Standardized Comparison of Voice-Based Information and Documentation Systems to Established Systems in Intensive Care: Crossover Study.

BACKGROUND: The medical teams in intensive care units (ICUs) spend increasing amounts of time at computer systems for data processing, input, and interpretation purposes. As each patient creates about 1000 data points per hour, the available information is abundant, making the interpretation difficult and time-consuming. This data flood leads to a decrease in time for evidence-based, patient-centered care. Information systems, such as patient data management systems (PDMSs), are increasingly used at ICUs. However, they often create new challenges arising from the increasing documentation burden. OBJECTIVE: New concepts, such as artificial intelligence (AI)-based assistant systems, are hence introduced to the workflow to cope with these challenges. However, there is a lack of standardized, published metrics in order to compare the various data input and management systems in the ICU setting. The objective of this study is to compare established documentation and retrieval processes with newer methods, such as PDMSs and voice information and documentation systems (VIDSs). METHODS: In this crossover study, we compare traditional, paper-based documentation systems with PDMSs and newer AI-based VIDSs in terms of performance (required time), accuracy, mental workload, and user experience in an intensive care setting. Performance is assessed on a set of 6 standardized, typical ICU tasks, ranging from documentation to medical interpretation. RESULTS: A total of 60 ICU-experienced medical professionals participated in the study. The VIDS showed a statistically significant advantage compared to the other 2 systems. The tasks were completed significantly faster with the VIDS than with the PDMS (1-tailed t59=12.48; Cohen d=1.61; P<.001) or paper documentation (t59=20.41; Cohen d=2.63; P<.001). Significantly fewer errors were made with VIDS than with the PDMS (t59=3.45; Cohen d=0.45; P=.03) and paper-based documentation (t59=11.2; Cohen d=1.45; P<.001). The analysis of the mental workload of VIDS and PDMS showed no statistically significant difference (P=.06). However, the analysis of subjective user perception showed a statistically significant perceived benefit of the VIDS compared to the PDMS (P<.001) and paper documentation (P<.001). CONCLUSIONS: The results of this study show that the VIDS reduced error rate, documentation time, and mental workload regarding the set of 6 standardized typical ICU tasks. In conclusion, this indicates that AI-based systems such as the VIDS tested in this study have the potential to reduce this workload and improve evidence-based and safe patient care.

Far-Red Emitting Fluorescent Dyes for Optical Nanoscopy: Fluorinated Silicon-Rhodamines (SiRF Dyes) and Phosphorylated Oxazines.

Far-red emitting fluorescent dyes for optical microscopy, stimulated emission depletion (STED), and ground-state depletion (GSDIM) super-resolution microscopy are presented. Fluorinated silicon-rhodamines (SiRF dyes) and phosphorylated oxazines have absorption and emission maxima at about λ≈660 and 680 nm, respectively, possess high photostability, and large fluorescence quantum yields in water. A high-yielding synthetic path to introduce three aromatic fluorine atoms and unconventional conjugation/solubilization spacers into the scaffold of a silicon-rhodamine is described. The bathochromic shift in SiRF dyes is achieved without additional fused rings or double bonds. As a result, the molecular size and molecular mass stay quite small (<600 Da). The use of the λ=800 nm STED beam instead of the commonly used one at λ=750-775 nm provides excellent imaging performance and suppresses re-excitation of SiRF and the oxazine dyes. The photophysical properties and immunofluorescence imaging performance of these new far-red emitting dyes (photobleaching, optical resolution, and switch-off behavior) are discussed in detail and compared with those of some well-established fluorophores with similar spectral properties.

First enantioselective total synthesis of (+)-(R)-Pinnatolide using an asymmetric domino allylation reaction.

An efficient total synthesis of (+)-(R)-Pinnatolide is described. As a key step an asymmetric multicomponent domino allylation reaction of methyl levulinate is used to form the quaternary stereogenic center in a highly selective way.

Asymmetric allylation of methyl ketones by using chiral phenyl carbinols.

Novel chiral auxiliaries for the stereoselective allylation of aliphatic methyl ketones with allyltrimethylsilane and their use in the synthesis of homoallylic ethers are described. In a multicomponent domino process catalyzed by trifluoromethanesulfonic acid, the allyl moiety and the auxiliary are transferred onto the substrate to yield tertiary homoallylic ethers. The most useful auxiliary for a general application turned out to be the trimethylsilyl ether of phenyl benzyl carbinol with an induced diastereoselectivity of 90:10 using ethyl methyl ketone and 94:6 using isopropyl methyl ketone as substrates. The transferred substituted benzyl moiety has good protecting properties in subsequent transformations and can easily be removed under reductive conditions to provide the corresponding homoallylic alcohol. The origin of the high selectivity could be elucidated by identifying the relevant transition states using quantum-chemical calculations. An excellent agreement between calculated and experimentally observed selectivities was obtained assuming an oxocarbenium ion as intermediate.