Radboud University Medical Center

The gut–brain axis represents a bidirectional communication system disrupted in obesity. Evidence suggests associations between gut microbiota composition and brain function and eating behaviour, as well as between dysregulated brain networks and dietary choices and metabolic regulation. In this review, we examine how obesity affects both components of this axis and explore physical activity as a modifiable factor related to microbial composition and brain network connectivity. We discuss compositional alterations in the gut microbiota associated with obesity, including reduced microbial diversity and altered short-chain fatty acid production. On the brain side, dysregulation of large-scale functional networks, particularly the salience network, central executive network, and default mode network, is linked to impaired inhibitory control and disinhibited eating patterns. Despite promising evidence connecting physical activity with improvements in both gut microbiota and brain connectivity, observational and interventional studies show inconsistencies regarding temporal dynamics and causal relationships. To examine these questions, we augment our review with longitudinal data from 702 participants assessed across three timepoints using random-intercept cross-lagged panel models, which distinguish stable individual differences from dynamic within-person variation. Our findings indicate temporal associations in which physical activity precedes shifts in connectivity in attention-related networks, which subsequently precede alterations in gut microbiota diversity, consistent with predominantly brain-to-gut temporal patterns with network specificity. Taken together, these results highlight a potential role of physical activity in modulating both brain connectivity and microbial composition, with possible relevance for obesity treatment.

This meta-analysis provided a comprehensive synthesis of research on the relationship between trait self-compassion (SC), operationalised by the Self-Compassion Scale (SCS), and symptoms of psychopathology, including depression, anxiety, PTSD, and eating disorders. Given that SC is a multifaceted construct, we examined it at the overall, dimensional (compassionate and uncompassionate self-responding; CS and UCS), and component levels (mindfulness, self-kindness, common humanity, self-judgement, over-identification and isolation) to identify distinct patterns of association. We analysed 256 studies (1106 effect sizes; N = 107,304) with a three-level approach to meta-analysis with restricted maximum likelihood estimation. Overall SC showed a strong negative association with psychopathology symptoms (r = −0.50). The UCS dimension (r = 0.49) was more strongly linked to psychopathology than the CS dimension (r = −0.31). The UCS dimension showed the strongest association with depression (r = 0.53) and anxiety (r = 0.49), followed by eating disorders (r = 0.44) and PTSD (r = 0.26), while the CS dimension showed its strongest association with depression (r = −0.35). At the component level, self-kindness was consistently linked to lower psychopathology across symptom domains, while mindfulness and common humanity had the strongest associations with lower PTSD symptoms. Over-identification and isolation showed stronger links to symptoms in non-clinical and medically vulnerable groups (all p < 0.05). Additionally, age, gender, ethnicity, and publication year did not significantly moderate these associations (all p > 0.05). Our findings demonstrated the transdiagnostic relevance of SC and emphasise the need to treat it as a multifaceted construct when examining its relationship with psychopathology. This study is not preregistered.

Individuals with severe mental illness (SMI) face daily challenges, often due to cognitive impairments. While cognitive remediation (CR) can improve both cognitive and functional outcomes, especially when combined with other rehabilitation interventions, its effectiveness in individuals with SMI requiring sheltered housing remains unclear. This trial primarily investigates whether CR improves daily and cognitive functioning compared to a waitlist period. As a second exploratory aim, we will examine whether adding transcranial direct current stimulation (tDCS) enhances the effectiveness of CR in a randomised sham-controlled comparison. Lastly, the trial examines participants’ subjective experiences of the CR intervention. We hypothesise improvements in goal attainment, daily functioning, and cognition. Using a non-concurrent multiple baseline design, 126 participants (aged 18–65) with SMI residing in sheltered housing facilities will receive 16–20 weeks of twice-weekly CR sessions lasting 30–45 min, combined with either active (N = 63) or sham tDCS (N = 63). Functional, cognitive, and clinical assessments will be conducted at baseline, post-waitlist, post-treatment, and 6-month follow-up. Additionally, participants’ meta-cognitive skills and subjective experiences will be evaluated post-treatment. In multilevel mixed models, we will evaluate the effect of CR (combining both CR groups) vs. waitlist, and compare CR + active tDCS vs. CR + sham tDCS to explore potential augmentation effects. If effective, integrating CR, with or without tDCS, into standard care may benefit recovery in individuals with SMI requiring long-term support. ClinicalTrials.gov: NCT06378463, registered on April 17, 2024.

To explore how non-geriatric specialists across UEMS bodies who care for older adults understand and approach frailty in order to guide future interspecialty educational initiatives. An online survey was conducted to capture their perspectives, practices and training needs regarding frailty. Non-geriatric specialists recognise the importance of frailty but report limited confidence and training, indicating a clear need for accessible and standardised education. Frailty in older adults is associated with increased vulnerability, poorer outcomes, and greater healthcare utilisation. To inform future inter-specialty educational initiatives, a survey across UEMS bodies was conducted. An online survey was disseminated between July and November 2025 via the UEMS Coordination team to all sections, divisions, multidisciplinary joint committees, and thematic federations. Eligible respondents were specialists not certified in Geriatric Medicine who provide care to older adults (≥ 65 years). Of 416 respondents, 283 were non-geriatric specialists caring for older people. They encompassed 40 specialties (40

Immunoglobulin A (IgA) deficiency is the most common primary antibody deficiency and contributes to recurrent respiratory tract infections (rRTIs) in children, with prevalence rates in this group ranging from 1:4 to 1:65. Previous studies in healthy humans and animals suggest that the gut microbiota significantly influences IgA production. We investigated the role of the gut microbiota in IgA deficiency and its potential in promoting IgA induction in children with rRTIs. Children under 7 years of age with rRTIs were enrolled in a prospective cohort study. Serum and feces were collected for IgA level measurement using ELISA and to determine the composition of the intestinal microbiota by 16S rRNA sequencing. We included 82 children with rRTIs, 38