Search

The purpose of this study is to introduce a new concept and term into the scientometric discourse and research—scientometric implosion—and test the idea on the example of the Armenian journals. The article argues that the existence of a compressed scientific area in the country makes pressure on the journals and after some time this pressure makes one or several journals explode—break the limited national scientific area and move to the international arena. As soon as one of the local journals breaks through this compressed space and appears at an international level, further explosion happens, which makes the other journals follow the same path.

Electrochemical preparation of chelates based on 5-ethynyl-2 H-tetrazole on the surface of iron, cobalt, and nickel results in colored polymer film at low current density. At higher current density the polymer chelate is transferred into the solution. The composition and structure of the polymer chelates has been studied by infrared spectroscopy, elemental analysis, and thermogravimetric analysis. The mechanism of the chelates formation in various solvents has been suggested. [ABSTRACT FROM AUTHOR]

In this paper we prove that for any function f from the class L on [0, 1) one can find a function g from the same class (which differs from f on a set of arbitrarily small measure) whose greedy algorithm with respect to the Vilenkin system converges to f. [ABSTRACT FROM AUTHOR]

The article presents the regularities of the vertical change in the air temperature of a ventilated room for various purposes, where the excess of sensible heat dominates, in the first case, when there is no process of air flow through the opening in a common vertical fence between the rooms located in a row, or the second case, when a similar air flow is observed. In heat-stressed rooms, the general ventilation arrangement scheme provides for the removal of air from the upper volume of the room. To determine the required air exchange with point, two-zone or multi-zone mathematical models of a ventilated room, it is necessary to have a reliable apparatus for determining the gradient of the vertical air parameters change for a ventilated room. The reasonably determined value of the gradient of the air temperature change along the vertical of the ventilated room makes it possible to calculate the air flow between different volumes inside the ventilated room. Determination of the air temperature near the suction flare makes it possible to determine the required air exchange more reasonably. A method is given for calculating the distribution of air temperature in rooms with an excess of apparent heat over the height of the room in the first case, when there is no process of air flow through the opening in the common vertical fence between the rooms located in a row, or the second case, when a similar air flow is observed. This takes into account the height of the supply air distributors relative to the working (serviced) area. Reasonable determination of the air temperature at different points in the room with an excess of sensible heat allows a correct calculation of the required air exchange. The presented method for determining the gradient of air temperature stratification along the height of the room with air flow between adjacent rooms and without it contributes to the reasonable determination of the air temperature at the suction flame of the exhaust air distributor, which increases the reliability of calculating the required air exchange.

The availability of highly economical indicators of convective type heating appliances, as well as the wide use of window sills, solid glazing of walls in the construction equipment, and the expansion of the use of convective (ribbed) type heating appliances, taking into account the possible improvement of their sanitary and hygienic and heat engineering properties. Constructions of convective type (convector) type heating devices with rather low heat engineering indicators. To improve the thermo-technical qualities of convectors, special attention is paid to the determination of the optimum dimensions of the fin, the channel for the passage of the coolant, the fin length, the optimum shape of the rib, and so on. The task of this work is to find new ways that require the heat transfer process of ribbed heating devices. The problem of the optimal distribution of the heat source (channel for the passage of the coolant) relative to the horizontal axis of symmetry of the rib is considered. Analytical dependences are obtained, which allow to determine the local values of heat transfer changes for nonisothermal plates, the temperature change at which is a step-change function. The process of convection in a laminar boundary layer is shown as a process of nonstationary thermal conductivity of a semi-boundary body. When solving the problem of radiant heat exchange between the ribs and surrounding surfaces, and between the edge and the environment. The directions of the experimental study are presented with the purpose of determining: the thickness of the boundary layer near the surface of the rib; the nature of the distribution of temperature along the edge with different locations of the source of heat; thermal engineering studies on convectors, various measurements of the channel for the passage of the coolant, various finning steps, and various fin sizes.

Abstract Background Overexpression of mutant copper/zinc superoxide dismutase (SOD1) in rodents has provided useful models for studying the pathogenesis of amyotrophic lateral sclerosis (ALS). Microglia have been shown to contribute to ALS disease progression in these models, although the mechanism of this contribution remains to be elucidated. Here, we present the first evidence of the effects of overexpression of mutant (TG G93A) and wild type (TG WT) human SOD1 transgenes on a set of functional properties of microglia relevant to ALS progression, including expression of integrin β-1, spreading and migration, phagocytosis of apoptotic neuronal cell debris, and intracellular calcium changes in response to an inflammatory stimulus. Results TG SOD1 G93A but not TG SOD1 WT microglia had lower expression levels of the cell adhesion molecule subunit integrin β-1 than their NTG control cells [NTG (G93A) and NTG (WT), respectively, 92.8 ± 2.8% on TG G93A, 92.0 ± 6.6% on TG WT, 100.0 ± 1.6% on NTG (G93A), and 100.0 ± 2.7% on NTG (WT) cells], resulting in decreased spreading ability, with no effect on ability to migrate. Both TG G93A and TG WT microglia had reduced capacity to phagocytose apoptotic neuronal cell debris (13.0 ± 1.3% for TG G93A, 16.5 ± 1.9% for TG WT, 28.6 ± 1.8% for NTG (G93A), and 26.9 ± 2.8% for NTG (WT) cells). Extracellular stimulation of microglia with ATP resulted in smaller increase in intracellular free calcium in TG G93A and TG WT microglia relative to NTG controls (0.28 ± 0.02 μM for TG G93A, 0.24 ± 0.03 μM for TG WT, 0.39 ± 0.03 μM for NTG (G93A), and 0.37 ± 0.05 μM for NTG (WT) microglia). Conclusions These findings indicate that, under resting conditions, microglia from mutant SOD1 transgenic mice have a reduced capacity to elicit physiological responses following tissue disturbances and that higher levels of stimulatory signals, and/or prolonged stimulation may be necessary to initiate these responses. Overall, resting mutant SOD1-overexpressing microglia may have reduced capacity to function as sensors of disturbed tissue/cellular homeostasis in the CNS and thus have reduced neuroprotective function.

Autism spectrum disorder (ASD) is a developmental disorder with symptoms that range from social and communication impairments to restricted interests and repetitive behavior and is the 4th most disabling condition for children aged 5-14. Risk factors of ASD are not fully understood. Environmental risk factors are believed to play a significant role in the ASD epidemic. Research focusing on air pollution exposure as an early-life risk factor of autism is growing, with numerous studies finding associations of traffic and industrial emissions with an increased risk of ASD. One of the possible mechanisms linking autism and air pollution exposure is metabolic dysfunction. However, there were no consensus about the key metabolic pathways and corresponding metabolite signatures in mothers and children that are altered by air pollution exposure and cause the ASD. Therefore, we performed a review of published papers examining the metabolomic signatures and metabolic pathways that are associated with either air pollution exposure or ASD risk in human studies. In conclusion, we found that dysregulated lipid, fatty acid, amino acid, neurotransmitter, and microbiome metabolisms are associated with both short-term and long-term air pollution exposure and the risk of ASD. These dysregulated metabolisms may provide insights into ASD etiology related to air pollution exposure, particularly during the perinatal period in which neurodevelopment is highly susceptible to damage from oxidative stress and inflammation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Purpose: To assess alignment of the Global Action for Measurement of Adolescent health (GAMA) draft adolescent health indicators with national policies and explore challenges and opportunities for collecting data on adolescent sexual, reproductive, and mental health in Armenia., Methods: We reviewed Armenia's national laws, decrees, policies, strategies, and programs for content related to the draft indicators. We conducted three focus group discussions with government and nongovernmental stakeholders and youth representatives on the feasibility of collecting the draft indicators, and analyzed the discussion segments related to sexual, reproductive, and mental health indicators., Results: The policy review included 22 documents. Armenia's national laws, policies, strategies, orders, and decrees mention a range of tracking and monitoring activities in adolescent health, and many draft GAMA indicators are already incorporated into national statistics and are collected in ongoing surveys. However, policies and strategies often lack specificity around how to measure and report indicators. Sexual, reproductive, and mental health indicators were particularly sensitive to collect due to Armenian cultural norms and expectations, especially for younger adolescents under the age of 15 years., Discussion: Guidance should be developed to facilitate the formulation of relevant policies with well-defined indicators and complete tracking and reporting information. Data collection should be further harmonized within the overall health information flow to avoid data overlap. While sensitization work and interviewer training can help address some issues around collecting data on sexual, reproductive, and mental health, it may be necessary to adapt certain indicators to be culturally acceptable in Armenia, such as by limiting the age range to above 15 years for highly sensitive indicators., (Copyright © 2024. Published by Elsevier Inc.)

Introduction: Chronic HC leads to the development of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). The treatment of chronic HC with DAAs reduces mortality from LC and HCC. The study aimed to investigate the serological markers specific to HCC (PIVKA-II and AFP) in patients with chronic HC before and after DAA treatment., Methodology: The study involved 35 HCV patients (mean age: 56.23 ± 1.45) divided into two groups. Group 1 included 15 HCV + HCC patients and Group 2 included 20 HCV non-HCC patients., Results: At the end of treatment all the patients were HCV RNA negative. Three months after the end of antiviral treatment, HCV RNA was undetectable in all patients, while a complete biochemical and virological response was observed in 66.7% of HCV + HCC patients and 85.0% of HCV non-HCC patients. PIVKA-II levels before the initiation of antiviral treatment were high in all patients. At the end of the treatment, in the HCV non-HCC group, normalization of PIVKA-II levels was observed only in 20.0% cases, and in 60.0% of cases 3 months after the treatment. Meanwhile, in patients with HCC and chronic HCV, PIVKA-II levels were within the normal range 3 months after treatment in only 13.3% of patients., Conclusions: It is necessary to monitor HCV patients with cirrhosis (F4) and severe fibrosis (F3) without HCC, who have high PIVKA-II and AFP levels and/or ALT activity despite obtaining sustained virologic response 3 months after treatment with DAAs., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Sona Sargsyan, Hripsime Magdesieva, Tsoghik Navoyan, Aregnaz Mkhitaryan, Lusine Atoyan, Violeta Sargsyan, Hayk Harutyunyan, Vahe Azatyan, Armine Minasyan, Naira Gyulazyan.)

Background: The emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in early 2020 and subsequent implementation of public health and social measures (PHSM) disrupted the epidemiology of respiratory viruses. This work describes the epidemiology of respiratory syncytial virus (RSV) observed during two winter seasons (weeks 40-20) and inter-seasonal periods (weeks 21-39) during the pandemic between October 2020 and September 2022., Methods: Using data submitted to The European Surveillance System (TESSy) by countries or territories in the World Health Organization (WHO) European Region between weeks 40/2020 and 39/2022, we aggregated country-specific weekly RSV counts of sentinel, non-sentinel and Severe Acute Respiratory Infection (SARI) surveillance specimens and calculated percentage positivity. Results for both 2020/21 and 2021/22 seasons and inter-seasons were compared with pre-pandemic 2016/17 to 2019/20 seasons and inter-seasons., Results: Although more specimens were tested than in pre-COVID-19 pandemic seasons, very few RSV detections were reported during the 2020/21 season in all surveillance systems. During the 2021 inter-season, a gradual increase in detections was observed in all systems. In 2021/22, all systems saw early peaks of RSV infection, and during the 2022 inter-seasonal period, patterns of detections were closer to those seen before the COVID-19 pandemic., Conclusion: RSV surveillance continued throughout the COVID-19 pandemic, with an initial reduction in transmission, followed by very high and out-of-season RSV circulation (summer 2021) and then an early start of the 2021/22 season. As of the 2022/23 season, RSV circulation had not yet normalised., Competing Interests: The following authors declare having received funding from the Innovative Medicines Initiative (IMI): Adam Meijer (The Netherlands) and Anne Teirlinck (The Netherlands). All other authors have no conflicts of interest to declare., (© 2023 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

The sequencing of SARS-CoV-2 provides essential information on viral evolution, transmission, and epidemiology. In this paper, we performed the whole-genome sequencing of SARS-CoV-2 using nanopore and Illumina sequencing to describe the circulation of the virus lineages in Armenia. The analysis of 145 full genomes identified six clades (19A, 20A, 20B, 20I, 21J, and 21K) and considerable intra-clade PANGO lineage diversity. Phylodynamic and transmission analysis allowed to attribute specific clades as well as infer their importation routes. Thus, the first two waves of positive case increase were caused by the 20B clade, the third peak caused by the 20I (Alpha), while the last two peaks were caused by the 21J (Delta) and 21K (Omicron) variants. The functional analyses of mutations in sequences largely affected epitopes associated with protective HLA loci and did not cause the loss of the signal in PCR tests targeting ORF1ab and N genes as confirmed by RT-PCR. We also compared the performance of nanopore and Illumina short-read sequencing and showed the utility of nanopore sequencing as an efficient and affordable alternative for large-scale molecular epidemiology research. Thus, our paper describes new data on the genomic diversity of SARS-CoV-2 variants in Armenia in the global context of the virus molecular genomic surveillance.

COVID-19 pandemic severely impacted the healthcare and economy on a global scale. It is widely recognized that mass testing is an efficient way to contain the spread of SARS-CoV-2 infection as well as aid in the development of informed policies for disease management. However, the current COVID-19 worldwide infection rates increased the demand for rapid and reliable screening of infection. We compared the performance of qRT-PCR in direct heat-inactivated (H), heat-inactivated and pelleted (HC) samples against RNA in a group of 74 subjects (44 positive and 30 negative). Then we compared the sensitivity of HC in a larger group of 196 COVID-19 positive samples. Our study suggests that HC samples show higher accuracy for SARS-CoV-2 detection PCR assay compared to direct H (89 % vs 83 % of the detection in RNA). The sensitivity of detection using direct samples varied depending on the sample transport and storage media as well as the viral loads (as measured by qRT-PCR Ct levels). Altogether, all the data suggest that purified RNA provides more accurate results, however, direct sample testing with qRT-PCR may help to significantly increase testing capacity. Switching to the direct sample testing is justified if the number of tests is doubled at least., (Copyright © 2021. Published by Elsevier B.V.)

Tobacco has long been known to be one of the greatest causes of morbidity and mortality in the adults, but the effects on the foetus and young children, which are lifelong, have been less well appreciated. Developing from this are electronic nicotine delivery systems or vapes, promulgated as being less harmful than tobacco. Nicotine itself is toxic to the foetus, with permanent effects on lung structure and function. Most vapes contain nicotine, but they also contain many other compounds which are inhaled and for which there are no toxicity studies. They also contain known toxic substances, whose use is banned by European Union legislation. Accelerating numbers of young people are vaping, and this does not reflect an exchange of vapes for cigarettes. The acute toxicity of e-cigarettes is greater than that of tobacco, and includes acute lung injury, pulmonary haemorrhage and eosinophilic and lipoid pneumonia. Given the worse acute toxicity, it should be impossible to be complacent about medium and long term effects of vaping. Laboratory studies have demonstrated changes in lung proteomics and the innate immune system with vaping, some but not all of which overlap with tobacco. It would be wrong to consider vapes as a weaker form of tobacco, they have their own toxicity. Children and young people are being targeted by the vaping industry (which is largely the same as the tobacco industry), including on-line, and unless an efficient legislative program is put in place, a whole new generation of nicotine addicts will result., (Copyright © 2021 Andrew Bush, Thomas Ferkol, Algirdas Valiulis, Artur Mazur, Ivane Chkhaidze, Tamaz Maglakelidze, Sergey Sargsyan, Gevorg Boyajyan, Olga Cirstea, Svitlana Doan, Oleksandr Katilov, Valeriy Pokhylko, Leonid Dubey, Edita Poluziorovienė, Nina Prokopčiuk, Vaida Taminskienė, Arūnas Valiulis.)

The collapse of the Soviet Union in 1991 left many ex-republics in a financial and administrative crisis for the ensuing two decades. Previously centralised processes like recertification of doctors and healthcare workers and continuing medical education fell by the wayside. Continuing medical education and continuing professional development in Armenia have evolved through multiple phases from Soviet, to immediate, mid and late-transitional post-Soviet periods, to current modernising efforts. This manuscript describes the phases of evolution of continuing medical education chronologically and details the legislative and regulatory framework surrounding each stage of development. Armenia is currently implementing a credit system of continuing medical education with the aim to introduce and adopt new and efficient approaches in this field. Continuing education credits fall into three categories: didactic or theoretical knowledge, practical skills and self-education/self-development. To recertify, professionals must collect credits from all three groups with specified minimum amounts according to their degrees. Armenia's guiding principle is to harmonise the continuing medical education and professional development model with internationally accepted criteria in order to contribute to the international mobility of healthcare workers and to provide for true on-going professional development and knowledge that will benefit our doctors, nurses and above all our patients., Competing Interests: SS, KY and AB are current employee of the NIH of Armenia, GY is a former Vice Dean for CME at the Yerevan State Medical University. The authors have no additional conflicts of interest to declare., (© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Competing Interests: Conflict of interest The authors declare that there is no conflict of interest.

Introduction: The "Child Certificate" program, launched in Armenia in 2011, made hospitalization for children less than seven years free in order to improve access to hospitalization, reduce out-of-pocket expenses and ensure Universal Health Coverage. We aimed to estimate trends in the number of outpatient and hospitalized acute respiratory infection (ARI) cases and related under-five mortality., Methodology: Cross-sectional study using data from national databases before (2008-2011) and after (2012-2017) Program implementation. The diagnosis of ARI was based on the International Classification of Disease (ICD-10)., Results: The average hospitalization per 1000 children under 14 and infants increased by 85% and 75% respectively, compared with the period before the introduction of the Program, while the frequency of outpatient visits remained unchanged. The ARI-related mortality in children less than five years and in infants decreased by 11% and 19%, respectively. Financial allocations for ARI-associated hospitalizations amounted to 2.1 billion Armenian drams in 2011 and increased to 3.3 billion drams in 2016 (an increase of 57%). For pneumonia, this increase was 108% (from 0.35 to 0.72 billion)., Conclusions: The introduction of free hospitalization for ARI led to an increase in the hospitalization rates. There was a favorable decline in under-five mortality and an exponential increase in financial allocations. The reasons for hospitalization should be investigated to ensure rational hospitalization with parallel improvement of primary care to reduce delayed presentations. It is necessary to find ways addressing the growing financial allocations for ARI-associated hospitalization., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2019 Sergey Gerasim Sargsyan, Diana Andreasyan, Samvel Kharazyan, Olga Denisiuk, Karapet Davtyan, Roni Zachariah.)

The health of children and adolescents of Armenia has been affected by various socioeconomic, environmental, educational, and behavioral factors, demonstrating trends typical for both developed and developing countries. Key issues to be addressed by Armenian pediatricians are child mortality, malnutrition, and growth failure in the early years and overweight in later years. The case of Armenia illustrates how countries in transition are currently tackling both "old" problems (mortality and malnutrition) and "new" emerging morbidities (chronic diseases and adolescent health problems) based on social and health determinants, but the financing of the health system is far from satisfactory. Lessons of Armenia indicate the need for more cooperation between general practitioners and pediatricians at a primary care level. In addition, a better balance between inpatient and outpatient care could be achieved, which is not yet the case. Nevertheless, the overall performance of the Armenian child health care system can be considered satisfactory when bearing in mind the limitation of resources. Among the successful factors are those inherited from the Soviet period health system, including key institutions such as rural health posts and health centers, city polyclinics, and hospitals. These institutions mostly meet the needs of Armenian children and families today., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: The Republic of Armenia was 1 of the 2 earliest countries in the Newly Independent States to introduce rotavirus vaccine into its national immunization program to reduce the burden of rotavirus disease (documented to cause 38% of acute gastroenteritis hospitalizations [AGE] among children aged <5 years). In November 2012, RV1 (Rotarix) was introduced for Armenian infants at ages 6 and 12 weeks., Methods: The established active surveillance system at 2 hospitals in the capital, Yerevan, whereby children aged <5 years hospitalized for AGE have stool sample tested for rotavirus antigen, was used to assess trends in rotavirus hospitalizations. Immunization records on children enrolled after vaccine introduction were obtained from clinics, and vaccine effectiveness (VE) was estimated using children with AGE who test negative for rotavirus as controls for the rotavirus-positive cases., Results: Among infants, rotavirus hospitalizations were reduced by 48% within the first year after introduction, and by ≥75% in years 2 and 3 following introduction. Reductions of ≥30% in other young children too old to have been vaccinated suggest additional benefit through indirect protection; overall in year 3, rotavirus hospitalizations were reduced by 69% among children aged <5 years. The overall VE of 2 RV1 doses in protecting against rotavirus hospitalization (any severity) was 62% (95% confidence interval [CI], 36%-77%) among children aged 6-23 months; 68% (95% CI, 24%-86%) among those aged 6-11 months, and 60% (95% CI, 20%-80%) in children aged 12-23 months. Against more severe rotavirus disease, VE was 79% (95% CI, 55%-90%) and similarly high in both age groups., Conclusions: RV1 is effective in young Armenian children and substantially reduced rotavirus hospitalizations shortly after introduction., (Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

We demonstrate the synthesis of sparse sampling and dimensionality reduction to characterize and model nonlinear dynamical systems over a range of bifurcation parameters. First, we construct modal libraries using the classical proper orthogonal decomposition in order to expose the dominant low-rank coherent structures. Here, libraries of the nonlinear terms are also constructed in order to take advantage of the discrete empirical interpolation method and projection that allows for the approximation of nonlinear terms from a sparse number of grid points. The selected grid points are shown to be effective sensing and measurement locations for characterizing the underlying dynamics, stability, and bifurcations of nonlinear dynamical systems. The use of empirical interpolation points and sparse representation facilitates a family of local reduced-order models for each physical regime, rather than a higher-order global model, which has the benefit of physical interpretability of energy transfer between coherent structures. The method advocated also allows for orders-of-magnitude improvement in computational speed and memory requirements. To illustrate the method, the discrete interpolation points and nonlinear modal libraries are used for sparse representation in order to classify and reconstruct the dynamic bifurcation regimes in the complex Ginzburg-Landau equation. It is also shown that point measurements of the nonlinearity are more effective than linear measurements when sensor noise is present.

Purpose: The neurohormones melatonin and dopamine mediate clock-dependent/circadian regulation of inner retinal neurons and photoreceptor cells and in this way promote their functional adaptation to time of day and their survival. To fulfill this function they act on melatonin receptor type 1 (MT1 receptors) and dopamine D4 receptors (D4 receptors), respectively. The aim of the present study was to screen transcriptional regulators important for retinal physiology and/or pathology (Dbp, Egr-1, Fos, Nr1d1, Nr2e3, Nr4a1, Pgc-1α, Rorβ) for circadian regulation and dependence on melatonin signaling/MT1 receptors or dopamine signaling/D4 receptors., Methods: This was done by gene profiling using quantitative polymerase chain reaction in mice deficient in MT1 or D4 receptors., Results: The data obtained determined Pgc-1α and Nr4a1 as transcriptional targets of circadian melatonin and dopamine signaling, respectively., Conclusions: The results suggest that Pgc-1α and Nr4a1 represent candidate genes for linking circadian neurohormone release with functional adaptation and healthiness of retina and photoreceptor cells.

Helminthic infections of reptiles habiting in the territory of Armenia are examined. Seven species of helminths new for reptiles from Armenia are registered: Parapharyngodon skrjabini, Oswaldocruzia goezei, Neoxysomatium sp., Telorchis assula, Nematotaenia tarentolae, Mesocestoides lineatus and Spirometra erinacei europea. Descriptions and pictures of them are given.

Hearing is of utmost importance for normal speech and social development. Even children who have mild or unilateral permanent hearing loss may experience difficulties with understanding speech, as well as problems with educational and psycho-social development. The increasing advantages of middle-ear implant technologies are opening new perspectives for restoring hearing. Active middle-ear implants can be used in children and adolescents with hearing loss. In addition to the well-documented results for improving speech intelligibility and quality of hearing in sensorineural hearing loss active middle-ear implants are now successfully used in patients with conductive and mixed hearing loss. In this article we present a case of successful, single-stage vibroplasty, on the right side with the fixation of the FMT on the stapes and PORP CLiP vibroplasty on the left side in a 6-year-old girl with bilateral mixed hearing loss and multiple dyslalia associated with Franceschetti syndrome (mandibulofacial dysostosis). CT revealed bilateral middle-ear malformations as well as an atretic right and stenotic left external auditory canal. Due to craniofacial dysmorphia airway and (post)operative, management is significantly more difficult in patients with a Franceschetti syndrome which in this case favoured a single-stage bilateral procedure. No intra- or postoperative surgical complications were reported. The middle-ear implants were activated 4 weeks after surgery. In the audiological examination 6 months after surgery, the child showed 100% speech intelligibility with activated implants on each side.

Astrocytes are the most numerous cell type within the central nervous system (CNS) and perform a variety of tasks, from axon guidance and synaptic support, to the control of the blood brain barrier and blood flow. To perform these roles, there is a great variety of astrocytes. In this review, we summarize the function of astrocytes, in particular, their role in maintaining homeostasis at the synapse, regulating neuronal signaling, protecting neurons from oxidative damage, and determining the fate of endogenous neural precursors. The review also highlights recent developments indicating the role of astrocytes in motor neuron disease (MND), emphasizing their potential as therapeutic targets and agents in cell replacement therapy. The Cu-Zn superoxide dismutase (SOD1) gene that has been implicated in 20% of cases of familial MND must be expressed in the glial cells as well as motor neurons to produce the disease state in murine models of disease. Selectively reducing mutant SOD1 (mSOD1) in astrocytes does not affect disease onset but slows disease progression, whereas reducing mSOD1 in motor neurons delays disease onset and slows early disease but has less effect on life span. This suggests that glial cells represent potential therapeutic targets in MND. However, the lack of specific markers for astrocytes, their precursors, and sub-types means that our knowledge of astrocyte development/differentiation and response to injury lags far behind our understanding of function. Only by filling this knowledge gap can astrocytes be effectively targeted or replaced to successfully treat chronic CNS disorders such as MND.