Nicolas Mario Mas D Alessandro

Background: Mobile health (mHealth) apps are increasingly integrated into clinical workflows to support decision-making and adherence to best practices. Usability is a critical determinant of adoption, engagement, and long-term use. Objective: This study aimed to evaluate the usability of the C8 Health platform deployed in the Department of Anesthesiology at MetroHealth in 2024. Methods: A quality improvement initiative was conducted using the mHealth App Usability Questionnaire (MAUQ). A total of 142 anesthesiology clinicians participated by completing the questionnaire. This study was reported in accordance with the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines for quality improvement reporting. Results: The overall MAUQ scores indicated high usability, with mean scores greater than 5.5 across core items (overall mean MAUQ score 5.73, SD 0.81). These findings suggest strong user satisfaction and positive engagement with the C8 Health platform among anesthesiology clinicians. Conclusions: The C8 Health platform demonstrated high usability in an anesthesiology setting. These results support its integration as a clinical decision support tool to enhance workflow efficiency and adherence to best practices.

Greater trochanteric pain syndrome (GTPS), a common cause of hip pain, is typically managed with conservative treatments such as physical therapy and corticosteroid injections. However, some cases do not respond to these conservative treatments, so alternative therapeutic options become necessary. Peripheral nerve stimulation (PNS) is a promising modality for chronic pain management and may be effective for GTPS. A 71-year-old female with a BMI of 30 kg/m² and chronic left hip pain for over a year, unresponsive to conservative treatments, underwent temporary PNS lead placement targeting the trochanteric branch of the femoral nerve. Within one week, she reported a 90% reduction in pain, improving to 95% at two months. She regained independent mobility and improved quality of life. Leads were removed at two months, with benefits sustained at 24 months. This is the first reported case of successful PNS (SPRINT PNS System, SPR Therapeutics, Cleveland, Ohio, US) targeting the trochanteric branch of the femoral nerve for treating GTPS.

BACKGROUND Mobile health (mHealth) applications are increasingly integrated into clinical workflows to support decision-making and adherence to best practices. Usability is a critical determinant of adoption, engagement, and long-term use. OBJECTIVE This study aimed to evaluate the usability of the C8-Health platform deployed in the Department of Anesthesiology at MetroHealth in 2024. METHODS A quality improvement initiative was conducted using the Modified Application Usability Questionnaire (MAUQ). A total of 142 anesthesiology clinicians participated by completing the survey. Data were analyzed according to the SQUIRE guidelines for quality reporting, with mean scores calculated for core usability domains. RESULTS The overall MAUQ scores indicated high usability, with mean scores greater than 5.5 across core items (Mean MAUQ score: 5.73 ± 0.81). These findings suggest strong user satisfaction and positive engagement with the C8-Health platform among anesthesiology clinicians. CONCLUSIONS The C8-Health platform demonstrated high usability in an anesthesiology setting. These results support its integration as a clinical decision support tool to enhance workflow efficiency and adherence to best practices.

Obesity and sleep apnea contribute to significant challenges in ambulatory surgical centers which include airway management and perioperative recovery. This narrative review was written following a literature review of articles available on ScienceDirect, PubMed, and Google Scholar from 2009 to 2024. This article highlights that obesity-related anatomical changes, such as increased neck circumference (NC) and reduced cervical extension, may complicate airway management. Successful ambulatory surgery for these high-risk patients depends on detailed attention throughout the perioperative period. Advanced airway techniques, along with continuous pulse oximetry and capnography, are vital for safe care. The use of continuous positive airway pressure or bilevel positive airway pressure in the perioperative phase is particularly beneficial in preventing respiratory complications. A systematic, multidisciplinary approach emphasizing preoperative screening, risk stratification, and standardized protocols is crucial for optimizing results.

Objectives TAVR is a minimally invasive alternative to SAVR, offering a key treatment for high-risk patients with severe aortic stenosis, including those with advanced age or comorbidities. Its popularity has led to its use in lower volume institutions, where outcomes are comparable to higher volume centers. This study analyzes procedural volume and outcomes at our institution, compares them with the PARTNER III trial, and evaluates complications and patient selection criteria. Design This was a retrospective descriptive study. Setting This study was performed at a public, multi-institutional healthcare system featuring an acute care hospital with a Level I Adult Trauma and Burn Center. Participants We obtained retrospective data on 37 patients who underwent TAVR in our hospital system in 2022. Data was collected on their outcomes, including mortality, readmission rates, and cardiovascular and cerebrovascular complications at 30 days and 1 year. Interventions No interventions were performed on patients as this was a retrospective study. Measurements and Main Results Patient outcomes were compared with PARTNER III trial results. There was no 30-day mortality (versus 1% in the PARTNER III trial), and a 1-year mortality rate of 2.7% as compared to 8.5% in the PARTNER III trial. At 30 days, 0% of patients were readmitted for valve-related issues. Conclusions This study demonstrates that lower volume healthcare institutions can achieve outcomes comparable/similar to higher volume institutions in specialized procedures like TAVR, challenging the assumption that superior outcomes are tied to institutional size. Our findings highlight the importance of quality, teamwork, and individualized care in achieving excellent clinical outcomes, regardless of size.