Caregivers' Perceptions, Needs, and Data Sharing Concerns in mHealth Research on Pediatric Asthma: Cross-Sectional Survey Study.

Background: Pediatric asthma is the most common chronic respiratory disease of childhood. Caregivers often report lacking knowledge in several aspects of asthma management at home. Although the use of mobile health (mHealth) tools, such as mobile apps, could facilitate asthma self-management and, simultaneously, the collection of data for research, few studies have explored the features that caregivers would like to see in such a tool and their perceptions on data sharing. Objective: This study evaluates caregivers' perceived knowledge gaps in asthma management; their perceptions of certain features and resources that should be included in a potential mobile app; and any concerns that they may have regarding data sharing for research, including privacy and security concerns. Methods: In this cross-sectional study, we surveyed 200 caregivers of children (aged 1-13 y) with asthma who were followed at a pediatric tertiary care center in Montreal, Canada. Anonymous data were collected through the institutional web-based survey platform. We collected the participants' answers by using a 5-category Likert scale ("completely agree," "agree," "neither agree nor disagree," "disagree," and "completely disagree"), multiple-choice questions, and free-text questions on the abovementioned topics. Descriptive statistics were performed, and answers were compared between caregivers of preschool-aged children and caregivers of school-aged children. Results: Participating children's mean age was 5.9 (SD 3.4) years, with 54% (108/200) aged ≤5 years and 46% (92/200) aged >6 years. Overall, caregivers reported having adequate knowledge about asthma and asthma self-management. Nonetheless, they identified several desirable features for a mobile app focused on asthma self-management. The most frequently identified features included receiving alerts about environmental triggers of asthma (153/199, 76.9%), having videos that demonstrate symptoms of asthma (133/199, 66.8%), and being able to log children's asthma action plans in the app (133/199, 66.8%). Interestingly, more caregivers of preschool-aged children preferred textual information when compared to caregivers of school-aged children (textual information for explaining asthma: P=.008; textual information for the symptoms of asthma: P=.005). Caregivers were generally highly in favor of sharing data collected through a mobile app for research. Conclusions: Caregivers of children with asthma in our study identified several desirable educational and interactive features that they wanted to have in a mobile app for asthma self-management. These findings provide a foundation for designing and developing mHealth tools that are relevant to caregivers of children with asthma.

Role of financial development, foreign direct investment inflow, innovation in environmental degradation in Pakistan with dynamic ARDL simulation model.

The purpose of this research is to determine the impact of innovation, economic growth, financial development, trade, foreign direct investment (FDI), electricity consumption, and urbanization on the environmental degradations in Pakistan. This study has employed the dynamic autoregressive distributed lag model (ARDL), to investigate the actual change in the independent variables and its impact on the dependent variable through graphs. The findings demonstrate that energy consumption, GDP growth, urbanization, and trade negatively influence the carbon emissions in the short term. On the other hand, the findings indicate that in the long term, only GDP growth and trade had a significantly negative impact on emissions. Urbanization has a positive and considerable impact on the emissions of carbon dioxide in the long run. On the other hand, financial development and foreign direct investment (FDI) help reduce the environmental degradation in the short term and long term. Moreover, innovation positively affects the carbon emissions in both the long and short run. Policy recommendations are given based on the findings of this study.

Electrolyte Abnormalities Associated With the Use of Atezolizumab - A Systematic Review.

Background and objectives: In recent years, immune-checkpoint inhibitors (ICIs) particularly atezolizumab is on the rise in treating advanced malignancies. With its increased clinical use, various electrolyte abnormalities have been reported in the literature. In this review, we have addressed the question of significant electrolyte abnormalities associated with atezolizumab. Materials and methods: Following PRISMA guidelines, we performed a thorough literature search in four databases including PubMed, Cochrane Library, Embase, and Clinicaltrials.gov. We included only randomized controlled trials from 2010 till March 2021. After a comprehensive screening of 1587 articles, we selected 14 articles for our review and tabulated the results. Following MeSH terms were used: "electrolyte abnormalities", "immune checkpoint inhibitors", "atezolizumab". Results: Non-small cell lung cancer (n = 1270) and metastatic urothelial carcinoma (n = 1164) were the most common malignancies among 3160 patients. The most common electrolyte abnormality was hypomagnesemia (4.7%). Hyponatremia, hypophosphatemia, hypercalcemia and hypokalemia were found in 2.3%, 0.63%, 0.25% and 0.06% patients respectively. For patients taking atezolizumab, hypomagnesemia was most frequently found in non-small cell lung carcinoma patients (9.4%), while urothelial metastatic carcinoma patients most commonly had hyponatremia (5.15%). Hypokalemia though insignificant was observed only in patients with metastatic renal cell carcinoma (2.85%). Conclusion: Since the use of atezolizumab is on the rise for the treatment of various cancers, more studies need to be conducted to better understand its safety and toxicity profile.

Do economic openness and electricity consumption matter for environmental deterioration: silver bullet or a stake?

Developing countries are enthusiastically on the road to economic progress and economic openness, which is proved to be a silver bullet for them. However, it has put their environmental quality at stake. This study examines whether economic openness and electricity consumption matter for environmental deterioration by controlling for the influence of economic progress. For this, we have used time series frequency data of Pakistan from 1971 to 2016 and employed the state-of-the-art dynamic autoregressive distributed lag (ARDL) simulation model. The model has the advantage over traditional ARDL in determining the positive and negative environmental deterioration variations induced by economic openness, electricity consumption, and economic progress. The main findings are as follows: Firstly, electricity consumption in both long and short run positively and significantly influenced CO2 emissions, while long-run influence exceeded that of short run. Secondly, economic progress validated an environmental Kuznets curve hypothesis and thus limited the environmental degradation. Thirdly, economic openness showed an insignificant influence on CO2 emissions both in the long and short run. Based on research findings, it is suggested that economic progress and economic openness are not the direct culprits to deteriorate a developing country's environmental condition like Pakistan; rather, electricity consumption remained the key role player. Therefore, the transition from fossil-based electricity consumption to renewable energy consumption would provide a sustainable pathway towards achieving sustainable economic openness in the future.

Cerebral Cavernous Angioma Associated with Klippel Trenaunay Syndrome Treated with Gamma Knife Radiosurgery: Case Report and Literature Review.

Klippel Trenaunay syndrome (KTS) is a rare, sporadic congenital syndrome characterized by cutaneous hemangiomas, venous varicosities, and osseous-soft tissue hypertrophy of the affected limb. It is genetically heterogeneous, and its clinical presentation is variable. We report the case of a 13-year-old male with KTS, who presented with a cerebral cavernous angioma in the corpus callosum. To the best of our knowledge, this is the first reported case of its kind from Pakistan and the only known case in the literature of KTS to be treated with stereotactic radiosurgery. The possibilities of shared genetic pathways between KTS and cavernous angiomas and the need for neurovascular scrutiny in patients with this syndrome are discussed.