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The rise of artificial intelligence (AI) is not going unnoticed in the agricultural sector. The processing of the large amounts of data (’big data’) generated in animal production is increasingly being done using artificial intelligence, particularly machine learning (ML). Machine learning is a branch of AI, in which algorithms are automatically trained to solve a task of interest using a given dataset. There are several sub-areas of ML, of which we focus on artificial neural networks (ANNs), the most successfully used in agriculture. The basic units of an ANN are artificial neurons. These are connected to each other similarly to synapses in the brain, forming a network. ANNs can be considered complex mathematical models that can make predictions from given data after a learning process, taking into account millions of parameters. Because they are pretty flexible, these networks have a wide range of applications in many fields. One such field is a subset of agriculture, namely animal production. In our work, we outline the general structure and operation of ANNs. We provide insight into the metrics widely used to indicate the accuracy of prediction and their calculation methods. Possible applications are illustrated with examples specifically from the field of food production. The wide range of applications is illustrated by the fact that the works cited also respond to the challenges faced by aquacultures and beekeepers, in addition to the problems of cattle, pig and poultry farms. Despite their many good features, ANNs cannot solve all problems, regardless of type. Therefore, in our work we also concern about the limitations of the method. Our work contributes to the definition of artificial intelligence, machine learning, and artificial neural networks in the context of agriculture.

A tanulmány célja az automatizált szoftvertesztelés elméleti és gyakorlati hatékonyságának vizsgálata. Ehhez felmérjük, milyen szempontok szerint érdemes automatizált tesztelői szoftvert választani, valamint rávilágítunk, milyen esetekben hatékonyabb az automatizált tesztelés a manuális teszteléssel szemben. Előbb elméleti síkon vetjük össze a két tesztelési módszertant, majd egy valós üzleti esettanulmányon keresztül mutatjuk be a tesztelői szoftver kiválasztását és végzünk el egy gyakorlati összehasonlító elemzést. Öt automata tesztrendszer összehasonlítása alapján kiderül, hogy az alapvető technológiai és gazdasági követelményeken felül a rugalmasság és a megbízhatóság is kiemelkedő szempont a kiválasztási folyamatban. A tanulmányból kiderül az is, hogy az automatizálás csak ismétlődő tesztelések esetén lehet hatékony. Egy legalább tíz ügyféllel rendelkező szoftvergyártónak azonban megéri az automatizált tesztelés irányába mozdulni.

The antiviral state, an initial line of defense against viral infection, is established by a set of IFN-stimulated genes (ISGs) encoding antiviral effector proteins. The effector ISGs are transcriptionally regulated by type I IFNs mainly via activation of IFN-stimulated gene factor 3 (ISGF3). In this study, the regulatory elements of effector ISGs were characterized to determine the (epi)genetic features that enable their robust induction by type I IFNs in multiple cell types. We determined the location of regulatory elements, the DNA motifs, the occupancy of ISGF3 subunits (IRF9, STAT1, and STAT2) and other transcription factors, and the chromatin accessibility of 37 effector ISGs in murine dendritic cells. The IFN-stimulated response element (ISRE) and its tripartite version occurred most frequently in the regulatory elements of effector ISGs than in any other tested ISG subsets. Chromatin accessibility at their promoter regions was similar to most other ISGs but higher than at the promoters of inflammation-related cytokines, which were used as a reference gene set. Most effector ISGs (81.1%) had at least one ISGF3 binding region proximal to the transcription start site (TSS), and only a subset of effector ISGs (24.3%) was associated with three or more ISGF3 binding regions. The IRF9 signals were typically higher, and ISRE motifs were “stronger” (more similar to the canonical sequence) in TSS-proximal versus TSS-distal regulatory regions. Moreover, most TSS-proximal regulatory regions were accessible before stimulation in multiple cell types. Our results indicate that “strong” ISRE motifs and universally accessible promoter regions that permit robust, widespread induction are characteristic features of effector ISGs.

Functional conditions like lung function and exercise capacity are important limiting factors of chest surgery in lung cancer with co-morbidities (chronic obstructive pulmonary disease (COPD) and other chronic respiratory diseases). Pulmonary rehabilitation has a favourable effect on the cardiovascular system, metabolism, respiratory and peripheral muscles and lung mechanics. Our aim was to assess the role of pre-, post- and peri-operative pulmonary rehabilitation in lung cancer in this review. We sought to size up the importance of pulmonary rehabilitation in patients undergoing surgery with or without (neo)adjuvant treatment, radiotherapy, chemotherapy, chemoradiotherapy, major physiological impairments and complications. Searches were performed in PubMed and ClinicalTrials.gov databases using the terms “exercise”, “rehabilitation”, “small cell lung cancer”, “non-small cell lung cancer”, “exercise capacity”, “chest surgery” and “quality of life” from inception to February 7th, 2022. Pulmonary rehabilitation has been recognized as an effective intervention to reduce lung cancer related symptoms and improve the pulmonary function, lung mechanics, chest kinematics, respiratory- and peripheral muscle function, physical activity and quality of life (QoL) of the patients. In conclusion, this review shows positive, highly encouraging and effective results of pulmonary rehabilitation in terms of the patients' lung function, functional mobility and quality of life. The tools for complex pulmonary rehabilitation have evolved considerably over the past two decades, thus this research has been conducted on a variety of studies about this subject and serves as a synthesis of the systematic and meta-analytic reviews.

Sub-clinical mastitis (SM) is the most economically damaging yet often visually undetectable disease of dairy cows. Early detection and treatment can reduce the loss caused by the disease, thus, the continuous improvement of SM diagnostic methods is necessary. Albeit, the somatic cell count (SCC) of milk is commonly measured for diagnostic purposes, its direct determination is not widely used in everyday practice. The primary objective of our work was to investigate whether the predictive value of SM diagnostics can be improved by training artificial neural networks (ANNs) on data generated using common milking machines. The best ANN classifier had a sensitivity of 0.54 and a specificity of 0.77, which is comparable to the performance of several California Mastitis Tests (CMT) in the literature. Combining two diagnostic tests, ANN and CMT, we concluded that the positive predictive value could be up to 50% higher than the value provided by the individual CMT. While the implementation of CMT is a labor-intensive process, in milking parlors where milk or milk yield data can be measured automatically, similar to our work, SCC-gain predictions for all individuals could be obtained on a daily basis.

Gas chromatography (GC) is an effective tool for the analysis of complex mixtures with a huge number of components. To keep tracking the chemical changes during the processes like plastic waste pyrolysis usually different sample states are profiled, but retention time drifts between the chromatograms make the comparability difficult. The aim of this study is to develop a fast and simple method to eliminate the time drifts between the chromatograms using easily accessible priori information. The proposed method is tested on GC chromatograms obtained by analysis of pyrolysis product (Mg/Y catalyst) of shredded real waste HDPE/PP/LDPE mixture. A modified k-means algorithm was developed to account the retention time drifts between samples (different sample states). The outcome of the retention time alignment is an averaged retention time for each peak from all the chromatograms which makes the comparison and further analysis (such as "fingerprinting") easier or possible.

Nowadays, since the demand for engine fuels is continuously changing, in petroleum refineries, increasing the flexibility of gasoline/middle distillate is still an important issue, e.g. by oligomerizing light olefins (3–6 carbon atoms). The aim of our work was to develop a valid kinetic model based on the extended Eley-Rideal mechanism to describe the oligomerization of the olefin content of light naphtha by fluidized catalytic cracking (FCC) on an ion-exchange resin. Experiments were carried out in a fixed-bed tubular reactor at temperatures of between 80 and 130 °C with liquid hourly space velocities (LHSV) of between 0.5 and 2.0 1/h using Amberlyst® 15 as a catalyst. The oligomerization process was characterized based on the composition of products determined by gas chromatography. The conversion of olefins and the selectivity of the oligomerization reactions forming C8-11 and C12+ hydrocarbons (C8-11 and C12+ selectivity; unit: relative %) were dependent on factors that determine the reactor performance in order to identify the kinetic model parameters. Given that the developed reactor model described the measured data reasonably accurately, it can be used in terms of the optimal design of an industrial oligomerization reactor.

The most widely used dating techniques in quaternary research are the radiocarbon (14C) and optically stimulated luminescence (OSL) dating methods. In some environments, the investigated sediments do not contain enough material for 14C dating. In these cases, 14C dating of bulk sediment may be used as a last resort. The major aim of the present study was to determine the reliability and limitations of the different fractions of the soil organic carbon (SOC) 14C ages in the Nyírség blown-sand study area, in Hungary. Therefore, the low- and high-temperature combustions of SOC (LT-SOC and HT-SOC) 14C age of fossil soils were compared with the charcoal ages from the same fossil soil layer, and their (LT-SOC, HT-SOC, and charcoal) age reliability was verified independently by applying OSL to the quartz fraction of the sediment samples. The 14C data show variable agreement with OSL ages. Charcoal fragments were collected from some of the best material for 14C dating and their ages are in agreement with the LT and HT-SOC 14C ages and OSL data. The 14C age LT-SOC gives a reliable, credible ages, which were confirmed by independent OSL measurements. If buried soils do not contain any other macroscopic remnants for 14C dating, the LT-SOC 14C ages can be used, in the case of the Nyírség study area. The LT-SOC, which is the younger fraction of the soil organic carbon, may be considered to represent the burial time of the fossil soil layer. The HT-SOC 14C ages are sometimes unrealistically older than expected and cannot be considered to be reliable.

The method of determining the biobased carbon content in liquid fuel samples is standardized, but different laboratories use different protocols during sample preparation and perform the measurements using different machines. The accelerator mass spectrometry (AMS) laboratories use different combustion, preparation, and graphitization methods for the graphite production for the spectrometric measurements. As a result, the intercomparison between the laboratories is inevitable to prove precision and accuracy and to demonstrate that the results are comparable. In this study, we present the results of an intercomparison campaign involving three C-14 accelerator mass spectrometry laboratories. Five samples were used in the measurement campaign, including two biocomponents (fatty acid methyl ester, hydrotreated vegetable oil), one fossil component (fossil diesel), and two blends (mixtures of fossil and biocomponent with 90-10% mixing ratio) in the laboratories of CEDAD (Italy), ETH (Switzerland), and INTERACT (Hungary). The results presented by the laboratories are comparable, and all three laboratories could determine the biobased carbon content of the samples within 1% relative uncertainty, which is acceptable in the scientific, economic, and industrial fields for biocomponent determination., Radiocarbon, 65 (2), ISSN:0033-8222

Bevezetés: A mikrobiom (az emberi szervezetben élő mikrobák összessége) több milliárd mikroorganizmusból áll, a benne élő fajok diverzitása és épsége döntő szerepet játszik a gazdaszervezet egészségének fenntartásában. A bél mikrobiom össztömege akár a két kilogrammot is elérheti, kb. egyharmada (30%-a) nagy hasonlóságot mutat a fajok között, azonban 70%-a abszolút egyedi azonosító csakis ránk jellemző, mint az ujjlenyomat. Kutatások leírják, hogy a bélflóra összetétele közvetlen kapcsolatban áll számos betegséggel pl. anyagcserezavarokkal, elhízással, szív- és érrendszeri betegségekkel, depresszióval, asztmával stb. Összefoglaló tanulmányunk célja a mikrobiom és módosulásának bemutatása, valamint a bél mikrobiom megváltozásával összefüggő betegségek áttekintése, továbbá a táplálkozáson, testmozgáson keresztüli pozitív irányú befolyásolása az egészségfejlesztés tekintetében. Módszertan: Hazai és nemzetközi orvostudományi adatbázisok áttekintése mikrobiom, betegségkockázat, diszbiózis és probiotikum keresőszavakkal. Eredmények: A mikrobiomnak fontos szerepe van az immunrendszer szabályozásában és számtalan betegség kialakulásában azonosították additív tényezőként pl. gyulladásos bélbetegségek, metabolikus eltérések (pl. elhízás, inzulinrezisztencia, cukorbetegség), autoimmun betegségek, neurológiai kórállapotok (pl. autizmus, Parkinson-kór, Alzheimer-kór), daganatos betegségek (pl. mellrák, vastagbélrák, májrák) esetében. A környezeti tényezők, a szisztémás gyulladás, a betegségek előfordulásának növekedése, és az ezzel együtt járó gyógyszerszedés megváltoztatja a mikrobiális közösség összetételét, melyet a fizikai inaktivitás és a bélrendszeren történő áthaladási idő megnövekedése még tovább fokoz. Az idősödéssel és a társuló betegségekkel az olyan kedvező baktériumok, mint a Laktobacillusok és Bifidobaktériumok száma csökken, míg a fakultatív anaerobok (Enterobacteriaceae, Streptococcusok,Staphylococcusok) száma nő, mely pozitív irányba befolyásolható egészséges életmóddal, táplálkozással és fizikai aktivitással. Következtetések: Feltételezhető, hogy a bél mikrobiom számos bélrendszeri és bélrendszeren kívüli kórkép patofiziológiájában központi szerepet tölt be. A mikrobiom-kutatás eddigi eredményei alapján elmondható, hogy a testben élő ökoszisztéma egészségünk alapja és mindent meg kell tennünk épségének megőrzése érdekében, mert egészséges életmóddal, megfelelő táplálkozással és mozgással összetétele pozitív irányba befolyásolható és kulcsszerepet tölt be az egészségfejlesztésben.

Összefoglaló. A COVID–19-fertőzésen átesett betegek közül többen elhúzódó panaszokról számolnak be a felépülést követően, sokaknál tartósan fennáll a köhögés, a nehézlégzés, a mellkasi fájdalom, a légszomj attól függetlenül, hogy enyhe vagy súlyosabb tüneteket okozott a koronavírus. A betegek erőtlennek érzik magukat, erős fáradtságérzetre panaszkodnak, míg mások gyomor-bél rendszeri panaszokra, fejfájásra, depresszióra, a szaglás- és ízérzékelés elvesztésére. Számtalan kutatás leírja, hogy a fertőzés még akár hónapokkal később is hatással lehet a tüdő működésére, és korábban egészséges tüdőn is látható a koronavírus-fertőzés a gyógyulás után három hónappal készült kontroll-mellkas-CT-leleten. Éppen ezért szükség van a fertőzés lezajlását követően tüdőgyógyászati kivizsgálásra, ha a betegnek elhúzódó panaszai vannak, vagy ha a betegség tüdőgyulladást okozott. Szükség van a jelenleg működő fekvőbeteg-légzőszervi rehabilitáció mellett a kezelés ambuláns kiterjesztésére is, melynek célja újabb kórházi ápolás nélkül a teljes gyógyulás elérése a betegeknél. A COVID–19-fertőzésen átesett betegeknél a komplex rehabilitáció hatására javul a terhelhetőség, az életminőség, javulnak a légzésfunkciós értékek, csökkennek a panaszok, javul a betegek fizikai és pszichikai állapota. Összefoglaló kutatásunk célja áttekinteni, hogy milyen COVID–19 ambuláns rehabilitációs programok indultak el a koronavírus-fertőzésen átesett betegek esetében nemzetközi és hazai színtereken. Orv Hetil. 22021; 162(42): 1671–1677. Summary. Several patients with COVID-19 infection report prolonged complaints after recovery and many of them suffer from persistent cough, dyspnea, chest pain and shortness of breath regardless of whether the coronavirus caused mild or more severe symptoms. They complain of severe fatigue and weakness while others grizzle about gastrointestinal complaints, headache, depression, loss of sense of smell and taste. Numerous studies describe that the infection can affect lung function even in months and coronavirus infection can be detectable in previously healthy lungs by taking a control chest CT scan three months after recovery. Therefore, chest follow-up is required after the infection if the patient has prolonged complaints or if the disease has caused pneumonia. In addition to the currently operating inpatient respiratory rehabilitation, there is also a need for an outpatient extension of treatment to achieve complete recovery in patients without further hospitalization. For those patients who have had the COVID-19 infection complex rehabilitation can improve their workload, quality of life, improves their respiratory function values, reduces their complaints and also improves their physical and mental condition. The aim of our summary research is to review what COVID-19 outpatient rehabilitation programs have been initiated for patients who went through coronavirus infection on international and domestic scenes. Orv Hetil. 2021; 162(42): 1671–1677.

We adapt the concept of evolutionary stability to familial selection when a game theoretic conflicts between siblings determines the survival rate of each sibling in monogamous, exogamous families in a diploid, panmictic population. Similarly to the classical evolutionary game theory, the static condition of evolutionary stability of mixed Nash equilibrium implies the local stability of the genotype dynamics, in spite of that the mating table based genotype dynamics is not a replicator dynamics.We apply our general result to the case where a matrix game determines the survival rate of siblings. In our numerical studies we consider the prisoner’s dilemma between siblings, when the cooperator and defector behaviour are unequally determined by a recessive-dominant allele pair at an autosomal locus. When the prisoner’s dilemma game is strict (cf. iterated one) and the cooperator phenotype is recessive resp. dominant, then the cooperator and defector phenotypes are the unique stable phenotypes, respectively. When the prisoner’s dilemma game is not strict, both phenotypes coexist, independently of the genotype-phenotype mapping. However, the frequencies of the phenotypes are different according to which phenotype is dominant.

Bovine adenoviruses (BAdV) are known to cause respiratory and/or intestinal disease in calves. Infection can manifest as acute outbreaks, but more often only sporadic cases occur. Here we describe the PCR detection and partial sequence characterization of several BAdVs found in sick or dead calves on different farms in Western Hungary. Intermittent diarrhoeal illnesses occurred after weaning among calves on several farms located up to 40 km apart. A high-sensitivity, broad-spectrum nested PCR, developed for the general detection of adenoviruses, gave positive results in four independent cases. Direct sequencing of PCR products showed clear results from only two samples, whereas sequences from the other two amplicons were mixed. Molecular cloning of these heterogeneous PCR products was performed to separate each DNA fragment therein. By sequencing several plasmid clones from both mixed samples, we were able to detect the simultaneous presence of two different BAdV types, namely types 6 and 10 classified into two separate (Atadenovirus and Mastadenovirus) genera. The sequence of one homogenous sample was identified as being derived also from BAdV-10, whereas the other sample contained a novel type, proposed to be BAdV-11. We demonstrated, for the very first time, the occurrence of the two latter virus types in continental Europe. Their appearance in Hungary marks a significant shift in the types of BAdVs actually circulating in the country. Considering the similarity of the pathological findings to those, attributed to BAdV-10 infections reported to date, the causative role of the viruses in these cases seems to be plausible. Phylogeny reconstruction further confirmed that BAdVs represent multiple genetic lineages.

Summary Background Asthma and chronic obstructive pulmonary diseases are conditions characterized by a variable progression. Some individuals experience longer asymptomatic periods while others acute worsening periods and/or exacerbations triggered by symptom multiplication factors. Medications are adjusted to the patients’ respiratory function, self-assessment of health and emerging certain physical changes. A more effective treatment may be applied by real-time data registered during the patient’s everyday life. Aim and methods Introducing new modern digital technology in pulmonary rehabilitation (PR) to help tracking the patients’ medication, thus we systematically reviewed the latest publications on telemedicine and pulmonary telerehabilitation. Conclusion The use of the latest digital technologies in PR is very exciting and offers great opportunities while treating patients affected by specific conditions. On the one hand, adherence to medication can be improved in patients with chronic respiratory diseases by using these new state of the art devices; on the other hand, digital devices will also be able to monitor various physiological parameters of patients during their usual everyday activities. Data can be stored on a smartphone and shared with the provider. Relying on this information, physicians will be able to tailor medications and dosage to the specific needs of individual patients. Telerehabilitation may be a sustainable solution to the growing burden of chronic respiratory disease worldwide. However, PR must keep its cornerstones, such as education and motivations, which are most successful when conducted in person. Many issues remain to be resolved in the future, e.g. cybersecurity while using smart devices since they offer unique opportunities for PR.

BackgroundChronic obstructive pulmonary disease (COPD) is the fourth most frequent disease globally, and its worldwide prevalence is projected to increase in the following decades. Health-related quality of life (HRQOL) of COPD patients depends on multiple factors.ObjectiveThe aim of this study was to identify the most important risk factors affecting HRQOL of COPD patients and to measure how specific clinical parameters can predict HRQOL.MethodsA questionnaire-based cross-sectional study combined with clinical data was conducted among patients diagnosed with COPD (n = 321, 52.6% females, mean age 66.4 ± 9.5) at the National Koranyi Institute for Pulmonology, Budapest in 2019–2020. The inclusion criteria were age ≥40 years and existing COPD. Multivariate linear regression analyses were conducted on three components of the COPD-specific Saint George's Respiratory Questionnaire (SGRQ-C) and on the physical (PCS) and mental component scales (MCS) of the 36-Item Short Form Health Survey (SF-36). Multiple linear regression analysis was performed to evaluate the effects of patient and disease characteristics on COPD Assessment Test (CAT) scores.ResultsWe found that frequent exacerbations, multiple comorbidities and tobacco smoking were associated with worse HRQOL. Engaging in more frequent physical activity and better 6-minute walking distance results were associated with better HRQOL.ConclusionsOur results indicate that the complex therapy of COPD should focus not only on improving lung functions and preventing exacerbation, but also on treating comorbidities, encouraging increased physical activity, and supporting smoking cessation to assure better HRQOL for patients.

Introduction: Pulmonary rehabilitation (PR) is beneficial for lung mechanics, chest kinematics, metabolism, and inspiratory and peripheral muscle function. Freediving training (FD) can be effective in sportsmen and can improve breath-holding time. Aims: We sought to determine the effectiveness of freediving training in the pulmonary rehabilitation of COPD patients. Patients and methods: Twenty-three COPD patients (15 men and 8 women; median age 63 years; FEV1: 41% pred; BMI: 28 kg/m2) participated in the FD + PR group (3 weeks PR and 3 weeks FD + PR) and 46 patients with COPD (25 men and 21 women; median age 66 years; FEV1: 43% pred; BMI: 27 kg/m2) participated in an inpatient PR program (6 weeks). Patients performed comfort zone breath holding for 30 min/day. Patients increased their breath-holding time within their comfort zone for 30 min. We detected lung function, chest expansion (CWE), inspiratory muscle pressure (MIP), peripheral muscle function (GS), and exercise capacity (6MWD), and we included breath-holding time (BHT), quality of life score (COPD Assessment Test (CAT)), modified Medical Research Dyspnea Scale (mMRC) score, and the severity of the disease assessed by the BODE index (FEV1, BMI, 6MWD, and mMRC) and an alternative scale (FEV1, BMI, 6MWD, and CAT). Result: There were significant differences in the characteristics of the two groups. Significant improvement was detected in all functional and quality of life parameters except lung function in both groups. Significantly higher improvement was detected in CWE, GS, 6MWD, BHT, CAT, mMRC, alternative scale, and MIP. The improvement in forced vital capacity (FVC) was not significant. There were no side effects of FD training. Conclusion: The FD method can potentiate the effect of PR, improving not only BHT but also other parameters. Trial registration: ISRCTN ISRCTN13019180. Registered 19 December 2017.

The intracerebroventricularly (icv) injected streptozotocin (STZ) induced brain state is a widely used model of sporadic Alzheimer-disease (AD). However, data have been generated in young, naive albino rats. We postulate that the translationally most relevant animal population of an AD model should be that of aged rats with substantial learning history. The objective of the study was thus to probe the model in old rats with knowledge in various cognitive domains. Long-Evans rats of 23 and 10 months age with acquired knowledge in five-choice serial reaction time task (5-CSRTT), a cooperation task, Morris water-maze (MWM) and “pot-jumping” exercise were treated with 3 × 1.5 mg/kg icv. STZ and their performance were followed for 3 months in the above and additional behavioral assays. Both STZ-treated age groups showed significant impairment in the MWM (spatial learning) and novel object recognition test (recognition memory) but not in passive avoidance and fear conditioning paradigms (fear memory). In young STZ treated rats, significant differences were also found in the 5CSRTT (attention) and pot jumping test (procedural learning) while in old rats a significant increase in hippocampal phospho-tau/tau protein ratio was observed. No significant difference was found in the cooperation (social cognition) and pairwise discrimination (visual memory) assays and hippocampal β-amyloid levels. STZ treated old animals showed impulsivity-like behavior in several tests. Our results partly coincide with partly deviate from those published on young, albino, unexperienced rats. Beside the age, strain and experience level of the animals differences can also be attributed to the increased dose of STZ, and the applied food restriction regime. The observed cognitive and non-cognitive activity pattern of icv. STZ in aged experienced rats call for more extensive studies with the STZ model to further strengthen and specify its translational validity.

BACKGROUND In severe chronic obstructive pulmonary disease (COPD), interval training (IT) can be performed with oxygen support, which provides beneficial effect on metabolic processes, tissue perfusion, and peripheral muscle function. METHODS A prospective cohort study with matched controls was performed on patients in Budapest at the Department of Pulmonary Rehabilitation of the National Koranyi Institute of Pulmonology between January 1, 2020 and March 1, 2020. After a complex condition assessment, both case and control patients participated in a 3-week long complex pulmonary rehabilitation (PR) program that included individual training, education, nutrition, and psychological counseling. Anthropometric and functional data of patients were recorded at both the beginning and end of the PR program. Our research aimed to assess the effect of non-invasive ventilation (NIV) in patients with severe COPD who underwent IT. RESULTS A total of 18 [male/female: 10 (55.6%)/8 (44.4%)] patients were enrolled in our study. IT with NIV significantly improved the patients' 6-minute walking distance (6MWD) (m) [216.0 (211.5-233.7) vs. 274.0 (247.5-313.5); P