A user evaluation of speech/phrase recognition software in critically ill patients: a DECIDE-AI feasibility study

Association with perceived stress and feasibility of an app for patient-reported stressor experiences during treatment in an intensive care unit: a nonrandomized controlled study (ICU Feel Better App)

BACKGROUND

Critically ill patients often experience substantial stress during their ICU treatment. The ICU Feel Better App is a novel mobile application that patients can use to evaluate ICU-related stressors during their stay. We aimed to investigate if using the app, without feedback to the ICU staff, would be associated with changes in perceived acute stress.

METHODS

This prospective cohort study used a before-and-after design. Data were collected at the beginning of ICU treatment (T1) and at discharge from ICU (T2). The comparison group (N.=20) received treatment as usual, i.e. standard critical care including assessment and treatment of pain and delirium. The App group (N.=20) used the ICU Feel Better App, which included 24 common ICU-related stressors, between T1 and T2. Secondary outcomes included app use extent and patients' ratings of acceptance and usability.

RESULTS

No significant differences were observed in clinical characteristics or stress levels between treatment groups at T1, T2, and from T1 to T2. Each app session averaged a median of 1.82 minutes (IQR: 1.54-2.66), with users averaging 8.5 sessions over 3.5 days, totaling 16.16 minutes of use (IQR: 9.72-27.51). Patients found the app highly usable and acceptable, with assistance needed in only one session for three users and no premature terminations.

CONCLUSIONS

The lack of significant stress reduction suggests that the effectiveness of the app could be improved by incorporating feedback mechanisms to communicate patients' stressor evaluations to staff, prompting stress-reducing measures. Data on app use, acceptability, and usability indicate feasibility of the ICU Feel Better App.

Communication in critical care tracheostomy patients dependent upon cuff inflation: A scoping review

OBJECTIVES

The aim of this study was to synthesise the evidence concerning communication in critically ill tracheostomy patients dependent on cuff inflation. The aim was to identify the psychological impact on patients awake and alert with tracheostomies but unable to speak; strategies utilised to enable communication and facilitators and barriers for the success of these strategies.

REVIEW METHOD USED

This scoping review was conducted using the Joanna Briggs Institute framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

DATA SOURCES

CINAHL, Embase, Medline, and Web of Science were searched from 1st January 2000 to 30th September 2023 and supplemented with hand searching of references from included studies.

REVIEW METHODS

Studies were eligible if they addressed the psychological impact of voicelessness and/or the structure, process, and outcomes of augmentative and alternative communication (AAC) systems, in addition to facilitators and barriers to effectiveness. The population of interest included critically ill tracheostomy patients dependent on cuff inflation, their families, and healthcare workers. Screening and data extraction were undertaken by two reviewers independently. Data analysis involved descriptive statistics and content analysis.

RESULTS

A total of 23 studies met the inclusion criteria: 11 were qualitative, nine were quantitative, and three were mixed-methods studies. Voicelessness elicited negative emotions, predominantly frustration. AAC systems, encompassing unaided and aided (low-tech and high-tech) methods, presented both advantages and drawbacks. High-tech strategies held promise for patients with physical limitations. Patients equally appreciated the support offered through unaided strategies, including eye contact and touch. Facilitating factors included speech therapy involvement and assessment. Patient-related challenges were the most frequent barriers.

CONCLUSION

Facilitating meaningful communication for critically ill tracheostomy patients dependent on cuff inflation is of paramount psychological significance. Whilst AAC systems are practicable, they are not without limitations, implying the absence of a universally applicable solution. This underscores the importance of continuous evaluation, reinforced by a multidisciplinary team.

REVIEW PROTOCOL REGISTERED

27 July 2022.

REVIEW REGISTRATION

Open Science Framework Registries: https://osf.io/kbrjn/.

Memristor-Based Neuromorphic Chips

In the era of information, characterized by an exponential growth in data volume and an escalating level of data abstraction, there has been a substantial focus on brain-like chips, which are known for their robust processing power and energy-efficient operation. Memristors are widely acknowledged as the optimal electronic devices for the realization of neuromorphic computing, due to their innate ability to emulate the interconnection and information transfer processes witnessed among neurons. This review paper focuses on memristor-based neuromorphic chips, which provide an extensive description of the working principle and characteristic features of memristors, along with their applications in the realm of neuromorphic chips. Subsequently, a thorough discussion of the memristor array, which serves as the pivotal component of the neuromorphic chip, as well as an examination of the present mainstream neural networks, is delved. Furthermore, the design of the neuromorphic chip is categorized into three crucial sections, including synapse-neuron cores, networks on chip (NoC), and neural network design. Finally, the key performance metrics of the chip is highlighted, as well as the key metrics related to the memristor devices are employed to realize both the synaptic and neuronal components.