, small canal, and lowland river) in north-western Vojvodina (Serbia) between 2009–2011 to study habitat use and to estimate nesting success in an understudied region of the breeding range of the Great Reed Warbler (Acrocephalus arundinaceus). Data from 174 nests showed that habitat use differed considerably between habitat types but was not related to the area of the study site or the reed bed. Higher than expected numbers of nests along the small canal and the river suggested that Great Reed Warblers preferred these to other habitats for nesting. Habitat use was closely linked to the availability of reed edges and the quality of the reed stand. Overall Mayfield nesting success was 43%, slightly lower than in northern and western Europe. Nesting success was low along the small and large canal, where brood parasitism by Common Cuckoos (Cuculus canorus) and nest predation were high because of the nearby presence of tree lines that p...

Az előadás a gyógyítás néhány interakciós vonatkozását taglalja, összekapcsolva az affektív pszichológia és a hipnózis alapkutatás fejleményeit két alkalmazott területtel: az orvosi kommunikációval és a perinatális tudományokkal. Amellett érvel, hogy az emberi kontaktus, a mély egymásra hangolódás, az érzelmi jelenlét a modern orvoslás kulcseleme lehet, illetve kellene, hogy legyen. A gyógyítás során tekintettel kell lenni a páciens „valahova tartozás” szükségletére. Ez a megközelítés kedvezőbb a gyógyító számára is.

A new control condition called Wiki is introduced. Key themes of each test suggestion of the Stanford Hypnotic Susceptibility Scale, Form C, were matched by a corresponding extract from Wikipedia.org. The authors compared phenomenological reports of participants across 4 conditions: hypnosis split into high and low hypnotizable subgroups, music, and Wiki condition, using the Phenomenology of Consciousness Inventory. High hypnotizables undergoing hypnosis reported higher altered experience and altered states of awareness than individuals in the Wiki condition, supporting the authors' hypothesis that the Wiki condition does not evoke an altered state of consciousness (internal dialogue, volitional control, and self-awareness did not differ). Wiki might be a viable control condition in hypnosis research given further examination.

Kutatásunkban az imaginatív tevékenység szinkronizációs folyamatának vizuális modalitását, az interakciós partnerek által átélt Vizuális Imaginatív Szinkront (rövidítve: VIS) vizsgáljuk. A VIS olyan interakciós szinkronjelenség, mely az egymásra hangolódás egy jellegzetes formáját, a képzeleti tevékenység külső megítélő által is azonosítható harmonizációját jelenti. A VIS operacionalizálási folyamata alkalmazható hipnózis és éber helyzetben egyaránt. A Vizuális Imaginatív Szinkron vizsgálatához standardizált eljárás segítségével inger-szavakat nyertünk. Az esetleges szinkronjelenségek megismeréséhez kialakítottuk a rajz és leírás együttesét alkalmazó VIS tesztet, melyet a diádok résztvevői minden egyes, interakciós helyzetenként 5 darab motívum után külön kitöltöttek. A VIS értékeket a diádok VIS tesztjeinek független megítélők hasonlóság alapján történő megítélésével határoztuk meg. A tanulmányban ismertetjük a standardizált keretek között zajló hipnózis és éber vizsgálati helyzetek eredményeit, illetve a VIS kapcsolatát további tesztekkel mért pszichológiai ismérvekkel (Képzeleti Tevékenység Kérdőív (VVIQ), Archaikus Bevonódási Skála (ABS), Phenomenology of Consciousness Inventory (PCI), Diádikus Interakciós Harmónia (DIH), Szemekből Olvasás Teszt (SZOT)). Az eredmények alapján kijelenthetjük, hogy egy új interakciós szinkronjelenséget azonosítottunk, mely megbízhatóan mérhető éber és hipnózis helyzetben egyaránt.

Kutatásunkban az imaginatív tevékenység szinkronizációs folyamatának vizuális modalitását, az interakciós partnerek által átélt Vizuális Imaginatív Szinkront (rövidítve:VIS) vizsgáljuk. A VIS olyan interakciós szinkronjelenség, mely az egymásra hangolódás egy jellegzetes formáját, a képzeleti tevékenység külső megítélő által is azonosítható harmonizációját jelenti. A VIS operacionalizálási folyamata alkalmazható hipnózis és éber szituációkban egyaránt. A Vizuális Imaginatív Szinkron vizsgálatához standardizált eljárás segítségével eltérő dimenziók mentén közepesen szóró verbális motívumokat nyertünk. Az átélt képek közötti esetleges szinkronjelenségek megismeréséhez kialakítottuk a rajz és leírás együttesét alkalmazó VIS tesztet. A standardizált keretek között zajló, egy-másfél órát igénybe vevő éber vizsgálatok során öt vizsgálati motívum kapcsán töltötték ki az interakciós felek a VIS tesztet, illetve a következőket: Képzeleti Tevékenység Kérdőív (VVIQ), Archaikus Bevonódási Skála (ABS), Phenomenology of Consciousness Inventory (PCI), Diádikus Interakciós Harmónia Kérdőív (DIH), Szemekből Olvasás Teszt (SZOT). A diádok (n= 48) VIS tesztjeinek hasonlóság alapján történő megítélésében optimális operacionalizálási eljárásnak a csoportos megítélés bizonyult, ahol minden egyes megítéltetési helyzetről három független megítélő alkotott véleményt, egy helyszínen, egymás választását nem ismerve. A megítélők saját preferenciájuk, személyiségük, beállítódásuk alapján döntöttek. A magas VIS-diád pontszámokat három új független megítélővel retesztben újramértük. A diádok 22,92%-nál találtunk reliábilisan megítélhető szinkront. A validitás vizsgálatok a VIS-nek a PCI Pozitív Érzelmek Alskálájával és a DIH Összhang Alskálájával való összefüggésére utalnak éber interakció esetén. Eredményeink alapján kijelenthetjük, hogy a VIS standardizált éber vizsgálati helyzetben külső megítélők által megbízhatóan azonosítható.

Gold nanoparticles (partially below 5 nm in diameter) were successfully deposited on hexagonal and monoclinic WO3 supports by deposition–precipitation, which had been considered previously not feasible owing to the low isoelectronic point of WO3. The catalysts were characterized by TEM, SEM, N2-adsorption, XRD, and XPS. In CO oxidation m-WO3/Au showed better catalytic activity over 100 °C than h-WO3/Au. This was explained by that m-WO3 had higher surface OH coverage, resulting in larger Au nanoparticle loading and thus better catalytic activity.

Long stay in intensive care unit (ICU) and prolonged ventilation are deleterious for subsequent quality of life and surcharge financial capacity. We have already demonstrated the beneficial effects of using suggestive communication on recovery time during intensive care. The aim of our present study was to prove the same effects with standardized positive suggestive message delivered by an MP3 player. Patients ventilated in ICU were randomized into a control group receiving standard ICU treatment and two groups with a standardized pre-recorded material delivered via headphones: a suggestive message about safety, self-control, and recovery for the study group and a relaxing music for the music group. Groups were similar in terms of age, gender, and mortality, but the SAPS II scores were higher in the study group than that in the controls (57.8 ± 23.6 vs. 30.1 ± 15.5 and 33.7 ± 17.4). Ourpost-hocanalysis results showed that the length of ICU stay (134.2 ± 73.3 vs. 314.2 ± 178.4 h) and the time spent on ventilator (85.2 ± 34.9 vs. 232.0 ± 165.6 h) were significantly shorter in the study group compared to the unified control. The advantage of the structured positive suggestive message was proven against both music and control groups.

Electrodermal activity (EDA) provides the means to gauge the activity of the sympathetic nervous system. Assessment of EDA for research purposes requires measurement systems that are sensitive to small changes in arousal in the full measurement range, collecting, storing, and monitoring data. The objective behind designing a new open-source device was to be able to measure EDA simultaneously on many subjects, monitoring their activity in real time remotely and collecting high precision data suitable for analyses. To assure feasibility of simultaneous measurements on multiple subjects, the devices must be compact and wearable, without compromising data quality. Experiments were carried out using synchronized devices in group and single subject environments. Validity of EDA measurements of Obimon was demonstrated compared to a reference system (Nexus) during a breathing exercise, a short movie, and while exposed to loud computer-generated tones, using Pearson correlation, Passing-Bablok regression, and Bland-Altman analysis. Seamless management of several Obimons and real-time visualization of EDA via Android phone/tablet application from a large number of participants was demonstrated. Based on analyses of the data collected, we conclude that the Obimon device presented here is a valid and feasible tool for collecting EDA in single or multisubject environments.

Research was conducted on ventilated patients treated in an intensive care unit (ICU) under identical circumstances; patients were divided into two groups (subsequently proved statistically identical as to age and Simplified Acute Physiology Score II [SAPS II]). One group was treated with positive suggestions for 15–20 min a day based on a predetermined scheme, but tailored to the individual patient, while the control group received no auxiliary psychological treatment. Our goal was to test the effects of positive communication in this special clinical situation. In this section of the research, the subsequent data collection was aimed to reveal whether any change in drug need could be demonstrated upon the influence of suggestions as compared to the control group. Owing to the strict recruitment criteria, a relatively small sample (suggestion group n = 15, control group n = 10) was available during the approximately nine-month period of research. As an outcome of suggestions, there was a significant drop in benzodiazepine (p < 0.005), opioid (p < 0.001), and the α2-agonist (p < 0.05) intake. All this justifies the presence of therapeutic suggestions among the therapies used in ICUs. However, repeating the trial on a larger sample of patients would be recommended.

This case report describes the way psychological support based on positive suggestions (PSBPS) was added to the traditional somatic treatment of an acute pancreatitis 36-year-old male patient. Psychological support based on positive suggestions (PSBPS) is a new adjunct therapeutic tool focused on applying suggestive techniques in medical settings. The suggestive techniques usually applied with critically ill patients are based on a number of pre-prepared scripts like future orientation, reframing, positivity, supporting autonomy, etc., and other, very unique and personalized interventions, which are exemplified with verbatim quotations. We describe the way several problems during treatment of intensive care unit (ICU) patients were solved using suggestive methods: uncooperativeness, difficulties of weaning, building up enteral nutrition, supporting recovery motivation, and so on, which permanently facilitated the patient's medical state: the elimination of gastrointestinal bleeding, recovery of the skin on the abdomen, etc. Medical effects follow-up data at 10 months show that the patient recovered and soon returned to his original work following discharge.

In a between-lab study, a constant and steady shift was found in hypnotizability scores measured with standard scales. To investigate a time effect in a Hungarian (within-lab) sample, 613 subjects’ scores on Stanford Hypnotic Susceptibility Scale, Forms A and B, 1898 subjects’ self-scores, and 1713 subjects’ observer-scores on the Harvard Group Scale of Hypnotic Susceptibility were analyzed. From the 1970s to 2010, a significant increase was observed in the SHSS:A and B scores of female subjects and the HGSHS:A scores of both genders. Females proved to be significantly more hypnotizable than males in a group setting but not in an individual context. Time and gender did not interact. The possible reasons for these effects on hypnotizability and the role of the testing context are discussed.

Changes in oxytocin and cortisol levels were tested in healthy volunteers during hypnotic interactions in standardized laboratory sessions. Pre- to posthypnosis changes of oxytocin and cortisol were related to the hypnotic susceptibility of subjects and the relational experiences reposted by subjects and hypnotists on several paper-and-pencil tests. Results show that the changes in oxytocin are not related to hypnotic susceptibility but to relational experiences. After the hypnotic interaction, the subject's oxytocin level increased if perceived harmony with the hypnotist was high, whereas it increased in the hypnotist if the subject had memories of less warm emotional relationships with his or her parents. The results are interpreted within the social-psychobiological model of hypnosis.

The paper introduces a series of articles where several detailed clinical examples will be presented on the effectiveness of using suggestive techniques in various fields of interventional medicine. The aim of this series is to raise the attention to the patients heightened openness to suggestions. By recognizing the unavoidable nature of suggestive effects on one hand we can eliminate unfavourable, negative suggestions and on the other hand go on and consciously apply positive, helpful variations. Research materials, reviews and case study will describe the way suggestions can reduce anxiety and stress connected to medical intervention, improve subjective well-being and cooperation, and increase efficiency by reducing treatment costs.

Although grasslands harbour significant biodiversity and their restoration is common in biodiversity conservation, we know very little about how such interventions influence arthropod groups. Here we compared orthopteran assemblages in croplands, natural grasslands and one to four-year-old grasslands restored in a large-scale programme in Hortobagy National Park (East Hungary). We sampled orthopterans by standardized sweep-netting both in a repeated measures design from Year 0 (croplands) to 4 and in a space-for-time substitution (chronosequence) design in 2009. Species richness, abundance and Shannon diversity of orthopterans decreased in Year 1 following restoration, but increased afterwards. By Year 4, species richness doubled and abundance increased almost ten-fold in restored grasslands compared to croplands. Species composition diversified compared to croplands and progressed towards natural grasslands. Local restoration conditions (last crop, seed mixture) and landscape configuration (proportion of natural grasslands) did not influence the above patterns in either study design, whereas time since restoration affected almost all community variables. We found that ubiquitous generalist species were the first to appear in restored grasslands and that species characteristic to the target natural grasslands colonised gradually in later years. The qualitative and quantitative properties of the orthopteran assemblages in restored fields did not yet reach those of natural grasslands, therefore, our study suggests that the full regeneration of the orthopteran assemblages takes more than four years. We also concluded that the repeated-measures design was more sensitive to subtle changes and was thus more effective than the chronosequence design at detecting post-restoration changes in orthopteran assemblages.

Research into landscape history makes it possible to follow landscape changes in the past and support landscape management, conservation and restoration programs. Floodplain habitats are lost, isolated and fragmented on account of land use. Nowadays, these habitats are threatened by modifications in the natural water regime, as well as agricultural and forestry practices. Floodplains have great importance because they provide a transition between aquatic habitats and terrestrial biotopes. Our analysis of aerial photographs and topographical maps revealed that the major predicted changes in the study area are related to agricultural abandonment and afforestation. The comparison of land cover maps from 1784 to 2005 showed intensification of agriculture with land cover conversions from arable land and orchards to grasslands, marshes and woodlands. The land use types that are mostly responsible for the fragmentation of the landscape are arable land, economic plantations and orchards. We found that fragmentation was greater after 1956. This was caused by socioeconomic changes and showed that the habitats of floodplains have changed intensively during the last 200 years. Knowledge of this last 200 years of history contributes to a more careful and wiser management of the region through biodiversity protection and environmental development.

Objective To explore the factor structure of the Maternal–Fetal Attachment Scale (MFAS) and investigate its psychosocial and demographic correlates in a Hungarian sample. Design Cross-sectional survey. Setting Sonography clinic in a metropolitan area. Participants One hundred fourteen women over the age of 18 years in the second or third trimesters of pregnancy. Methods Participants completed the Hungarian version of the MFAS and provided information on demographic, socioeconomic, and pregnancy-related factors. Results The internal consistency of the MFAS total scale was acceptable (Cronbach's alpha=.87). However, the reliability of the five subscales was low (alpha coefficients between .57 and .74), and the original five-factor model was not supported by the factor analyses. Married mothers had higher scores on the MFAS than participants who were unmarried, and uncertainty about the sex of the fetus was associated with lower attachment scores. Furthermore, gestational age showed a positive correlation with MFAS scores. No significant association was found between the total score on the MFAS and such factors as age, income, or education of the parents; whether the pregnancy was planned; method of conception; number of children born previously; prior perinatal losses; and circumstances of the mother's own birth. Conclusion Our study showed that marital status, uncertainty about the sex of the fetus, and gestational age were associated with maternal–fetal attachment; however, more detailed analysis was not possible because of the instability of the subscales of the instrument. Further research is warranted on the underlying factors related to maternal–fetal attachment.

Pain and anxiety are commonly reported among those undergoing orthopaedic surgery. Improvement in anxiety and pain control might be achieved by supplementing standard care with psychological interventions. However, the effectiveness of adjunctive psychosocial interventions in anxiety and pain control have not been addressed sufficiently by previous systematic reviews in orthopaedic surgeries. The present study aimed to assess the effectiveness of adjunctive psychosocial techniques to improve perioperative clinical care in orthopaedic surgery, to identify the most effective intervention types and to evaluate potential moderators.We will perform a systematic review and meta-analysis to address the study aims. PubMed, PsycINFO, CINAHL and ProQuest DissertationsTheses will be searched between 1980 and 2015. Prospective controlled clinical trials completed in adults, contrasting standard care and standard care supplemented with psychosocial methods, will be eligible for inclusion. Effectiveness will be assessed through the outcomes of postoperative pain intensity, analgesic requirement, perioperative anxiety, quality of life and postoperative recovery. The results of a random-effect meta-analysis will be reported. To aid implementation of best practice, moderating effects of the type and timing of psychosocial intervention, type of surgical intervention and type of anaesthesia will be evaluated through meta-regression. Sensitivity analyses and subgroup contrasts will follow as necessary.Recommendations will be made to improve medical care in orthopaedic procedures. The quality of evidence will be rated using GRADE criteria. Copyright © 2016 John WileySons, Ltd.

Images evoked immediately before the induction of anesthesia by means of suggestions may influence dreaming during anesthesia. This study is a retrospective re-evaluation of the original prospective randomized trial. Dream reports were studied in two groups. In group 1. dreams of patients who received suggestions, and in group 2, those of the control group of patients who did not. The incidence of dream reports and the characteristics and the theme of the reported dreams were compared among the groups. In general, the control and the psychological intervention groups were different in terms of dreaming frequency, and non-recall dreaming. The incidence of dream reports was significantly higher in the suggestion group (82/190 at 10 min and 71/190 at 60 min respectively) than in the control group (16/80 at 10 min and 13/80 at 60 min, respectively; p10 = 0.001 and p60 = 0.002). There were no differences in the nature (thought- like or cinematic), quality (color or B&W) and the mood (positive vs. negative) of the recalled dreams. In general, the contents of the imaginary favorite place and the reported dream were identical in 73.2 %. Among the topics most successfully applied in the operating theater were loved ones (83.8 %), holiday (77.8 %) and sport (63.6 %). The results of the present study suggest that dreams during anesthesia are influenced by suggestions administered immediately preceding anesthesia. The study was registered in ClinicalTrials.gov. Identifier: Q1 NCT01839201 , Date: 12 Apr. 2013.

Hexagonal (h-) and monoclinic (m-) WO3 nanoparticles with controlled composition (oxidized/yellow color or partially reduced/blue color) were prepared through annealing (NH4)xWO3−y. The formation, structure, composition, morphology, and optical properties of the samples were analyzed by powder X-ray diffraction, scanning and transmission electron microscopy combined with electron diffraction, and Raman, X-ray photoelectron, 1H magic angle spinning nuclear magnetic resonance, diffuse reflectance ultraviolet–visual, and photoluminescence spectroscopy. Their photocatalytic properties were tested by decomposing methyl orange in the aqueous phase and acetone in the gas phase. Oxidized m-WO3 (m-WO3 ox) was the most active photocatalyst both in the aqueous and in the gas phase, followed by the oxidized h-WO3 (h-WO3 ox) sample. Reduced h-WO3 (h-WO3 red) and m-WO3 (m-WO3 red) exhibited much lower activity. Thus, in contrast to TiO2, where crystalline structure (rutile or anatase) plays a key effect in photocatalysis, for WO3, it is the composition that is of greatest importance: the more oxidized the WO3 sample, the better a photocatalyst it is. The crystal structure of WO3 has only an indirect effect, in that it influences the composition of WO3 samples. While oxidized m-WO3 is completely oxidized, oxidized h-WO3 is always in a partially reduced state due to the presence of stabilizing positive ions in its hexagonal channels. Consequently, an oxidized monoclinic WO3 material will always provide better photocatalytic activity than an oxidized hexagonal one.