Lessons from traumatic head injury for assessing functional status after brain tumour

Assessment of global functional status plays a central role in describing outcome after traumatic head injury, but has played a relatively minor role as an endpoint in brain tumour studies. Advantages of functional status as an outcome include simplicity, objectivity, and interpretability, and it is particularly useful in conditions where cognitive impairment is common. Work in the field of traumatic brain injury, specifically on the Glasgow Outcome Scale (GOS), provides lessons in how the validity and reliability of global outcome assessment can be improved. Functional status is conceptually and empirically distinct from cognition and health-related quality of life, and neither of these can adequately substitute for it as an outcome. The strongest candidate for a global outcome measure in brain tumour work is the Karnofsky Performance Status (KPS). Many of the lessons from the GOS could be applied to improvement of KPS assessment. However, the KPS has additional limitations, particularly that it is not brain injury specific. Global functional status is potentially a useful outcome for brain tumour studies, but there is a gap in the tools currently available

The Family Streptomycetaceae

The family Streptomycetaceae comprises the genera Streptomyces, Kitasatospora, and Streptacidiphilus that are very difficult to differentiate both with genotypic and phenotypic characteristics. A separate generic status for Kitasatospora and Streptacidiphilus is questionable. Members of the family can be characterized as non-acid-alcohol-fast actinomycetes that generate most often an extensively branched substrate mycelium that rarely fragments. At maturity, the aerial mycelium forms chains of few to many spores. A large variety of pigments is produced, responsible for the color of the substrate and aerial mycelium. The organisms are chemoorganotrophic with an oxidative type of metabolism and grow within different pH ranges. Streptomyces are notable for their complex developmental cycle and production of bioactive secondary metabolites, producing more than a third of commercially available antibiotics. Antibacterial, antifungal, antiparasitic, and immunosuppressant compounds have been identified as products of Streptomyces secondary metabolism. Streptomyces can be distinguished from other filamentous actinomycetes on the basis of morphological characteristics, in particular by vegetative mycelium, aerial mycelium, and arthrospores. The genus comprises at the time of writing more than 600 species with validated names. 16S rRNA gene sequence-based analysis for species delineation within the Streptomycetaceae is of limited value. The variations within the 16S rRNA genes—even in the variable regions—are too small to resolve problems of species differentiation and to establish a taxonomic structure within the genus. Comprehensive comparative studies including protein-coding gene sequences with higher phylogenetic resolution and genome-based studies are needed to clarify the species delineation within the Streptomycetaceae