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Nagorno-Karabakh, also known as Artsakh, was a region in the former Soviet Union with a predominately Armenian population that had restricted self-governance. Since 1991, Nagorno-Karabakh has been a de facto independent state. Even before the current crisis, this region had challenges in providing adequate health care to the population; the blockade has driven it to a crucial point. On Aug 7, 2023, the former chief prosecutor of the International Criminal Court stated “there is an ongoing genocide against 120 000 Armenians living in Nagorno-Karabakh”.

Purpose Central nervous system (CNS) tumors are the most common solid malignancies in children worldwide, including in Armenia. The current study aims to analyze epidemiological data, treatment, and outcomes of children and young adults (≤25 years) with CNS tumors in Armenia during the last 26 years. Methods We collected data from pediatric and young adult patients treated in selected sites in Armenia from 1 st January 1995 to 31 st December 2020. Incidence by sex, age at diagnosis, time from first complaints to diagnosis, histopathology results, treatment strategies, complications, and overall survival (OS) rates were calculated. Results The multicenter data analysis revealed 149 patients with diagnosed primary CNS tumors over 26 years. Among them, 84 (56.4%) were male. The median age at diagnosis was 7 years (range, 3 months to 25 years), and the median time from the first complaints to diagnosis was 2 months (range, 1 week to 70 months). Medulloblastomas and other embryonal tumors (47), low-grade gliomas (32), and high-grade gliomas (22) were the most commonly diagnosed malignancies. Ependymomas, craniopharyngiomas, germ cell tumors, and other malignancies were observed in 22 patients. For 26 patients, no histopathological or radiological diagnosis was available. Follow-up information was available for 98 (65.8%) patients. The 5-year OS rate for the whole study group was 67.7%. Conclusion Consistent with international data, embryonal tumors, and gliomas were the most commonly diagnosed CNS malignancies in Armenia. Multimodal treatment was often not available in Armenia during the study period, especially for early cases.

Which treatment strategy for MTT would be most effective and provide the best possible prognosis in this case? * A. Surgery * B. Chemotherapy * C. Chemotherapy and radiotherapy * D. Combination chemotherapy with surgery and/or radiation therapy Advertisement CORRECT ANSWER: * D. Combination chemotherapy with surgery and/or radiation therapy Discussion Malignant peripheral nerve sheath tumor (MPNST), also known as malignant schwannoma or neurogenic sarcoma, is a rare form of soft tissue sarcoma (STS) that develops from Schwann cells or pluripotent cells of the neural crest, constituting peripheral nerve branches or sheaths of peripheral nerve fibers.1 MPNST represents approximately 5% of all STS.2 In turn, MTT is a histological subtype of MPNST, in which malignant Schwann cells coexist with malignant rhabdomyoblasts.2,3 MTT accounts for less than 10% of MPNST.4,5 MTT is a highly aggressive tumor that most often affects patients aged less than 35 years, although it is very rare in pediatric patients.6 The prognosis is poor; 5-year survival rate among children ranges between 5% and 20%.2 The disease occurs equally among males and females.7 MTT may originate in different parts of the body, affecting extremities, head, neck, or trunk. Forty-three months after diagnosis, the child was still in remission.15 However, this is the only case report available noting successful treatment without surgical resection, so the effect of this chemotherapy/radiotherapy approach remains uncertain and thus cannot be recommended for MTT treatment. [...]chemo- and radiotherapies were followed by stem cell transplantation, and the contribution of stem cell transplantation to the outcome is questionable. If complete resection of the tumor is considered feasible, patients with MTT often undergo surgery in combination with adjuvant chemotherapy and/or postoperative radiation therapy.8,10 Postoperative chemotherapy and radiation therapy to the primary site can improve the chances of survival.7,9,10 In 2020, Ailing Zhao, MD, and colleagues compared the survival rates of children treated by different modalities and demonstrated that the rates were significantly improved for children who received postoperative therapies, vs those who had surgery alone.7 However, enlarged tumors and metastatic lesions limit the efficacy of surgery followed by adjuvant therapy. According to the data available in the literature, for children who received combination treatment of surgery, chemotherapy, and radiation therapy, the overall survival (OS) is 15 months (range, 8-22 months), and the 5-year OS rate is about 30%.7 Analyzing all these data leads us to conclude that the most effective treatment option is likely to be a combination of neoadjuvant chemotherapy, including ifosfamide/doxorubicin, followed by complete resection

A supercapacitor is an energy storage device that has the advantage of rapidly storing and releasing energy compared to traditional batteries. One powerful method for creating a wide range of materials is combustion synthesis, which relies on self-sustained chemical reactions. Specifically, solution combustion synthesis involves mixing reagents at the molecular level in an aqueous solution. This method allows for the fabrication of various nanostructured materials, such as binary and complex oxides, sulfides, and carbon-based nanocomposites, which are commonly used for creating electrodes in supercapacitors. The solution combustion synthesis offers flexibility in tuning the properties of the materials by adjusting the composition of the reactive solution, the type of fuel, and the combustion conditions. The process takes advantage of high temperatures, short processing times, and significant gas release to produce well crystalline nanostructured materials with a large specific surface area. This specific surface area is essential for enhancing the performance of electrodes in supercapacitors. Our review focuses on recent publications in this field, specifically examining the relationship between the microstructure of materials and their electrochemical properties. We discuss the findings and suggest potential improvements in the properties and stability of the fabricated composites based on the results.