Background and aims Dolines are small-to large-sized bowl-shaped depressions of karst surfaces. They may constitute important microrefugia, as thermal inversion often maintains cooler conditions within them. This study aimed to identify the effects of large-(macroclimate) and small-scale (slope aspect and vegetation type) environmental factors on cool-adapted plants in karst dolines of East-Central Europe. We also evaluated the potential of these dolines to be microrefugia that mitigate the effects of climate change on cool-adapted plants in both forest and grassland ecosystems.Methods We compared surveys of plant species composition that were made between 2007 and 2015 in 21 dolines distributed across four mountain ranges (sites) in Hungary and Romania. We examined the effects of environmental factors on the distribution and number of cool-adapted plants on three scales: (1) regional (all sites); (2) within sites and; (3) within dolines. Generalized linear models and non-parametric tests were used for the analyses.Key Results Macroclimate, vegetation type and aspect were all significant predictors of the diversity of cooladapted plants. More cool-adapted plants were recorded in the coolest site, with only few found in the warmest site. At the warmest site, the distribution of cool-adapted plants was restricted to the deepest parts of dolines. Within sites of intermediate temperature and humidity, the effect of vegetation type and aspect on the diversity of cooladapted plants was often significant, with more taxa being found in grasslands (versus forests) and on north-facing slopes (versus south-facing slopes).Conclusions There is large variation in the number and spatial distribution of cool-adapted plants in karst dolines, which is related to large-and small-scale environmental factors. Both macro-and microrefugia are therefore likely to play important roles in facilitating the persistence of cool-adapted plants under global warming.

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Pannonian forest-steppes host a high number of endemic species and contribute to landscape-scale heterogeneity. Alterations in the proportion of forests and grasslands due to changes in land-use practice and climatic parameters can have serious nature conservation consequences. Hypotheses about forest-steppe dynamics have rarely been verified by detailed analyses, especially for the sandy forest-steppes. We integrated historical analysis, aerial photo interpretation and field investigation to determine how vegetation of a sandy forest-steppe has changed, how current dynamical processes operate and how native and exotic tree species regenerate under present conditions. The vegetation of the study area before the onset of major anthropogenic environmental transformations in the Carpathian Basin may have been a mosaic of forested and unforested patches. However, there is strong evidence that after heavy deforestation, the region was almost completely treeless between the 15 th and the 19 th centuries. Forest cover was able to recover by the 1800s but the lack of forested areas in the region for centuries explains why forest patches are still poor in species. Grasslands, which existed continuously, are more diverse, supporting several rare and endemic species. From 1953 till 2013, 72.45% of the area proved to be stable, but 27.55% showed clear dynamical character, changing either from forest to grassland, or vice versa. Thus, cyclic dynamics can occur in sandy forest-steppes. We found that forest patches of different size, differently exposed edges and grasslands provide different habitats for the tree species. Exotic species were present in large numbers, probably due to the small size of the reserve and the lack of a buffer zone. Abbreviations: DBH-diameter at breast height, DCA-Detrended Correspondence Analysis.

Patients with comorbidities and obesity are more likely to be hospitalized with coronavirus disease 2019 (COVID-19), to have a higher incidence of severe pneumonia and to also show higher mortality rates. Between 15 March 2020 and 31 December 2021, a retrospective, single-center, observational study was conducted among patients requiring hospitalization for COVID-19 infection. Our aim was to investigate the impact of comorbidities and lifestyle risk factors on mortality, the need for intensive care unit (ICU) admission and the severity of the disease among these patients. Our results demonstrated that comorbidities and obesity increased the risk for all investigated endpoints. Age over 65 years and male sex were identified as independent risk factors, and cardiovascular diseases, cancer, endocrine and metabolic diseases, chronic kidney disease and obesity were identified as significant risk factors. Obesity was found to be the most significant risk factor, associated with considerable odds of COVID-19 mortality and the need for ICU admission in the under-65 age group (aOR: 2.95; p < 0.001 and aOR: 3.49, p < 0.001). In our study, risk factors that increased mortality and morbidity among hospitalized patients were identified. Detailed information on such factors may support therapeutic decision making, the proper targeting of vaccination campaigns and the effective overall management of the COVID-19 epidemic, hence reducing the burden on the healthcare system.

Data to the flora and vegetation of Hungary III.