Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations

Summary Points Brucellosis remains the commonest anthropozoonosis worldwide, and its treatment remains complex, requiring protracted administration of more than one antibiotic. In November 2006, a consensus meeting aimed at reaching a common specialist statement on the treatment of brucellosis was held in Ioannina, Greece under the auspices of the International Society of Chemotherapy and the Institute of Continuing Medical Education of Ioannina. The author panel suggests that the optimal treatment of uncomplicated brucellosis should be based on a six-week regimen of doxycycline combined either with streptomycin for 2–3 weeks, or rifampicin for six weeks. Gentamicin may be considered an acceptable alternative to streptomycin, while all other regimens/combinations should be considered second-line. The development of a common global therapeutic language for human brucellosis, and future, properly conducted clinical trials would definitely solve controversies regarding the disease.

Profile of European radiotherapy departments contributing to the EORTC Radiation Oncology Group (ROG) in the 21st century.

PURPOSE: Since 1982, the Radiation Oncology Group of the EORTC (EORTC ROG) has pursued an extensive Quality Assurance (QA) program involving all centres actively participating in its clinical research. The first step is the evaluation of the structure and of the human, technical and organisational resources of the centres, to assess their ability to comply with the current requirements for high-tech radiotherapy (RT). MATERIALS AND METHODS: A facility questionnaire (FQ) was developed in 1989 and adapted over the years to match the evolution of RT techniques. We report on the contents of the current FQ that was completed online by 98 active EORTC ROG member institutions from 19 countries, between December 2005 and October 2007. RESULTS: Similar to the data collected previously, large variations in equipment, staffing and workload between centres remain. Currently only 15 centres still use a Cobalt unit. All centres perform 3D Conformal RT, 79% of them can perform IMRT and 54% are able to deliver stereotactic RT. An external reference dosimetry audit (ERDA) was performed in 88% of the centres for photons and in 73% for electrons, but it was recent (<2 years) in only 74% and 60%, respectively. CONCLUSION: The use of the FQ helps maintain the minimum quality requirements within the EORTC ROG network: recommendations are made on the basis of the analysis of its results. The present analysis shows that modern RT techniques are widely implemented in the clinic but also that ERDA should be performed more frequently. Repeated assessment using the FQ is warranted to document the future evolution of the EORTC ROG institutions.

Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations.

Brucellosis is probably the commonest anthropozoonotic infection worldwide [1-3], but remains in various aspects an enigma in the 21st century [4]. Brucella melitensis remains the major cause of human disease worldwide, followed by B. abortus and B. suis, while rare but persisting cases of B. canis human infection and disease by novel Brucella pathogens of marine mammals have also emerged. The disease is re-emerging as a significant cause of travel-related disease [5] and represents an index of poor socioeconomic status (Figure 1). Its treatment is largely based even today on the principles applied half a century ago by pioneer researchers [6] and few modifications have been made in the following years, despite the emergence of new antibiotic classes and different therapeutic approaches [7].

Amyloid Beta Precursor Protein: Proper Credit for the Basic Biochemical Properties of the Most Studied Protein in the 21st Century

The amyloid precursor protein (APP) is mainly known for being the precursor of the ß-amyloid peptide, which accumulates in plaques found in the brain of Alzheimer's disease patients. Expression in different tissues and the degree of sequence identity among mammals indicate an essential and non-tissue specific physiological function. APP is anchored to the membrane and displays a single C-terminal intracellular domain and a longer N-terminal extracellular domain. The basic biochemical properties and the scattered data on research, not related to production of beta-amyloid peptide, suggest that the protein and the molecules resulting from APP proteolytic cleavage may act as adhesion factors, enzymes, hormones/neurotransmitters and/or protease inhibitors. APP deserves to be known for its quite notable properties and its physiological role(s).

The Implementation of Jenkins’s 21st-Century Skills in the Curriculum: A Cross-National Policy Analysis

This meta-analytic study sought to determine if cross-national curricula are aligned with burgeoning digital learning environments in order to help policy makers develop curriculum that incorporates 21st-century skills instruction. The study juxtaposed cross- national curricula in Ontario (Canada), Australia, and Finland against Jenkins’s (2009) framework of 11 crucial 21st-century skills that include: play, performance, simulation, appropriation, multitasking, distributed cognition, collective intelligence, judgment, transmedia navigation, networking, and negotiation. Results from qualitative data collection and analysis revealed that Finland implements all of Jenkins’s 21st-century skills. Recommendations are made to implement sound 21st-century skills in other jurisdictions.

The subversion of the good life (enlightened rebelliousness for the 21st century: a critical perspective on the work of Bolívar Echeverría)

El debate sobre el modelo civilizatorio de la modernidad de Occidente, consu economía concentradora y excluyente, y su matriz económico energética petrolera y extractivista no sustentable, ha reavivado en los escenarios políticos y académicos de la salud la discusión de la propuesta del buen vivir inscrita en las nuevas constituciones de Bolivia y Ecuador. Ante la crisis social, sanitaria y ambiental producida por la imposición de una economía de la muerte, y la consiguiente multiplicación de modos de vivir malsanos, se discuten aquí las tesis de Bolívar Echeverría sobre la base material de la vida y la cultura, como una herramienta para evaluar históricamente los desempeños de los gobiernos de las izquierdas realmente existentes, y trabajar un modelo de transición histórica y el indispensable remozamiento de la conciencia crítica desde una visión radicalmente renovadora, pero que mire la realidad sin dogmatismo, sin estridencias míticas y con un sentido de profunda autocrítica.

The frequency and dynamics of stratospheric sudden warmings in the 21st century

Changes to stratospheric sudden warmings (SSWs) over the coming century, as predicted by the Geophysical Fluid Dynamics Laboratory (GFDL) chemistry climate model [Atmospheric Model With Transport and Chemistry (AMTRAC)], are investigated in detail. Two sets of integrations, each a three-member ensemble, are analyzed. The first set is driven with observed climate forcings between 1960 and 2004; the second is driven with climate forcings from a coupled model run, including trace gas concentrations representing a midrange estimate of future anthropogenic emissions between 1990 and 2099. A small positive trend in the frequency of SSWs is found. This trend, amounting to 1 event/decade over a century, is statistically significant at the 90% confidence level and is consistent over the two sets of model integrations. Comparison of the model SSW climatology between the late 20th and 21st centuries shows that the increase is largest toward the end of the winter season. In contrast, the dynamical properties are not significantly altered in the coming century, despite the increase in SSW frequency. Owing to the intrinsic complexity of our model, the direct cause of the predicted trend in SSW frequency remains an open question.