Two children with C. difficile infection had no recurrence during follow-up. The child with fulminant infection achieved remission by day 14 and remained recurrence-free at one year. The child with Crohn’s disease and severe infection returned to her pre-infection stool pattern by day 14 and also remained free of C. difficile recurrence at one year. These were individual outcomes in a small case series rather than evidence of a general treatment effect.

The first patient received fecal microbiota transplantation through a nasojejunal or nasogastric tube after developing fulminant C. difficile infection that had not responded to treatment. The procedure was associated with remission by day 14 in the reported clinical course, followed by no recurrence through the one-year observation period. Because the report included no comparator, it cannot determine how much of the outcome was attributable to transplantation or how the result would compare with other care.

The second patient was a girl with Crohn’s disease and severe, treatment-refractory C. difficile infection. She received transplantation by colonoscopy and returned to her pre-infection stool pattern by day 14. She remained free of C. difficile recurrence at one year. The report provides evidence that transplantation was delivered in this selected paediatric case, but it does not establish efficacy for Crohn’s disease or for severe C. difficile infection more generally.

The third child was treated for pan-refractory acute gastrointestinal graft-versus-host disease. Transplantation was delivered in lyophilised oral capsules, and the child achieved complete clinical control of the gastrointestinal condition by day 14. The child died on day 50 from haemorrhagic complications of cerebral fungal infection. No adverse event was judged directly attributable to fecal microbiota transplantation, but donor-derived transmission of the fatal fungal infection could not be definitively excluded.

That unresolved possibility limits interpretation of the third case. Improvement in the acute gastrointestinal manifestations occurred before the fatal infection, but the sequence does not establish whether transplantation contributed to the infection. The investigators therefore documented both the observed control of graft-versus-host disease and the uncertainty surrounding the source and route of the fungal infection.

The fourth child had IPEX syndrome and intestinal carriage of multidrug-resistant organisms. In this case, decolonisation was the therapeutic aim rather than treatment of a gastrointestinal disorder. Initial transplantation with lyophilised oral capsules did not eliminate carriage by day 14. The procedure was repeated on day 60, after which cultures were negative on days 90 and 365.

Administration methods varied according to the individual case. Nasojejunal or nasogastric tubes and oral capsules were used for three children, while one child received transplantation by colonoscopy. The routes, diagnoses, clinical objectives and outcomes were not uniform, making direct comparisons among the four cases inappropriate. The report also combined conditions for which the intended outcomes differed, from infection remission and clinical control to microbiological decolonisation.

The investigators described no adverse event as directly caused by transplantation. Nevertheless, the case series does not establish the procedure’s safety or efficacy across severe gastrointestinal disorders because it included only four children, no comparator group and several distinct treatment goals. The authors concluded that larger controlled studies are required to assess patient selection and long-term outcomes. The findings are therefore preliminary observations from selected cases, not proof of routine benefit or safety.

Subject of Research: One-year clinical outcomes of fecal microbiota transplantation in four seriously ill children treated for severe gastrointestinal disorders or multidrug-resistant organism carriage.

Article Title: Fecal microbiota transplantation in children with severe gastrointestinal disorders: the first Hungarian paediatric experience with 1-year follow-up

Article References: SZABÓ, B. G., KORÓZS, D., PETRIK, B. R., HAJÓSI-KALCAKOSZ, S., CZELECZ, J., TAKÁCS, L., VISNYOVSZKI, Á., CSORDÁS, K., KASSA, C., DEÁK, Á., BEDNÁRIK, D. S., HORVÁTH, M., KRIVÁN, G., & KÁLLAY, K. (2026). Fecal microbiota transplantation in children with severe gastrointestinal disorders: the first Hungarian paediatric experience with 1-year follow-up. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07901-4

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07901-4

Keywords: fecal microbiota transplantation, paediatric gastroenterology, Clostridioides difficile, Crohn’s disease, graft-versus-host disease, IPEX syndrome, multidrug-resistant organisms, case report, Hungary, microbiome therapy, Fecal, microbiota

The study combined the capture, examination, photography, measurement and release of the snake with a compilation of published, social-media and database records of albino Aesculapian snakes in Europe. It was an observational wildlife record rather than a controlled animal experiment or population study. The report did not estimate the prevalence of albinism in wild snakes or test its causes.

The snake was observed and captured by Krisztián Halász at 7:26 a.m. local time on 22 May 2025. The male was pale yellowish to light pink, with white or yellowish mottled or blotched patterns along its dorsal surface. Its underside was distinctly yellow, its head had a pinkish hue, and a yellow or cream crescent-shaped blotch marked each side of its neck. Its eyes were conspicuously red.

Albinism in reptiles is marked by an absence of melanin production even though chromatophores are present and functioning normally. The lack of melanin can produce white or very pale skin, while its absence from the iris allows underlying blood vessels to show through, giving the eyes a pink or reddish appearance. The red eyes observed in the Vácrátót snake helped distinguish albinism from other melanin deficiencies.

Halász used a measuring tape and a digital balance to record a snout–vent length of 720 mm, a tail length of 125 mm and a body mass of 97 g. Based on its size, dorsal pattern and the crescent-shaped neck blotches, the researchers classified the individual as a subadult and estimated its age at two to four years. After photographs and measurements were taken, the snake was released at the site where it had been captured.

The report stated that four observations of Z. longissimus had been made in the National Botanic Garden over the preceding five years, including the 2025 albino male. The first was documented by Halász on 20 July 2020, when an individual was found on a dirt road after being struck by a vehicle. A second snake was observed in 2022 but was neither captured nor photographed, and Csongor Halász recorded another unphotographed observation on 15 July 2024. The report did not provide photographs or measurements establishing the pigmentation status of those three earlier observations.

The authors suggested that the garden’s relative isolation, potentially influenced by urbanization barriers, and its status as a well-protected area with reduced predation may have contributed to the concentration of records there. These were proposed explanations rather than demonstrated causes; the observation did not directly test either factor or establish a site-specific prevalence of albinism.

The regional review found previously reported albino Z. longissimus in Austria, Bosnia and Herzegovina, Italy, Serbia, Slovakia and Slovenia. It also compiled image-based Hungarian observations from Szekszárd in 2017, Abasár in 2020 and Medina in 2021, with the observers’ permission to include their photographs. A review of 1,158 Z. longissimus observations in iNaturalist on 10 July 2025 identified no albino individuals in that Hungarian dataset. Broader European examples compiled by the authors included a Vipera berus in Slovakia, a partially albino Natrix natrix in the Czech Republic, a completely albino Natrix natrix in Romania and partial albinism in Natrix tessellata.

By documenting the Vácrátót observation and consolidating regional records, the report extended the known geographic record of albinism in Z. longissimus. The authors said that such documentation can provide a foundation for future studies of its prevalence and underlying causes in natural populations.

Subject of Research: First reported albino Aesculapian snake in Hungary and a compilation of European records

Article Title: First records of albino Aesculapian snakes ( Zamenis longissimus ) in Hungary

Article References: Mészáros, B., Halász, K., & Szakács, É. (2025). First records of albino Aesculapian snakes (Zamenis longissimus) in Hungary. Herpetozoa, 38, 359-363. https://doi.org/10.3897/herpetozoa.38.e163261

Image Credits: AI Generated

DOI: 10.3897/herpetozoa.38.e163261

Keywords: Aesculapian snake, Zamenis longissimus, albinism, wildlife observation, Hungary, Vácrátót, National Botanic Garden, melanin deficiency, European herpetology, First, records, albino

The study examined Asclepias syriaca, a clonal, rhizomatous perennial native to North America that is spreading in Central Europe. Investigators worked in the protected Fülöpháza Sand Dunes within Kiskunság National Park, in the Pannonic sand steppe of central Hungary. The landscape consists of calcareous sand dunes with open perennial grasslands, and all six sampled stands were located within semi-natural grassland categories, including Natura 2000 habitat.

Field sampling took place in May and June 2023 at six spatially separated invaded stands selected to represent differences in common milkweed shoot density and invasion pattern. Sites affected by roads, wheel tracks or intense trampling were excluded, and transects avoided major topographic variation. The transects were deliberately positioned rather than randomly placed so that each crossed a clearly identifiable invasion front and included invaded, non-invaded and transitional vegetation. Because the stands shared a regional invasion context, the authors treated the transects as spatial replicates within that context rather than fully independent invasion events.

Each transect was 12 metres long and 1 metre wide, with the central 6 metres containing the last detected common milkweed shoots. The sampling design divided every transect into 1,200 contiguous quadrats, each measuring 10 cm by 10 cm. Investigators recorded the presence of vascular plants, mosses and terricolous lichens, then aggregated the records across the transect width into 10-centimetre segments. Moving split-window analysis compared species composition in adjacent half-windows whose widths ranged from 10 to 100 centimetres.

Two dissimilarity measures characterized the boundaries. Squared Euclidean Distance was sensitive to differences in species frequencies, while the Differential Renkonen Index captured relative changes in species dominance. Restricted random-shift permutations with 1,000 Monte Carlo iterations generated null models used to standardize the profiles. Peaks above a threshold of Z = 1.65, corresponding to a one-tailed p = 0.05, were classified as statistically significant boundaries. Boundary position, peak height and peak width were used to distinguish sharp transitions from more diffuse zones, although boundary curvature could not be estimated along the linear transects.

Common milkweed was consistently well established, with 42–64 shoots recorded per transect, while total species richness ranged from 21 to 38. Its abundance was not associated with a clear reduction in richness within the sampled transects. Transects with relatively high milkweed counts also contained numerous other abundant taxa, including Secale sylvestre, Stipa borysthenica and the moss Tortula muralis. The observed pattern was therefore chiefly a change in dominance and community configuration rather than a demonstrated loss of species.

Squared Euclidean Distance detected significant boundaries in all six transects, but their positions and structures varied. In Transect 3, significant peaks occurred from 3.9 to 4.2 metres, whereas the last milkweed shoot was recorded at 7.4 metres, creating a 3.2-metre separation. The main dissimilarity zone in Transect 5, at 3.6–3.8 metres, preceded its 6.6-metre shoot limit by 2.8 metres. In Transect 2, the significant maximum lay 0.7 metres beyond the invasion front, while Transect 4 showed close alignment between the last shoot and several compositional peaks.

The Differential Renkonen Index produced a different and sometimes additional pattern. It detected no significant maximum in Transects 1 and 5. Transect 4 contained significant zones at 2.1–2.4 metres and 3.6–3.8 metres, both before its 6.5-metre invasion front, while Transect 3 had a maximum at 9.0 metres, 1.6 metres beyond the last milkweed shoot. In Transect 6, a continuous significant zone from 6.1 to 6.8 metres contained the visible front at 6.3 metres. These contrasting results show that the detected boundary depended on whether the analysis emphasized species-frequency differences or changes in relative dominance.

Overall, the findings support spatially structured transition zones associated with common milkweed, but not a uniform sequence in which ecological change always precedes visible colonization. The authors considered possible explanations including invasion stage, community resistance, legacy effects, microclimate, competition and below-ground interactions, none of which was directly tested. The analysis was limited by six deliberately positioned transects in one habitat type and region, a single field season and the absence of site-specific invasion histories, so it cannot establish invasion rates or direction over time. Detailed soil-moisture, microtopography, disturbance-history and below-ground measurements were also unavailable, preventing biotic effects from being separated from fine-scale environmental variation. The authors considered the labor-intensive method more suitable for targeted ecological assessment and management planning than for rapid, large-scale early detection.

Subject of Research: Fine-scale vegetation boundary detection at common milkweed invasion fronts in Hungarian sand grasslands

Article Title: Hidden fronts of invasion: Fine-scale boundaries reshape native plant communities

Article References: Bakacsy, L. (2026). Hidden fronts of invasion: Fine-scale boundaries reshape native plant communities. NeoBiota, 107, 287-307. https://doi.org/10.3897/neobiota.107.185747

Image Credits: AI Generated

DOI: 10.3897/neobiota.107.185747

Keywords: common milkweed, plant invasion, vegetation boundaries, novel ecotones, species composition, Hungary, sand grasslands, dissimilarity analysis, field study, Hidden, fronts, invasion

The samples came from perennial plants imported from Italy (42), the Netherlands (16) and Spain (2). Garden-centre staff selected batches that had arrived earlier that spring, minimizing exposure to local seed rain. Each sample pooled material from multiple containers of the same plant species and batch, generally covering approximately the upper 5 centimetres of substrate; wood shavings and bark mulch were excluded.

The samples were washed through sieves to remove fine material and reduce their volume. Each litre was then spread over steam-sterilised potting soil in balcony planters in an unheated greenhouse. Five planters containing only sterilised soil served as contamination controls.

The plants were watered daily from 17 April to 16 November 2023, and emerging seedlings were regularly counted, identified and removed. Plants that could not yet be identified were transplanted and grown until identification was possible, with some retained until November 2024. The 60 samples yielded 2,181 germinating seeds.

After 14 seedlings died before identification, the remaining 2,167 seedlings belonged to 80 taxa, 74 of which were identified to species level. Individual samples ranged from zero to 783 seedlings and from zero to 22 taxa, with means of 36.35 seedlings and 5.38 taxa per litre. Only two samples were free of germinating contaminant seeds.

The most abundant taxa were Sagina procumbens with 957 seedlings, Cardamine occulta with 221, Euphorbia maculata with 201, Portulaca oleracea with 77 and Oxalis corniculata with 76. Most of the detected taxa were non-native in Hungary, with 48 classified as non-native species. On average, 78.8% of the germinating seeds in each sample belonged to species non-native in Hungary, and 91.7% of samples contained at least one such species.

Neophytes accounted for an average of 45.1% of seeds per sample, including emerging neophytes at 12.1%; 48.3% of samples contained at least one emerging neophyte. Seeds of species considered invasive in Hungary represented 28.6% of the detected seeds, while species invasive in at least one part of Europe accounted for 53.9%. Among notable detections, Dittrichia viscosa , native to the Mediterranean Basin, had not been reported from Hungary.

Gnaphalium pensylvanicum , native to North and South America, had previously been recorded in Hungary only from the container of an ornamental plant in a garden centre. Symphyotrichum squamatum , a South American species considered invasive in several European countries, had also been reported recently in Hungary. Exporter country was associated with both seed abundance and community composition.

Italian samples contained significantly more seeds and more taxa than Dutch samples: a Wilcoxon rank-sum test found a difference in seed number, while a negative binomial model found a difference in species number. Permutational multivariate analysis also detected a significant difference in composition, although exporter country explained a relatively small proportion of the variation, with an R² of 0.046. Taxa found only in Dutch samples were largely native and widely distributed in Europe, whereas several taxa restricted to Italian samples were more closely associated with Southern Europe.

Among the 42 Italian samples, substrates from needle- or scale-leaved garden plants contained significantly more seeds than substrates from broadleaved plants, although leaf habit was not significantly associated with the number of taxa. The country difference remained when the analysis was restricted to broadleaved plants, so it was not solely attributable to the greater representation of conifers among Italian shipments. The researchers did not establish a mechanism.

They noted that slower-growing plants might remain in nurseries longer and allow seeds to accumulate, while broadleaved foliage might intercept more incoming seeds, but both remained possible explanations. The greenhouse assay demonstrated that viable seeds were present and could germinate from the sampled imported substrates. It did not establish that those seeds became established or invasive in Hungary, and it did not measure the total volume of seeds transported through the horticultural trade.

Its scope was limited to 60 samples from one Hungarian region, and country was confounded with garden centre because some centres imported plants from only one country. Comparison with earlier assessments in Alaska and Norway also requires caution because sampling methods and depths differed; the Hungarian results specifically describe approximately the upper layer of imported substrates. The results provide information relevant to invasion-risk assessment because the study quantified species carried unintentionally with an international horticultural commodity.

EU phytosanitary requirements for growing media imported from non-member countries primarily address plant-health concerns rather than contaminating seeds, while trade among EU members is subject to less stringent controls; the EU Plant Passport likewise covers inspections and quarantine pests and diseases but not seeds in growing media. The authors argue that data on contaminant species and more detailed information on horticultural trade could support more precise risk assessments and policies for this introduction pathway.

Subject of Research: Viable contaminant seeds in growing media of container-grown garden plants imported into Hungary

Article Title: Unintentional seed dispersal via container-grown garden plants: Seed density and composition vary among exporter countries

Article References: Sonkoly, J., Törő-Szijgyártó, V., Petró, E., Takács, A., Guallichico Suntaxi, L. R., McIntosh-Buday, A., Díaz Cando, P. E., Tóth, K., Madar, S., Kovacsics-Vári, G., & Török, P. (2026). Unintentional seed dispersal via container-grown garden plants: Seed density and composition vary among exporter countries. NeoBiota, 107, 331-351. https://doi.org/10.3897/neobiota.107.184691

Image Credits: AI Generated

DOI: 10.3897/neobiota.107.184691

Keywords: biological invasions, horticultural trade, container-grown plants, seed contamination, growing media, non-native plants, biosecurity, propagule pressure, Hungary, Unintentional, seed, dispersal

Participants were aged 8 to 18, with a mean age of 13.97 years, and 55.7% were boys. Most, 69.4%, attended segregated special-education institutions, while 30.6% attended mainstream or integrative institutions. Physical or motor impairment was the most common diagnosis, accounting for 52.4% of the sample, followed by multiple disabilities, visual impairment, intellectual disability, autism spectrum disorder, speech impairment, learning disability and hearing impairment. Recruitment through the National Federation of Disabled Students’ Sports, schools and community organisations provided broad access but was not based on a population sampling frame.

Researchers asked whether respondents would like to take part in a sports club where people with and without disabilities exercised together. They retained all three original response categories rather than combining “no” and “not interested” into a binary outcome. Because no separate questions established whether respondents had considered the offer, understood it in the same way or refused after active deliberation, the labels remain nominal. In particular, “not interested” cannot be interpreted as passive disengagement from sport, a distinction challenged by the finding that this group had the highest rate of participation outside physical education.

The survey also assessed seven domains in which disability might limit daily life: mobility, making friends, everyday tasks, leisure, learning, sport and social integration. These items had good internal consistency, with a Cronbach’s alpha of 0.851, and their correlations were moderate and consistently positive. A latent profile analysis divided respondents into low-, moderate- and high-limitation groups, representing 39.3%, 29.2% and 31.5% of classified cases. The groups differed mainly in overall severity rather than in the pattern of affected domains, indicating a gradient rather than distinct functional types.

A categorical latent class model provided a sensitivity check by treating the five-point limitation items as ordinal rather than Gaussian variables. It again produced an ordered low-to-high structure, assigning 87.6% of respondents to the same ordered category as the Gaussian analysis, with an adjusted Rand index of 0.689. Average posterior classification probabilities in the Gaussian model were high: 0.953 for the low-limitation group, 0.902 for the moderate group and 0.938 for the high group. Even so, three classes were selected for parsimony and interpretability rather than as a uniquely optimal statistical solution.

The main multinomial logistic regression modelled “yes” and “not interested” separately against “no.” Its explanatory power was modest, with McFadden’s R-squared of 0.088, meaning that most differences among the three responses remained unexplained. Liking sport was the strongest individual correlate: compared with young people who disliked sport, those who liked it had nearly three times the relative odds of saying “yes” rather than “no” and more than four times the odds of selecting “not interested” rather than “no.” These figures are not causal effects, however, and liking sport is conceptually close to willingness to enter a sport setting.

Awareness of provision was also associated with the responses. Knowing that integrated sport existed was linked to both “yes” and “not interested” rather than “no,” while knowing a relevant club showed the same general pattern. The relationship with perceived local availability was unexpectedly non-monotonic. Compared with respondents who did not know what was available locally, those who believed no integrated option existed had 2.73 times the relative odds of saying “yes” and 2.81 times the odds of saying “not interested.” Respondents who said an option did exist were more likely to choose “not interested” than “no.” The cross-sectional data cannot determine whether local provision changes interest or whether perceptions of availability are shaped by other factors.

Impairment type contributed to the model mainly in the contrast between “not interested” and “no.” Relative to young people with physical or motor impairments, those with learning disabilities, autism spectrum disorder, multiple disabilities or intellectual disabilities had higher relative odds of selecting “not interested.” Estimates for the smallest groups were imprecise: hearing impairment included only nine participants and learning disability 30, producing wide confidence intervals. Continuous activity-limitation severity showed a weaker association with “not interested” than with “no,” but it did not significantly improve the full model, and adding the three limitation profiles also failed to produce a statistically significant overall gain.

Stated openness did not match actual sporting behaviour in a straightforward way. Overall, 59.4% of respondents took part in sport outside compulsory physical education, with similar proportions in the low-, moderate- and high-limitation groups. Among the three openness categories, 48.5% of those saying “no,” 61.5% of those saying “yes” and 73.9% of those saying “not interested” reported sport outside physical education. Among active respondents, however, participation frequency did not differ significantly across the categories. The results therefore show that a young person’s willingness to join an integrated club cannot be inferred from whether that person plays sport elsewhere.

The study’s practical message is exploratory rather than a tested prescription. Its results make visibility and signposting plausible subjects for future intervention research, especially because awareness of integrated sport and relevant clubs was associated with responses other than “no.” They also motivate evaluation of opportunities designed around enjoyment, competence, predictable structure and adaptation for young people with different support needs. None of those measures has yet been shown by this survey to cause greater openness. The authors emphasise that shared physical presence is not the same as inclusion, and that openness is not participation. Longitudinal and experimental research using validated measures will be needed to determine whether changes in awareness, access and the design of provision actually affect inclusion and sustained involvement.

Subject of Research: Correlates of stated openness to integrated sport among Hungarian youth with disabilities

Article Title: What is associated with openness to integrated sport among school-aged youth with disabilities? A cross-sectional study from Hungary

Article References: Müller, A., Lengyel, A., Mező, K., Bácsné Bába, É., Czimbalmos, N. L., Židek, P., & Mező, F. (2026). What is associated with openness to integrated sport among school-aged youth with disabilities? A cross-sectional study from Hungary. Frontiers in Sports and Active Living, 8, Article 1922255. https://doi.org/10.3389/fspor.2026.1922255

Image Credits: AI Generated

DOI: 10.3389/fspor.2026.1922255

Keywords: integrated sport, youth with disabilities, Hungary, sport participation, disability inclusion, latent profile analysis, multinomial regression, survey research, physical activity, associated, openness, integrated

The study focused on Pannonian sand steppes within Kiskunság National Park in central Hungary. This priority habitat, protected under the European Union’s Habit Directive, consists largely of dry, nutrient-poor grasslands that historically supported little woody vegetation. Large tracts were converted to cropland during the nineteenth and twentieth centuries, and the surviving fragments are now under pressure from altered water regimes, intensified agriculture, abandonment of traditional grazing, and the spread of alien plants. The habitat is officially classified as being in an “unfavourable-bad” conservation status, meaning that it faces a substantial risk of further deterioration or disappearance.

Sand dropseed, or Sporobolus cryptandrus, first appeared in the study area in 2016 and then expanded rapidly. Unlike many invasive plants that require heavily disturbed ground, this C4 grass can invade intact, species-rich grassland. Its dense stands displace native perennial grasses, reduce plant diversity and homogenize the structure of the vegetation. Another alien species, common milkweed, was also present at the surveyed sites, although it generally favors degraded meadows, roadsides and formerly ploughed or overgrazed land. Native and introduced woody plants were simultaneously advancing into the grasslands as traditional grazing declined.

Researchers selected 48 plots, each measuring 25 by 25 meters, across the six study sites. The design deliberately included plots with little or no sand dropseed alongside heavily invaded patches. In September 2024, teams of six or seven observers walked parallel transects through each plot and recorded every reptile seen, including its species, age class, sex, position and time. The investigators also measured the cover of sand dropseed, common milkweed and woody vegetation, then assigned each plot a naturalness score reflecting its plant composition, structure and ecological functioning.

Counting animals directly is notoriously difficult for reptiles. Many are elusive or cryptically colored, and their activity changes with temperature, particularly because they depend on external heat to regulate their bodies. The researchers therefore used single-visit N-mixture models, a statistical approach designed to estimate population abundance while explicitly accounting for imperfect detection. Vegetation variables were placed in the abundance component of the models, while operative temperature and observer effort were used to explain the likelihood that an individual present would actually be seen. Separate models were fitted for the two lizard species.

Surveyors recorded 56 Balkan wall lizards and 28 Eastern green lizards. The Balkan wall lizard appeared in 30 of the 48 plots and was detected more reliably than the Eastern green lizard, which appeared in 18 plots. Model results showed a statistically significant negative association between sand dropseed cover and Balkan wall lizard abundance. The effect of common milkweed was not significant. For the Eastern green lizard, invasive-plant cover had no significant effect, but increasing woody encroachment was associated with greater abundance. Mean detection probabilities were estimated at 0.82 for the Balkan wall lizard and 0.51 for the Eastern green lizard, while estimated mean densities were 48.5 and 11.2 individuals per hectare, respectively.

The results are consistent with the different ecological demands of the two reptiles. Balkan wall lizards in this region depend on open, sandy and loess grasslands with low, sparse vegetation. As sand dropseed expands, it creates more uniform stands that may offer less varied shade, refuge and thermal conditions. The invader also supports fewer and less diverse arthropod communities, potentially reducing prey availability and the habitat’s overall carrying capacity. By contrast, Eastern green lizards are generalists that occupy grasslands, forest edges and a wide range of wetter and drier environments. Shrubs and trees create the more structurally diverse habitat this species can exploit, even as they replace the treeless conditions favored by the wall lizard.

The study also illustrates why the impact of an invasive species cannot be inferred simply from the fact that it is spreading. A plant may transform habitat without affecting every resident in the same way, and vegetation encroachment can itself generate winners and losers. The authors note several limitations: the sampling was concentrated in only six sites, the number of plots was modest, and there was no temporal replication. Stratification by sand dropseed abundance may also have limited the precision of estimates for milkweed and woody encroachment. Nevertheless, complementary generalized linear mixed models assuming perfect detection produced patterns similar to the N-mixture results, supporting the main conclusions.

Because sand dropseed has already spread extensively, researchers argue that total eradication is unrealistic and that management should focus on preventing further expansion while limiting ecological damage. Mapping colonies and identifying the forces driving their spread could improve forecasting and early intervention. Restricting vehicle movement on sandy roads may help, because seeds are readily transported on tires. Small founder populations could potentially be removed manually, while grazing, mowing, burning, chemical treatment and combinations of these methods require urgent testing in larger stands. Repeated surveys across multiple seasons and years would also help determine whether the observed lizard responses persist as invasion progresses.

For now, the study provides an early warning from one of Europe’s most distinctive and threatened grassland types. Sand dropseed appears to be eroding the habitat of the Balkan wall lizard not merely by replacing native plants, but by simplifying the structure and food web on which the species depends. The Eastern green lizard’s apparent benefit from woody growth should not be mistaken for ecosystem recovery: shrubs can improve cover for a generalist while simultaneously pushing a threatened specialist out of its preferred habitat. Protecting Pannonian sand steppes will therefore require more than stopping the spread of a single invasive grass. It will demand active maintenance of open, thermally varied and prey-rich grassland, alongside targeted control of the plants and vegetation changes reshaping one of Central Europe’s vanishing ecological arenas.

Subject of Research: Effects of invasive sand dropseed and woody encroachment on two lizard species in Pannonian sand steppes

Article Title: Effect of plant-related threats on lizards of open sand steppes: a snapshot at the beginning of the spread of a novel invader

Article References: Mizsei, E., Adorjáni, C., Bancsik, B., Kovács, G., Rák, G., Babocsay, G., & Budai, M. (2025). Effect of plant-related threats on lizards of open sand steppes: a snapshot at the beginning of the spread of a novel invader. NeoBiota, 104, 95-111. https://doi.org/10.3897/neobiota.104.159611

Image Credits: AI Generated

DOI: 10.3897/neobiota.104.159611

Keywords: sand dropseed, Balkan wall lizard, Eastern green lizard, invasive plants, grassland degradation, Pannonian sand steppe, woody encroachment, reptile ecology, N-mixture models, Hungary, Effect, plant-related

Diatoms, single-celled algae encased in ornate silica shells called frustules, are among the most trusted bioindicators in aquatic science. Under the European Water Framework Directive, benthic diatoms are one of five biological elements used to assess the ecological status of surface waters, with diatom indices built on the relative abundance of species and their known sensitivities to pollution and salinity. That system works only if species are identified accurately and consistently, which is precisely where the trouble begins. Traditional identification relies on subtle features of valve shape and stria density, demanding deep taxonomic expertise and often yielding subjective results.

DNA metabarcoding has been proposed as a more objective alternative. The technique amplifies short barcode regions of DNA from an environmental sample, sequences them in bulk on next-generation platforms, and matches the resulting sequences against reference databases to identify the taxa present. Yet studies comparing the two approaches have repeatedly found significant deviations, and the research team behind the new work points to one dominant cause: reference libraries are incomplete, particularly for species from unusual habitats. Soda pans, with their high sodium and hydrogen carbonate content, host rare and halophilic organisms that are exactly the kinds of species missing from genetic databases.

The loss of sodic character is the principal threat facing these habitats, as water management practices can channel lower-salinity water into the pans and dilute them. Accurate identification of species and precise knowledge of their salinity tolerance are therefore essential for judging ecological status. Within the framework of a Hungarian national monitoring project, the researchers sampled 37 soda pans and soda lakes across spring and autumn campaigns in 2019 and 2020, producing 69 samples analysed by light microscopy, of which 26 were also subjected to DNA sequencing. Twenty-two of the water bodies were subsaline and 15 hyposaline, ranging from natural to disturbed conditions.

The team focused on Halamphora, the fourth most common and seventh most species-rich genus among the 72 genera found in their soda samples. Two species in particular, Halamphora dominici and Halamphora veneta, occurred in nearly half of all samples and were frequently dominant, sometimes reaching relative abundances of 40 to 60 percent. The Halamphora veneta group, which also includes H. kevei and H. paraveneta, is notoriously difficult to resolve morphologically, with species boundaries resting on fine differences in stria density and valve outline that can shift with environmental stress, including salinity.

The molecular results delivered a striking revelation. Of 23 short amplicon sequence variants that automated pipelines assigned to H. veneta, phylogenetic analysis and BLAST searches showed they actually belonged to H. dominici. The culprit was a misidentified sequence in the Diat.barcode reference database. Using long-read sequencing of a sample where both species co-occurred, the researchers obtained a full 1547-nucleotide rbcL sequence for H. dominici that showed roughly 2 percent divergence from H. veneta, confirming the two are genuinely distinct species. The newly deposited sequences now supplement the reference library, and the team emphasizes that sequences should only enter databases after precise morpho-taxonomic verification.

Overall, six Halamphora species were detected in the soda habitats. Five were recovered by both methods, while H. oligotraphenta was found only by microscopy because it appeared exclusively in samples that were not sequenced. The comparison between techniques revealed a significant positive correlation between microscopy- and metabarcoding-based relative abundances for H. dominici, with a Pearson correlation coefficient of 0.73. Discrepancies in the other direction were also informative: DNA detected species in some samples where microscopy missed them, likely because sequencing draws on far more cells than the minimum 500 valves counted per slide, while some microscopically observed valves may have belonged to dead cells.

The ecological payoff is clear. Classified as mesohalobous, H. dominici showed a positive correlation with salinity, with an average salinity of 3.1 parts per thousand in the waters where it occurred, compared with 1.6 parts per thousand for the more cosmopolitan H. veneta, which tolerates freshwater to slightly brackish conditions. Given that the ecological status of Hungarian soda pans depends fundamentally on salinity, the correct discrimination between these two species, one a reliable flag of sodic character and the other a generalist, is critical for conservation-relevant assessments.

The study also contributed taxonomic housekeeping. By comparing length-to-width ratios and ultrastructural features, the researchers questioned whether Halamphora elongata is truly distinct from the older H. subcapitata, noting overlapping morphometrics and absent areolar occlusions in their specimens, though formal synonymisation awaits type-material analysis. Meanwhile, H. paraveneta, which lacks any reference sequence in Diat.barcode or GenBank, may have been lurking as an outlier sequence variant assigned to H. veneta, a hypothesis flagged for future work.

As environmental DNA methods face growing pressure to replace traditional microscopy in routine monitoring across Europe, this study offers both a caution and a roadmap. Misidentified dominant species in reference databases can silently distort the results of ecological status assessments, potentially misclassifying protected habitats. But the combination of meticulous morphology and DNA sequencing, applied to extreme habitats that represent environmental endpoints of genetic diversification, can close the gaps. For Hungary’s soda pans, some of Europe’s most distinctive and threatened aquatic ecosystems, that means the microscopic sentinels of their salty character can finally be named with confidence.

Subject of Research: Diatom biodiversity and salinity indicators in Hungarian soda pans assessed by microscopy and rbcL metabarcoding

Article Title:  Halamphora taxa in Hungarian soda pans and shallow soda lakes detected via metabarcoding and microscopic analyses

Article References: Ács, É., Bíró, T., Boros, E., Dobosy, P., Duleba, M., Földi, A., Kiss, K. T., Levkov, Z., Orgoványi, P., Szén, O. P., Trábert, Z., Vadkerti, E., & Grigorszky, I. (2023). Halamphora taxa in Hungarian soda pans and shallow soda lakes detected via metabarcoding and microscopic analyses. Metabarcoding and Metagenomics, 7, Article e111679. https://doi.org/10.3897/mbmg.7.111679

Image Credits: AI Generated

DOI: 10.3897/mbmg.7.111679

Keywords: diatoms, metabarcoding, soda pans, Halamphora, salinity, rbcL, ecological status, Water Framework Directive, reference database, Hungary, bioindicators, phylogeny

Reconstructing invasions at a local scale is notoriously difficult. Historical data are scattered, incomplete and often contradictory, and most research on invasion biology works at national or continental scales, where patterns blur the details. The research team, working within the OAKEYLIFE conservation project, therefore combined six independent data sources: a literature review of digitised forestry journals dating back to the 1860s, the archived records of Hungary’s National Forestry Database spanning 1958 to 2016, a full-coverage field survey conducted over 510 field days, mapping and felling of the largest tree specimens for annual ring counts, a statistical hotspot analysis of abundance data, and structured collection of local knowledge from twelve key informants aged between 40 and 85. Each source filled gaps the others could not, and the researchers argue that this mixed approach is essential wherever data density is low.

The literature delivered the most striking early clues. A 1964 journal article described a 25-year-old tree of heaven specimen at a specific location on the north-western edge of the forest, implying the species was already present in the 1930s. For black cherry, the evidence was even sharper: a short communication from 1954 documented that the first experimental stand was established in 1937 in an arboretum set up by a leading forest engineer, a date confirmed by a later publication identifying the exact forest subcompartment. The other two species left no paper trail at all — no literature source recorded their first introduction. That is where the forestry database and the trees themselves had to speak.

Hungary’s National Forestry Database requires standard data sheets for every forest subcompartment, updated roughly every decade. The researchers processed 1,686 of these sheets across six survey periods, extracting every mention of the four species and converting the records into chronological GIS layers. The earliest record belonged to boxelder, listed in 1958 as a major species in an 18-year-old seed-origin stand — evidence that the species had been present since at least the 1940s. Yet the database told a story of long silence: black cherry, despite its documented 1937 planting, did not appear in the database until 2002, when it suddenly showed up in 45 subcompartments at once. Tree of heaven first appeared in 1971 in a single subcompartment, and common hackberry in 1982 in four.

The field survey revealed how badly those records understated reality. Covering 910 hectares in 16,056 grid-based survey units of 625 square metres each, the team directly counted 98,136 adult specimens (diameter at breast height at least 5 cm) and estimated around 2,175,000 saplings in the smaller size class. All four species turned out to be two to three times more prevalent and abundant than the currently valid 2016 database entries indicated. Tree of heaven was found in 82 percent of the 300 forest subcompartments and hackberry in 95 percent, with mass presence — density thresholds that make the trees impossible to miss — in more than a quarter of subcompartments for both species. Black cherry and boxelder occupied 64 and 36 percent of subcompartments respectively.

Annual ring counts turned old trees into living archives. The largest tree of heaven, with a diameter over 50 cm, proved to be 48 years old. Three enormous common hackberry trees, between 50 and 65 cm across, were found arranged in neat rows beneath the northern forester’s house — a signature of deliberate planting — and all three proved to be the same age, roughly 75 years, pushing the species’ presence back to at least the 1940s. More surprising still, a separate group of planted hackberries on a sand dune turned out to be 30 years old, proving that foresters were still planting the species after the 1980s, decades after its wood was considered worthless.

The hotspot analysis, using local Gi* statistics on the survey grid, added a spatial dimension to the detective work. For tree of heaven and boxelder, the primary hotspots — the survey units in the top 1 percent of Z-scores — coincided almost perfectly with their first known locations of occurrence. Eighty years after introduction, these species are most abundant exactly where they were first established. For hackberry and black cherry, however, the primary hotspots sat elsewhere. Local knowledge resolved the puzzle: the former two species had been ignored and avoided since the 1950s, while the latter two continued to be planted as admixed species in black locust and grey poplar plantations until the early 1990s, especially on the least productive sandy soils. Their primary hotspots most likely mark those undocumented plantations, not the original introductions.

The deepest mystery was the lag. Why would four species introduced decades apart sit essentially dormant for 60 to 70 years and then erupt simultaneously? Genetic change can be ruled out — at most 10 to 15 generations had elapsed, and a simultaneous genetic shift across all four species is implausible. Simple exponential growth also fails to explain the synchrony. Instead, the evidence points to a prolonged lag ended abruptly by three environmental changes that happened to coincide around the turn of the millennium. First, after Hungary’s 1989–1990 regime change, the intensity of forest management declined: the frequent treatments that once suppressed unwanted vegetation in socialist-era plantations and coppice forests largely ceased, allowing dense shrub layers — and invasive saplings — to develop. Second, the fallow deer population, kept at around 100 animals into the late 1990s, was reduced to nearly zero within a couple of years, removing browsing pressure and disturbance; notably, hackberry is the one invasive species deer actually favour. Third, droughts became markedly more frequent from 2000 onwards, with hot summers and mild winters that eliminated the frost damage to which tree of heaven seedlings are famously sensitive.

One informant captured the shift vividly, recalling that after the brutal drought years of 2000 and 2003, seedlings of tree of heaven appeared everywhere in very large numbers for the first time. The researchers frame this as a classic case of a prolonged lag phase, in which the species had gradually built up enough presence in the forest — steadily appearing in new subcompartments over decades — that the changed environmental conditions could trigger synchronous outbreaks. The study also notes that Hungarian mean annual temperature sits near 11°C, a threshold identified in Mediterranean research above which tree of heaven can no longer spread, a coincidence that may matter as the climate continues to warm. Other work predicts substantial range shifts for black cherry and hackberry in North America and increasing invasion pressure from black cherry in Europe.

The broader lesson is sobering. Official databases, essential as they are for national research and policy, can understate local invasions by a factor of two or three, and a species can be documented as planted nearly 70 years before it appears in any record. For protected areas of high conservation value, such as the Peszér Forest, which hosts more than 10 percent of the Carpathian Basin’s priority Eurosiberian steppic oak woods habitat, fine-grained local data are the only reliable basis for targeting control. The six-source methodology is replicable in virtually any forested area in Hungary and beyond, and the authors emphasise that eradication across a country the size of Hungary remains unthinkable even if small-scale successes are achievable. The most labour-intensive work — removing seedlings and saplings — requires no specialised skill, and the study makes the case that telling these species’ hidden histories is itself a tool: it turns scattered archives, old stumps and the memories of retired foresters into an argument that everyone, from park managers to garden-store customers, can act on before the next silent invader wakes.

Subject of Research: Historical reconstruction of the local-scale invasion history of four non-native tree species in a Hungarian forest

Article Title: Historical reconstruction of the invasions of four non-native tree species at local scale: a detective work on Ailanthus altissima , Celtis occidentalis , Prunus serotina and Acer negundo

Article References: Erdélyi, A., Hartdégen, J., Malatinszky, Á., & Vadász, C. (2023). Historical reconstruction of the invasions of four non-native tree species at local scale: a detective work on Ailanthus altissima, Celtis occidentalis, Prunus serotina and Acer negundo. One Ecosystem, 8, Article e108683. https://doi.org/10.3897/oneeco.8.e108683

Image Credits: AI Generated

DOI: 10.3897/oneeco.8.e108683

Keywords: invasive species, Ailanthus altissima, Prunus serotina, Celtis occidentalis, Acer negundo, forest-steppe, lag phase, dendrochronology, hotspot analysis, local knowledge, Hungary, forest management

The study, led by Márta Fekete of Uzsoki Hospital in Budapest together with Patricia Lajko of Semmelweis University and colleagues including corresponding author Xenia Gonda, recruited 223 Hungarian-speaking participants aged 50 and above. Each respondent completed a Hungarian adaptation of the CASP-19 that used a modified agreement-based response format — a seemingly small design decision that, as the authors show, can ripple through the entire measurement. The work was approved by the Scientific and Research Ethics Committee of the Medical Research Council of Hungary, and the team supplemented the CASP-19 with a battery of established quality-of-life instruments to test whether the scale actually measures what it claims to measure.

The headline number is impressive. The full 19-item questionnaire achieved a Cronbach’s alpha of 0.91, a statistic that ranges from zero to one and expresses how tightly the items hang together; anything above 0.90 is generally considered excellent for a multi-dimensional scale. In plain terms, when a Hungarian respondent reports a strong sense of control over their life, they are very likely to also report high autonomy, self-realization and pleasure. For researchers and clinicians who want a single summary score of psychosocial quality of life in later life, the Hungarian CASP-19 delivers one they can trust.

But the deeper story lies in the factor analysis — the statistical machinery used to ask how many separate psychological dimensions actually live inside a questionnaire. The team ran a principal axis factoring with varimax rotation, a classical exploratory technique that extracts underlying factors from the correlations among items. This yielded a four-factor solution explaining 53.1 percent of the total variance, superficially matching the theory. Yet when the researchers applied sensitivity analyses — parallel analysis, which compares observed factors against those arising from random noise, and oblique rotation, which allows factors to correlate — the evidence favoured fewer factors. The tidy four-part architecture of the CASP framework, it turns out, is partly in the eye of the beholder.

The most telling detail concerns the boundary between Control and Autonomy, two dimensions that sound distinct in theory but blur in practice. In the Hungarian data, all of the Autonomy items and most of the Control items loaded onto a single common factor, meaning that respondents do not experience these two ideas as psychologically separable. Control, in the CASP framework, refers to the sense of being able to influence one’s own life, while Autonomy concerns freedom from the dictates of others. In the lived experience of Hungarian adults over 50, however, having free choice and having influence apparently merge into one broader feeling of personal agency. Consistent with this, the Autonomy subscale showed the weakest internal consistency of the four, with an alpha of just 0.69 — below the conventional 0.70 threshold that psychometricians typically demand.

To confirm these exploratory findings, the researchers turned to confirmatory factor analysis, the stricter sibling of exploratory methods. Rather than letting the data suggest a structure, CFA tests pre-specified structural models and grades how well each fits. Crucially, the team estimated their models from polychoric correlations using the weighted least squares mean- and variance-adjusted estimator, known as WLSMV — a technical choice that matters enormously here. The CASP-19 uses ordered response categories rather than continuous measurements, and treating such ordinal data with methods designed for continuous variables can distort factor structures. Polychoric correlations and WLSMV respect the ordinal nature of the responses, making this one of the more methodologically careful adaptations of the scale to date.

Validity was assessed from two directions. On the convergent side, the CASP-19 correlated moderately to strongly with three independent measures: the EuroQol 5-Dimension 5-Level questionnaire, the 36-Item Short Form Health Survey, and the Mental Health Quality of Life questionnaire. This pattern is exactly what one hopes to see — the scale tracks other quality-of-life and well-being instruments closely enough to be measuring something real, but not so perfectly that it is redundant with them. The correlations thus anchor the Hungarian CASP-19 within the wider family of health and well-being measures, giving researchers confidence that scores can be compared and integrated across studies.

The study also tackled a practical question that increasingly confronts ageing research: does it matter whether older adults fill in a paper questionnaire or an online version? The authors compared total CASP-19 scores between respondents who completed the paper-based form and those who used the online version, matching participants on background characteristics using propensity scores and then running matched-pair t-tests. The matched subgroups showed no difference in total scores. But the researchers are admirably cautious about this finding: the matched sample consisted of different individuals rather than the same people completing both formats, and it contained only 26 pairs. As they emphasize, this cannot be interpreted as evidence of true measurement equivalence between the two administration modes — a caveat that should temper any rush to digital data collection in later-life surveys.

Why does all this matter beyond Hungary? Populations across Europe and much of the world are ageing rapidly, and instruments like the CASP-19 feed directly into policy decisions about pensions, health services and social care. If a scale’s subscale scores are used to target interventions — say, programmes designed to boost autonomy specifically — but the data show that autonomy and control are empirically inseparable in a given culture, then the theoretical scaffolding behind those programmes wobbles. The Hungarian findings add a cross-cultural data point to a growing international conversation about whether the CASP framework’s four dimensions are universal psychological realities or, at least in part, artefacts of the original British context in which the scale was developed.

The authors’ conclusions are measured. They report that the Hungarian CASP-19 demonstrated high internal consistency and interpretable structural characteristics, supporting its use for assessing psychosocial quality of life in adults aged 50 and over. At the same time, they state plainly that their findings did not support a strictly separated four-dimensional interpretation, particularly with regard to the Control and Autonomy domains. The study also highlights the methodological relevance of response format adaptation — a reminder that how a question is asked, not just what it asks, shapes what researchers discover about the quality of later life. For anyone measuring well-being in ageing populations, the message is clear: trust the total score, but handle the subscales with care.

Subject of Research: Psychometric evaluation of the Hungarian CASP-19 quality-of-life scale in adults aged 50 and over

Article Title: Psychometric evaluation and factor structure of the Hungarian CASP-19: methodological and practical implications from an ageing population

Article References: Fekete, M., Lajko, P., Szekeres, T., Rethy, L. J., & Gonda, X. (2026). Psychometric evaluation and factor structure of the Hungarian CASP-19: methodological and practical implications from an ageing population. BMC Psychology. https://doi.org/10.1186/s40359-026-05810-w

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05810-w

Keywords: CASP-19, quality of life, psychometrics, factor analysis, ageing, older adults, Hungary, internal consistency, confirmatory factor analysis, cross-cultural adaptation, response format, psychosocial well-being

The trial, known as PROACTIVE-19, was launched at the height of the first pandemic wave with an ambitious design. Researchers planned to enroll 3,800 participants per arm and randomly assign adults aged 60 and older to receive either general health education or personalized lifestyle counselling delivered entirely by telephone. The intervention targeted five domains: mental health, smoking habits, physical activity, dietary habits including body mass index assessment, and alcohol consumption. General counselling followed standard public health guidelines in roughly 10-minute calls, while personalized counselling tailored recommendations to each individual’s lifestyle patterns in 15 to 20 minute sessions. Follow-up assessments were conducted weekly during the first month, biweekly during the second month, and monthly thereafter, allowing researchers to track behavioral trajectories with unusual granularity for a trial of this scale.

Delivering the intervention required remarkable legislative flexibility. Hungarian law was amended through a special government decree to allow participants to provide verbal consent by phone during the very first call, accommodating the restrictions imposed by the pandemic. Enrollment began on March 26, 2020, across Hungary, with participants recruited through television, radio, and social media advertisements directed to a toll-free phone number. Calls were delivered by trained personnel including medical doctors, dietitians, psychologists, and research administrators, with call quality supervised by a Steering Committee. In total, 3,975 calls were performed across the study period, creating one of the most detailed longitudinal behavioral datasets assembled during the pandemic.

Ultimately, 441 participants were analyzed, with 214 assigned to the general counselling arm and 227 to the personalized arm. The study was terminated early after reaching only about 5 percent of the planned sample size, following a predefined stopping rule triggered by the successful introduction of SARS-CoV-2 vaccines. This early closure had significant consequences for the trial’s statistical power. Only one confirmed SARS-CoV-2 infection was recorded during intervention follow-up, making it impossible to compare the prespecified COVID-19 severity endpoint, a composite of intensive care admission, hospitalization lasting more than 48 hours, and mortality among participants with incident infection. Instead, the researchers reported all-cause mortality obtained from national records, with follow-up extending to March 17, 2023.

The survival analysis revealed no statistically significant difference between the two arms. Median follow-up for all-cause mortality was 930 days in the general arm and 937 days in the personalized arm. A Cox proportional hazards model estimated a hazard ratio of 0.66 favoring the personalized group, with a 95 percent confidence interval of 0.28 to 1.53, but the result did not reach statistical significance. The researchers noted that statistical power for the survival analysis was only 16 percent, severely limiting the interpretation of null findings. The proportional hazards assumption was verified using Schoenfeld residuals, confirming no evidence of violation, but the low event count meant that multivariable adjustment was not performed.

Where the trial truly shines is in its longitudinal behavioral analysis. Using linear mixed-effects models with random intercepts to account for within-subject correlation, and quantifying parameter uncertainty with percentile wild bootstrap confidence intervals based on 2,000 resamples, the researchers identified several significant improvements over time. Fruit and vegetable consumption increased significantly across the full sample, with a time effect of 0.052 units per call. Smoking amount decreased significantly, particularly among participants who were current smokers at baseline, where the time effect was −0.372 cigarettes per day. Psychological variables also showed meaningful change, though the direction varied by domain.

The personalized intervention showed one clear advantage over general counselling: a significantly greater reduction in estimated alcohol consumption among baseline drinkers, with a time-by-group interaction of −1.357. This effect remained significant in sex-stratified analyses for women but not for men. However, the personalization came with an unexpected drawback. Among participants with obesity, body mass index increased in the personalized group, with a more pronounced interaction effect of 0.068 compared to the full sample. The researchers suggest that the tailored dietary counselling may have inadvertently encouraged increased food intake in some individuals, though the exact mechanism remains unclear.

Physical activity showed no significant change over time in the full sample, and the time-by-group interaction was not statistically significant. Graphical trends visually favored the personalized arm in both men and women, but these differences were not supported by the model results. Seasonal and pandemic-wave effects substantially influenced physical activity and psychological distress. Participants joining in autumn exhibited significantly more negative slopes in both physical activity and fruit and vegetable consumption compared with those joining in spring. COVID-related fear was significantly lower in summer compared with spring, while physical activity levels were significantly higher in autumn. Compared with the first pandemic wave, physical activity was significantly higher outside wave one, and COVID-related fear was significantly lower, indicating that the initial wave was associated with reduced activity levels and higher psychological distress.

The trial’s findings carry important implications for pandemic preparedness and healthy ageing. While the additional benefit of personalization was limited overall, the significant improvements observed across several lifestyle domains, including diet, smoking, and alcohol consumption, emphasize the importance of maintaining and promoting healthy behaviors during pandemic situations. The researchers note that unhealthy lifestyle factors in combination accounted for 51 percent of severe COVID-19 in the UK population, and that adherence to healthy lifestyle prior to infection has been shown to reduce the risk of post-COVID-19 condition. The trial also demonstrates the real-world feasibility of telemedicine-delivered lifestyle interventions at a system level, requiring legislative adaptation but ultimately reaching a geographically diverse population.

Several limitations warrant consideration. The early termination reduced statistical power, particularly for infrequent clinical outcomes and subgroup analyses. Several outcomes were self-reported, and COVID-19-specific mortality and potentially mild infections could not be reliably captured. The open-label nature precluded participant blinding, though participants from the same household were not enrolled to minimize contamination between groups. No correction for multiple comparisons was applied across outcomes, and seasonality and pandemic-wave effects were not included in the primary models, although secondary analyses suggested these contextual factors influenced several results. Despite these constraints, the trial provides randomized evidence supporting the potential role of lifestyle-based, non-pharmacological strategies in maintaining overall health during pandemic conditions, and highlights the importance of contextual factors when interpreting behavioral changes in older adults.

Subject of Research: Effect of telemedicine-delivered lifestyle interventions in older adults during the COVID-19 pandemic: a nationwide two-arm randomized trial (PROACTIVE-19)

Article Title: Effect of telemedicine-delivered lifestyle interventions in older adults during the COVID-19 pandemic: a nationwide two-arm randomized trial (PROACTIVE-19)

Article References: Váncsa, S., Nagy-Szakolczai, A., Molontay, R., Miklós, E., Szentesi, A., Ocskay, K., Hegyi, P. J., Hegyi, J., Hegyi, A., Hegyi, E., Czapári, D., Molnár, Z., Erőss, B., Hegyi, P., PROACTIVE-19 Trial Contributors, Abonyi-Tóth, Z., Birkás, B., Csathó, Á., Czopf, L., … Zsigmond, B. (2026). Effect of telemedicine-delivered lifestyle interventions in older adults during the COVID-19 pandemic: a nationwide two-arm randomized trial (PROACTIVE-19). GeroScience. https://doi.org/10.1007/s11357-026-02585-1

Image Credits: AI Generated

DOI: 10.1007/s11357-026-02585-1

Keywords: PROACTIVE-19, telemedicine, lifestyle intervention, older adults, COVID-19, randomized controlled trial, GeroScience, healthy ageing, Hungary, behavioural change, Effect, telemedicine-delivered