 I'm Nela Brösläs, I'm a clinical epidemiologist, I'm a medical doctor by training and I'm a researcher doing lots of research in the microbiome field and also on long-term effects of commonly prescribed drugs. Well, I think nowadays in medicine we have made huge advancements already and we can treat the large majority of diseases but there are still many diseases that we don't have an answer for that we can't treat many chronic diseases that we just keep treating with drugs and for me precision medicine may be a solution to also treat those people to get them back in a more healthy state which can be of course be beneficial for a very long time and for many many people although we can do a lot in medicine already. You do see that many of those new technologies and new fields of research are already tested also in clinics. I am a medical doctor so I know what's going on among my colleagues. A few years ago, it's not that long ago that nobody had heard about the microbiome for example, now everyone is like oh we want to do something with microbiome also in clinics. Very often it's small studies so they do need bigger studies to be very useful on a long term and global perspective but all those little initiatives and a bit less small initiatives can help in this whole story and have also an impact outside of the local settings for example Belgium, Europe and globally but we do need more international research and big research. There are really things which are implemented but for those it's often without a solid basis of knowledge for example probiotics pre-biotics it's a hype it's a big market already but there is not enough research to really show that it works so I think we need to have a more solid research first and it's not only the probiotics we also need to restore our microbiome ourselves for example by limiting our prescribed drug use, living healthier if those factors are not in place I don't think any supplement will do the trick so we do need to understand everything better before we can really implement it but it has a very big potential in women's health like for example to prevent preterm birth also in cancer treatment will cancer treatment work or not so those are or in chronic diseases obesity metabolic diseases so there is a big potential and so I do see that I do foresee that there will be microbiome treatments in the near future some of them are already there but then it can it's a very fast evolving field if you see like 10 years ago nobody knew about the microbiome and now everybody is already talking about there are already microbiome treatments on the market for example fecal microbial transplants and yeah since so many people are now doing research on it there will be many things already implemented not all of them will have the label as a drug but also more like treatments like maybe the vaginal smearing after c-section which is already tested there is not enough evidence yet to make it widespread so that's in babies who get c-section that they smear the perineal microbiome of the mother around the mouth to give them a better start so that's something it's easy it doesn't cost anything but if it shows to be beneficial in a few years after a few big studies come out then it's something that can be implemented worldwide already well I think the problem is that we don't know yet yet most of these are based on small cohorts so we do need to know what is normal in a big population so precision medicine is I think something which will not be useful for everyone because it's also something expensive but to really know how it works and how it can be beneficial we need to know what the normal is in the total population so we can know enough to then treat that little group which has special needs in that perspective I think yeah we do need big data and luckily with all the technological advancements the prices go down because indeed if you have like thousands of samples it's still expensive so in that aspect it's good that we go bigger because we humans have a lot of variation as well okay the microbiome the bacteria have a lot of variation we have a lot of genetic variation as well so I think bigger isn't that aspects for sure better and I also think it's very good that there is more and more multidisciplinary transdisciplinary collaborations because indeed as we heard as well we do need collaborations between clinicians basic researcher epidemiologist it's still you're still not that present in the field of precision medicine I think but if you go bigger you need good study that time you need the good methods to really consider all the variability between humans as well we're not all the same we have different ages different comorbidities different characteristics lifestyle diet drug use I think it's already wonderful that there are so many clinicians and also students and who will become active clinicians in future are participating in events like this because they are the next generation they will be treating us and our family members in not such a distant future and now they already know what's going on and they were will be the ones who need to convince their patients and the public as well to live healthier to use treatments and hopefully I always hope that the clinicians do have a solid research training as well because that's also something I see in in research that is often still a bit of a translation problem between the basic researchers and clinicians they do they are yeah both groups are excellent in what they do in daily life but they do often have some communication problems so it's very good that events like this hopefully fill that gap and make it's easier to communicate so to reach the research to a higher level