Novel deep transfer learning model for COVID-19 patient detection using X-ray chest images.

Around the world, more than 250 countries are affected by the COVID-19 pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This outbreak can be controlled only by the diagnosis of the COVID-19 infection in early stages. It is found that the radiographic images are ideal for the fastest diagnosis of COVID-19 infection. This paper proposes an ensemble model which detects the COVID-19 infection in the early stage with the use of chest X-ray images. The transfer learning enables to reuse the pretrained models. The ensemble learning integrates various transfer learning models, i.e., EfficientNet, GoogLeNet, and XceptionNet, to design the proposed model. These models can categorize patients as COVID-19 (+), pneumonia (+), tuberculosis (+), or healthy. The proposed model enhances the classifier's generalization ability for both binary and multiclass COVID-19 datasets. Two popular datasets are used to evaluate the performance of the proposed ensemble model. The comparative analysis validates that the proposed model outperforms the state-of-art models in terms of various performance metrics.

Sleep and Covid-19.

BACKGROUND: COVID-19 pandemic has affected the world globally causing widespread repercussions on individuals' physical, mental and emotional well-being. In such times, sleep is likely to be affected. OBJECTIVE: The aim of this study was to present the available literature on sleep and also the foresight as to the future national strategy to mitigate the effects of this pandemic. MATERIALS AND METHODS: An extensive literature search on PubMed, Google Scholar, Epistemonikos database (https://www.epistemonikos.org), PsycINFO for available literature on the prevalence of sleep problem on COVID-19 was done. Cross-citation search was also conducted to increase relevance of the review. The key words used were- (((((((((((insomnia)) OR (sleep)) OR (sleepiness)) OR ("sleep quality")) OR (OSA)) OR ("obstructive sleep apnoea")) OR ("obstructive sleep apnea")) OR (("sleep problem")) AND "covid-19" OR covid19* OR "COVID-19" OR "2019-nCoV" OR cv19* OR "cv-19" OR "cv 19" OR "n-cov" OR ncov* OR "sars-cov-2" OR "sars-cov2" OR "2019-ncov" OR "SARS-Coronavirus-2" OR "SARS-Coronavirus2" OR (wuhan* AND (virus OR viruses OR viral)) OR (covid* AND (virus OR viruses OR viral)) OR "covid-19-related" OR "SARS-CoV-2-related" OR "SARS-CoV2-related" OR "2019-nCoV-related" OR "cv-19-related" OR "n-cov-related"). Inclusion criteria consisted of articles in English, published from Jan 2020 till 19 Apr 2020. Two reviewers independently screened each research study for inclusion and eligibility. RESULTS AND CONCLUSION: Sleep is affected during COVID-19 pandemic in patients, their families, health-care workers and their families, population in isolation, and quarantine and as such in public. Limited literature exists with subjective data and no objective criteria were found to study sleep in COVID-19 pandemic. OSA was found to be a frequent baseline characteristic of COVID-19 patients. A need to follow guidelines is of paramount importance and strategies to better sleep in the population needs to be addressed.

The Nature and Extent of Online Marketing by Big Food and Big Alcohol During the COVID-19 Pandemic in Australia: Content Analysis Study.

BACKGROUND: Emerging evidence demonstrates that obesity is associated with a higher risk of COVID-19 morbidity and mortality. Excessive alcohol consumption and "comfort eating" as coping mechanisms during times of high stress have been shown to further exacerbate mental and physical ill-health. Global examples suggest that unhealthy food and alcohol brands and companies are using the COVID-19 pandemic to further market their products. However, there has been no systematic, in-depth analysis of how "Big Food" and "Big Alcohol" are capitalizing on the COVID-19 pandemic to market their products and brands. OBJECTIVE: We aimed to quantify the extent and nature of online marketing by alcohol and unhealthy food and beverage companies during the COVID-19 pandemic in Australia. METHODS: We conducted a content analysis of all COVID-19-related social media posts made by leading alcohol and unhealthy food and beverage brands (n=42) and their parent companies (n=12) over a 4-month period (February to May 2020) during the COVID-19 pandemic in Australia. RESULTS: Nearly 80% of included brands and all parent companies posted content related to COVID-19 during the 4-month period. Quick service restaurants (QSRs), food and alcohol delivery companies, alcohol brands, and bottle shops were the most active in posting COVID-19-related content. The most common themes for COVID-19-related marketing were isolation activities and community support. Promotion of hygiene and home delivery was also common, particularly for QSRs and alcohol and food delivery companies. Parent companies were more likely to post about corporate social responsibility (CSR) initiatives, such as donations of money and products, and to offer health advice. CONCLUSIONS: This is the first study to show that Big Food and Big Alcohol are incessantly marketing their products and brands on social media platforms using themes related to COVID-19, such as isolation activities and community support. Parent companies are frequently posting about CSR initiatives, such as donations of money and products, thereby creating a fertile environment to loosen current regulation or resist further industry regulation. "COVID-washing" by large alcohol brands, food and beverage brands, and their parent companies is both common and concerning. The need for comprehensive regulations to restrict unhealthy food and alcohol marketing, as recommended by the World Health Organization, is particularly acute in the COVID-19 context and is urgently required to "build back better" in a post-COVID-19 world.

Perceived Stress among Iranians during COVID-19 Pandemic; Stressors and Coping Mechanisms: A Mixed-methods Approach.

OBJECTIVE: New coronavirus (COVID-19) pandemic socioeconomically affected the world. In this study, we measured the perceived stress in response to the COVID-19 pandemic among Iranians to determine the groups at both extremes of the spectrum followed by identifying the stressors and coping mechanisms. METHODS: This study was a mixed-methods study. We distributed a web-based 10-item perceived stress scale (PSS-10), to measure perceived stress score (PSS), through social networks from March 12 to 23, 2020. Then, we interviewed 42 students, 31 homemakers, 27 healthcare providers, and 21 male participants to identify the sources of stress and coping mechanisms. RESULTS: Finally, 13,454 participants completed the questionnaires. The median and interquartile range (IQR) of the participants' PSS was 21 (15-25). Students, homemakers, and healthcare workers (HCWs) showed a higher median (IQR) of PSS compared to other groups (23 [18 to 27], 22 [16 to 26], and 19 [14 to 24], respectively). Male participants showed a lower median (IQR) PSS (17 [12 to 23]). Content analysis of 121 participants' answers showed that the most common stressors were school-related issues mentioned by students, family-related issues mentioned by homemakers, and COVID-19-related issues mentioned by healthcare providers. Male participants' coping mechanisms were mostly related to the perception of their abilities to cope with the current crisis. CONCLUSION: Our participants clinically showed a moderate level of PSS. The main stressors among students, homemakers, and HCWs were related to their principal role in this period, and male participants' coping mechanisms were inspired by the self-image retrieved from the social perspectives.

Self-care of Frontline Health Care Workers: During COVID-19 Pandemic.

The world is amidst the COVID-19 pandemic that has used social distancing as a tool for containing the virus from spreading exponentially among other individuals. Previous literature suggests that human contact and attachment is a key for well-being which is why punishments like solitary confinement in detention centers like jail has always been debated as being torturous (Wolfendal 2020). With this notion, anxiety and stress may become more prevalent in individuals who experience self-isolation or are under a forced lockdown. For health-care workers like doctors and psychologists, who advocate for physical health, mental health and wellbeing; the challenges might increase during the pandemic phase as they are expected to go through the crises just like others while simultaneously contributing in rendering services related to dealing with physical and psychological health issues present in patients and clients with their continued practice from either on-site or online platforms. Although all health care professional's training inoculates the ill effects of compassion fatigue by other's overwhelming situations and discussions but they might still be prone to vicarious burnout, trauma and stress. Hence, they may become exposed to being at risk of experiencing anxiety more than the general population. This review discusses facets of the importance of self-care as mental health first aid tool for health care professionals including doctors and psychologists using research and supportive techniques to help them process stress and anxiety during and after the global pandemic.

Sedentary lifestyle among office workers and coronary heart disease risk factors due to the COVID-19 quarantine.

The COVID-19 pandemic has affected the entire world. It is difficult to follow protocols and regulations set forth by governments, designed by the World Health Organization. The most common protocol set forth by governments is quarantining at home. Many occupations must stay home to comply with this protocol. Among these occupations, office workers are the most common group to comply and work from home. This has led to a lack of daily movement and increased sedentary lifestyle, which has made employees prone to developing coronary heart disease (CHD). Additionally, obesity is a known risk factor for this group. This commentary presents feasible protocols aimed at helping home-based office workers stay healthy and decrease the risk of developing CHD.

Nutrition in times of Covid-19, how to trust the deluge of scientific information.

PURPOSE OF REVIEW: The Covid-19 pandemic has daunted the world with its enormous impact on healthcare, economic recession, and psychological distress. Nutrition is an integral part of every person life care, and should also be mandatorily integrated to patient care under the Covid-19 pandemic. It is crucial to understand how the Covid-19 does develop and which risk factors are associated with negative outcomes and death. Therefore, it is of utmost importance to have studies that respect the basic tenets of the scientific method in order to be trusted. The goal of this review is to discuss the deluge of scientific data and how it might influence clinical reasoning and practice. RECENT FINDINGS: A large number of scientific manuscripts are daily published worldwide, and the Covid-19 makes no exception. Up to now, data on Covid-19 have come from countries initially affected by the disease and mostly pertain either epidemiological observations or opinion papers. Many of them do not fulfil the essential principles characterizing the adequate scientific method. SUMMARY: It is crucial to be able to critical appraise the scientific literature, in order to provide adequate nutrition therapy to patients, and in particular, to Covid-19 infected individuals.

Crime Rates in a Pandemic: the Largest Criminological Experiment in History.

The COVID-19 pandemic of 2020 has impacted the world in ways not seen in generations. Initial evidence suggests one of the effects is crime rates, which appear to have fallen drastically in many communities around the world. We argue that the principal reason for the change is the government ordered stay-at-home orders, which impacted the routine activities of entire populations. Because these orders impacted countries, states, and communities at different times and in different ways, a naturally occurring, quasi-randomized control experiment has unfolded, allowing the testing of criminological theories as never before. Using new and traditional data sources made available as a result of the pandemic criminologists are equipped to study crime in society as never before. We encourage researchers to study specific types of crime, in a temporal fashion (following the stay-at-home orders), and placed-based. The results will reveal not only why, where, when, and to what extent crime changed, but also how to influence future crime reduction.

[Effects of the COVID-19 Pandemic on childhood immunization in Morocco: electronic survey of 103 pediatricians]. / Impact de la pandémie COVID-19 sur la vaccination des enfants au Maroc: enquête électronique auprès de 103 pédiatres.

INTRODUCTION: no one can deny that vaccination against several serious diseases in the world, and particularly in Morocco, has given very satisfactory protective results. The extension of the COVID-19 pandemic in our country has led to a significant decline in childhood immunization, which could have severe repercussions increasing the risk of future outbreaks. Hence, the measures of the Ministry of Health to correct the situation. The purpose of this study was to highlight the extent of vaccine release during COVID-19 pandemic and to make recommendations to restore vaccination programmes. METHODS: we conducted a cross-sectional study of the effect of containment measures during this pandemic on the monitoring of children´s vaccinations. We conducted a national survey of pediatricians using an electronic questionnaire administered via Google Forms. We collected, analyzed and interpreted the results. RESULTS: one hundred and three Moroccan pediatricians answered the questionnaire. More than 2-thirds (78.6%) of pediatricians practiced in the private sector and delivered vaccines in the immunization schedule. The majority of pediatricians (95%) were asked about parental vaccine concerns. We noted that 82.5% of parents were reluctant to go to the local health department and 5.8% refused to take vaccination during COVID-19 pandemic. About 22% of pediatricians completely stopped immunization services and 72.8% delayed immunizations from 3 to 4 weeks. Vaccination stoppage involved older children in two thirds of cases. CONCLUSION: it is essential to maintain public confidence in vaccination. Ongoing and timely assessment of vaccine coverage as well as clear recommendations and broad public awareness are essential to respond to vaccine changes during the COVID-19 pandemic.

The mediator role of the fear of COVID-19 in the relationship between psychological resilience and life satisfaction.

COVID-19, which has recently affected the world, has caused serious adversities in many areas as well as on the mental health of individuals. People have had a serious fearful mood due to situations such as catching COVID-19, having health problems after catching the disease, and worrying about infecting someone else. This negative mood is discussed in the literature through the concept of the fear of COVID-19. Accordingly, the mediator role of the fear of COVID-19 in the relationship between psychological resilience and life satisfaction was examined in this study. This study was conducted with 430 Turkish university students, 279 women and 151 men, who are between the ages of 18 and 30. The data of the study were collected with the psychological resilience, the fear of COVID-19 and life satisfaction scales. As a result of the analysis, it was concluded that psychological resilience is a negative predictor of the fear of COVID-19 and a positive predictor of life satisfaction, and that the fear of COVID-19 is a negative predictor of life satisfaction. It was also concluded that the fear of COVID-19 mediates the relationship between psychological resilience and life satisfaction. The results are discussed in relation to the relevant literature, and suggestions are made for practitioners and researchers.

Combined drug repurposing and virtual screening strategies with molecular dynamics simulation identified potent inhibitors for SARS-CoV-2 main protease (3CLpro).

The current coronavirus (SARS-COV-2) pandemic and phenomenal spread to every nook and cranny of the world has raised major apprehensions about the modern public health care system. So far as a result of this epidemic, 4,434,653 confirmed cases and 302,169 deaths are reported. The growing infection rate and death toll demand the use of all possible approaches to design novel drugs and vaccines to curb this disease. In this study, we combined drugs repurposing and virtual drug screening strategies to target 3CLpro, which has an essential role in viral maturation and replication. A total of 31 FDA approved anti-HIV drugs, and Traditional Chinese medicines (TCM) database were screened to find potential inhibitors. As a result, Saquinavir, and five drugs (TCM5280805, TCM5280445, TCM5280343, TCM5280863, and TCM5458190) from the TCM database were found as promising hits. Furthermore, results from molecular dynamics simulation and total binding free energy revealed that Saquinavir and TCM5280805 target the catalytic dyad (His41 and Cys145) and possess stable dynamics behavior. Thus, we suggest that these compounds should be tested experimentally against the SARS-COV-2 as Saquinavir has been reported to inhibit HIV protease experimentally. Considering the intensity of coronavirus dissemination, the present research is in line with the idea of discovering the latest inhibitors against the coronavirus essential pathways to accelerate the drug development cycle.Communicated by Ramaswamy H. Sarma.

The Contribution of Neutrophils to the Pathogenesis of RSV Bronchiolitis.

Acute viral bronchiolitis causes significant mortality in the developing world, is the number one cause of infant hospitalisation in the developed world, and is associated with the later development of chronic lung diseases such as asthma. A vaccine against respiratory syncytial virus (RSV), the leading cause of viral bronchiolitis in infancy, remains elusive, and hence new therapeutic modalities are needed to limit disease severity. However, much remains unknown about the underlying pathogenic mechanisms. Neutrophilic inflammation is the predominant phenotype observed in infants with both mild and severe disease, however, a clear understanding of the beneficial and deleterious effects of neutrophils is lacking. In this review, we describe the multifaceted roles of neutrophils in host defence and antiviral immunity, consider their contribution to bronchiolitis pathogenesis, and discuss whether new approaches that target neutrophil effector functions will be suitable for treating severe RSV bronchiolitis.

Short-run environmental effects of COVID-19: Evidence from forest fires.

The outbreak of the 2019 novel coronavirus disease (COVID-19) has raised questions about changes in economic production and subsequent effects on the environment. This article employs satellite data on real-time active fire locations in Nepal to evaluate the short-term environmental effects of COVID-19. Using plausibly exogenous variation in the number of reported COVID-19 cases across the country, this study finds that the incidence of COVID-19 led to a strong negative effect on the incidence of human-induced forest fires. Results indicate that an additional reported case of COVID-19 resulted in a 4.54% decrease in the number of forest fire incidents and a 11.36% reduction in fire radiative power associated with these events. Findings also show that districts with smaller areas of community-managed forests per capita experienced a 8.11% decrease in the number of forest fire incidents. Restrictions on movement of people across districts in response to the pandemic likely reduced the incidence of forest fire events in Nepal. These short-run estimates of environmental benefits, which do not account for negative consequences of the virus outbreak on health and labor market outcomes, partially offset the social cost of pandemics in the developing world.

Recent Insights into Emerging Coronavirus: SARS-CoV-2.

The SARS-CoV-2 outbreak that emerged at the end of 2019 has affected more than 58 million people with more than 1.38 million deaths and has had an incalculable impact on the world . Extensive prevention and treatment measures have been implemented since the pandemic. In this Review, we summarize current understanding on the source, transmission characteristics, and pathogenic mechanism of SARS-CoV-2. We also detail the recent development of diagnostic methods and potential treatment strategies of COVID-19 with focus on the ongoing clinical trials of antibodies, vaccines, and inhibitors for combating the emerging coronavirus.

Effect of COVID-19 Pandemic on Gynecological Cancer Radiation During Complete Nationwide Lockdown: Observations and Reflections From Tertiary Care Institute in India.

PURPOSE: To report real-world compliance to radiation in gynecologic cancers during the complete lockdown phase of COVID-19 pandemic. METHODS AND MATERIALS: From March 23, 2020, until June 30, 2020, complete lockdown was imposed in India. During this period there was restructuring of cancer care and radiation oncology department due to operational policies prevalent in the institution, and the care for gynecological cancer was based on the evolving international recommendations. Institutional review board approval was obtained to audit patterns of care during the complete lockdown phase. Descriptive variables were used to report on patient characteristics, compliance, delays, toxicity, and observed deviations in recommended care. RESULTS: During the lockdown period spanning 100 days, treatment of 270 and telephonic follow-up of 1103 patients with gynecological cancer was undertaken. Of 270 new patients, due to travel restrictions, 90 patients were referred to the facilities in vicinity of their residence. Of the remaining 180 patients, 138 were planned for complete treatment at our institution and 42 were referred to our center for brachytherapy. Of 138 patients, only 106 (76%) completed the planned external radiation. Twenty-four (26%) patients completed full course of concurrent chemotherapy, 11 (12%) received chemotherapy dose reduction, and 57 (62%) received no concurrent chemotherapy. Treatment delay of up to 3 weeks was noted in 8.6% patients due to COVID-19 infection. No grade 4 to 5 acute sequelae were observed. No excess adverse effects were observed in high-risk population. Low rate of symptom burden was observed among 1103 patients on telephonic follow-up. With 100 (9.6%) patients reporting symptoms, among these, 54% (54 of 100) had complete resolution of symptoms within 4 weeks of teleconsultation, and 10% had disease progression. CONCLUSIONS: Low compliance with planned treatment was observed for radiation and concurrent chemotherapy due to lockdown and fear of contracting COVID-19 and will likely lead to increased risk of cancer-related mortality. Rapid restructuring of care is needed to prevent the same as COVID-19 pandemic further evolves.

Current Strategies of Antiviral Drug Discovery for COVID-19.

SARS-CoV-2 belongs to the family of enveloped, single-strand RNA viruses known as Betacoronavirus in Coronaviridae, first reported late 2019 in China. It has since been circulating world-wide, causing the COVID-19 epidemic with high infectivity and fatality rates. As of the beginning of April 2021, pandemic SARS-CoV-2 has infected more than 130 million people and led to more than 2.84 million deaths. Given the severity of the epidemic, scientists from academia and industry are rushing to identify antiviral strategies to combat the disease. There are several strategies in antiviral drugs for coronaviruses including empirical testing of known antiviral drugs, large-scale phenotypic screening of compound libraries and target-based drug discovery. To date, an increasing number of drugs have been shown to have anti-coronavirus activities in vitro and in vivo, but only remdesivir and several neutralizing antibodies have been approved by the US FDA for treating COVID-19. However, remdesivir's clinical effects are controversial and new antiviral drugs are still urgently needed. We will discuss the current status of the drug discovery efforts against COVID-19 and potential future directions. With the ever-increasing movability of human population and globalization of world economy, emerging and reemerging viral infectious diseases seriously threaten public health. Particularly the past and ongoing outbreaks of coronaviruses cause respiratory, enteric, hepatic and neurological diseases in infected animals and human (Woo et al., 2009). The human coronavirus (HCoV) strains (HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1) usually cause common cold with mild, self-limiting upper respiratory tract infections. By contrast, the emergence of three deadly human betacoronaviruses, middle east respiratory syndrome coronavirus (MERS) (Zaki et al., 2012), severe acute respiratory syndrome coronavirus (SARS-CoV) (Lee et al., 2003), the SARS-CoV-2 (Jin et al., 2020a) highlight the need to identify new treatment strategies for viral infections. SARS-CoV-2 is the etiological agent of COVID-19 disease named by World Health Organization (WHO) (Zhu N. et al., 2020). This disease manifests as either an asymptomatic infection or a mild to severe pneumonia. This pandemic disease causes extent morbidity and mortality in the whole world, especially regions out of China. Similar to SARS and MERS, the SARS CoV-2 genome encodes four structural proteins, sixteen non-structural proteins (nsp) and accessory proteins. The structural proteins include spike (S), envelope (E), membrane (M), nucleoprotein (N). The spike glycoprotein directly recognizes and engages cellular receptors during viral entry. The four non-structural proteins including papain-like protease (PLpro), 3-chymotrypsin-like protease (3CLpro), helicase, and RNA-dependent RNA polymerase (RdRp) are key enzymes involved in viral transcription and replication. The spike and the four key enzymes were considered attractive targets to develop antiviral agents (Zumla et al., 2016). The catalytic sites of the four enzymes of SARS-CoV2 share high similarities with SARS CoV and MERS in genomic sequences (Morse et al., 2020). Besides, the structures of the key drug-binding pockets are highly conserved among the three coronaviruses (Morse et al., 2020). Therefore, it follows naturally that existing anti-SARS-CoV and anti-MERS drugs targeting these enzymes can be repurposed for SARS-CoV-2. Based on previous studies in SARS-CoV and MERS-CoV, it is anticipated a number of therapeutics can be used to control or prevent emerging infectious disease COVID-19 (Li and de Clercq, 2020; Wang et al., 2020c; Ita, 2021), these include small-molecule drugs, peptides, and monoclonal antibodies. Given the urgency of the SARS-CoV-2 outbreak, here we discuss the discovery and development of new therapeutics for SARS-CoV-2 infection based on the strategies from which the new drugs are derived.

Tissue Lipidomic Alterations Induced by Prolonged Dexamethasone Treatment.

Dexamethasone is a synthetic glucocorticoid medication vastly used to treat abnormal immune responses and inflammation. Although the medication is well-established in the medical community, the prolonged treatment with high dosages of dexamethasone may lead to severe adverse effects through mechanisms that are not yet well-known. Lipids are a large class of hydrophobic molecules involved in energy storage, signaling, modulation of gene expression, and membranes. Hence, untargeted lipidomics may help unravel the biochemical alterations following prolonged treatment with high dosages of dexamethasone. We performed comprehensive lipidomic analyses of brain, heart, kidney, liver, and muscle samples obtained from rats that were treated with intramuscular injections of dexamethasone for 14 weeks compared to healthy controls. The employed methodology and statistical analysis showed that phosphatidic acids, glycerophospholipids, plasmalogens, and fatty acids are deeply affected by prolonged use of the medication. Brain tissue was only mildly affected, but skeletal muscle showed a strong accumulation of lipids that may be correlated with alterations in the energy metabolism, myopathy, and oxidative processes. This work provides new insights into the mechanisms of action and adverse effects for one of the most commonly prescribed class of drugs in the world.

United in earnest: first pilot sites for increased surgical capacity for rheumatic heart disease announced by cardiac surgery intersociety alliance.

OBJECTIVES: Rheumatic heart disease (RHD) affects >33 000 000 individuals, mostly from low- and middle-income countries. The Cape Town Declaration on Access to Cardiac Surgery in the Developing World was published in August 2018, signalling the commitment of the global cardiac surgery and cardiology communities to improving care for patients with RHD. METHODS: As the Cape Town Declaration formed the basis for which the Cardiac Surgery Intersociety Alliance (CSIA) was formed, the purpose of this article is to describe the history of the CSIA, its formation, ongoing activities and future directions, including the announcement of selected pilot sites. RESULTS: The CSIA is an international alliance consisting of representatives from major cardiothoracic surgical societies and the World Heart Federation. Activities have included meetings at annual conferences, exhibit hall participation for advertisement and recruitment and publication of selection criteria for cardiac surgery centres to apply for CSIA support. Criteria focused on local operating capacity, local championing, governmental and facility support, appropriate identification of a specific gap in care and desire to engage in future research. Eleven applications were received for which 3 finalist sites were selected and site visits conducted. The 2 selected sites were Hospital Central Maputo (Mozambique) and King Faisal Hospital Kigali (Rwanda). CONCLUSIONS: Substantial progress has been made since the passing of the Cape Town Declaration and the formation of the CSIA, but ongoing efforts with collaboration of all committed parties-cardiac surgery, cardiology, industry and government-will be necessary to improve access to life-saving cardiac surgery for patients with RHD.

Creating conditions for male partner involvement in birth in the Hungarian obstetric wards during the COVID-19 pandemic / Az együttszülés feltételeinek megteremtése a hazai szülészeti osztályokon a COVID-19-járvány idején.

Összefoglaló. Bevezetés: Az Egészségügyi Világszervezet adatai alapján 2020 oszére a világ minden régióját elérte az új koronavírus (SARS-CoV-2) okozta fertozés. Magyarországon 2020 márciusában az elso esetek - több más betegjogi kérdés mellett - ráirányították a figyelmet a betegtájékoztatás kiemelt fontosságára, annak jogszabály szerinti betartására, valamint az alkalmazás során fellépo nehézségekre. Tekintve, hogy az együttszülés lehetosége az utóbbi évtizedekben egyre népszerubb a családtervezés és a közös életkezdés folyamatában, az apák felkészítése a szülésre - a járványhelyzet miatt megváltozott tájékoztatási szigorítások összehangolásával - a szülészeti osztályok jelentos feladata lett. A betegtájékoztatás teljes köru alkalmazása során számos szempontot kellett figyelembe venni ahhoz, hogy a szülés az anya és az apa számára pozitív emlék maradjon, még olyan helyzetben is, mint a COVID-19-járvány. Célkituzés: Elemezni kívántuk, hogy a magyarországi szülészeti osztályokon hogyan lehetett a világjárvány idején is betartani a hatályos jogszabályokat és eljárásrendeket, milyen intézkedések váltak szükségessé az együttszülés gyakorlatának fenntartásához, és egyidejuleg biztosítani, hogy a szülononek és férfi partnerének a tájékoztatáshoz való jogai ne sérüljenek. Módszer: Online 14 feleletválogatós kérdoívet küldtünk valamennyi magyarországi, állami fenntartású kórház és klinika szülészeti osztálya vezetojének. A beérkezett kérdoívek adatait összevetettük az intézmények honlapján az együttszüléssel kapcsolatos információkkal is. Eredmények: A 2020. március 20. és szeptember 20. közötti fél évben a várandós párok tájékoztatása során a szolgáltatók minden esetben a hatályos eljárásrendeket követték, ez azonban több esetben többlet anyagi ráfordítást és szervezést jelentett számukra. Következtetés: Adataink rámutatnak arra, hogy az együttszüléssel kapcsolatosan a szülésre érkezok igyekeznek a leheto legjobban tájékozódni, és ugyanolyan elvárásaik vannak a szülés körülményeit illetoen, mint a járványmentes idoszakban. Amennyiben a tájékoztatás kielégíto és részletes számukra, az esetleges hátrányos változtatásokat is jobban tolerálják. A járványra tekintettel valamennyi osztályon megmaradt az együttszülés lehetosége, a megfelelo járványügyi intézkedések megtartása mellett. Orv Hetil. 2021; 162(21): 824-829. INTRODUCTION: According to data collected by the World Health Organization, by the autumn of 2020, all regions of the world were affected by SARS-CoV-2 viral infection. In Hungary, the first cases were detected in March 2020, and the epidemic, among several other patient rights issues, drew attention to the paramount importance of patient information, its compliance with the law, and the difficulties encountered in its application. During the last decades, the possibility of male partner involvement in birth has become increasingly popular in the process of family planning and starting a life together. Preparing fathers for childbirth and coordinating information restrictions that have changed due to the epidemic is a priority for obstetric departments. The full application of patient information requires a number of considerations to ensure that childbirth remains a positive memory for mother and father, even in a situation such as the COVID-19 pandemic. OBJECTIVE: We wanted to analyze how the obstetric wards in Hungary were able to comply with the laws and procedures in force at the time of the pandemic, what measures became necessary for creating male partner involvement in births, and at the same time to ensure that the rights of the mother and the father are not violated. METHOD: We sent an online questionnaire to the head of the obstetrics department of all Hungarian state hospitals and clinics, using 14 multiple-choice questions. The data of the received questionnaires were also compared with the information related to male partner involvement in births published on the websites of the institutions. RESULTS: In the period from 20 March to 20 September 2020, in terms of informing pregnant couples, the service providers always followed the procedures in force, but in several cases this meant more financial expenditure and organization for them. CONCLUSION: Our data showed that those who give birth insist on the best possible information about conditions of male partner involvement in births, have the same expectations about the conditions of childbirth as during the epidemic-free period. If the information is satisfactory and detailed for them, they are more tolerant of adverse changes. In view of the epidemic, the possibility of father involvement in birth remained in all departments available, while maintaining appropriate epidemiological measures. Orv Hetil. 2021; 162(21): 824-829.