Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: a systematic review and critical analysis.

BACKGROUND: Early reports of COVID-19 in pregnancy described management by caesarean, strict isolation of the neonate and formula feeding. Is this practice justified? OBJECTIVE: To estimate the risk of the neonate becoming infected with SARS-CoV-2 by mode of delivery, type of infant feeding and mother-infant interaction. SEARCH STRATEGY: Two biomedical databases were searched between September 2019 and June 2020. SELECTION CRITERIA: Case reports or case series of pregnant women with confirmed COVID-19, where neonatal outcomes were reported. DATA COLLECTION AND ANALYSIS: Data were extracted on mode of delivery, infant infection status, infant feeding and mother-infant interaction. For reported infant infection, a critical analysis was performed to evaluate the likelihood of vertical transmission. MAIN RESULTS: Forty nine studies included information on mode of delivery and infant infection status for 655 women and 666 neonates. In all, 28/666 (4%) tested positive postnatally. Of babies born vaginally, 8/292 (2.7%) tested positivecompared with 20/374 (5.3%) born by Caesarean. Information on feeding and baby separation were often missing, but of reported breastfed babies 7/148 (4.7%) tested positive compared with 3/56 (5.3%) for reported formula fed ones. Of babies reported as nursed with their mother 4/107 (3.7%) tested positive, compared with 6/46 (13%) for those who were reported as isolated. CONCLUSIONS: Neonatal COVID-19 infection is uncommon, rarely symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or remains with the mother. TWEETABLE ABSTRACT: Risk of neonatal infection with COVID-19 by delivery route, infant feeding and mother-baby interaction.

Looking for the "connection": A clinical vignette on pediatric chest wall masses.

Chest wall masses in the pediatric population are relatively rare, and the differential diagnosis predominantly includes neoplastic soft tissue or osseous tumours, either benign or malignant in etiology, although local infectious processes represent additional diagnostic possibilities. Among recent immigrants, a more diverse array of less commonly observed pathogens warrant consideration. Here, we present a case of a chest wall mass in an immunocompetent child who had recently immigrated from the Philippines.

Les masses de la paroi thoracique sont relativement rares dans la population pédiatrique, et le diagnostic différentiel touche surtout les tumeurs néoplasiques des tissus mous ou des os, d'étiologie bénigne ou maligne, même si les processus infectieux locaux s'ajoutent aux possibilités diagnostiques. Chez des immigrants récents, de nombreux agents pathogènes moins fréquents méritent d'être envisagés. Les chercheurs présentent un cas de masse de la paroi thoracique chez un enfant immunocompétent récemment immigré des Philippines.

Event data recorders in the analysis of frontal impacts.

Evaluations of crash protection safety features require measures for quantifying impact severity. Velocity change (delta-V) is the major descriptor of collision severity used in most real-world crash databases. One of the limitations of delta-V is that it does not account for the time over which the crash pulse occurs (delta-t). Late model GM vehicles equipped with event data recorders capture the cumulative delta-V in 10 ms intervals over the crash pulse. Deceleration can be readily calculated from these data and provides a complementary measure of severity that has not previously been available for real world crashes. The relationship between maximum delta-V and deceleration was examined for different vehicle platforms involved in real world frontal impacts and frontal crash tests. Maximum deceleration was observed to be closely correlated to the maximum delta-V.