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Background This study aimed to compare the stage of coronary heart disease in patients who underwent invasive cardiac diagnostics during the COVID-19 pandemic and before, based on the number of medical devices used and the number of complex coronary angioplasty procedures performed. Material and Methods A retrospective, single-center study was conducted, which included 187 successive patients with diagnosed coronary heart disease, who were divided into 2 groups: group I (N = 92, pre-COVID-19 pandemic) and group II (N = 95, during COVID-19 pandemic). Results Despite a comparable number of invasive procedures in both groups, stent length and contrast use per procedure were significantly higher during the COVID-19 pandemic. Similarly, a higher number of stents was used per patient in 2021, however, the difference was not statistically significant (p = 0.0817). Similarly, fluoroscopy time per procedure and procedure duration were significantly longer in the 2021 group. Among patients treated during the COVID-19 pandemic, higher glucose concentration, blood pressure parameters, low-density lipoprotein and total cholesterol were observed; however, these differences were not statistically significant. Conclusions During the COVID-19 pandemic, coronary atherosclerosis progression were found, requiring a higher number of complex coronary angioplasty procedures, which contributed to a statistically significant increase in the number of medical devices used (angioplasty guidewires, angioplasty balloons) and procedures duration. Med Pr Work Health Saf. 2024;75(4):333–342

Abstract: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is becoming more prominent globally due to an increase in the prevalence of obesity, dyslipidemia, and type 2 diabetes. A great deal of studies have proposed potential treatments for MASLD, with few of them demonstrating promising results. The aim of this study was to investigate the potential effects of (-)-epicatechin (EPI) on the development of MASLD in an in vitro model using the HepG2 cell line by determining the metabolic viability of the cells and the levels of PPARα, PPARγ, and GSH. HepG2 cells were pretreated with 10, 30, 50, and 100 μM EPI for 4 h to assess the potential effects of EPI on lipid metabolism. A MASLD cell culture model was established using HepG2 hepatocytes which were exposed to 1.5 mM oleic acid (OA) for 24 h. Moreover, colorimetric MTS assay was used in order to determine the metabolic viability of the cells, PPARα and PPARγ protein levels were determined using enzyme-linked immunosorbent assay (ELISA), and lipid accumulation was visualized using the Oil Red O Staining method. Also, the levels of intracellular glutathione (GSH) were measured to determine the level of oxidative stress. EPI was shown to increase the metabolic viability of the cells treated with OA. The metabolic viability of HepG2 cells, after 24 h incubation with OA, was significantly decreased, with a metabolic viability of 71%, compared to the cells pretreated with EPI, where the metabolic viability was 74–86% with respect to the concentration of EPI used in the experiment. Furthermore, the levels of PPARα, PPARγ, and GSH exhibited a decrease in response to increasing EPI concentrations. Pretreatment with EPI has demonstrated a great effect on the levels of PPARα, PPARγ, and GSH in vitro. Therefore, considering that EPI mediates lipid metabolism in MASLD, it should be considered a promising hepatoprotective agent in future research.

Background: Allergic rhinitis (AR) is a highly prevalent disease. We aimed to assess the symptoms that physicians who see patients with AR perceive as the most bothersome in their patients. Methods: We performed a cross-sectional study based on an online questionnaire sent to all members of the Allergic Rhinitis and its Impact on Asthma (ARIA) initiative. The survey included questions on the physicians' perceptions of patients’ AR symptoms as well as of their own AR symptoms. Results: Among 401 respondents, 155 (38.7%) reported having AR. ARIA members reported nasal symptoms to be the most frequent (89.7%) and bothersome (80.0%) symptoms experienced by themselves. Likewise, nasal symptoms were reported by ARIA members as the most frequent (94.8% in members with AR vs 96.0% in members without AR) and bothersome (57.0% in members with AR vs 67.9% in members without AR) in their patients. We found a significant association (p = 0.001) between physicians’ own symptoms and those perceived as the most bothersome in their patients. Conclusion: Physicians perceive nasal symptoms to be the most frequent and the most bothersome symptoms in AR patients. The physicians' personal experiences with AR may influence their perception of patients’ symptoms.

Patients’ collaboration with healthcare providers, along with their individual dedication to follow medical recommendations, is a crucial component of effective therapy in chronic diseases. If a patient fails to fill their prescription, administers the medication improperly in terms of method and/or dosage, misses follow-up visits, or discontinues the treatment for any reason, these lapses can adversely affect disease management, impairing the effectiveness of symptom relief and prevention of progression and complications. A comparable situation pertains to allergic diseases, which require long-term and consistent treatment to achieve symptom alleviation and control. Research has shown that adherence rates for long-term therapy in chronic diseases have improved marginally over the years and continue to hover at approximately the figure published in a World Health Organization (WHO) report “Adherence to long-term therapies: evidence for action.” from 2003, which had stated that only 50% of patients in developed countries follow medical recommendations and that this rate would be even lower in developing countries. Over 20 years later, literature indicated that there has been only a slight improvement on the matter, leaving room for developing and implementing effective solutions to improve medication compliance. Further investigation on this matter is required. Causes for non-adherence classified by the Global Initiative for Asthma in their main report seem to correspond to those of the report by the WHO. Similar dependency might be determined by other allergic diseases as they fit chronic disease criteria, and the issue of non-adherence affects them too. This literature review seeks to compile and synthesize current insights on factors that influence adherence, as well as explore potential methods for monitoring, evaluating, and improving its outcomes in chronic diseases related to the medical field of allergology, such as asthma, allergic rhinitis, allergic conjunctivitis, rhinoconjunctivitis, atopic dermatitis, and urticaria.

Human dirofilariasis is an emerging disease that is rising and driven by increasing travel of both humans and their companion animals and climate change. We report a case of Dirofilaria repens in the scrotum of a 21-year-old patient, who experienced right testicular pain. Ultrasonography revealed a tubular, worm-like lesion extracted successfully and confirmed as an immature D. repens through parasitological and molecular analyses. Post-surgery, the patient underwent anthelmintic treatment and was discharged. Increased awareness of this parasitosis among healthcare professionals is crucial, given the expected rise in dirofilariasis cases. Climate change in Poland, characterized not so much by record high temperatures but by a systematic increase in the number of warm days, affects many aspects of life. Due to the presence of disease vectors, the introduction and reintroduction of exotic and parasitic disease, previously rare or absent in temperate climate zones, is possible.

MacIntyre’s ‘liberal’ view of the state’s toleration of hate speech may seem surprising given his radical rejection of liberalism. It appears liberal because MacIntyre agrees with some classical liberal conclusions, as formulated by Locke, concerning the requirement of evaluative neutrality of the state. This seems to be the main reason why MacIntyre argues that the hate speech toleration at the governmental level should not be ‘content-based’, i.e. it should be strictly ‘context-based’. The paper argues that MacIntyre’s ‘context-based’ approach seems problematic because it does not take the relevance of different political contexts seriously enough and should be modified towards the ‘regime-based’ model, in which hate speech bans are justified only by the insufficient quality of a given democratic society.

Amin Ramezani,1– 4 Amir Sharafkhaneh,1,4 Ahmed S BaHammam,5,6 Samuel T Kuna,7 Javad Razjouyan1– 4 1VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA; 2Big Data Scientist Training Enhancement Program, VA Office of Research and Development, Washington, DC, 20420, USA; 3VA Quality Scholars Coordinating Center, Iquest, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA; 4Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA; 5Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia; 6The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia; 7Department of Medicine, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USACorrespondence: Amir Sharafkhaneh, VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA, Email amirs@bcm.eduPurpose: The COVID-19 pandemic affected the utilization of various healthcare services differentially. Sleep testing services utilization (STU), including Home Sleep Apnea Testing (HSAT) and Polysomnography (PSG), were uniquely affected. We assessed the effects of the pandemic on STU and its recovery using the Veterans Health Administration (VHA) data.Patients and Methods: A retrospective cohort study from the VHA between 01/2019 and 10/2023 of veterans with age ≥ 50. We extracted STU data using Current Procedural Terminology codes for five periods based on STU and vaccination status: pre-pandemic (Pre-Pan), pandemic sleep test moratorium (Pan-Mor), and pandemic pre-vaccination (Pan-Pre-Vax), vaccination (Pan-Vax), and postvaccination (Pan-Post-Vax). We compared STU between intervals (Pre-Pan as the reference).Results: Among 261,371 veterans (63.7± 9.6 years, BMI 31.9± 6.0 kg/m², 80% male), PSG utilization decreased significantly during Pan-Mor (− 56%), Pan-Pre-Vax (− 61%), Pan-Vax (− 42%), and Pan-Post-Vax (− 36%) periods all compared to Pre-Pan. HSAT utilization decreased significantly during the Pan-Mor (− 59%) and Pan-Pre-Vax (− 9%) phases compared to the Pre-Pan and subsequently increased during Pan-Vax (+6%) and Pan-Post-Vax (− 1%) periods. Over 70% of STU transitioned to HSAT, and its usage surged five months after the vaccine Introduction.Conclusion: Sleep testing services utilization recovered differentially during the pandemic (PSG vs HSAT), including a surge in HSAT utilization post-vaccination.Keywords: home sleep apnea testing, polysomnography, COVID-19, pandemic, current procedural terminology

Background: Second-generation oral H1-antihistamines, including bilastine, represent the emerging treatments of allergic rhinitis (including rhinoconjunctivitis) and chronic urticaria in both adults and children. This study analyses available evidence supporting the use of bilastine amongst second-generation antihistamines for the symptomatic treatment of allergic rhinitis and urticaria in adults and children. Methods: Consensus amongst experts from 17 countries on the ideal treatment of rhinitis and urticaria, and the specific role of bilastine was measured by means of a modified Delphi process. A total of 12 statements were voted on by the experts using a five-point Likert scale (1 = strongly disagree; 2 = disagree; 3 = undecided; 4 = agree; 5 = strongly agree). The definition of consensus was set at a minimum of 80% concordance for 4+5 scores (agree or strongly agree). Results: All proposed statements reached consensus, with a concordance of ≥98% for five statements and ≥96% for seven. Conclusions: The wide consensus obtained for the proposed statements suggests a prominent role for bilastine in the management of allergic rhinitis and urticaria.

Abstract Colour centres in silicon carbide emerge as a promising semiconductor quantum technology platform with excellent spin-optical coherences. However, recent efforts towards maximising the photonic efficiency via integration into nanophotonic structures proved to be challenging due to reduced spectral stabilities. Here, we provide a large-scale systematic investigation on silicon vacancy centres in thin silicon carbide membranes with thicknesses down to 0.25 μm. Our membrane fabrication process involves a combination of chemical mechanical polishing, reactive ion etching, and subsequent annealing. This leads to highly reproducible membranes with roughness values of 3–4 Å, as well as negligible surface fluorescence. We find that silicon vacancy centres show close-to lifetime limited optical linewidths with almost no signs of spectral wandering down to membrane thicknesses of ~0.7 μm. For silicon vacancy centres in thinner membranes down to 0.25 μm, we observe spectral wandering, however, optical linewidths remain below 200 MHz, which is compatible with spin-selective excitation schemes. Our work clearly shows that silicon vacancy centres can be integrated into sub-micron silicon carbide membranes, which opens the avenue towards obtaining the necessary improvements in photon extraction efficiency based on nanophotonic structuring.

Introduction Inhaled corticosteroid/formoterol fumarate (ICS/FF) as needed is recommended by the Global Initiative for Asthma (GINA) as sole therapy in adults with mild asthma, with low-dose maintenance ICS plus short-acting β2-agonist (SABA) as an alternative. SABA alone is no longer recommended. Given these changes in recommendations, the observational PRIME study aimed to describe real-world treatment patterns in mild asthma in Europe. Methods Adults with asthma receiving low-dose maintenance ICS, or as needed ICS/FF or SABA were followed for 6 months. Data collected included Asthma Control Test (ACT), Asthma Control Questionnaire 5-item (ACQ-5), forced expiratory volume in 1 s (FEV1) and asthma exacerbations. Results The study was conducted in 883 patients in Germany, Italy, Poland and Spain; 833 (94.3%) completed follow-up. At enrolment, 32.2% received maintenance ICS, 56.3% ICS/FF as needed and 11.6% SABA as needed; 57.4%, 61.2% and 54.9%, respectively, had well-controlled asthma (ACQ-5/ACT definition). After 6 months, changes in mean FEV1 were small in the maintenance ICS and ICS/FF as needed groups, whereas there was a decline in FEV1 in the SABA as needed group. ACQ-5 total score improved from baseline in all three groups; 0.4%, 0.4% and 2.0% patients, respectively, had a severe exacerbation during the study. Conclusions More patients received ICS/FF as needed than SABA as needed, suggesting that physicians are aware of the latest treatment recommendations. This real-world study provides additional support to the use of ICS/FF as needed as preferred treatment for patients with mild asthma, whereas SABA as needed was associated with a fall in lung function and more severe exacerbations.

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.

IntroductionChronic obstructive lung diseases, such as asthma and COPD, appear to have a more extensive impact on overall functioning than previously believed. The latest data from clinical trials suggests a potential link between cognitive deterioration and chronic obstructive inflammatory lung disease. This raises the question of whether these diseases affect cognitive functions and whether any relevant biomarker may be identified.MethodsThis prospective observational study included 78 patients divided equally into asthma, COPD, and control groups (n=26, 27 and 25 respectively). The participants underwent identical examinations at the beginning of the study and after at least 12 months. The test battery comprised 16 questionnaires (11 self-rated, 5 observer-rated, assessing cognition and mental state), spirometry, and blood samples taken for PKA and CREB mRNA evaluation.ResultsA 2.3-fold increase in CREB mRNA was observed between examinations (p=0.014) for all participants; no distinctions were observed between the asthma, COPD, and control groups. Pooled, adjusted data revealed a borderline interaction between diagnosis and CREB expression in predicting MMSE (p=0.055) in COPD, CREB expression is also associated with MMSE (β=0.273, p=0.034) like with the other conducted tests (β=0.327, p=0.024) from COPD patients. No correlations were generally found for PKA, although one significant negative correlation was found between the first and second time points in the COPD group (β=-0.4157, p=0.049),.DiscussionChronic obstructive lung diseases, such as asthma and COPD, may have some linkage to impairment of cognitive functions. However, the noted rise in CREB mRNA expression might suggest a potential avenue for assessing possible changes in cognition, especially in COPD; such findings may reveal additional transcription factors linked to cognitive decline.

Background: Concurrent chemoradiotherapy (CRT) is the standard treatment for locally advanced cervical cancer. We investigated how additional bone marrow sparing (BMS) affects the clinical outcomes. Methods: We queried MEDLINE, Embase, Web of Science Core Collection, Google Scholar, Sinomed, CNKI, and Wanfang databases for articles published in English or Chinese between 2010/01/01 and 2023/10/31. Full-text manuscripts of prospective, randomised trials on BMS in cervical cancer patients treated with definitive or postoperative CRT were included. Risk of bias (RoB) was assessed using Cochrane Collaboration’s RoB tool. Random-effects models were used for the meta-analysis. Results: A total of 17 trials encompassing 1297 patients were included. The majority were single-centre trials (n = 1268) performed in China (n = 1128). Most trials used CT-based anatomical BMS (n = 1076). There was a comparable representation of trials in the definitive (n = 655) and postoperative (n = 582) settings, and the remaining trials included both.Twelve studies reported data on G ≥ 3 (n = 782) and G ≥ 2 (n = 754) haematologic adverse events. Both G ≥ 3 (OR 0.39; 95 % CI 0.28–0.55; p

The position accuracy of standalone Navigation with Indian Constellation (NavIC) may not be met for certain applications like civil aviation. To improve the position accuracy of the user receiver, the technique used is Differential NavIC, which makes use of Differential corrections. The position accuracy of the user receiver also depends on the satellite availability (i.e. number of satellites available at a certain time instant to estimate the user position) and delay in transmission of differential corrections. In this article, the analysis of differential NavIC using different numbers of visible satellites (satellite availability) and different time delays for transmission of corrections is carried out. For this analysis, three cases are considered, Case I is when all (six) NavIC satellites are visible, Case II is when five satellites (3 Geosynchronous Orbit (GSO) and 2 Geostationary Earth Orbit (GEO)) are visible, and Case III is when five satellites (3 GEO and 2 GSO) are visible. The comparative analysis for these three cases is carried out with respect to the position accuracy parameters and Geometric Dilution of Precision. It is observed that, with the satellite availability in case I and case III, the user receiver accuracy is approximately the same. In case III, the accuracy of the user receiver (3.08 m) is similar to the accuracy (3.09 m) in case I. For time delay in transmission of corrections, different time delays (0, 5, 10, 20, …, 300 s) are considered to observe the effect on the positional accuracy of the user receiver. Due to the increase in this time delay, there is a significant degradation in the user receiver position accuracy of differential NavIC.

A one-dimensional climate energy balance model (1D EBM) is a simplified climate model for the zonally averaged global temperature profile, based on the Earth's energy budget. We examine a class of 1D EBMs which emerges as the parabolic equation corresponding to the Euler–Lagrange equations of an associated variational problem, covering spatially inhomogeneous models such as with latitude-dependent albedo. Sufficient conditions are provided for the existence of at least three steady-state solutions in the form of two local minima and one saddle, that is, of coexisting “cold”, “warm” and unstable “intermediate” climates. We also give an interpretation of minimizers as “typical” or “likely” solutions of time-dependent and stochastic 1D EBMs. We then examine connections between the value function, which represents the minimum value (across all temperature profiles) of the objective functional, regarded as a function of greenhouse gas concentration, and the global mean temperature (also as a function of greenhouse gas concentration, i.e. the bifurcation diagram). Specifically, the global mean temperature varies continuously as long as there is a unique minimizing temperature profile, but coexisting minimizers must have different global mean temperatures. Furthermore, global mean temperature is non-decreasing with respect to greenhouse gas concentration, and its jumps must necessarily be upward. Applicability of our findings to more general spatially heterogeneous reaction–diffusion models is also discussed, as are physical interpretations of our results.

The aim of this study was to investigate whether initial fibroid volume, FIGO classifi cation, signal intensity ratio (SIR) on T2-weighted magnetic resonance images (MRI) and the number of fi broids aff ect the outcome of Uterine Artery Embolization (UAE) as well as report of 6-year single-center experience with UAE procedures. Medical history, UAE and MRI examinations from 75 patients from the Sestre milosrdnice University Hospital Centre who underwent UAE between 2017 and 2023 were reviewed retrospectively. Results showed a negative correlation between baseline fi broid volume and volume reduction of the fi broid, with larger fi broids showing smaller volume reduction (p < 0.001). There was a statistically significant diff erence between FIGO classification groups and volume reduction of the fibroids. Submucosal fi broids showed the best volume reduction compared to hybrid fi broids and subserosal fibroids. There was no signifi cant diff erence between hybrid and subserosal fi broids in volume reduction. We found no correlation between MRI SIR and the number of fibroids on UAE procedure outcomes. The present study suggests that submucosal fibroids and smaller baseline fibroid volume could be related to greater volume reduction and may be a useful prognostic factor for UAE procedure success. In conclusion, this study confi rms that UAE is a safe and effective procedure for the treatment of uterine fibroids

Bolesti paratireoidnih žlijezda često dovode do oštećenja bubrega poput primarnog hiperparatireoidizma ili se javljaju kao posljedica insuficijencije bubrega u sekundarnom i tercijarnom hiperparatireoidizmu. Bolesnici razvijaju hiperkalcemiju s povišenom razinom PTH, a većina ima smanjenu mineralnu gustoću kostiju uz deformitete, bolove i sklonost prijelomima, ali i oštećenje bubrežne funkcije, nefrokalcinozu ili nefrolitijazu uz opstruktivnu uropatiju. Cilj izvješća je predstaviti nuklearno-medicinske metode u dijagnostici i liječenju bolesnika s poremećajima paratireoidnih žlijezda. Najčešće korištene slikovne metode u dijagnostici jesu ultrazvuk visoke rezolucije s obojenim doplerom, zatim SPECT/CT scintigrafija u kombinaciji s kompjutoriziranom tomografijom s tehnecij-99m sestamibijem (Tc-99m-MIBI), te po potrebi PET/CT s fluor 18-kolinom. Ultrazvuk može biti praćen ciljanom citološkom punkcijom, a iz punktata se može odrediti i razina PTH koji također služi za potvrdu dijagnoze u slučaju da citološka analiza ne pokaže pravo podrijetlo epitelnih stanica iz punktata. U odjelima nuklearne medicine određuju se i laboratorijski parametri, odnosno razina PTH u serumu, važna u praćenju bolesnika. Najčešće se koriste kombinacije nekoliko različitih slikovnih metoda za određivanje veličine, položaja i odnosa paratireoidnih žlijezdi s okolnim strukturama, a u radu su prezentirane glavne indikacije te prednosti i ograničenja svake od metoda uz slikovni materijal.

Anemija zbog manjka željeza ili sideropenična anemija najčešći je oblik anemije u populaciji. Sideropenična anemija može nastati uslijed gastrointestinalnih bolesti, ginekoloških i drugih kroničnih krvarenja, može biti dio kliničke slike nefroloških i drugih bolesti i stanja, može doprinositi srčanom zatajenju u kardioloških bolesnika te pogoršavati ishode operativnih zahvata. Zbog navedenoga potreban je timski rad u liječenju sideropenične anemije, važno je otkriti i liječiti uzrok koji je doveo do gubitka željeza te liječiti anemiju nadoknadom željeza. Cilj je ovog rada prikazati pregled literature i klinička iskustva različitih nehematoloških specijalističkih usmjerenja u liječenju sideropenične anemije parenteralnim pripravcima željeza u različitim tercijarnim centrima u Hrvatskoj. U radu su opisani pristupi i postupnici u zbrinjavanju sideropenije i sideropenične anemije parenteralnim željezom iz aspekta gastroenterologa, ginekologa, nefrologa, kardiologa te anesteziologa, sa specifičnostima pojedinih bolesti i pristupa njihovom liječenju. U zaključku, novi visokodozni pripravci parenteralnog željeza unaprijedili su mogućnosti liječenja sideropenične anemije i primjenjuju se sve više u dnevnim bolnicama i odjelima različitih struka u Hrvatskoj, a ne samo u hematološkim dnevnim bolnicama ili odjelima.

During the covid pandemic period of 2019–2020, teaching was carried out via homeschooling, and secondary vocational schools had to deal with the problem of ensuring the implementation of excursions, which were a part of their apprentices’ practical training. In the context of the COVID-19 pandemic, a group of people at Constantine the Philosopher University in Nitra (Slovakia) came up with a plan to develop some virtual excursions to help secondary vocational schools replace field trips with their virtual counterparts. In the paper, the authors describe the results of the stated intention: two virtual excursions aimed at the production and processing of metal products and verification of their applicability in educational practice based on a qualitative analysis of expert opinions collected by means of individually led semi-structured interviews. The conclusions of the analysis confirm the high degree of usability of the created excursions and verify some positive impacts of the implementation of virtual excursions into the teaching practice, e.g., it increased student motivation to learn, increased student interest in lesson content, increased student activity, and intensified study activities overall, including various forms of self-study.

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.