The Factors Contributing to Physicians' Current Use of and Satisfaction With Electronic Health Records in Kuwait's Public Health Care: Cross-sectional Questionnaire Study.

BACKGROUND: Electronic health record (EHR) has emerged as a backbone health care organization that aims to integrate health care records and automate clinical workflow. With the adoption of the eHealth care system, health information communication technologies and EHRs are offering significant health care advantages in the form of error reduction, improved communication, and patient satisfaction. OBJECTIVE: This study aimed to (1) investigate factors associated with physicians' EHR adoption status and prevalence of EHRs in Kuwait and (2) identify factors predicting physician satisfaction with EHRs in public hospitals in Kuwait. METHODS: This study was conducted at Kuwait's public Al-Jahra hospital from May to September 2019, using quantitative research methods. Primary data were gathered via questionnaires distributed among 295 physicians recruited using convenience sampling. Data were analyzed in SPSS using descriptive, bivariate, and multivariate linear regression, adjusted for demographics. RESULTS: Results of the study revealed that the controlled variable of gender (ß=-.197; P=.02) along with explanatory variables, such as training quality (ß=.068; P=.005), perception of barriers (ß=-.107; P=.04), and effect on physician (ß=.521; P<.001) have a significant statistical relationship with physicians' EHR adoption status. Furthermore, findings also suggested that controlled variables of gender (ß=-.193; P=.02), education (ß=-.164; P=.03), effect on physician (ß=.417; P<.001), and level of ease of use (ß=.254; P<.001) are significant predictors of the degree of physician satisfaction with the EHR system. CONCLUSIONS: The findings of this study had significant managerial and practical implications for creating an inductive environment for the acceptance of EHR systems across a broad spectrum of health care system in Kuwait.

Safety and Efficacy of Convalescent Plasma to Treat Severe COVID-19: Protocol for the Saudi Collaborative Multicenter Phase II Study.

BACKGROUND: The COVID-19 pandemic is expected to cause significant morbidity and mortality. The development of an effective vaccine will take several months to become available, and its affordability is unpredictable. Transfusion of convalescent plasma (CP) may provide passive immunity. Based on initial data from China, a group of hematologists, infectious disease specialists, and intensivists drafted this protocol in March 2020. OBJECTIVE: The aim of this study is to test the feasibility, safety, and efficacy of CP in treating patients with COVID-19 across Saudi Arabia. METHODS: Eligible patients with COVID-19 will be recruited for CP infusion according to the inclusion criteria. As COVID-19 has proven to be a moving target as far as its management is concerned, we will use current definitions according to the Ministry of Health (MOH) guidelines for diagnosis, treatment, and recovery. All CP recipients will receive supportive management including all available recommended therapies according to the available MOH guidelines. Eligible CP donors will be patients with COVID-19 who have fully recovered from their disease according to MOH recovery criteria as detailed in the inclusion criteria. CP donors have to qualify as blood donors according to MOH regulations except for the history of COVID-19 in the recent past. We will also test the CP donors for the presence of SARS-CoV-2 antibodies by a rapid test, and aliquots will be archived for future antibody titration. Due to the perceived benefit of CP, randomization was not considered. However, we will compare the outcome of the cohort treated with CP with those who did not receive CP due to a lack of consent or lack of availability. In this national collaborative study, there is a likelihood of not finding exactly matched control group patients. Hence, we plan to perform a propensity score matching of the CP recipients with the comparator group patients for the major characteristics. We plan to collect demographic, clinical, and laboratory characteristics of both groups and compare the outcomes. A total sample size of 575 patients, 115 CP recipients and 460 matched controls (1:4 ratio), will be sufficient to detect a clinically important hospital stay and 30-day mortality difference between the two groups with 80% power and a 5% level of significance. RESULTS: At present, patient recruitment is still ongoing, and the interim analysis of the first 40 patients will be shared soon. CONCLUSIONS: In this paper, we present a protocol for a national collaborative multicenter phase II study in Saudi Arabia for assessing the feasibility, safety, and potential efficacy of CP in treating patients with severe COVID-19. We plan to publish an interim report of the first 40 CP recipients and their matched comparators soon. TRIAL REGISTRATION: ClinicalTrials.gov NCT04347681; https://clinicaltrials.gov/ct2/show/NCT04347681. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/23543.

Size and dimensionality dependent phonon conductivity in nanocomposites.

We have studied size and dimensionality dependent phonon conductivity of PbTe-PbSe nanocomposites by considering three configurations: superlattice, embedded nanowire and embedded nanodot. Calculations have been performed in the framework of an effective medium theory. The required bulk thermal conductivities of PbTe and PbSe are evaluated by using Callaway's effective relaxation-time theory, and by accounting for relevant scattering mechanism including three-phonon Normal and Umklapp interactions involving acoustic as well as optical branches. The thermal interface resistance is computed using the diffuse mismatch theory. It is found that the size (thickness) and volume fraction of PbSe are the two main factors that control the effective thermal conductivity in these nanocomposites. In particular, for PbSe size d = 10 nm and volume fraction Vf = 0.1, our results predict significant reductions over the weighted average of room-temperature bulk results of 9%, 17% and 15% in the conductivity across the interfaces for the superlattice, embedded nanowire, and nanosphere structures, respectively. For a given Vf, an increase in d reduces the interface density and the effective conductivity varies approximately as [Formula: see text]. It is shown that nanocompositing in any of the three configurations can beat the alloy limit for lattice thermal conductivity.

Three-phonon scattering processes and thermal conductivity in IV-chalocogenides.

We present a systematic study of allowed three-phonon scattering processes, involving acoustic and optical branches, and their relative roles in explaining the low thermal conductivity κ of IV-chalcogenide thermoelectric materials PbTe, PbSe, PbS, and SnTe. Using numerical results for κ, computed by employing the isotropic continuum scheme, we have examined the extent of the additional contribution the Callaway theory and the Allen theory provide over the single-mode relaxation time theory. Within the Callaway theory, for all these materials the acoustic (TA, LA) and transverse optical (TO) phonons contribute between 10-25% towards κ at and above room temperature, with κ(TO) > κ(TA) > κ(LA). The longitudinal optical (LO) phonons contribute negligibly (<5%) in Pb-chalogenides, but their contribution is larger (22%) than that of TO phonons (18%) in SnTe. Due to the presence of high defect concentration in these materials, the high temperature conductivity varies less strongly than T(-1). In confirmation with experimental measurements, our study finds that below the Debye temperature the resistivity of SnTe varies as the square-root of the point defect concentration.