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In the TIDe study (a randomised controlled trial of just over 100 participants with COPD) they test a high-frequency airway oscillating device vs a sham device. The common assumption, in idiopathic pulmonary fibrosis, is that alveolar cells are the source of all the problems and should be placed into detention to figure out who they are! [...]in this issue of Thorax (see page 669) Kumar and colleagues challenge this assumption using publicly available data to demonstrate that airway Club Cells gene signatures are upregulated in IPF and correlate with poor lung function.

[...]human papillomavirus (HPV) is a true villain and the principal risk factor for cervical cancer. Thornton and colleagues (see page 625 ) investigated HPV and cervical dysplasia in adult female cystic fibrosis lung transplant recipients. 35% of patients studied had more than one abnormal Papanicolaou smear test and demonstrated complications including refractory anogenital warts, vulvectomy and cervical cancer, with two deaths from metastatic disease. Viruses can be both heroes and villains but we need to provide a cloak of hero protection with HPV vaccination to our female cystic fibrosis patients.

Come on baby light my fire Non-adherence to treatment is a common cause of tension between patients and their clinical care teams and cystic fibrosis (with patients commonly spending around 2 hours per day on treatment) is a good example of this. Gravier et al (see page 486) investigate, in a systematic review and meta-analysis, the effects of exercise training in non-small cell lung cancer as part of ‘prehabilitation’ prior to lung resection. In this issue of Thorax (see page 477) Thomsen and colleagues analysed data from a cohort of motor vehicle workers and found, not without controversy as described in the corresponding editorial (see page 426), that risk of mesothelioma was not increased in motor mechanics, in contrast with lung cancer and asbestosis both of which were increased in mechanics and lead to increased mortality.