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Encoding quantum information in quantum states with disjoint wave-function support and noise-insensitive energies is the key behind the idea of qubit protection. While fully protected qubits are expected to offer exponential protection against both energy relaxation and pure dephasing, simpler circuits may grant partial protection with currently achievable parameters. Here, we study a fluxonium circuit in which the wave functions are engineered to minimize their overlap while benefiting from a first-order-insensitive flux sweet spot. Taking advantage of a large superinductance (L∼1 μH), our circuit incorporates a resonant tunneling mechanism at zero external flux that couples states with the same fluxon parity, thus enabling bifluxon tunneling. The states |0⟩ and |1⟩ are encoded in wave functions with parities 0 and 1, respectively, ensuring a minimal form of protection against relaxation. Two-tone spectroscopy reveals the energy-level structure of the circuit and the presence of 4π quantum-phase slips between different potential wells corresponding to m=±1 fluxons, which can be precisely described by a simple fluxonium Hamiltonian or by an effective bifluxon Hamiltonian. Despite suboptimal fabrication, the measured relaxation (T_{1}=177±3 μs) and dephasing (T_{2}^{E}=75±5 μs) times not only demonstrate the relevance of our approach but also open an alternative direction toward quantum computing using partially protected fluxonium qubits.

Demonstration of phase matching mechanism in Josephson traveling wave parametric amplifiers involving in-situ sign reversal of Kerr nonlinearity opens up experimental possibilities in the framework of microwave quantum optics.

In recent decades, the laws of thermodynamics have been pushed down to smaller and smaller scales, within the theoretical field of stochastic thermodynamics and state-of-the-art experiments performed on microfabricated mesoscopic systems. These measurements concern thermal properties of electrons, photons, and mesoscopic mechanical objects. Here we report on the measurements of thermal fluctuations of a single mechanical mode in equilibrium with a heat reservoir. The device under study is a nanomechanical beam with a first flexural mode resonating at 3.8MHz, cooled down to temperatures in the range from 100 to 400mK. The technique is constructed around a microwave optomechanical setup using a cryogenic high electron mobility transistor, and is based on two parametric amplifications implemented in series: an in-built optomechanical “blue detuned” pumping plus a traveling wave parametric amplifier stage. We demonstrate our ability to resolve energy fluctuations of the mechanical mode in real time up to the fastest relevant speed given by the mechanical relaxation rate. The energy probability distribution is then exponential, matching the expected Boltzmann distribution. The variance of fluctuations is found to be (k_{B}T)^{2} with no free parameters. Our microwave detection floor is about three times the standard quantum limit at 6GHz; the resolution of our fastest acquisition tracks reached about 100phonons, and is directly related to the rather poor optomechanical coupling of the device (g_{0}/2π≈0.5Hz). This result is deeply in the classical regime, but shall be extended to the quantum case in the future with systems presenting a much larger g_{0} (up to 2π×250Hz), potentially reaching the resolution of a single mechanical quantum. We believe that it will open an experimental field, phonon-based quantum stochastic thermodynamics, with fundamental implications for quantum heat transport and macroscopic mechanical quantum coherence.

Advances in the design and fabrication of superconducting devices enable physicists to design and monitor quantum electronic systems in synthetic environments. Here the authors observe how many-body effects influence the zero-point motion of a Josephson junction coupled to a high impedance transmission line.

A microwave amplifier combining noise performances as close as possible to the quantum limit with large bandwidth and high saturation power is highly desirable for many solid-state quantum technologies. Here, we introduce a new traveling-wave parametric amplifier based on superconducting quantum interference devices. It displays a 3-GHz bandwidth, a -100-dBm saturation (1-dB compression) point and added noise near the quantum limit. Compared to the previous state of the art, it is an order of magnitude more compact, its characteristic impedance is in situ tunable, and its fabrication process requires only two lithography steps. The key is the engineering of a gap in the dispersion relation of the transmission line. This is obtained using a periodic modulation of the SQUID size, similarly to what is done with photonic crystals. Moreover, we provide a new theoretical treatment to describe the nontrivial interplay between nonlinearity and such periodicity. Our approach provides a path to cointegration with other quantum devices such as qubits given the low footprint and easy fabrication of our amplifier.

We experimentally and theoretically investigate the quantum trajectories of jointly monitored transmon qubits embedded in spatially separated microwave cavities. Using nearly quantum-noise-limited superconducting amplifiers and an optimized setup to reduce signal loss between cavities, we can efficiently track measurement-induced entanglement generation as a continuous process for single realizations of the experiment. The quantum trajectories of transmon qubits naturally split into low and high entanglement classes. The distribution of concurrence is found at any given time, and we explore the dynamics of entanglement creation in the state space. The distribution exhibits a sharp cutoff in the high concurrence limit, defining a maximal concurrence boundary. The most-likely paths of the qubits’ trajectories are also investigated, resulting in three probable paths, gradually projecting the system to two even subspaces and an odd subspace, conforming to a “half-parity” measurement. We also investigate the most-likely time for the individual trajectories to reach their most entangled state, and we find that there are two solutions for the local maximum, corresponding to the low and high entanglement routes. The theoretical predictions show excellent agreement with the experimental entangled-qubit trajectory data.

Abstract Patient‐reported outcome measures (PROMs) are used to assess a patient's health status at a particular point in time. They are essential in the development of person‐centred care. This paper reviews studies performed on PROMs for assessing AR and asthma control, in particular VAS scales that are included in the app MASK‐air® (Mobile Airways Sentinel networK) for asthma and rhinitis. VASs were initially developed on paper and pencil and tested for their criterion validity, cut‐offs and responsiveness. Then, a multicentric, multinational, double‐blind, placebo‐controlled, randomised control trial (DB‐PC‐RCT) using an electronic VAS form was carried out. Finally, with the development of MASK‐air® in 2015, previously validated VAS questions were adapted to the digital format and further methodologic evaluations were performed. VAS for asthma, rhinitis, conjunctivitis, work and EQ‐5D are included in the app. Additionally, two control‐medication scores for allergic symptoms of asthma (e‐DASTHMA) were validated for their criterion validity, cut‐offs and responsiveness.

Abstract The problem of missing heritability requires the consideration of genetic interactions among different loci, called epistasis. Current GWAS statistical models require years to assess the entire combinatorial epistatic space for a single phenotype. We propose Next-Gen GWAS (NGG) that evaluates over 60 billion single nucleotide polymorphism combinatorial first-order interactions within hours. We apply NGG to Arabidopsis thaliana providing two-dimensional epistatic maps at gene resolution. We demonstrate on several phenotypes that a large proportion of the missing heritability can be retrieved, that it indeed lies in epistatic interactions, and that it can be used to improve phenotype prediction.

Abstract Rationale It is unclear how each individual asthma symptom is associated with asthma diagnosis or control. Objectives To assess the performance of individual asthma symptoms in the identification of patients with asthma and their association with asthma control. Methods In this cross‐sectional study, we assessed real‐world data using the MASK‐air® app. We compared the frequency of occurrence of five asthma symptoms (dyspnea, wheezing, chest tightness, fatigue and night symptoms, as assessed by the Control of Allergic Rhinitis and Asthma Test [CARAT] questionnaire) in patients with probable, possible or no current asthma. We calculated the sensitivity, specificity and predictive values of each symptom, and assessed the association between each symptom and asthma control (measured using the e‐DASTHMA score). Results were validated in a sample of patients with a physician‐established diagnosis of asthma. Measurement and Main Results We included 951 patients (2153 CARAT assessments), with 468 having probable asthma, 166 possible asthma and 317 no evidence of asthma. Wheezing displayed the highest specificity (90.5%) and positive predictive value (90.8%). In patients with probable asthma, dyspnea and chest tightness were more strongly associated with asthma control than other symptoms. Dyspnea was the symptom with the highest sensitivity (76.1%) and the one consistently associated with the control of asthma as assessed by e‐DASTHMA. Consistent results were observed when assessing patients with a physician‐made diagnosis of asthma. Conclusions Wheezing and chest tightness were the asthma symptoms with the highest specificity for asthma diagnosis, while dyspnea displayed the highest sensitivity and strongest association with asthma control.

Porous-activated carbons (ACs) derived from Moroccan pine cones (PC) were synthesised by a two step-chemical activation/carbonisation method using phosphoric acid (PC-H) and zinc chloride (PC-Z) as activating agents and used for the adsorption of bisphenol A (BPA) from water. Several techniques (TGA/DTA, FT-IR, XRD, SEM and BET) were used to determine the surface area and pore characterisation and variations during the preparation of the adsorbents. The modification significantly increased the surface area of both ACs, resulting in values of 1369.03 m2 g−1 and 1018.86 m2 g−1 for PC-H and PC-Z, respectively. Subsequent adsorption tests were carried out, varying parameters including adsorbent dosage, pH, initial BPA concentration, and contact time. Therefore, the highest adsorption capacity was observed when the BPA molecules were in their neutral form. High pH values were found to be unfavourable for the removal of bisphenol A from water. The results showed that BPA adsorption kinetics and isotherms followed pseudo-second-order and Langmuir models. Thermodynamic studies indicated that the adsorption was spontaneous and endothermic. Besides, the regeneration of spent adsorbents demonstrated their reusability. The adsorption mechanisms can be attributed to physical adsorption, hydrogen bonds, electrostatic forces, hydrophobic interactions, and π-π intermolecular forces.

Background: The quantification of electromyographic activity using surface electrodes is invaluable for understanding gait disorders in patients with central nervous system lesions. We propose to evaluate a commercially available low-cost system compared to a reference system in participants with stroke-related movement disorders in functional situations. Methods: Three hemiparetic participants performed three functional tasks: two treadmill walks at different speeds and a sit-to-stand test. The vastus lateralis and gastrocnemius medialis muscles were equipped with two EMG sensors. The comparison between the two EMG systems was based on 883 identified cycles. Spearman’s correlation coefficients (SCs), linear correlation coefficients (LCCs), and cross-correlation coefficients (CCCs) were calculated. Results: The main results indicate good to very good similarity of the EMG signals collected from the two tested sEMG systems. In the comfortable-walking condition, an SC of 0.894 ± 0.091 and an LCC of 0.909 ± 0.094 were noted. In the fast-walking condition, an SC of 0.918 ± 0.064 and an LCC of 0.935 ± 0.056 were observed. For the 1 min sit-to-stand test, an SC of 0.880 ± 0.058 and an LCC of 0.881 ± 0.065 were noted. Conclusions: This study demonstrates good to very good similarity between the two sEMG systems, enabling the analysis of muscle activity during functional tasks.

A pandemia da COVID-19 afetou as pessoas de diferentes maneiras. Diversas mudanças aconteceram nas atividades de trabalho e de lazer, impactando na saúde física e mental. Este estudo de revisão bibliográfica analisou as adaptações referente às práticas de lazer ativo e social que ocorreram durante a pandemia da COVID-19 e sua influência na saúde mental da população brasileira. Foram selecionados os artigos mais relevantes que foram publicados nos últimos 4 anos (2020- 2023). Os resultados apresentaram que as práticas de lazer durante o período pandêmico foram adaptadas aos pequenos espaços, e que pessoas que já praticavam algum tipo de atividade anteriormente possuem melhor capacidade de adaptação as adversidades. O acesso a internet e as plataformas de entretenimento aumentaram consideravelmente e as práticas de lazer social foram substituídas pelo lazer artístico, virtual, manual e intelectual.

Abstract Introduction Primary spontaneous pneumothorax (PSP) is the presence of air in the pleural space, occurring in the absence of trauma and known lung disease. Standardized expert guidelines on PSP are needed due to the variety of diagnostic methods, therapeutic strategies and medical and surgical disciplines involved in its management. Methods Literature review, analysis of the literature according to the GRADE (Grading of Recommendation, Assessment, Development and Evaluation) methodology; proposals for guidelines rated by experts, patients and organizers to reach a consensus. Only expert opinions with strong agreement were selected. Results A large PSP is defined as presence of a visible rim along the entire axillary line between the lung margin and the chest wall and ≥ 2 cm at the hilum level on frontal chest X-ray. The therapeutic strategy depends on the clinical presentation: emergency needle aspiration for tension PSP; in the absence of signs of severity: conservative management (small PSP), needle aspiration or chest tube drainage (large PSP). Outpatient treatment is possible if a dedicated outpatient care system is previously organized. Indications, surgical procedures and perioperative analgesia are detailed. Associated measures, including smoking cessation, are described. Conclusion These guidelines are a step towards PSP treatment and follow-up strategy optimization in France.

Locomotor and balance disorders are major limitations for subjects with hemiparesis. The Timed Up and Go (TUG) test is a complex navigational task involving oriented walking and obstacle circumvention. We hypothesized that subjects with hemiparesis adopt a cautious gait during complex locomotor tasks. The primary aim was to compare spatio-temporal gait parameters, indicators of cautious gait, between the locomotor subtasks of the TUG (Go, Turn, Return) and a Straight-line walk in people with hemiparesis. Our secondary aim was to analyze the relationships between TUG performance and balance measures, compare spatio-temporal gait parameters between fallers and non-fallers, and identify the biomechanical determinants of TUG performance. Biomechanical parameters during the TUG and Straight-line walk were analyzed using a motion capture system. A repeated measures ANOVA and two stepwise ascending multiple regressions (with performance variables and biomechanical variables) were conducted. Gait speed, step length, and % single support phase (SSP) of the 29 participants were reduced during Turn compared to Go and Return and the Straight-line walk, and step width and % double support phase were increased. TUG performance was related to several balance measures. Turn performance (R2 = 63%) and Turn trajectory deviation followed by % SSP on the paretic side and the vertical center of mass velocity during Go (R2 = 71%) determined TUG performance time. People with hemiparesis adopt a cautious gait during complex navigation at the expense of performance.

Introducción: la ingesta de cuerpos extraños es un problema médico frecuente, especialmente en el servicio de urgencias. Existen algunos estudios pequeños que describen las experiencias al respecto. Materiales y métodos: estudio descriptivo, retrospectivo, en el cual se incluyó a pacientes con sospecha de ingesta de cuerpos extraños, ingresados al servicio de gastroenterología y endoscopia digestiva de La Clínica Universitaria Colombia, entre enero de 2007 y agosto de 2020. Resultados: la edad de ocurrencia del evento se presentó en pacientes desde los 18 hasta los 95 años, y la edad promedio fue de 45 años. Los cuerpos extraños ingeridos y encontrados fueron variables; los más frecuentes fueron la ingesta de espinas de pescado, que representó el 64,11% de los casos, seguido por la ingesta de huesos de pollo y la impactación alimentaria. Un 38% de los pacientes requirieron la extracción de cuerpo extraño y la herramienta usada con mayor frecuencia fue la pinza de cuerpo extraño. La localización principal fue el esófago, en el 12,53% de los casos, seguido por la cricofaringe, en el 11,18%, y la hipofaringe, en el 10%. Conclusiones: la Clínica Universitaria Colombia es un sitio de referencia de una gran cantidad de urgencias en gastroenterología debido a su alto nivel tecnológico y al gran recurso humano que requieren. Este trabajo representa probablemente la cantidad más grande de pacientes con este motivo de consulta, razón por la que se diseñó este estudio descriptivo retrospectivo, que muestra las características demográficas, los tipos de cuerpo extraño, los hallazgos radiológicos y endoscópicos y las complicaciones asociadas, que son de utilidad para tener un conocimiento más real de esta patología.

Aim To compare prednisone and placebo for the treatment of outpatients treated for acute exacerbations of chronic obstructive pulmonary disease (COPD) in a primary care setting. Methods A multicentre, parallel, double-blind, pragmatic randomised controlled trial was performed in France. A total of 66 general practitioners included patients aged ≥40 years with cumulative smoking of ≥10 pack-years and a diagnosis of certain or likely acute exacerbation of COPD. Oral prednisone (40 mg) or placebo were administered daily for 5 days. The main outcome was treatment failure at 8 weeks, defined as a composite criterion based on the occurrence of at least one of the following: unplanned visit to an emergency department or to a practitioner in the ambulatory setting, hospital admission or death. The planned sample size was 202 patients per group. Results 175 patients were included from February 2015 to May 2017 (43% of the planned sample). All-cause 8-week treatment failure rate was 42.0% in the prednisone group and 34.5% in the placebo group (relative risk 1.22, 95% CI 0.87–1.69, p=0.25). Respiratory-related 8-week treatment failure rate was 27.6% in the prednisone group and 13.6% in the placebo group (relative risk 2.00, 95% CI 1.15–3.57, p=0.015). Conclusion Although the planned sample size was not achieved, the study does not suggest that oral corticosteroids are more effective than placebo for the treatment of an acute exacerbation of COPD in a primary care setting.

Abstract Introduction Discriminating asthma from chronic obstructive pulmonary disease (COPD) using medico-administrative databases is challenging but necessary for medico-economic analyses focusing on respiratory diseases. Artificial intelligence (AI) may improve dedicated algorithms. Objectives To assess performance of different AI-based approaches to distinguish asthmatics from COPD patients in medico-administrative databases where the clinical diagnosis is absent. An “Asthma COPD Overlap” category was defined to further test whether AI can detect complexity. Methods This study included 178,962 patients treated by two “R03” treatment prescriptions at least from January 2016 to December 2018 and managed by either a general practitioner and/or a pulmonologist participating in a permanent longitudinal observatory of prescription in ambulatory medicine (LPD). Clinical diagnoses are available in this database and were used as gold standards to develop diagnostic rules. Three types of AI approaches were explored using data restricted to demographics and treatment dispensations: multinomial regression, gradient boosting and recurrent neural networks (RNN). The best performing model (based on metric properties) was then applied to estimate the size of asthma and COPD populations based on a database (LRx) of treatment dispensations between July, 2018 and June, 2019. Results The best models were obtained with the boosting approach and RNN, with an overall accuracy of 68%. Performance metrics were better for asthma than COPD. Based on LRx data, the extrapolated numbers of patients treated for asthma and COPD in France were 3.7 and 1.2 million, respectively. Asthma patients were younger than COPD patients (mean, 49.9 vs. 72.1 years); COPD occurred mostly in men (68%) compared to asthma (33%). Conclusion AI can provide models with acceptable accuracy to distinguish between asthma, ACO and COPD in medico-administrative databases where the clinical diagnosis is absent. Deep learning and machine learning (RNN) had similar performances in this regard.

IntroductionSerious games can be used to provide intensive rehabilitation through attractive exercises as part of post-stroke rehabilitation. However, currently available commercial and serious games systems primarily train shoulder and elbow movements. These games lack the grasping and displacement components that are essential to improve upper limb function. For this reason, we developed a tabletop device that encompassed a serious game with a tangible object to rehabilitate combined reaching and displacement movements: the Ergotact system.ObjectivesThe aim of this pilot study was to assess the feasibility and the short-term effects of a training program using the Ergotact prototype in individuals with chronic stroke.MethodsParticipants were assigned to one of two groups: a serious game training group (Ergotact) or a control training group (Self).ResultsTwenty-eight individuals were included. Upper limb function increased after the Ergotact training program, although not statistically significantly, and the program did not induce pain or fatigue, demonstrating its safety.ConclusionThe Ergotact system for upper limb rehabilitation was well accepted and induced participant satisfaction. It complies with current recommendations for people with stroke to autonomously perform intensive active exercises in a fun context, in addition to conventional rehabilitation sessions with therapists.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT03166020?term=NCT03166020&draw=2&rank=1, identifier NCT03166020.

Summary: Background: Validated questionnaires are used to assess asthma control over the past 1–4 weeks from reporting. However, they do not adequately capture asthma control in patients with fluctuating symptoms. Using the Mobile Airways Sentinel Network for airway diseases (MASK-air) app, we developed and validated an electronic daily asthma control score (e-DASTHMA). Methods: We used MASK-air data (freely available to users in 27 countries) to develop and assess different daily control scores for asthma. Data-driven control scores were developed based on asthma symptoms reported by a visual analogue scale (VAS) and self-reported asthma medication use. We included the daily monitoring data from all MASK-air users aged 16–90 years (or older than 13 years to 90 years in countries with a lower age of digital consent) who had used the app in at least 3 different calendar months and had reported at least 1 day of asthma medication use. For each score, we assessed construct validity, test–retest reliability, responsiveness, and accuracy. We used VASs on dyspnoea and work disturbance, EQ-5D-VAS, Control of Allergic Rhinitis and Asthma Test (CARAT), CARAT asthma, and Work Productivity and Activity Impairment: Allergy Specific (WPAI:AS) questionnaires as comparators. We performed an internal validation using MASK-air data from Jan 1 to Oct 12, 2022, and an external validation using a cohort of patients with physician-diagnosed asthma (the INSPIRERS cohort) who had had their diagnosis and control (Global Initiative for Asthma [GINA] classification) of asthma ascertained by a physician. Findings: We studied 135 635 days of MASK-air data from 1662 users from May 21, 2015, to Dec 31, 2021. The scores were strongly correlated with VAS dyspnoea (Spearman correlation coefficient range 0·68–0·82) and moderately correlated with work comparators and quality-of-life-related comparators (for WPAI:AS work, we observed Spearman correlation coefficients of 0·59–0·68). They also displayed high test–retest reliability (intraclass correlation coefficients range 0·79–0·95) and moderate-to-high responsiveness (correlation coefficient range 0·69–0·79; effect size measures range 0·57–0·99 in the comparison with VAS dyspnoea). The best-performing score displayed a strong correlation with the effect of asthma on work and school activities in the INSPIRERS cohort (Spearman correlation coefficients 0·70; 95% CI 0·61–0·78) and good accuracy for the identification of patients with uncontrolled or partly controlled asthma according to GINA (area under the receiver operating curve 0·73; 95% CI 0·68–0·78). Interpretation: e-DASTHMA is a good tool for the daily assessment of asthma control. This tool can be used as an endpoint in clinical trials as well as in clinical practice to assess fluctuations in asthma control and guide treatment optimisation. Funding: None.

Background: The aim of this study was to compare energy expenditure (EE) predicted by accelerometery (EEAcc) with indirect calorimetry (EEMETA) in individuals with hemiparesis. Methods: Twenty-four participants (12 with stroke and 12 healthy controls) performed a six-minute walk test (6MWT) during which EEMETA was measured using a portable indirect calorimetry system and EEACC was calculated using Bouten’s equation (1993) with data from a three-axis accelerometer positioned between L3 and L4. Results: The median EEMETA was 9.85 [8.18;11.89] W·kg−1 in the stroke group and 5.0 [4.56;5.46] W·kg−1 in the control group. The median EEACC was 8.57 [7.86;11.24] W·kg−1 in the control group and 8.2 [7.05;9.56] W·kg−1 in the stroke group. The EEACC and EEMETA were not significantly correlated in either the control (p = 0.8) or the stroke groups (p = 0.06). The Bland–Altman method showed a mean difference of 1.77 ± 3.65 W·kg−1 between the EEACC and EEMETA in the stroke group and −2.08 ± 1.59 W·kg−1 in the controls. Conclusions: The accuracy of the predicted EE, based on the accelerometer and the equations proposed by Bouten et al., was low in individuals with hemiparesis and impaired gait. This combination (sensor and Bouten’s equation) is not yet suitable for use as a stand-alone measure in clinical practice for the evaluation of hemiparetic patients.

ObjectivesChatbots, conversational agents that walk medical students (MS) though a clinical case, are serious games that seem to be appreciated by MS. Their impact on MS's performance in exams however was not yet evaluated. Chatprogress is a chatbot-based game developed at Paris Descartes University. It contains 8 pulmonology cases with step-by-step answers delivered with pedagogical comments. The CHATPROGRESS study aimed to evaluate the impact of Chatprogress on students' success rate in their end-term exams.MethodsWe conducted a post-test randomized controlled trial held on all fourth-year MS at Paris Descartes University. All MS were asked to follow the University's regular lectures, and half of them were randomly given access to Chatprogress. At the end of the term, medical students were evaluated on pulmonology, cardiology and critical care medicine.Main outcomes measuresThe primary aim was to evaluate an increase in scores in the pulmonology sub-test for students who had access to Chatprogress, compared to those who didn't. Secondary aims were to evaluate an increase in scores in the overall test (Pulmonology, Cardiology and Critical care medicine test (PCC)) and to evaluate the correlation between access to Chatprogress and overall test score. Finally, students' satisfaction was assessed using a survey.ResultsFrom 10/2018 to 06/2019, 171 students had access to Chatprogress (the Gamers) and among them, 104 ended up using it (the Users). Gamers and Users were compared to 255 Controls with no access to Chatprogress. Differences in scores on the pulmonology sub-test over the academic year were significantly higher among Gamers and Users vs Controls (mean score: 12.7/20 vs 12.0/20, p = 0.0104 and mean score: 12.7/20 vs 12.0/20, p = 0.0365 respectively). This significant difference was present as well in the overall PCC test scores: (mean score: 12.5/20 vs 12.1/20, p = 0.0285 and 12.6/20 vs 12.1/20, p = 0.0355 respectively). Although no significant correlation was found between the pulmonology sub-test's scores and MS's assiduity parameters (number of finished games among the 8 proposed to Users and number of times a User finished a game), there was a trend to a better correlation when users were evaluated on a subject covered by Chatprogress. MS were also found to be fans of this teaching tool, asking for more pedagogical comments even when they got the questions right.ConclusionThis randomised controlled trial is the first to demonstrate a significant improvement in students' results (in both the pulmonology subtest and the overall PCC exam) when they had access to Chatbots, and even more so when they actually used it.

Abstract MASK‐air®, a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK‐air® is a Good Practice of DG Santé on digitally‐enabled, patient‐centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co‐operation and Development). MASK‐air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK‐air® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as‐needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom‐medication score (ARIA‐EAACI‐CSMS) has been validated for clinical practice and trials. The implications of the novel MASK‐air® results should lead to change management in rhinitis and asthma.