Where Next for Microbiome Research?

The development of high-throughput sequencing technologies has transformed our capacity to investigate the composition and dynamics of the microbial communities that populate diverse habitats. Over the past decade, these advances have yielded an avalanche of metagenomic data. The current stage of “van Leeuwenhoek”–like cataloguing, as well as functional analyses, will likely accelerate as DNA and RNA sequencing, plus protein and metabolic profiling capacities and computational tools, continue to improve. However, it is time to consider: what’s next for microbiome research? The short pieces included here briefly consider the challenges and opportunities awaiting microbiome research

European Respiratory Society Statement on preschool wheezing disorders: updated definitions, knowledge gaps, and proposed future research directions.

Since the publication of the European Respiratory Society (ERS) Task Force reports on the management of preschool wheezing in 2008 and 2014, a large body of evidence has accumulated suggesting the clinical phenotypes that were proposed, episodic (viral) wheezing and multiple-trigger wheezing, do not relate to underlying airway pathology and may not help determine response to treatment. Specifically, using clinical phenotypes alone may no longer be appropriate, and new approaches that can be used to inform clinical care are needed for future research. This ERS Task Force reviewed the literature published after 2008 related to preschool wheezing and has suggested the criteria used to define wheezing disorders in preschool children should include age of diagnosis (0 to <6 years), confirmation of wheezing on at least one occasion, and more than one episode of wheezing ever.Furthermore, diagnosis and management may be improved by identifying treatable traits, including inflammatory biomarkers (blood eosinophils, aeroallergen sensitisation) associated with type-2 immunity and differential response to inhaled corticosteroids, lung function parameters, and airway infection. However, more comprehensive use of biomarkers/treatable traits in predicting the response to treatment requires prospective validation. There is evidence that specific genetic traits may help guide management, but these must be adequately tested. In addition, the Task Force identified an absence of caregiver-reported outcomes, caregiver/self-management options, and features that should prompt specialist referral for this age group. Priorities for future research include a focus on identifying i) mechanisms driving preschool wheezing, ii) biomarkers of treatable traits and efficacy of interventions in those without allergic sensitisation/eosinophilia, iii) the need to include both objective outcomes and caregiver-reported outcomes in clinical trials, iv) the need for a suitable action plan for children with preschool wheezing and v) a definition of severe/difficult-to-treat preschool wheezing

ERS International Congress 2023:highlights from the Paediatrics Assembly

Respiratory health in children is essential for general wellbeing and healthy development in the short and long term. It is well known that many respiratory diseases in adulthood have their origins in early life, and therefore research on prevention of respiratory diseases and management of children with respiratory diseases will benefit patients during the full life course. Scientific and clinical advances in the field of respiratory health are moving at a fast pace. This article summarises some of the highlights in paediatric respiratory medicine presented at the hybrid European Respiratory Society (ERS) International Congress 2023 which took place in Milan (Italy). Selected sessions are summarised by Early Career Members of the Paediatrics Assembly (Assembly 7) under the supervision of senior ERS officers, and cover a wide range of research areas in children, including respiratory physiology and sleep, asthma and allergy, cystic fibrosis, respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology and bronchology.</p

ERS International Congress 2021: highlights from the Paediatric Assembly

In this review, Early Career Members of the European Respiratory Society (ERS) and the Chairs of the ERS Assembly 7: Paediatrics present the highlights in paediatric respiratory medicine from the ERS International Congress 2021. The eight scientific Groups of this Assembly cover respiratory physiology and sleep, asthma and allergy, cystic fibrosis (CF), respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology, bronchology, and lung and airway development. We here describe new developments in lung function testing and sleep-disordered breathing diagnosis, early life exposures affecting pulmonary function in children and effect of COVID-19 on sleep and lung function. In paediatric asthma, we present the important role of the exposome in asthma development, and how biologics can provide better outcomes. We discuss new methods to assess distal airways in children with CF, as some details remain blind when using the lung clearance index. Moreover, we summarise the new ERS guidelines for bronchiectasis management in children and adolescents. We present interventions to reduce morbidity and monitor pulmonary function in newborns at risk of bronchopulmonary dysplasia and long-term chronic respiratory morbidity of this disease. In respiratory epidemiology, we characterise primary ciliary dyskinesia, identify early life determinants of respiratory health and describe the effect of COVID-19 preventive measures on respiratory symptoms. Also, we describe the epidemiology of interstitial lung diseases, possible consequences of tracheomalacia and a classification of diffuse alveolar haemorrhage in children. Finally, we highlight that the characterisation of genes and pathways involved in the development of a disease is essential to identify new biomarkers and therapeutic targets

Studying neuroanatomy using MRI

The study of neuroanatomy using imaging enables key insights into how our brains function, are shaped by genes and environment, and change with development, aging, and disease. Developments in MRI acquisition, image processing, and data modelling have been key to these advances. However, MRI provides an indirect measurement of the biological signals we aim to investigate. Thus, artifacts and key questions of correct interpretation can confound the readouts provided by anatomical MRI. In this review we provide an overview of the methods for measuring macro- and mesoscopic structure and inferring microstructural properties; we also describe key artefacts and confounds that can lead to incorrect conclusions. Ultimately, we believe that, though methods need to improve and caution is required in its interpretation, structural MRI continues to have great promise in furthering our understanding of how the brain works

How effective are Balint group leaders?

Objectives: Balint leadership until today is based on views of experts. Empirical research is still lacking. This paper reports about leadership effects in Balint groups measured by the newly developed Balint Group Questionnaire (BGSQ). The questionnaire comprises three scales: Scale 1 - Reflection of Transference Dynamics in the Doctor-Patient Relationship, Scale 2 - Emotional and Cognitive Learning, Scale 3 - Case Mirroring in the Group Dynamic. Results: 87 out of 107 cooperating Balint group leaders had six or more participants who filled out the questionnaire after a Balint session. Based on the scale scores of the BGSQ from 1459 medical participants we found three clusters of differentially effective leadership. 52 leaders (59.8%) belonged to the most effective cluster in scale 1, 11 leaders (12.6 %) were particularly effective in scale 2, and 21 leaders (24.1%) in scale 3. Five out of 87 leaders were found most effective for all three scales. No other influencing factors predicted leadership effectiveness. Conclusions: This is the first quantitative study to differentiate leadership effects on learning processes of participants of Balint groups. The importance for training of Balint group leaders is discussed. More research regarding predictive variables and helpful leadership interventions is needed

Political skill and cross-cultural adjustment among self-initiated expatriates

Publisher Copyright: © 2022, Alexei Koveshnikov, Heidi Wechtler, Miriam Moeller and Cecile Dejoux.Purpose: Using social influence theory, this study examines the relationship between self-initiated expatriates' (SIE) political skill, as a measure of their social effectiveness, and cross-cultural adjustment (CCA). It also tests whether the host employer's psychological contract (PC) fulfillment mediates this relationship. Design/methodology/approach: Partial least square structural equation modeling (covariance-based SEM) technique is employed to analyze a sample of 209 SIEs. Findings: The study finds SIEs' political skill positively and significantly associated with SIEs' work-related adjustment. The relationship with interactional adjustment is only marginally significant. It also finds that SIEs' PC fulfillment mediates the relationship between SIEs' political skill and work-related adjustment. The mediation is marginally significant for the relationship between SIEs' political skill and general living adjustment. Originality/value: The study adds to the literature on expatriates' skills and CCA by theorizing and testing the hitherto unexplored role of SIEs' political skill in their work and non-work CCA. It also theorizes and examines the host employer's PC fulfillment as a mediating mechanism, through which SIEs' political skill facilitates their CCA. Finally, it advances the literature on political skill by testing the construct's application in the cross-cultural and non-work domain.Peer reviewe

Balint Group Session Questionnaire. Instrument for identification of group processes in Balint groups

The study reports on the development and validation of a time-economical questionnaire aiming at the objectivation of processes in Balint groupwork. Based on the data from the responses to two pilot studies, a 17-item Balint group session questionnaire (BG-F) was developed covering the perceptions and impressions of participants in each preceding Balint group session. The final factor structure of the questionnaire was investigated based on data from a sample of 1635 predominantly medical Balint group participants. Using explorative and confirmative factor analyses resulted in a three-factor solution, which could be assigned to four out of five latent dimensions of Balint's theory of group work with physicians. Scale 1 covers reflection of transference dynamics in the doctor-patient relationship, scale 2 specifies emotional and cognitive learning while scale 3 measures case mirroring in the group dynamics. The fit indices of the resulting model from the confirmative factor analysis ranged within a good to excellent spectrum (CFI = 0.97, RMSEA = 0.054 und SRMR = 0.033). A multilevel effect due to the data structure and the influence of group leader effects on the factor structure could be excluded by a confirmative factor analysis with a subsample (only one member in each group) and by a random effect test using linear mixed model analyses. The BG-F was cross-validated with the group self-experience questionnaire (G-SEF) using a subsample of 255 participants of Balint groups, resulting in satisfactory convergent and discriminant validities. The BG-F can be deployed as an economic instrument in daily clinical practice as well as in research, which enables the process experiences of Balint group participants to be collated

ERS International Congress 2023:highlights from the Paediatrics Assembly

Respiratory health in children is essential for general wellbeing and healthy development in the short and long term. It is well known that many respiratory diseases in adulthood have their origins in early life, and therefore research on prevention of respiratory diseases and management of children with respiratory diseases will benefit patients during the full life course. Scientific and clinical advances in the field of respiratory health are moving at a fast pace. This article summarises some of the highlights in paediatric respiratory medicine presented at the hybrid European Respiratory Society (ERS) International Congress 2023 which took place in Milan (Italy). Selected sessions are summarised by Early Career Members of the Paediatrics Assembly (Assembly 7) under the supervision of senior ERS officers, and cover a wide range of research areas in children, including respiratory physiology and sleep, asthma and allergy, cystic fibrosis, respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology and bronchology.</p