Validity of Apgar Score as an Indicator of Neonatal SARS-CoV-2 Infection: A Scoping Review

The coronavirus disease 2019 (COVID-19) pandemic has had profound impacts on healthcare systems worldwide, particularly regarding the care of pregnant women and their neonates. The use of the Apgar score—a discrete numerical index used to evaluate neonatal condition immediately following delivery that has been used ubiquitously as a clinical indicator of neonatal condition and widely reported in the literature for decades—has continued during the pandemic. Although health systems adopted protocols that addressed pregnant women and their neonates during the pandemic, limited research has assessed the validity of Apgar scores for determining neonatal conditions in the context of COVID-19. Therefore, this scoping review was conducted on the first 2 years of the pandemic and included mothers with reverse transcription-polymerase chain reaction confirmed COVID-19 and their resulting positive or negative neonates. In total, 1,966 articles were assessed for eligibility, yielding 246 articles describing 663 neonates. Neonates who tested negative had median Apgar scores of 9 and 9 at 1 and 5 mins, respectively, while test-positive neonates had median Apgar scores of 8 and 9 at the same time points. The proportions of test-negative neonates with Apgar scores below 7 were 29 (4%) and 11 (2%) at 1 and 5 mins, which was not statistically significant (p = 0.327, χ2 = 0.961). These proportions were even lower for positive neonates: 22 (3%) and 11 (2%) at 1 and 5 mins, respectively, which was not statistically significant (p = 1, χ2 = 0). The low proportion of Apgar scores below 7 suggests that low Apgar scores are likely to be associated with severe maternal COVID-19 symptoms during delivery rather than neonatal COVID-19. Therefore, this study indicated that Apgar scores are poor indicators of neonatal COVID-19 status.

A modelling study across the Italian regions: Lockdown, testing strategy, colored zones, and skew-normal distributions. How a numerical index of pandemic criticality could be useful in tackling the CoViD-19. (Preprint)

BACKGROUND As Europe is facing the second wave of the CoViD-19 pandemic, each country should carefully review how it dealt with the first wave of outbreak. Lessons from the first experience should be useful to avoid indiscriminate closures and, above all, to determine universal (understandable) parameters to guide the introduction of containment measures to reduce the spreading of the virus. OBJECTIVE The use of few (effective) parameters is indeed of extreme importance to create a link between authorities and population, allowing the latter to understand the reason for some restrictions and, consequently, to allow an active participation in the fight against the pandemic. METHODS Testing strategies, fitting skew parameters (as mean, mode, standard deviation, and skewness), mortality rates, and weekly CoViD-19 spreading data, as more people are getting infected, were used to compare the first wave of the outbreak in the Italian regions and to determine which parameters have to be checked before introducing restrictive containment measures. RESULTS We propose few \textit{universal} parameters that, once appropriately weighed, could be useful to correctly differentiate the pandemic situation in the national territory and to rapidly assign the properly pandemic risk to each region. CONCLUSIONS The numerical index of pandemic criticality introduced in this paper could be useful in tackling the CoViD-19.

Identification of novel thiadiazin derivatives as potentially selective inhibitors towards trypanothione reductase from Trypanosoma cruzi by molecular docking using the numerical index poses ratio Pr and the binding mode analysis

Chagas disease is a serious health problem in Central and South America for which effective treatment is not currently available. This illness is caused by the protozoa Trypanosoma cruzi, a species that relies on a thiol-based metabolism to regulate oxidative stress. Trypanothione reductase enzyme plays a central role in the metabolic pathway of the parasite. In this work, a virtual screening of a library of novel thiadiazine derivatives against trypanothione reductase using molecular docking was performed. Four different series of hybrid ligands having in the structure one or two peptoid moieties (series I and II) or the tetrazole ring (series III and IV) were considered. An ad hoc numerical index called poses ratio was introduced to interpret the results of the docking analysis and to establish relevant structure-interaction relationships. In addition, six binding modes were found for the ligands with the highest populated conformational clusters after applying contact-based analysis. The most regular and relevant were binding modes I and II, found mainly for ligands from series I. A subsequent molecular docking on human glutathione reductase enzyme allowed to assess the possible cytotoxicity of the ligands towards human cells. A selective binding profile was found for ligands with interactions in the Hydrophobic cleft, the spermidine and the Z subsites inside the active site of trypanothione reductase. At the end of the study, new thiadiazine-based compounds were identified as plausible candidates to selectively inhibit the parasitic enzyme. Graphic abstract

A Quantitative Index to Assess the Influence of Joint Fit-Up on Pipeline Weld Root Discontinuities

Field experience on pipelines suggests that under the unique conditions of tie-in welding, a high-low offset at the inner pipe wall is related to an increased occurrence of latent root weld discontinuities such as cold cracking. Codes and standards offer conflicting and unclear guidelines regarding acceptance criteria for high-low offset. This study presents a numerical index to quantify the influence of non-ideal joint geometry on the latent discontinuity susceptibility of the root pass for circumferential pipeline welds. The index is based on the stress concentration at the root and the angular distortion associated with plastic strains produced during welding. This index relates geometric considerations such as pipe diameter, wall thickness, and the cross section of the root pass with welding procedure variables and the mechanical properties of the pipeline material. Although this study is meant for steel pipelines, the conclusions obtained are also applicable to other materials. The index presented is a contribution towards an objective criterion for acceptance of high-low offset during field welding, ranking the susceptibility to latent discontinuities as a function of variables available to practitioners during field welding.