Impact of the COVID-19 pandemic on employment and inequalities: a systematic review of international evidence and critical appraisal of statistical methods.

AIMS: To assess the impact of the COVID-19 pandemic on individual labour market outcomes and how these vary over time and between different groups of individuals. METHODS: Searches were conducted using Medline, Scopus and EconLit. Grey literature searches used Google Scholar and Econpapers. Study quality was assessed using the risk of bias in non-randomised studies of exposure tool (ROBINS-E), accompanied by a directed acyclic graph (DAG) to identify relevant mediators, moderators and confounders. RESULTS: A total of 85 studies (77 peer-reviewed articles, 8 working papers) were included. The ROBINS-E showed that the overall risk of bias varied between studies from low (n = 14), moderate (n = 56) to serious (n = 15). Studies also varied in terms of outcome measures, study designs and the academic disciplines of researchers. Generally, studies using data collected before and during the pandemic showed large negative effects on employment, working hours and income. Studies that assessed moderators (e.g. by industry, occupation, age, gender, race and country of birth) indicated the pandemic has likely worsened pre-existing disparities in health and work. Generally, women, less educated, non-whites and young workers were affected the most, perhaps due to their jobs involving high levels of personal contact (e.g. hospitality, sales and entertainment) and being less amenable to remote working. The DAG highlighted methodological challenges in drawing robust inferences about COVID-19's impact on employment, including the lack of an unexposed control group. CONCLUSIONS: The COVID-19 health crisis caused unanticipated and unprecedented changes to employment opportunities around the world, with potential long-term health consequences. Further research should investigate the longer-term impact of COVID-19, with greater attention given to low- and middle-income countries. Our study provides guidance on the design and critical appraisal of future studies.

Synthesis of N-[1-(2-Acetyl-4,5-dimethoxyphenyl)propan-2-yl]benzamide and Its Copper(II) Complex.

This paper represents a convenient method for the synthesis of N-[1-(2-acetyl-4,5-dimethoxyphenyl)propan-2-yl]benzamide and its Cu(II) complex. In silico analysis predicted spasmolytic activity for the compound. Based on the in silico calculations, the importance of the predicted ketoamide, and our previous experiments, we synthesized the ketoamide via ortho-acylation of N-[1-(3,4-dimethoxyphenyl)propan-2-yl]benzamide with acetic anhydride in polyphosphoric acid. We applied the title ketoamide in reaction with Cu(II) varying the solvents. We found that the reaction leads to the formation of a coordination compound when the ligand dissolved in DMSO reacts with a water solution of CuCl2 in an alkaline environment in a molar ratio M : L : OH- = 1 : 2 : 2. The structures of the new compounds are discussed based on their melting points, IR, 1H, 13C NMR and Raman spectral data.

Metopic skull with occipitalisation of the atlas.

In this study we report a combination of anatomic variations in the neurocranium of an adult male skull. The skull is scanned using an industrial µCT system Nikon XT H 225. The cranial vault shows a persistent metopic suture, a remnant from the mendosal suture and supernumerary bones. Cranial base inspection reveals atlas occipitalisation (AO), basilar kyphosis, unusually shaped dorsum sellae and bilateral interclinoid bridging. AO is extensive without signs of atlantooccipital articulation. The anterior and posterior arches of the atlas and the right transverse process are fussed to the occipital bone above. The complete fusion of the posterior arch causes a formation of bone canals for the vertebral arteries passage into the cranium. AO in this case is not related to a reduction of the foramen magnum dimensions and clivus length.

Facial soft tissue thicknesses in Bulgarian adults: relation to sex, body mass index and bilateral asymmetry.

BACKGROUND: The aim of the study is to measure the facial soft tissue thicknesses (STTs) in Bulgarians, to evaluate the relation of the STTs to the nutritional status, sex and bilateral asymmetry, and to examine the correlations between the separate STTs as well as between the STTs and body weight, height, and body mass index (BMI). In the present study, the facial STTs were measured on computed tomography scans of the head of Bulgarian adults. MATERIALS AND METHODS: The STTs were measured at 7 midline and 9 bilateral landmarks. The measurements were performed in the free software InVesalius in the axial and sagittal planes. The mean, standard deviation, minimum and maximum values, median and coefficient of variation were reported for the STT at each landmark according to the sex and BMI category. The BMI, sex and bilateral differences were assessed for statistical significance. Pearson correlation analysis was applied to assess the strength and direction of the relationships between the STTs and body height, weight and BMI, as well as between separate STTs. RESULTS AND CONCLUSIONS: The facial soft tissues in Bulgarian adults changed in accordance with the nutritional status of the individual and in both sexes all STTs augmented with the increasing BMI. For both normal and overweight BMI categories, males had more soft tissue at the majority of facial points than females, as the only exceptions were observed in the cheek zone, where STTs were thicker in females. Significant bilateral differences were observed in either sex and BMI category. Stronger correlations were established for the STTs in the jaw region and between the cheek and jaw soft tissues. Besides, the correlations between the homologous bilateral landmarks were among the strongest ones.

Evaluation of DNA extraction methods for the detection of Cytomegalovirus in dried blood spots.

BACKGROUND: Dried blood spots (DBS) are collected universally from newborns and may be valuable for the diagnosis of congenital Cytomegalovirus (CMV) infection. The reported analytical sensitivity for DBS testing compared to urine or saliva varies greatly across CMV studies. The purpose of this study was to directly compare the performance of various DNA extraction methods for identification of CMV in DBS including those used most often in CMV studies. STUDY DESIGN: Whatman(®) Grade 903 filter paper cards were spotted with blood samples from 25 organ transplant recipients who had confirmed CMV viremia. Six DNA extraction methods were compared for relative yield of viral and cellular DNA: 2 manual solution-based methods (Gentra Puregene, thermal shock), 2 manual silica column-based methods (QIAamp DNA Mini, QIAamp DNA Investigator), and 2 automated methods (M48 MagAttract Mini, QIAcube Investigator). DBS extractions were performed in triplicate followed by real-time quantitative PCR (qPCR). RESULTS: For extraction of both viral and cellular DNA, two methods (QIAamp DNA Investigator and thermal shock) consistently gave the highest yields, and two methods (M48 MagAttract Mini and QIAamp DNA Mini) consistently gave the lowest yields. There was an average 3-fold difference in DNA yield between the highest and lowest yield methods. CONCLUSION: The choice of DNA extraction method is a major factor in the ability to detect low levels of CMV in DBS and can largely account for the wide range of DBS sensitivities reported in studies to date.

Variations in the squamous part of the occipital bone in medieval and contemporary cranial series from Bulgaria.

The squamous part of the occipital bone is a place of many different variations. They are a result of faulty ossification in the occipital squama or due to the presence of sutural bones in the lambda region. As their differentiation is intricate because of the various criteria used, the issue of their recognition in the adult skull still remains difficult even though they can be clearly distinguished at a younger age. The aim of the present study was to compare the frequency of interparietal, preinterparietal and sutural bones in the lambda region in medieval male and female cranial series as well as between medieval and contemporary male series from Bulgaria. We also discuss the development of the occipital squama in order to set clearer criteria for further differentiation of such variations in the adult skull. In the reviewed 3 cranial series, the variations in the squamous portion of the occipital bone were observed with a low frequency. The incidence of preinterparietal bones was more common than the interparietal ones. The sutural bones in the lambda region were numerous in the series. No statistically significant sex or intergroup differences were established. So even if these anatomical variations are relatively rare, the understanding of them is of significance for many disciplines like anthropology, comparative and developmental anatomy, clinical and forensic medicine.

Morphology of suprascapular notch in medieval skeletons from Bulgaria.

The suprascapular notch is situated in the lateral part of the superior border of the scapula, just medial to the base of the coracoid process, giving passage for the suprascapular nerve. The aim of this study is to determine the frequency of different types of suprascapular notch in male and female medieval skeletal series and to assess the sexual differences. The shape of the notch was classified into 5 types, based on the scheme given by Alekseev. A total of 102 scapulae and scapular fragments were investigated. The results show that the deep notch was the most common. In the left female scapulae the shallow notch was frequently observed as well. Three cases of suprascapular foramen, which is considered as a risk factor for suprascapular nerve neuropathy, were observed and there was a double foramen in one of them, which is a very rare case. According to the results of c2 test, there were no significant sexual differences in the distribution of notch types. Our results illustrate that there were some individuals among the investigated medieval population potentially affected by suprascapular nerve entrapment syndrome and their way of livingmay have been impacted by the symptoms accompanying this condition.

[Screning study on pregnant women and neonatal infection with streptococcus agalactiae (group B streptococci)].

We report the results of a screening study on pregnant women and early onset neonatal group B streptococcal infections in Sofia, Bulgaria, July 2009-July 2010. Women were studied for risk factors at delivery, intrapartum antibiotic prophylaxis (lAP) and outcome for the newborns. All GBS positive women who had risk factors at delivery gave birth to newborns with neonatal infection despite the IAP given in 50% of the cases. The majority of the GBS positive women who had no risk factors at delivery gave birth to healthy newborns although only 32% of them received IAP However 11% of the GBS positive women without risk factors delivered children with neonatal infection. We consider that IAP should be given to all GBS positive women to prevent from neonatal infection. The dominant GBS serotypes were ll, 11 and la. The isolates were 100% susceptible to penicillin, cefazolin, cefotaxime, vancomycin and 91.66% susceptible to erythromycin and clindamycin, the resistant strains being from the MLSB phenotype.

[Therapeutic approach to obstetric delivery in women with gestational diabetes mellitus].

With the development of gestational diabetes the normal delivery process is impaired more frequently and respectively the risks for the newborns and the mothers are higher. Most of the perinatal complications are related directly or indirectly with the hyperglycemia of the mother and hyperinsulinemia of the newborn. By reason of this is important the blood glucose level to be normal during the delivery process. In this paper have been shown the protocols for behavior during a normal delivery and a delivery by Cesarean section.

Pretreatment of guinea-pigs with iron or desferal influences the course of Yersinia enterocolitica infections.

The effects of iron excess and desferrioxamine in pretreated guinea-pigs on the immune response (production of Yops) and on the histological changes in infections with Yersinia enterocolitica 0:3 and Y. enterocolitica 0:8 were investigated. The prior overload of the guinea pigs with Dextrofer or treatment with Desferal increased the pathogenic activity of Y. entercolitica 0:3 and led to a generalized infection. Immunoblot analysis showed that in conditions of iron overload the expression of outer membrane proteins (Yops) of Y. enterocolitica 0:8 was blocked. This was accompanied by weak changes in the tissues. The iron limited conditions stimulated production of a low molecular weight protein (17 kDa) on day 6 and easier proliferation of the bacterium. This in vivo study intends to show that in Y. enterocolitica infections a leading role is played not only by iron itself but also by the bacterial strain.

Isolation of pathogenic yersiniae from wild animals in Bulgaria.

Pathogenic Yersinia strains were isolated between December 1998 and April 1999 from 37 wild animals: rabbit (Lepus europeus), boar (Sus scrofa scrofa), asiatic jackal (Canis aureus), red fox (Vulpes vulpes), mouflon (Ovis musimon), european river otter (Lutra lutra), beech marten (Martes foina), polecat (Musleta putorius) and wild cat (Felis silvestris). It was established that among the wild animals Y. enterocolitica strains of serotype 0:3 predominated, accompanied by Y. pseudotuberculosis strains of serotype 0:3. In one sample from asiatic jackal and one sample from rabbit, Y. enterocolitica serotype 0:8 was isolated. Yersinia enterocolitica and Y. pseudotuberculosis strains were isolated from tonsils and tongues as well as from the viscera--lung, liver, heart, spleen, kidney and lymph nodes, mainly in young animals (1-2 years of age). The results showed that wild animals are a possible natural reservoir for pathogenic Y. enterocolitica and Y. pseudotuberculosis and are included in the epidemiological chain of yersinioses.

Arthritis after experimental infection with Yersinia enterocolitica 0:3 in rabbits.

Arthritis in rabbits was caused after experimental oral infection with Yersinia enterocolitica (serotype 0:3, biotype 4, pYV+). Clinical and laboratory signs, bacterial dissemination to the viscera, immune response and morphological findings were studied from day 1 to day 40 post-infection (p.i.). Augmentation of body temperature and erythrocyte sedimentation rate occurred on day 1, and on day 8 p.i. was accompanied by leucopenia. The number of alveolar macrophages was increased up to the 15th day p.i., in contrast to peritoneal macrophage numbers. Extensive bacterial colonization of the internal organs was detected at necropsy until the end of the experiment. Analysis of the cell immune response revealed activation of B cells in peripheral blood, spleen and thymus as well as augmentation of T-cell number in the lymphoid organs examined on days 15, 28 and 40 p.i. Histological changes typical of a generalized infection, such as purulent meningoencephalitis, catarrhal pneumonia and lymphadenitis, were observed. Clinical and morphological manifestations of arthritis were also established. The results obtained show that Y. enterocolitica (serotype 0:3, pYV+) induces a generalized, non-lethal infection in Chinchilla rabbits, complicated by arthritis.

Identification of whey proteins in tradional Bulgarian yougurt.

Functional foods hold a great promise for future trends in human nutrition. Consumption of milk and milk products have a pronounced probiotic effects together with the expected modification of allergenic properties of milk due to the process of fermentation. The proteolytic system of lactic acid bacteria consists a cell wall bound proteinase and several intracellular peptidases, and can contribute to the liberation of bioactive peptides. Food-derived bioactive peptides are claimed to be health enhancing components which can be used for functional food. In our study we focused our attention on beta-lactoglobulin and alpha-lactalbumin in early stages of yogurt fermentation of traditional Bulgarian products. Biochemical techniques were used to measure the concentration of these two whey proteins during fermentation. At a result of the done study alteration in the concentration of beta-lactoglobulin and alpha-lactalbumin were detected. The studied proteolytic activity of the strains, used in the fermentation process confirmed the received results.

Treatment of adjuvant arthritis in mice with yeast superoxide dismutase.

Yeast Cu/Zn superoxide dismutase (SODy) was used for treatment of adjuvant-induced arthritis in mice. SODy was applied intraperitoneally (i.p.) in doses of 10 mg/kg (30,000 U/kg) and 30 mg/kg (90,000 U/kg) one or three times daily on consecutive days. It was very effective in reducing the paw swelling whether administered before or immediately after induction or when the treatment began at the onset of inflammation or at the peak of the arthritic process. The effect of yeast SOD was compared to that of commercial SOD from bovine erythrocytes (SODb), as well as with indomethacin treatment. Histological data confirmed the antiinflammatory effect of yeast SOD. The schedules and doses tested did not elicit anti-SOD antibodies in serum.

[The effect of protoplast formation on the antibiotic activity and composition of the actinomycin complex in a strain of Streptomyces galbus (F) subsp. achromogenes 695 and in its active variants]. / Vliianie protoplastirovaniia na antibioticheskuiu aktivnost' i sostav aktinomitsinovogo kompleksa shtamma Streptomyces galbus (F) subsp. achromogenes 695 i ego aktivnykh variantov.

Protoplasting and regeneration promoted variation by the antibiotic production property in Streptomyces galbus (F) subsp. achromogenes 695 and its active variants 695-3-2 and 695-3-2-206. Variant 695-P24 with the potency 2 times higher than that of the initial strain 695 revertants was selected. No variants lacking the capacity for biosynthesis of the main components of antibiotic A-695 were detected among the revertants still, protoplasting of strains 695-3-2-206 and 695-P24 resulted in formation of variants synthesizing new components of the actinomycin complex.

Studies of Yersinia enterocolitica 0:3 experimental infection in pigs.

Y. enterocolitica (serotype 0:3, pYV+, biotype 4) infection of 20-day-old pigs challenged per os with a total dose of 5 x 10(10) CFU was studied. Clinical, paraclinical and morphological findings were examined in dynamics from 1st to 25th days post infection (p.i.). Augmentation of body temperature and erythrocyte sedimentation rate during the first days p.i. were established. The number of leucocytes, peritoneal (pMa) and alveolar (aMa) macrophages was increased significantly from 4th to 15th days p.i. Phagocytic activity of pMa and aMa examined in vitro was maximal on days 15 and 25 p.i. The enhanced phagocytic activity of macrophages was in correlation with the observed histological changes--purulent meningoencephalitis, necrotic tonsillitis, peribronchial lymphoid-leucocytic cell infiltration and catarrhal enteritis. Extensive colonization of internal organs was detected at necropsy till the end of trial. Analysis of the results shows that this orally caused infection runs slowly with dissemination and persistency of Y. enterocolitica 0:3 in the macroorganism, like a generalized infection.

Experimental mixed infection with Yersinia enterocolitica and Listeria monocytogenes in guinea pigs.

The pathogenesis and the cell immune response (CIR) of guinea pigs after mixed infection with Y. enterocolitica and L. monocytogenes was investigated. The guinea pigs were infected per os with 1.1 x 10(9) CFU Y. enterocolitica 0:3, (pYV+) and four days later with 1.1 x 10(9) CFU L. monocytogenes 4B. Clinical, paraclinical and morphological findings attending the infectious process were followed in dynamics up to the 28th day post infection (p.i.) with L. monocytogenes. The phagocyting activity of alveolar macrophages (aMa) was suppressed against Y. enterocolitica, in contrast to peritoneal macrophages (pMa) engulfing yersiniae more actively at the end of the study. Moreover, the tendency of augmented entering in both phagocytes of L. monocytogenes cells was well demonstrated, starting at the earlier intervals of examination. Histopathological studies showed a purulent meningoencephalitis and a catarrhal pneumonie, non-reactive micronecroses in the spleen and lymphadenitis catarrhalis in the mesenteric lymph nodes. Analysis of the T-cell immune response (T-CIR) showed maximal values in the spleen lymphocytes after Y. enterocolitica and L. monocytogenes mixed infection. The B-CIR occurred early (at the 7th day p.i.) and was maximal at the 28th day p.i. in blood lymphocytes. The results obtained demonstrated that the mixed infection of guinea pigs with Y. enterocolitica and L. monocytogenes runs has a non lethal, generalized illness with a dominant role of L. monocytogenes cells.

Cell wall-deficient forms (L-forms) of Listeria monocytogenes in experimentally infected rats.

Experimental infections were induced with different bacterial forms of Listeria monocytogenes: parental (S-forms), protoplastic (L-forms) and combined inoculum of both forms by i.p. injection of rats. The parental bacterial forms (S-forms) were isolated up to 7 days after challenge from the peritoneal cavity and the liver, while the L-forms were isolated up to 60 days from the peritoneal cavity. Continuous adhesion of L-forms on the peritoneal macrophage surface was found by scanning-electron microscopy. Erythrocyte and leucocyte count as well as some clinical chemistry parameters were measured during infections. They showed different dynamics in the three experimental groups. Histomorphological changes in the liver (microabscesses and mononuclear cellular granulomas) of infected animals were observed. They were less intensive and appeared later in rats infected with L-forms. The experiments demonstrated that infections caused by parental bacterial forms and by combined inoculum took an acute course, while the infection caused by L-forms could be distinguished as a prolonged and persistent one.