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Mandibular fractures are among the most common fractures in cattle. The medical records of 108 cattle with a mandibular fracture, that were referred to the University of Zurich Veterinary Hospital from 2005 to 2019, were analysed to document the types of treatment, complications and long-term outcomes. Cattle, still alive at the time of retrospective analysis, underwent clinical and radiographic examinations. A fall was the single most common cause of a mandibular fracture (48,1 %), and a third of all cattle had a concomitant disease at the time of referral. Seventy-five cattle (69,4 %) had a single fracture, 26 (24,1 %) had two fractures and seven (6,5 %) had three fractures of the mandible. The molar part of the mandibular body was most commonly (40,7 %) fractured followed by the diastema (23,6 %), the pars incisiva (13,4 %), the ramus (12,1 %) and the symphysis (10,2 %) of the mandible. The majority of cattle (84/108, 77,8 %) had open fractures. Treatment was instituted in 63/108 animals (58,3 %) with 77/148 fractures. Of these fractures, 28 were treated with plate osteosynthesis, 25 with an external fixator, 8 with cerclage wire, 7 using mixed techniques, 4 with fragment excision, 4 underwent conservative treatment and one a mucosal suture. In total, 45/108 animals (41,7 %) were culled because of multiple fractures, concomitant diseases and because of economic reasons. Complications occurred in 34 (54,0 %) treated cattle; 22 had abnormal wound healing of which 18 developed osteomyelitis complicated by a sequestrum (14). Of the treated 63 cattle, 56 (88,9 %) were discharged. The mean postoperative productive life was 46 ± 29,2 months for animals that were deceased at the time of the study. Thirteen of the cattle with a sequestrum remained in the herd for 15 to 92 months (mean, 47 months) and one for 2 months. The life expectancy after treatment did not differ significantly from that of the Brown Swiss and Swiss Holstein dairy cattle populations, where the cattle of this study mainly came from. Eleven cattle were available for long-term follow-up; all had a good general health status but nine had dental abnormalities including missing teeth, steps or enamel points, which did not noticeably affect the body condition of the animals. Surgical treatment of selected mandibular fractures had a favourable prognosis (52/63 healed, 82,5 %) in cattle.Unterkieferfrakturen zählen zu den häufigsten Knochenbrüchen bei Rindern. Mit dem Ziel der Dokumentation von Behandlungstechniken, von Komplikationen sowie von Langzeitergebnissen wurden die Krankenakten von 108 Rindern, welche in den Jahren 2005–2019 aufgrund einer Unterkieferfraktur am Tierspital Zürich vorgestellt worden waren, ausgewertet. Bei noch lebenden Tieren wurde eine klinische und röntgenologische Spätuntersuchung durchgeführt. Die häufigste bekannte Ursache für eine Unterkieferfraktur war ein Sturz (52 Tiere, 48,1 %). Ein Drittel der Rinder wies bei der Eintrittsuntersuchung unterschiedliche Begleiterkrankungen auf. Bei 75 Tieren (69,4 %) war der Unterkiefer an einer Lokalisation gebrochen, bei 26 (24,1 %) an zwei und bei sieben Tieren (6,5 %) an drei Lokalisationen. Am häufigsten waren die Pars molaris (40,7 %) und das Diastema (23,6 %), weniger oft die Pars incisiva (13,4 %), der Ramus mandibulae (12,1 %) und die Symphysis mandibulae (10,2 %) betroffen. Bei der Mehrheit der Tiere (84/108; 77,8 %) waren offene Frakturen festzustellen. Insgesamt wurden 77/148 Frakturen (52,0 %) bei 63/108 Tieren (58,3 %) behandelt, und zwar durch Plattenosteosynthese (28), Fixateur externe (25), Drahtzerklage (8), gemischte Techniken (7), Fragmentexzision (4), konservativ (4) und mittels einer Mukosanaht (1). Aufgrund von Mehrfachfrakturen, Begleiterkrankungen und aus ökonomischen Gründen wurden 45/108 Rindern (41,7 %) eingeschläfert oder geschlachtet. Insgesamt 34/63 behandelten Rindern (54,0 %) entwickelten eine Komplikation. Bei 22/34 Tieren war dies eine Wundheilungsstörung, wovon bei 18 Tieren eine Osteomyelitis mit Sequesterbildung (14) auftrat. Von den 63 behandelten Tieren konnten 56 (88,9 %) aus der Klinik entlassen werden. Die postoperative Nutzungsdauer betrug bei 45 zum Untersuchungszeitpunkt bereits abgegangenen Tieren durchschnittlich 46 ± 29,2 Monate (Mittelwert, Standardabweichung). Tiere, die einen Sequester gebildet hatten, blieben, mit einer Ausnahme (2 Monate), noch durchschnittlich 47 Monate (Mittelwert; Min. 15, Max. 92 Monate) in Nutzung. Die Lebenserwartung nach Behandlung von Unterkieferfrakturen unterschied sich nicht signifikant von der der Populationen Brown-Swiss- und Holstein-Milchkühe, aus denen die meisten der hier angeführten Rinder mit Unterkieferfrakturen stammten. Die 11 Rinder der Spätuntersuchungen wiesen alle einen guten Allgemeinzustand auf; neun zeigten Gebissfehler, wie fehlende Zähne, Stufen oder Zahnspitzen, jedoch ohne erkennbare Beeinträchtigung des Ernährungszustandes. Die chirurgische Behandlung von ausgewählten Unterkieferfrakturen bei Rindern (63/108) hatte somit eine günstige Prognose (52/63 geheilt, 82,5 %).Les fractures mandibulaires font partie des fractures les plus fréquentes chez les bovins. Les dossiers médicaux de 108 bovins présentant une fracture mandibulaire, référés à l’hôpital vétérinaire de l’Université de Zurich entre 2005 et 2019, ont été analysés afin de documenter les types de traitement, les complications et les résultats à long terme. Les bovins, encore vivants au moment de l’analyse rétrospective, ont subi des examens cliniques et radiographiques. Une chute était la cause la plus fréquente d’une fracture mandibulaire (48,1 %), et un tiers des bovins présentaient une maladie concomitante au moment de la consultation. Septante-cinq bovins (69,4 %) avaient une seule fracture, 26 (24,1 %) avaient deux fractures et sept (6,5 %) avaient trois fractures de la mandibule. La partie molaire du corps mandibulaire était le plus souvent (40,7 %) fracturée, suivie du diastème (23,6 %), de la pars incisiva (13,4 %), du ramus (12,1 %) et de la symphyse (10,2 %) de la mandibule. La majorité des bovins (84/108, 77,8 %) présentaient des fractures ouvertes. Un traitement a été institué chez 63/108 animaux (58,3 %) avec 77/148 fractures. Parmi ces fractures, 28 ont été traitées par une ostéosynthèse par plaque, 25 par un fixateur externe, 8 par cerclage, 7 par des techniques mixtes, 4 par une excision du fragment, 4 par un traitement conservateur et une par une suture muqueuse. Au total, 45/108 animaux (41,7 %) ont été abattus en raison de fractures multiples, de maladies concomitantes et pour des raisons économiques. Des complications sont survenues chez 34 (54,0 %) des bovins traités ; 22 ont présenté une cicatrisation anormale dont 18 ont développé une ostéomyélite compliquée par un séquestre (14). Sur les 63 bovins traités, 56 (88,9 %) sont sortis de clinique. La vie productive postopératoire moyenne était de 46 ± 29,2 mois pour les animaux qui étaient décédés au moment de l’étude. Treize des bovins avec un séquestre sont restés dans le troupeau pendant 15 à 92 mois (moyenne, 47 mois) et un pendant 2 mois. L’espérance de vie après traitement ne différait pas significativement de celle des populations de vaches laitières Brown Swiss et Swiss Holstein d’où provenaient principalement les bovins de cette étude. Onze bovins étaient disponibles pour un suivi à long terme ; tous avaient un bon état de santé général mais neuf présentaient des anomalies dentaires, notamment des dents manquantes, des différences de niveau de la table dentaire ou des pointes d’émail, ce qui n’a pas affecté de manière notable l’état corporel des animaux. Le traitement chirurgical de certaines fractures mandibulaires a donc eu un pronostic favorable (52/63 guéries, 82,5 %) chez les bovins.Le fratture mandibolari sono tra le fratture ossee più comuni nei bovini. Allo scopo di documentare le tecniche di trattamento, le complicanze e gli esiti a lungo termine, sono state analizzate le cartelle cliniche di 108 bovini presentati all’Ospedale Veterinario di Zurigo per fratture mandibolari tra il 2005 e il 2019. Gli animali ancora in vita sono stati sottoposti a esami clinici e radiografici tardivi. La causa più comune conosciuta per una frattura mandibolare è la caduta (52 animali, 48,1 %). Un terzo dei bovini presentava diverse malattie concomitanti all’esame di ingresso. In 75 animali (69,4 %) la mandibola era fratturata in un solo sito, in 26 (24,1 %) in due siti e in sette animali (6,5 %) in tre siti. Le parti mandibolari più frequentemente colpite erano la pars molaris (40,7 %) e il diastema (23,6 %) e meno spesso la pars incisiva (13,4 %), il ramus mandibulae (12,1 %) e la symphysis mandibulae (10,2 %). La maggior parte degli animali (84/108; 77,8 %) presentava fratture aperte. Un totale di 77/148 fratture (52,0 %) in 63/108 animali (58,3 %) sono state trattate con osteosintesi a placca (28), fissatore esterno (25), cerchiaggio con filo (8), tecniche miste (7), escissione del frammento (4), conservativa (4) e via una sutura mucosa (1). A causa di fratture multiple, malattie concomitanti e per motivi economici, 45/108 bovini (41,7 %) sono stati sottoposti a eutanasia o macellazione. Un totale di 34/63 bovini trattati (54,0 %) ha sviluppato una complicazione. In 22/34 animali si è trattato di un disturbo nella guarigione della ferita, di cui 18 animali hanno sviluppato osteomielite con sequestro (14). Dei 63 animali trattati, 56 (88,9 %) hanno potuto essere dimessi dall’ospedale. La durata post-operatoria dei 45 animali già dimessi al momento dello studio è stata in media di 46 ± 29,2 mesi (media, deviazione standard). Gli animali che avevano formato un sequestro sono stati tenuti, con una sola eccezione (2 mesi), in media 47 mesi (media; min. 15, max. 92 mesi). L’aspettativa di vita dopo il trattamento delle fratture mandibolari non è risultata significativamente diversa da quella delle popolazioni di bovini da latte Brown-Swiss e Holstein, da cui provengono la maggior parte dei bovini con fratture mandibolari qui esaminati. Gli 11 bovini esaminati in ritardo mostravano tutti buone condizioni generali; nove presentavano difetti della dentizione, come denti mancanti, gradini o punte di denti, ma senza apparente compromissione dello stato nutrizionale. Il trattamento chirurgico di fratture mandibolari selezionate nei bovini (63/108) ha quindi avuto una prognosi favorevole (52/63 guariti, 82,5 %).

Background Follow-up of very preterm infants is essential for reducing risks of health and developmental problems and relies on parental engagement. We investigated parents’ perceptions of post-discharge healthcare for their children born very preterm in a European multi-country cohort study. Methods Data come from a 5-year follow-up of an area-based cohort of births Results Questionnaires were returned for 3635 children (53.8% response rate). Care was rated as poor/fair for 14.2% [from 6.1% (France) to 31.6% (Denmark)]; rates were higher when children had health or developmental problems (e.g. cerebral palsy (34.4%) or epilepsy (36.9%)). From 971 responses, 4 themes and 25 subthemes concerning care improvement were identified. Conclusions Parents’ experiences provide guidance for improving very preterm children’s post-discharge care; this is a priority for children with health and developmental problems as parental dissatisfaction was high. Impact In a European population-based very preterm birth cohort, parents rated post-discharge healthcare as poor or fair for 14.2% of children, with a wide variation (6.1–31.6%) between countries. Dissatisfaction was reported in over one-third of cases when children had health or developmental difficulties, such as epilepsy or cerebral palsy. Parents’ free-text suggestions for improving preterm-related post-discharge healthcare were similar across countries; these focused primarily on better communication with parents and better coordination of care. Parents’ lived experiences are a valuable resource for understanding where care improvements are needed and should be included in future research.

Involvement of the cerebellum in the pathophysiology of hypoxic‐ischemic encephalopathy (HIE) in preterm infants is increasingly recognized. We aimed to assess the neuroprotective potential of intravenously administered multipotent adult progenitor cells (MAPCs) in the preterm cerebellum. Instrumented preterm ovine fetuses were subjected to transient global hypoxia‐ischemia (HI) by 25 minutes of umbilical cord occlusion at 0.7 of gestation. After reperfusion, two doses of MAPCs were administered intravenously. MAPCs are a plastic adherent bone‐marrow‐derived population of adult progenitor cells with neuroprotective potency in experimental and clinical studies. Global HI caused marked cortical injury in the cerebellum, histologically indicated by disruption of cortical strata, impeded Purkinje cell development, and decreased dendritic arborization. Furthermore, global HI induced histopathological microgliosis, hypomyelination, and disruption of white matter organization. MAPC treatment significantly prevented cortical injury and region‐specifically attenuated white matter injury in the cerebellum following global HI. Diffusion tensor imaging (DTI) detected HI‐induced injury and MAPC neuroprotection in the preterm cerebellum. This study has demonstrated in a preclinical large animal model that early systemic MAPC therapy improved structural injury of the preterm cerebellum following global HI. Microstructural improvement was detectable with DTI. These findings support the potential of MAPC therapy for the treatment of HIE and the added clinical value of DTI for the detection of cerebellar injury and the evaluation of cell‐based therapy., Systemic multipotent adult progenitor cells protected the preterm cerebellum in a preclinical animal model of perinatal asphyxia. Diffusion tensor imaging detected cerebellar injury and repair underlining the added clinical value of this imaging technique.

Congenital heart defects (CHD) is one of the most common types of birth defects. Thanks to advances in surgical techniques and intensive care, the majority of children with severe forms of CHD survive into adulthood. However, this increase in survival comes with a cost. CHD survivors have neurological functioning at the bottom of the normal range. A large spectrum of central nervous system dysmaturation leads to the deficits seen in critical CHD. The heart develops early during gestation, and CHD has a profound effect on fetal brain development for the remainder of gestation. Term infants with critical CHD are born with an immature brain, which is highly susceptible to hypoxic-ischemic injuries. Perioperative blood flow disturbances due to the CHD and the use of cardiopulmonary bypass or circulatory arrest during surgery cause additional neurological injuries. Innate patient factors, such as genetic syndromes and preterm birth, and postoperative complications play a larger role in neurological injury than perioperative factors. Strategies to reduce the disability burden in critical CHD survivors are urgently needed.

Aim Among children who receive hospital care, preterm infants are Europe's largest group, whose numbers are continually increasing. Currently, no pan-European standards of care for preterm or critically ill infants are available, except for a few specific topics, and practices vary widely in different regions. Methods The European Foundation for the Care of Newborn Infants (EFCNI) has initiated a transdisciplinary collaboration project to provide agreed standards for high-quality perinatal and neonatal care, whose implementation will ensure fairer and more equitable care across Europe. This will improve care for these vulnerable infants and their families, ameliorate the long-term conditions found in preterm and critically ill infants, and enhance the quality of family life of affected families. More than 220 experts - healthcare professionals, patient representatives, and other relevant stakeholders - have come together for the first time to develop a broad reference guidance in neonatology and associated fields. Results 96 standards on 11 overarching topic areas were developed and endorsed. Conclusion This reference framework serves as a basis for the development of binding national standards for high-quality care. A robust translation and implementation strategy is facilitated, with the goal of improved health outcomes following preterm birth all around Europe.

Parenteral nutrition, usually indicated for preterm infants with a birthweight1500 g and sick newborns, enables the supply with critical nutrients. As a high degree of therapy safety is required, a European guideline provides recommendations for safe therapy procedures. The present project aimed to evaluate the implementation of the European guideline in German perinatal centers and to identify possible barriers that impede its implementation. A further goal was to develop solution approaches to overcome possible barriers.A multidisciplinary cooperation conducted an online survey questioning the current implementation procedures of the European guideline among pediatricians and hospital pharmacists. Results show barriers in the provisioning process of parenteral nutrition that hinder a guideline-compliant implementation in practice. Based on results of this survey, an expert network developed an interactive toolkit with simplified guideline recommendations, guideline-compliant advice for practice, best-practice examples, forms, and handouts. It seeks to encourage critical reflection of routine processes and provides concrete solutions to overcome barriers in practice.The current procedures related to parenteral nutrition deviate from guideline recommendations. The developed toolkit provides practice-oriented support aiming to enhance the guideline-compliant implementation of parenteral nutrition in perinatal centers.Die parenterale Ernährung (PE) ist gewöhnlich bei Frühgeborenen1500 g Geburtsgewicht und kranken Neugeborenen indiziert und gewährleistet eine Versorgung mit essentiellen Nährstoffen. Da ein hohes Maß Therapiesicherheit erforderlich ist, gibt die europäische Leitlinie Empfehlungen zur sicheren Anwendung. Dieses Projekt zielte darauf ab, die Anwendung der europäischen Leitlinie in deutschen Perinatalzentren zu evaluieren und Barrieren, die die Umsetzung erschweren oder verhindern, abzubilden. Zusätzlich sollten Lösungsansätze zur Überwindung möglicher Barrieren erarbeitet werden.In einer multidisziplinären Kooperation wurde eine Online-Umfrage durchgeführt, in der PädiaterInnen und KrankenhausapothekerInnen aus Perinatalzentren zur Umsetzung der europäischen Leitlinien befragt wurden. Die Umfrageergebnisse wiesen auf Barrieren entlang des Bereitstellungsprozesses der PE hin, die eine leitliniengerechte Anwendung erschweren. Basierend auf den Ergebnissen erarbeitete das Expertennetzwerk ein interaktives Toolkit mit vereinfachten Leitlinienempfehlungen, leitlinienkonformen Anwendungsratschlägen, Best-Practice-Beispielen, Formularen und Handouts. Es soll zur kritischen Reflexion der Routineprozesse anregen und liefert konkrete Lösungsansätze zur Überwindung der Barrieren in der Praxis.Die Anwendung der PE bei Früh- und kranken Neugeborenen weicht von den Leitlinienempfehlungen ab. Das erarbeitete Toolkit liefert praxisorientiere Hilfestellungen mit dem Ziel, eine leitliniengerechte Anwendung in Perinatalzentren zu fördern.

BackgroundAcute respiratory distress syndrome (ARDS) can have various causes. The study objective was to investigate whether different pathophysiologic models of ARDS would show different respiratory, cardiovascular and inflammatory outcomes.MethodsWe performed a prospective, randomized study in 27 ventilated ewes inducing ARDS using three different techniques to mimic the pulmonary causes of ARDS (ARDSp): warm saline lavage (n = 6), intratracheal hydrochloric acid (HCl; n = 6), intratracheal albumin (n = 10), and one technique to mimic an extrapulmonary cause of ARDS (ARDSexp): intravenous lipopolysaccharide (LPS iv;n = 5). ARDS was defined when PaO2was 2O and FiO2 = 1.0. The effects on gas exchange were investigated by calculating the oxygenation index (OI) and the ventilation efficacy index (VEI) every 30 min for a period of 4 h. Post mortem lung lavage was performed to obtain broncho-alveolar lavage fluid (BALF) to assess lung injury and inflammation. Lung injury and inflammation were assessed by measuring the total number and differentiation of leukocytes, the concentration of protein and disaturated phospholipids, and interleukine-6 and -8 in the BALF. Histology of the lung was evaluated by measuring the mean alveolar size, alveolar wall thickness and the lung injury score system by Matute-Bello et al., as markers of lung injury. The concentration of interleukin-6 was determined in plasma, as a marker of systematic inflammation.ResultsThe OI and VEI were most affected in the LPS iv group and thereafter the HCl group, after meeting the ARDS criteria. Diastolic blood pressure was lowest in the LPS iv group. There were no significant differences found in the total number and differentiation of leukocytes, the concentration of protein and disaturated phospholipids, or interleukin-8 in the BALF, histology of the lung and the lung injury score. IL-6 in BALF and plasma was highest in the LPS iv group, but no significant differences were found between the other groups. It took a significantly longer period of time to meet the ARDS criteria in the LPS iv group.ConclusionsThe LPS model caused the most severe pulmonary and cardiovascular insufficiency. Surprisingly, there were limited significant differences in lung injury and inflammatory markers, despite the different pathophysiological models, when the clinical definition of ARDS was applied.

Since the first description of galactosemia in 1908 and despite decades of research, the pathophysiology is complex and not yet fully elucidated. Galactosemia is an inborn error of carbohydrate metabolism caused by deficient activity of any of the galactose metabolising enzymes. The current standard of care, a galactose‐restricted diet, fails to prevent long‐term complications. Studies in cellular and animal models in the past decades have led to an enormous progress and advancement of knowledge. Summarising current evidence in the pathophysiology underlying hereditary galactosemia may contribute to the identification of treatment targets for alternative therapies that may successfully prevent long‐term complications. A systematic review of cellular and animal studies reporting on disease complications (clinical signs and/or biochemical findings) and/or treatment targets in hereditary galactosemia was performed. PubMed/MEDLINE, EMBASE, and Web of Science were searched, 46 original articles were included. Results revealed that Gal‐1‐P is not the sole pathophysiological agent responsible for the phenotype observed in galactosemia. Other currently described contributing factors include accumulation of galactose metabolites, uridine diphosphate (UDP)‐hexose alterations and subsequent impaired glycosylation, endoplasmic reticulum (ER) stress, altered signalling pathways, and oxidative stress. galactokinase (GALK) inhibitors, UDP‐glucose pyrophosphorylase (UGP) up‐regulation, uridine supplementation, ER stress reducers, antioxidants and pharmacological chaperones have been studied, showing rescue of biochemical and/or clinical symptoms in galactosemia. Promising co‐adjuvant therapies include antioxidant therapy and UGP up‐regulation. This systematic review provides an overview of the scattered information resulting from animal and cellular studies performed in the past decades, summarising the complex pathophysiological mechanisms underlying hereditary galactosemia and providing insights on potential treatment targets.

BACKGROUND Worldwide, many newborns who are preterm, small or large for gestational age, or born to mothers with diabetes are screened for hypoglycemia, with a goal of preventing brain injury. However, there is no consensus on a treatment threshold that is safe but also avoids overtreatment. METHODS In a multicenter, randomized, noninferiority trial involving 689 otherwise healthy newborns born at 35 weeks of gestation or later and identified as being at risk for hypoglycemia, we compared two threshold values for treatment of asymptomatic moderate hypoglycemia. We sought to determine whether a management strategy that used a lower threshold (treatment administered at a glucose concentration of

PANDA (anti-proton annihiliation at Darmstadt) is planned to be one of the four main experiments at the future international accelerator complex FAIR (Facility for Antiproton and Ion Research) in Darmstadt, Germany. It is going to address fundamental questions of hadron physics and quantum chromodynamics using cooled antiproton beams with a high intensity and and momenta between 1.5 and 15 GeV/c. PANDA is designed to reach a maximum luminosity of 2 × 1032 cm−2 s. Most of the physics programs require an excellent particle identification (PID). The PID of hadronic states at the forward endcap of the target spectrometer will be done by a fast and compact Cherenkov detector that uses the detection of internally reflected Cherenkov light (DIRC) principle. It is designed to cover the polar angle range from 5° to 22° and to provide a separation power for the separation of charged pions and kaons up to 3 standard deviations (s.d.) for particle momenta up to 4 GeV/c in order to cover the important particle phase space. This document describes the technical design and the expected performance of the novel PANDA disc DIRC detector that has not been used in any other high energy physics experiment before. The performance has been studied with Monte-Carlo simulations and various beam tests at DESY and CERN. The final design meets all PANDA requirements and guarantees sufficient safety margins.

Contains fulltext : 282590.pdf (Publisher’s version ) (Open Access) Messenger RNA (mRNA) has emerged as a novel therapeutic approach for inborn errors of metabolism. Classic galactosemia (CG) is an inborn error of galactose metabolism caused by a severe deficiency of galactose-1-phosphate:uridylyltransferase (GALT) activity leading to neonatal illness and chronic impairments affecting the brain and female gonads. In this proof of concept study, we used our zebrafish model for CG to evaluate the potential of human GALT mRNA (hGALT mRNA) packaged in two different lipid nanoparticles to restore GALT expression and activity at early stages of development. Both one cell-stage and intravenous single-dose injections resulted in hGALT protein expression and enzyme activity in the CG zebrafish (galt knockout) at 5 days post fertilization (dpf). Moreover, the levels of galactose-1-phosphate (Gal-1-P) and galactonate, metabolites that accumulate because of the deficiency, showed a decreasing trend. LNP-packaged mRNA was effectively translated and processed in the CG zebrafish without signs of toxicity. This study shows that mRNA therapy restores GALT protein and enzyme activity in the CG zebrafish model, and that the zebrafish is a suitable system to test this approach. Further studies are warranted to assess whether repeated injections safely mitigate the chronic impairments of this disease.

Background: The COVID-19 pandemic restrictions affect provision and quality of neonatal care. This global study explores parents' experiences regarding the impact of the restrictions on key characteristics of infant and family-centred developmental care (IFCDC) during the first year of the pandemic. Methods: For this cross-sectional study, a pre-tested online survey with 52 questions and translated into 23 languages was used to collect data between August and November 2020. Parents of sick or preterm infants born during the pandemic and receiving special/intensive care were eligible for participation. Data analysis included descriptive statistics and statistical testing based on different levels of restrictive measures. Findings: In total, 2103 participants from 56 countries provided interpretable data. Fifty-two percent of respondents were not allowed to have another person present during birth. Percentages increased with the extent of restrictions in the respondents' country of residence (p = 0.002). Twenty-one percent of total respondents indicated that no-one was allowed to be present with the infant receiving special/intensive care. The frequency (p < 0.001) and duration (p = 0.001) of permitted presence largely depended on the extent of restrictions. The more restrictive the policy measures were, the more the respondents worried about the pandemic situation during pregnancy and after birth. Interpretation: COVID-19 related restrictions severely challenged evidence-based cornerstones of IFCDC, such as separating parents/ legal guardians and their newborns. Our findings must therefore be considered by public health experts and policy makers alike to reduce unnecessary suffering, calling for a zero separation policy. Funding: EFCNI received an earmarked donation by Novartis Pharma AG in support of this study. (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Traditional methods for estimating age-at-death of caprines are based on dental and epiphyseal fusion data and known to produce rather wide age intervals. In order to better interpret prenatal to early infantile mortality of sheep in prehistoric assemblages more precise age predictions are needed. We address this issue using a Generalized Additive Model (GAM) developed on humerus measurements of unborn and very young sheep of known age housed in modern collections. We then verify the resulting prediction model with the aid of a pregnant ewe and her foetus (Ovis aries) excavated in the Ptolemaic-Roman animal cemetery at Syene (modern Aswan, Egypt). Her condition illustrates that both the mother and her mature foetus must have died during birthing. Subsequently, we apply the model to humeri of very young archaeological sheep (Ovis orientalis/O. aries) unearthed at early Neolithic Aşıklı Höyük (Central Turkey). Both study cases underscore the practicality of our approach whilst illustrating the cultural and historical importance of precise age determinations in foetal, newborn and infantile sheep. Finally, we discuss the possible causes for foetal and neonatal mortality in sheep at Aşıklı Höyük., We most gratefully acknowledge funding in the frame of the DFG long-term project, ‘The Prehistoric Societies of Upper Mesopotamia and their Subsistence’ by the Deutsche Forschungsgemeinschaft under Grants PE 424/10-1,2,3,4 (J. P.) and of the DFG project ‘Die Tempelherde und ihr Bestattungsplatz im ptolemäisch-römischen Syene aus archäozoologischer, archäologischer und religionshistorischer Perspektive’ under Grant PE424/14-1 (J. P.). Research at Aşıklı Höyük would not have been possible without the support of the General Directorate of Cultural Assets and Museums, Ministry of Culture and Tourism of Turkey, and the Aksaray Museum.

Perioperative stress detection in children with congenital heart disease (CHD), particularly in the brain, is still limited. Among biomarkers, γ-amino-aminobutyric acid (GABA) assessment in biological fluids appears to be promising for its regulatory action on the cardiovascular and cerebral systems. We aimed to investigate cyanotic (C) or non-cyanotic (N) CHD children for GABA blood level changes in the perioperative period. We conducted an observational study in 68 CHD infants (C: n = 33, N: n = 35) who underwent perioperative clinical, standard laboratory and monitoring parameter recordings and GABA assessment. Blood samples were drawn at five predetermined time-points before, during and after surgery. No significant perioperative differences were observed between groups in clinical and laboratory parameters. In C, perioperative GABA levels were significantly lower than N. Arterial oxygen saturation and blood concentration significantly differed between C and N children and correlated at cardiopulmonary by-pass (CPB) time-point with GABA levels. The present data showing higher hypoxia/hyperoxia-mediated GABA concentrations in C children suggest that they are more prone to perioperative cardiovascular and brain stress/damage. The findings suggest the usefulness of further investigations to detect the “optimal” oxygen concentration target in order to avoid the side effects associated with re-oxygenation during CPB.

The antiproton experiment PANDA at FAIR is designed to bring hadron physics to a new level in terms of scope, precision and accuracy. In this work, its unique capability for studies of hyperons is outlined. We discuss ground-state hyperons as diagnostic tools to study non-perturbative aspects of the strong interaction, and fundamental symmetries. New simulation studies have been carried out for two benchmark hyperon-antihyperon production channels: $\bar{p}p \to \bar{\Lambda}\Lambda$ and $\bar{p}p \to \bar{\Xi}^+\Xi^-$. The results, presented in detail in this paper, show that hyperon-antihyperon pairs from these reactions can be exclusively reconstructed with high efficiency and very low background contamination. In addition, the polarisation and spin correlations have been studied, exploiting the weak, self-analysing decay of hyperons and antihyperons. Two independent approaches to the finite efficiency have been applied and evaluated: one standard multidimensional efficiency correction approach, and one efficiency independent approach. The applicability of the latter was thoroughly evaluated for all channels, beam momenta and observables. The standard method yields good results in all cases, and shows that spin observables can be studied with high precision and accuracy already in the first phase of data taking with PANDA., Comment: 26 pages, 16 figures. Changes: Revised title and abstract and corrections/clarifications in the text according to suggestions by journal referees

The European physical journal / A 57(4), 149 (2021). doi:10.1140/epja/s10050-021-00444-5, Published by Springer, Heidelberg

Neonatal respiratory failure is a common and serious clinical problem which in a considerable proportion of infants requires invasive mechanical ventilation. The basic goal of mechanical ventilation is to restore lung function while limiting ventilator-induced lung injury, which is considered an important risk factor in the development of bronchopulmonary dysplasia (BPD). Over the last decades, new conventional mechanical ventilation (CMV) modalities have been introduced in clinical practice, aiming to assist clinicians in providing lung protective ventilation strategies. These modalities use more sophisticated techniques to improve patient-ventilator interaction and transfer control of ventilation from the operator to the patient. Knowledge on how these new modalities work and how they interact with lung physiology is essential for optimal and safe use. In this review, we will discuss some important basic lung physiological aspects for applying CMV, the basic principles of the old and new CMV modalities, and the evidence to support their use in daily clinical practice.

Background: People who inject drugs (PWID) are frequently incarcerated, which is associated with multiple negative health outcomes. Aim: We aimed to estimate the associations between a history of incarceration and prevalence of HIV and HCV infection among PWID in Europe. Methods: Aggregate data from PWID recruited in drug services (excluding prison services) or elsewhere in the community were reported by 17 of 30 countries (16 per virus) collaborating in a European drug monitoring system (2006–2020; n=52,368 HIV+/-; n=47,268 HCV+/-). Country-specific odds ratios (OR) and prevalence ratios (PR) were calculated from country totals of HIV and HCV antibody status and self-reported life-time incarceration history, and pooled using meta-analyses. Country-specific and overall population attributable risk (PAR) were estimated using pooled PR. Results: Univariable HIV OR ranged between 0.73 and 6.37 (median: 2.1; pooled OR: 1.92; 95% CI: 1.52–2.42). Pooled PR was 1.66 (95% CI 1.38–1.98), giving a PAR of 25.8% (95% CI 16.7–34.0). Univariable anti-HCV OR ranged between 1.06 and 5.04 (median: 2.70; pooled OR: 2.51; 95% CI: 2.17–2.91). Pooled PR was 1.42 (95% CI: 1.28–1.58) and PAR 16.7% (95% CI: 11.8–21.7). Subgroup analyses showed differences in the OR for HCV by geographical region, with lower estimates in southern Europe. Conclusion: In univariable analysis, a history of incarceration was associated with positive HIV and HCV serostatus among PWID in Europe. Applying the precautionary principle would suggest finding alternatives to incarceration of PWID and strengthening health and social services in prison and after release (‘throughcare’). © 2021 European Centre for Disease Prevention and Control (ECDC). All rights reserved.

The Facility for Antiproton and Ion Research (FAIR) in Darmstadt, Germany, provides unique possibilities for a new generation of hadron-, nuclear- and atomic physics experiments. The future antiProton ANnihilations at DArmstadt (PANDA or $$\overline{\mathrm{P}}$$ P ¯ ANDA) experiment at FAIR will offer a broad physics programme, covering different aspects of the strong interaction. Understanding the latter in the non-perturbative regime remains one of the greatest challenges in contemporary physics. The antiproton–nucleon interaction studied with PANDA provides crucial tests in this area. Furthermore, the high-intensity, low-energy domain of PANDA allows for searches for physics beyond the Standard Model, e.g. through high precision symmetry tests. This paper takes into account a staged approach for the detector setup and for the delivered luminosity from the accelerator. The available detector setup at the time of the delivery of the first antiproton beams in the HESR storage ring is referred to as the Phase One setup. The physics programme that is achievable during Phase One is outlined in this paper.

Introduction. This study intends to determine the Apnea-Hypopnea Index in patients hospitalized with acute hypercapnic respiratory failure from chronic obstructive pulmonary disease exacerbation, who require noninvasive ventilation with average volume-assured pressure support (AVAPS), as well as describes the clinical characteristics of these patients. Materials and Methods. We designed a single-center prospective study. The coexistence of Apnea-Hypopnea Index and clinical, gasometric, spirometric, respiratory polygraphy, and ventilatory characteristics were determined. The clinical characteristics found were categorized and compared according to the Apnea-Hypopnea Index (AHI) 15. A p value 5 was present in 24 of the 30 patients recruited (80%). Neck circumference (cm), Epworth scale, and Mallampati score evidenced significant differences when compared to the patient’s AHI 15 ( p < 0.05 ). Furthermore, patients with an AHI >5 had longer hospital admissions, prolonged periods on mechanical ventilation, and a higher percentage of intubation rates. Conclusion. Apnea-Hypopnea Index and chronic obstructive pulmonary disease exacerbation are a frequent association found in patients with acute hypercapnic respiratory failure and COPD exacerbations that require NIV. This association could be a determining factor in the response to NIV, especially when AVAPS is used as a ventilatory strategy.

ObjectivesThe COVID-19 pandemic has disrupted healthcare systems, challenging neonatal care provision globally. Curtailed visitation policies are known to negatively affect the medical and emotional care of sick, preterm and low birth weight infants, compromising the achievement of the 2030 Development Agenda. Focusing on infant and family-centred developmental care (IFCDC), we explored parents’ experiences of the disruptions affecting newborns in need of special or intensive care during the first year of the pandemic.DesignCross-sectional study using an electronic, web-based questionnaire.SettingMulticountry online-survey.MethodsData were collected between August and November 2020 using a pretested online, multilingual questionnaire. The target group consisted of parents of preterm, sick or low birth weight infants born during the first year of the COVID-19 pandemic and who received special/intensive care. The analysis followed a descriptive quantitative approach.ResultsIn total, 1148 participants from 12 countries (Australia, Brazil, Canada, China, France, Italy, Mexico, New Zealand, Poland, Sweden, Turkey and Ukraine) were eligible for analysis. We identified significant country-specific differences, showing that the application of IFCDC is less prone to disruptions in some countries than in others. For example, parental presence was affected: 27% of the total respondents indicated that no one was allowed to be present with the infant receiving special/intensive care. In Australia, Canada, France, New Zealand and Sweden, both the mother and the father (in more than 90% of cases) were allowed access to the newborn, whereas participants indicated that no one was allowed to be present in China (52%), Poland (39%), Turkey (49%) and Ukraine (32%).ConclusionsThe application of IFCDC during the COVID-19 pandemic differs between countries. There is an urgent need to reconsider separation policies and to strengthen the IFCDC approach worldwide to ensure that the 2030 Development Agenda is achieved.

Chorioamnionitis (CA) is considered a key risk factor for very preterm birth and for developing early onset sepsis (EOS) in preterm infants, but recent data suggest that CA might be protective against late onset sepsis (LOS). We performed a systematic review and meta-analysis of studies exploring the association between CA and sepsis. A comprehensive literature search was performed in PubMed/MEDLINE and EMBASE, from their inception to 1 December 2018. A random-effects model was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Sources of heterogeneity were analyzed by subgroup and meta-regression analyses. The following categories of sepsis were analyzed: EOS, LOS, unspecified onset sepsis (UOS), culture-proven, and clinical sepsis. CA was subdivided into clinical and histological chorioamnionitis. Funisitis was also analyzed. We found 3,768 potentially relevant studies, of which 107 met the inclusion criteria (387,321 infants; 44,414 cases of CA). Meta-analysis showed an association between any CA and any EOS (OR 4.29, CI 3.63 to 5.06), any LOS (OR 1.29, CI 1.11 to 1.54), and any UOS (OR 1.59, CI 1.11 to 1.54). Subgroup analysis showed that CA was associated with culture-proven EOS (OR 4.69, CI 3.91 to 5.56), clinical EOS (OR 3.58, CI 1.90 to 6.76), and culture-proven LOS (OR 1.31, CI 1.12 to 1.53), but not with clinical LOS (OR 1.52, CI 0.78 to 2.96). The presence of funisitis did not increase the risk of either EOS or LOS when compared with CA without funisitis. CA-exposed infants had lower gestational age (-1.11 weeks, CI -1.37 to -0.84) than the infants not exposed to CA. Meta-regression analysis showed that the lower gestational age of the CA group correlated with the association between CA and LOS but not the with association between CA and EOS. In conclusion, our data suggest that the positive association between chorioamnionitis and LOS may be modulated by the effect of chorioamnionitis on gestational age.

We report on a new measurement of the beam transverse single spin asymmetry in electron-proton elastic scattering, $A^{ep}_{\perp}$, at five beam energies from 315.1 MeV to 1508.4 MeV and at a scattering angle of $30^{\circ} < \theta < 40^{\circ}$. The covered $Q^2$ values are 0.032, 0.057, 0.082, 0.218, 0.613 (GeV/c)$^2$. The measurement clearly indicates significant inelastic contributions to the two-photon-exchange (TPE) amplitude in the low-$Q^2$ kinematic region. No theoretical calculation is able to reproduce our result. Comparison with a calculation based on unitarity, which only takes into account elastic and $\mathrm{\pi N}$ inelastic intermediate states, suggests that there are other inelastic intermediate states such as $\mathrm{\pi \pi N}$, $\mathrm{K \Lambda}$ and $\mathrm{\eta N}$. Covering a wide energy range, our new high-precision data provide a benchmark to study those intermediate states., Comment: 6 pages, 3 figures

STUDY QUESTION What is the effect of growth velocity (height and weight) in early infancy on metabolic end-points and endothelial function in children born after ART? SUMMARY ANSWER Neonatal, infant and childhood growth is positively related to blood pressure in 9-year-old IVF/ICSI offspring, while growth in childhood was negatively associated with endothelial function. WHAT IS KNOWN ALREADY Offspring of pregnancies conceived after ART are at risk for later cardiometabolic risk factors. It is well established that early growth is related to numerous later cardiometabolic risk factors such as high blood pressure. This concept is known as the Developmental Origin of Health and Disease theory. STUDY DESIGN, SIZE, DURATION The relation between early growth and later cardiometabolic risk profile was studied in the MEDIUM-KIDS study, a prospective observational cohort study in children born after an IVF/ICSI treatment. In 131 children (48.1% males) at the average age of 9.4 years, cardiometabolic outcomes were assessed and growth data from birth until age 9 years were collected from child welfare centers. PARTICIPANTS/MATERIALS, SETTINGS, METHODS The following cardiometabolic outcomes were assessed: blood pressure, skinfolds, lipid spectrum, hair cortisone and glucose and insulin levels. Data on maximum skin perfusion after transdermal delivery of acetylcholine as a measure of endothelial function were collected. Growth charts were obtained electronically from child welfare centers, which offer free consultations and vaccinations to all Dutch children. At these centers, height and weight are recorded at predefined ages. Growth was defined as z-score difference in weight between two time points. Multivariable linear regression analysis was used to model the relation between growth and cardiometabolic outcomes. The following growth windows were –studied simultaneously in each model: 0–1 month, 1–3 months, 3–6 months, 6–11 months, 11–24 months and 2–6 years. The model was adjusted for height growth in all intervals except for 0–1 month. MAIN RESULTS AND THE ROLE OF CHANCE In multivariable linear regression analyses, multiple growth windows were positively associated with blood pressure, for example growth from 2–6 years was significantly related to systolic blood pressure: B = 4.13, P = 0.005. Maximum skin perfusion after acetylcholine was negatively associated with height-adjusted weight gain from 2 to 6 years: B = −0.09 (log scale), P = 0.03. Several growth windows (weight 1–3 months, 3–6 months, 6–11 months, 11–24 months, 2–6 years) were positively linked with total adiposity. Lipids, glucose tolerance indices and cortisone were not related to growth. LIMITATIONS, REASONS FOR CAUTION This study is of modest size and of observational nature, and we did not include a control group. Therefore, we cannot assess whether the observed associations are causal. It is also not possible to analyze if our observations are specific for, or exacerbated in, the ART population. Ideally, a control group of naturally conceived siblings of IVF/ICSI children should simultaneously be studied to address this limitation and to assess the impact of the ART procedure without the influence of parental (subfertility) characteristics. WIDER IMPLICATIONS OF THE FINDINGS The results of this study contribute to our understanding of the reported increased risk for hypertension in ART offspring. We speculate that early, accelerated growth may be involved in the reported increased risk for hypertension in ART offspring, with endothelial dysfunction as a possible underlying mechanism. However, additional research into the mechanisms involved is required. STUDY FUNDING/COMPETING INTEREST(S) The study was financially supported by the March of Dimes, grant number #6-FY13-153. The sponsor of the study had no role in study design, data collection, data analysis, data interpretation or writing of the paper. The authors have no conflict of interest to declare. TRIAL REGISTRATION NUMBER NTR4220

Background Maternal overweight and obesity are related to several health risks in the periods before, during and after pregnancy including a higher risk of gestational diabetes mellitus, preeclampsia and preterm birth. At the same time, women’s daily life quickly changes in these periods. Therefore, we hypothesize that the value of determinants of lifestyle behavior within different levels of the socio-ecological model differ accordingly and influence lifestyle behavior. These dynamics of determinants of lifestyle behavior in the periods before, during and after pregnancy are unexplored and therefore evaluated in this study. These insights are needed to offer appropriate guidance to improve lifestyle in women of childbearing age. Methods Individual semi-structured interviews were conducted before, during or after pregnancy in 26 women with overweight or obesity living in the Netherlands. Questions covered all levels of the socio-ecological model, i.e. intrapersonal, interpersonal, institutional and environmental/societal. All interviews were transcribed and coded. Results Determinants at all levels of the socio-ecological model were perceived as relevant by women of childbearing age. Various determinants were mentioned including knowledge of a healthy lifestyle, social support, access to customized lifestyle guidance, and distance to healthy lifestyle supporting activities. The importance women attributed to determinants differed between the periods before, during and after pregnancy. Before pregnancy, child’s wellbeing as motivator for adopting a healthy lifestyle was mentioned less frequently than during and after pregnancy. Women described that the interplay and balance between determinants varied on a daily basis, and not merely per period. This was often expressed as fluctuation in energy level per day which influences their willingness to put effort in making healthy choices. Conclusions Findings of this study confirm the importance of determinants at multiple socio-ecological levels for shaping lifestyle behavior in women of childbearing age. The findings add to current insights that the perceived importance of determinants and their interplay differ before, during and after pregnancy. They influence lifestyle behavior decisions, not only per period but even on a daily basis, in particular in this phase of life. This perspective can be helpful in optimizing lifestyle guidance for women of childbearing age in order to prevent perinatal complications.

BACKGROUND: General anesthetics could protect key neurotransmitter systems, such as the dopaminergic system, from hypoxic-ischemic encephalopathy (HIE) by limiting excessive glutamatergic neurotransmission. However, anesthetics may adversely affect inflammation and tau phosphorylation. METHODS: A near-term sheep model of HIE by umbilical cord occlusion (UCO) under anesthesia was used. The effect of propofol and isoflurane on the dopaminergic neurotransmitter phenotype in the substantia nigra (SN) was studied using tyrosine hydroxylase immunohistochemistry. The overall microglial response and tau phosphorylation were also measured in the SN, surrounding the midbrain gray matter structures and the hippocampal white matter. RESULTS: The isoflurane-treated UCO group had fewer tyrosine hydroxylase-expressing neurons in the SN at 8 h after the insult than the propofol-treated UCO or sham operated groups (P < 0.05). The microglial response was unchanged in the SN region. In the thalamus and the hippocampal stratum moleculare layer, the propofol-treated UCO group had a lower microglial response than the corresponding sham-operated group. Both UCO and the use of anesthetics additively increased tau phosphorylation in the SN region, thalamus, and hippocampus. CONCLUSION: The choice of anesthetics is important for an emergency C section. Propofol could potentially protect the dopaminergic neurotransmitter phenotype within the SN at the cost of a widespread increase in tau phosphorylation.

textabstractAims: Evidence for drug use in newborns is sparse, which may cause large differences in drug prescriptions. We aimed to investigate the differences between neonatal intensive care units (NICUs) in the Netherlands in currently prescribed drugs. Methods: This multicentre study included neonates admitted during 12 months to four different NICUs. Drugs were classified in accordance with the Anatomical Therapeutic Chemical (ATC) classification system and assessed for on/off-label status in relation to neonatal age. The treatment protocols for four common indications for drug use were compared: pain, intubation, convulsions and hypotension. Results: A total of 1491 neonates (GA range 23+6–42+2 weeks) were included with a total of 32 182 patient days, 181 different drugs and 10 895 prescriptions of which 23% was off-label in relation to neonatal age. Overall, anti-infective drugs were most frequently used with a total of 3161 prescriptions, of which 4% was off-label in relation to neonatal age. Nervous system drugs included 2500 prescriptions of which 31% was off-label in relation to neonatal age. Nervous system drugs, blood and blood forming organs, and cardiovascular drugs showed the largest differences between NICUs with ranges of 919–2278, 554–1465, and 238–952 total prescriptions per 1000 patients per ATC class, respectively. Conclusions: We showed that drug use varies widely in neonatal clinical practice. The drug classes with the highest proportion of off-label drugs in relation to neonatal age showed the largest differences between NICUs, i.e. cardiovascular and nervous system drugs. Drug research in neonates should receive high priority to guarantee safe and appropriate medicines and optimal treatment.

Background: Antenatal infection (i.e., chorioamnionitis) is an important risk factor for adverse neurodevelopmental outcomes after preterm birth. Destructive and developmental disturbances of the white matter are hallmarks of preterm brain injury. Understanding the temporal effects of antenatal infection in relation to the onset of neurological injury is crucial for the development of neurotherapeutics for preterm infants. However, these dynamics remain unstudied.Methods: Time-mated ewes were intra-amniotically injected with lipopolysaccharide at 5, 12, or 24 h or 2, 4, 8, or 15 days before preterm delivery at 125 days gestational age (term similar to 150 days). Post mortem analyses for peripheral immune activation, neuroinflammation, and white matter/neuronal injury were performed. Moreover, considering the neuroprotective potential of erythropoietin (EPO) for perinatal brain injury, we evaluated (phosphorylated) EPO receptor (pEPOR) expression in the fetal brain following LPS exposure.Results: Intra-amniotic exposure to this single bolus of LPS resulted in a biphasic systemic IL-6 and IL-8 response. In the developing brain, intra-amniotic LPS exposure induces a persistent microgliosis (IBA-1 immunoreactivity) but a shorter-lived increase in the pro-inflammatory marker COX-2. Cell death (caspase-3 immunoreactivity) was only observed when LPS exposure was greater than 8 days in the white matter, and there was a reduction in the number of (pre) oligodendrocytes (Olig2- and PDGFR alpha-positive cells) within the white matter at 15 days post LPS exposure only. pEPOR expression displayed a striking biphasic regulation following LPS exposure which may help explain contradicting results among clinical trials that tested EPO for the prevention of preterm brain injury.Conclusion: We provide increased understanding of the spatiotemporal pathophysiological changes in the preterm brain following intra-amniotic inflammation which may aid development of new interventions or implement interventions more effectively to prevent perinatal brain damage.

In this work we report the results of experimental studies of the phase composition and structure of the nanodispersed Al–O powder produced by the plasmodynamic method. Using X-ray diffractometry and transmission electron microscopy, we show that the product contains σ-Al2O3 and MgAl2O4. The phase composition evolution of the initial product of plasmodynamic synthesis is studied during its heat treatment. Thermogravimetric analysis in an argon atmosphere shows no changes in mass of the sample weighed when it is heated, while differential scanning calorimetry studies indicate a marked manifestation of the endothermic effect.