Hassina S*, Krichene MA, Hazil Z, Bekkar B, Hasnaoui I, Robbana L, Bardi S, Akkanour Y, Serghini L and Abdallah EL
Published on: 18th June, 2024
Intracranial meningiomas are usually non-cancerous tumors that develop from arachnoid cells in the meningeal envelope. However, there are rare forms called intraosseous meningiomas, which present unique challenges for diagnosis and treatment. In this report, we describe a rare case of a giant sphenotemporal meningioma in a 72-year-old male with diabetes. The patient experienced progressive exophthalmos and visual impairment over a period of five months. Radiological imaging confirmed the diagnosis, showing extensive infiltration into the infra-temporal region. Histopathological examination confirmed a plaque-type meningothelial meningioma. The patient underwent surgical management, which involved maxillofacial surgery. Intraosseous meningiomas are rare but are increasingly being recognized, accounting for about two percent of all meningiomas. The spheno-orbital region is a common site for these tumors. Histologically, there are various subtypes, with meningothelial meningioma being the most common. The differential diagnosis includes Paget’s disease and osteomas. The optimal treatment approach involves extensive surgical resection, followed by adjuvant radiotherapy for any remaining or symptomatic tumors. The prognosis depends on the extent of resection and tumor progression, underscoring the importance of regular monitoring. Early intervention is crucial to preserve visual function and achieve favorable outcomes.
An empirical framework that accurately describes radioactive binding energies is the Somewhat Empirical Mass Equation (SEMF). They showcase many implementations and uses of the idea that rely on graphics and printed objects. A key new addition is a contrast with real experiments, as well as a visualization of the energy environment as supplied by the SEMF. The shortcomings of the empirical theory are shown by our visualization of this differential energy scenery, which also highlights the significance of what is known as magic numbers—an explanation provided by the outermost approach, which was developed much more recently than the water drop theory. This provides a great chance to talk about the advantages and limitations of simulations everywhere within the framework of science teaching.
A thorough knowledge of the stationary characteristics of the nuclei of atoms, their stimulation wavelengths, how they react to outside factors, and how they disintegrate is the aim of nuclear structural science. Although achieving these objectives within just one structure is difficult and prevents the existence of a nuclear "standard model," it is evident that radioactive Density Functional Theory (DFT) offers perhaps the broadest variety of applications to date. We attempt to place DFT in a larger perspective in this study by making frequent allusions to electrical DFT. We also provide a brief overview of the numerous uses and an explanation of the connections between beginning techniques and Useful Field Concepts (EFTs) in particular. The article tries to promote collaborations with different scientific fields while being published from a subjective and perhaps biased point of view.
Nandlal Bhojraj*, Prem K Sreenivasan, Paras Mull Gehlot, Vinutha Manjunath and Manjunath MK
Published on: 19th June, 2024
Aim: To evaluate the effectiveness of an ayurvedic gel in tooth pain reduction due to dental caries. Materials and methods: This in vivo cross-over design study enrolled adults with at least one tooth with caries and a symptom of pain after the application of an ice stimulus. Two hundred patients were screened and eligible patients were enrolled in the study. Forty-five subjects completed washout phases before each recall visit. During each recall visit, subjects evaluated pain relief following an ice bar stimulus and one random finger-tip application of a treatment i.e. Ayurveda Herbal gel containing clove oil, camphor, and menthol (Ayurveda Herbal Gel Group), and two control formulations: a gel without active ingredients and commercial olive oil as a surrogate of home remedy. At each assessment, subjects used a stopwatch to record the onset of pain relief and tooth pain using visual analog scores (VAS), dental pain scores (DPS), and relief from tooth pain by dental pain relief scores (DPRS). After each treatment, subjects recorded their satisfaction with the provided treatment using a four-point satisfaction index. Data were tabulated and statistical analysis was performed with (ANCOVA) and two-way ANOVA with a p - value of 0.05 considered statistically significant. Results: Forty-five subjects (28 males and 17 females) completed the entire study without any adverse events. Application of the Ayurveda gel resulted in a significantly faster onset of pain relief (2.47 min) in comparison to the onset of pain relief after 4 minutes recorded with the controls (p < 0.05). Subjects reported lower VAS and DPS scores over the study period of evaluation when using the Ayurveda gel compared to the application of each control formulation. Subjects also reported greater relief of pain and greater satisfaction after the application of the Ayurveda gel as compared to the controls. Conclusion: Significantly better tooth pain relief from caries was observed from an Ayurveda Herbal gel than from controls.
Pushing forward with leveraging water resources, promoting international cooperation, and ensuring transparency in deep-sea mining operations. There is also a concern about where to discharge the toxins of unpurified water. Artificial Intelligence has created a dominance in the applications field with a totally automated system.Out of a thorough analysis completed with indicators, satellite radar, and A Journals, there are 30 years of research and 8 years of monitored testing to achieve accuracy and relevance. The patents in place are, Oceanic Mining System (4446636), Flexible Solar Skin in Combination with an Airplane (4768738), Cargo Torpedo (4421050), Oceanic seaplow system (4398362), and previous articles like “Is Extracting Lithium and deep-sea mining more sustainable?”, “AI as a Means of Water Purification Protection”, “Global Water Distribution”, and “Can Deep Sea Water be Processed into Potable Water and Distributed into the Middle East’?To report some ballpark numbers on the proposal and how we would navigate these projects, there will be an exact location of where the plant will be built as well as a water/salinity report of the water being treated. There are still issues with analyzing the cost of desalination compared to other alternatives. Deep Sea Water proves to be a higher quality water and the investment is well worth it. The surveys lean toward clients preferring the International Standards Operating Procedure. All recipients agree there should be a sense of urgency on water shortages. Currently, AI has proven to be a vital asset in eliminating biases and expenses.
Background: Post-infarction ventricular septal rupture (VSR) is a rare but lethal mechanical complication of an acute myocardial infarction (AMI). It results in 90% - 95% mortality within two months of diagnosis without any kind of intervention. Given high surgical mortality, transcatheter closure has emerged as a potential strategy as an alternative to high-risk surgical closure. Indian data on percutaneous device closure of post-AMI-VSR is limited hence we report our resource-limited single-centre experience with different kinds of occluder devices for closure of post-AMI VSR.Methods and results: In this single-centre, retrospective, cohort study, patients who underwent transcatheter closure of post-MI VSR between 2018 and 2024 at Health World hospitals, in Durgapur, West Bengal, were included. The primary outcome was a mortality rate of 30 days. The study population was eleven primary cases of post-MI VSR. The mean age of the population was 61 years. The majority of the patients had anterior wall MI (54.5%) and the remaining had inferior wall MI. Different kinds of devices (ASO, PostMI VSD device, Konar MFO) were used to close VSR. Successful closure was performed in 9 patients (81%) with minimal residual shunt in 2 patients. Out of 9 cases 3 patients expired, one was lost to follow up and the rest are doing well at 30 days follow-up. Conclusion: Transcatheter closure of PMIVSRs can be performed with different kinds of devices with high technical success, relatively low procedural complication rates, and 30 days survival even in a resource-limited setup as an alternative to high-risk surgical closure.
Tatiane Franco, Weslley Barbosa Sales*, José Vinicius Bulhões da Silva, Djavan Gomes Leite and Giovanna Pontes Pina Vidal
Published on: 21st June, 2024
Introduction: Dermatofunctional Physiotherapy is an area of physiotherapeutic specialty that aims to promote, prevent, and treat integumentary injuries. However, this field of action is usually erroneously limited to aesthetic and cosmetic procedures. However, the scope of Physical Therapy goes beyond aesthetic procedures. Objective: To identify the scope of dermatofunctional physiotherapy beyond aesthetics. Methodology: This is an integrative literature review with the objective of summarizing and exploring the proposed theme. For this, the PRISMA guidelines were used, as well as the PICOT strategy for a better delineation of the research question and research theme. Results and discussions: It was observed that the role of the physiotherapist in this field is directly related to aesthetics, which is one of the most prosperous segments within the health area, due to the great demand for aesthetic procedures. Among the main resources evidenced in this study, lymphatic drainage, electrothermophototherapeutic resources, myofascial release, and manual techniques were observed. Final considerations: The area of physical therapy is not exclusively dedicated to the aesthetic environment, it was observed that this specialty acts strongly in the promotion, and prevention of rehabilitation of patients with metabolic, integumentary, and musculoskeletal alterations, in addition to promoting and preventing diseases related to obesity, scars, geloid edema, flaccidity, and other integumentary dysfunctions.
Joanna Viana Cacho Neta, Weslley Barbosa Sales*, José Vinicius Bulhões da Silva and Giovanna Pontes Pina Vidal
Published on: 21st June, 2024
Introduction: The practice of plastic surgery began in the field of reconstructive surgery, in an attempt to recover the functionality of some area of the body or give it a more natural appearance. In this sense, the role of the physical therapist is recommended in various aesthetic surgeries that, through physical therapy resources and techniques, promote tissue healing, reduce the appearance of adhesions, and reduce or eliminate pain, bruises, and edema. Objective: to identify the effects of physical therapy in the postoperative period of plastic surgery. Methodology: This is an integrative literature review, in which there will be a review of articles related to the study of the effects of physical therapy assistance applied to the postoperative period of plastic surgery. Articles related to the proposed theme were included, published between 2011 and 2024, available in full, without language restriction; in addition to theses, dissertations, and monographs. Exclusion criteria were literature review articles, articles or abstracts that had been published in conference proceedings; as well as letters from editors and preprints. Results and discussions: it can show that physiotherapy in the postoperative period of plastic surgery is essential in reducing recovery time, reducing edema, improving the healing process, and preventing the risk of complications in the postoperative period. The main physiotherapeutic resources and techniques were: lymphatic drainage, ultrasound, radiofrequency, laser, and high frequency. Regarding plastic surgeries, the most frequent in the literature were: abdominoplasty, blepharoplasty, rhytidectomy, and liposuction. Final considerations: Dermatofunctional physiotherapy is of paramount importance in the postoperative period of plastic surgery. It is essential in reducing recovery time and reducing the risks arising from surgery.
Mohamed Baha Saeed*, Salah Eltom Elamin and Mark D Laing
Published on: 26th June, 2024
A field study was carried out to evaluate the efficacy of pendimethalin 500 EC (trade name: Pendimight®) and oxyfluorfen 240 EC (trade name: Harris®) to control weeds in direct-seeded onion (Allium cepa L.). Pendimethalin and oxyfluorfen were applied solely at reduced rates (1.35 and 0.17 kg a.i. ha-1), and at the recommended rates (1.8 and 0.25 kg a.i. ha-1) as pre-and post-emergence herbicides, respectively. Both herbicides were also applied sequentially at the same doses. Ten weeks after sowing (WAS), the application of pendimethalin alone provided better weed control (62% - 65%) than oxyfluorfen alone (33% - 43%) when they were applied at the lower and recommended rates, respectively. Sequential applications of the two herbicides as pre-and post-emergence herbicides, outperformed applications of the two herbicides alone, and resulted in the best weed control (79% to 85%), lowest weed dry weight (18.35 to 35.60 g.m-2), significantly increased plant height and the number of leaves per plant, and resulted in a ten-fold higher onion yield (24.64 to 26.37 t. ha-1) compared with the Un-weeded control (2.27 t. ha-1). There were no significant differences observed between the treatments on the emergence (%) of onion seeds and the survival of onion seedlings. Sequential applications of pendimethalin and oxyfluorfen is a promising techniques for weed control in direct-seeded onions in Sudan.
Introduction: We aim to evaluate the performance of pre-treatment MRI-based habitat imaging to segment tumor micro-environment and its potential to identify patients with esophageal cancer who can achieve pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT).Material and methods: A total of 18 patients with locally advanced esophageal cancer (LAEC) were recruited into this retrospective study. All patients underwent MRI before nCRT and surgery using a 3.0 T scanner (Ingenia 3.0 CX, Philips Healthcare). A series of MR sequences including T2-weighted (T2), diffusion-weighted imaging (DWI), and Contrast Enhance-T1 weighted (CE-T1) were performed. A clustering algorithm using a two-stage hierarchical approach groups MRI voxels into separate clusters based on their similarity. The t-test and receiver operating characteristic (ROC) analysis were used to evaluate the predictive effect of pCR on habitat imaging results. Cross-validation of 18 folds is used to test the accuracy of predictions.Results: A total of 9 habitats were identified based on structural and physiologic features. The predictive performance of habitat imaging based on these habitat volume fractions (VFs) was evaluated. Students’ t-tests identified 2 habitats as good classifiers for pCR and non-pCR patients. ROC analysis shows that the best classifier had the highest AUC (0.82) with an average prediction accuracy of 77.78%.Conclusion: We demonstrate that MRI-based tumor habitat imaging has great potential for predicting treatment response in LAEC. Spatialized habitat imaging results can also be used to identify tumor non-responsive sub-regions for the design of focused boost treatment to potentially improve nCRT efficacy.
Yogendra Singh, CB Pandey, Nitin Chandola* and Deeksha Agarwal
Published on: 24th June, 2024
Ischemic Heart Disease (IHD) remains a significant cause of morbidity and mortality worldwide. We present a case report of a 54-year-old individual presenting with symptoms suggestive of IHD, including palpitations and chest heaviness. Utilizing a Spandan device at home, the patient detected anteroseptal and lateral wall ischemia, prompting consultation with a cardiologist. Subsequent diagnostic evaluations revealed Left Ventricular Hypertrophy (LVH), concentric LVH, regional wall motion abnormality, and Grade I diastolic dysfunction. Hypertension and dyslipidemia were identified as prominent risk factors, with additional findings of carotid artery disease. Management strategies included antihypertensive medications, lipid-lowering therapy, and lifestyle modifications. This case underscores the complexity of diagnosing and managing IHD, highlighting the importance of comprehensive assessment and multidisciplinary care in optimizing patient outcomes.
Introduction: Wet wrapping is a local care technique adapted to the treatment of severe forms of eczema. It is a good alternative for AD resistant to the usual local treatments. We report a case. Observation: A 5-month-old infant, with a personal history of allergic rhinitis has been seen in a dermatological for diffuse skin eruption and pruritus evolving in flare-ups since 4 months, without improvement after several courses of dermocorticoids, anti-H1, and emollient from several doctors. Clinical examination revealed erythematous plaques surmounted by vesicles with a crumbled border located on the convexities and extension face of the limbs and in the folds behind the ears and diffuse skin xerosis. The examination of the other devices was unremarkable. The evaluated SCORAD was 59.8. We carried out the treatment by the wet wrapping technique, a clear regression of the cutaneous lesions and pruritus with the decrease of the SCORAD from 59.8 to 8.8 in 1 month of treatment. Discussion: This observation further illustrates the effectiveness of the Wet wrapping technique in the management of recalcitrant atopic dermatitis. In resource-poor countries, Wet wrapping may be an alternative for recalcitrant forms of atopic dermatitis. For fostering critical nurse observation as a source of research topics, we propose four strategies. First, cultivating awareness through a culture of evidence-based practice and critical reflection on common practice. Second, stimulating persistence in addressing moral dilemmas concerning better care despite resistance. Third, facilitating interprofessional learning in an open culture, where diverse perspectives are valued, and it is psychologically safe to bring them in. Fourth, overcoming funding disparities and facilitating nurse-led research, acknowledging the underrepresentation of nurses in funding agencies. These measures aim to empower nurses to observe critically, use their unique perspectives, and bring in research topics.
Cognitive impairment has been increasingly observed among patients with anxiety disorders and major depressive disorders impacting their normal daily functioning as well as quality of life. A multitude of evidence suggests that the most affected cognitive abilities are memory, attention, perception, and executive functioning in patients with anxiety and depression. Impairment in these higher-order cognitive functions can be attributed to age, education, diet, hormonal changes, stress, and prolonged use of drugs/alcohol/ medicines. To address the issues related to cognitive impairment various non-pharmacological therapeutic modalities such as Cognitive remediation approaches viz; cognitive rehabilitation, cognitive stimulation, and cognitive training; Audio-visual entrainment; mindfulness-based interventions; and neurofeedback have come into play in recent years. It is imperative to understand that the ability to test, measure, and monitor cognitive performance along with implementing cognitive remediation approaches viz; cognitive stimulation, cognitive training, etc. across the lifespan helps in early identification, accessing treatments faster, staying healthy for longer, and improving overall quality of life. This article discusses a case study of a client suffering from generalized anxiety disorder and moderate depression who after undergoing and following a novel therapeutic approach, ‘The Cognitome Program’ has shown credible improvement in cognitive abilities, along with a prominent reduction in the symptoms of anxiety, depression, and better psychological and physical well-being. Guided by the concept of neuroplasticity and cognitive plasticity, our innovative neuroscientific holistic program- ‘The Cognitome Program’ empowers unlocking hidden cognitive potential using cutting-edge methodologies and personalized strategies.
Mohammad Shamiea, Martin H Ellis, Michael Lishner and Osnat Jarchowsky Dolberg*
Published on: 25th June, 2024
Carfilzomib, a highly selective proteasome inhibitor, is commonly used in the treatment of multiple myeloma and AL amyloidosis. While its efficacy is well-established, there is increasing recognition of its association with cardiovascular adverse events, including hypertension, heart failure, and arrhythmias. However, cases of carfilzomib-induced pericardial disease remain rare. Here, we present a case of a 78-year-old female with multiple myeloma who experienced two episodes of hemorrhagic pericardial effusion following carfilzomib therapy, highlighting the importance of vigilant cardiovascular monitoring during treatment.
Noor Jawad Khadhum, Neepal Imtair Al-Garaawi* and Antethar Jabbar Al-Edani
Published on: 25th June, 2024
The current study included a variety of phytochemical substances that were extracted from Centaurium pulchellum and showed a wide range of medicinal properties from the plant's reproductive and vegetative parts against the pathogenic fungus Aspergillus flavus. The vegetative and reproductive components of Centaurium pulchellum were subjected to (GC-MS) analysis for phytochemical study. The data indicated that fungal activity was the highest. Four extract concentrations of 5, 10, 15, and 20 mg/ml were utilized in the investigation, and the diameter of the colonies measured at each concentration was 90.00, 36.00, 28.00, 18.00, and 0.00 mm, respectively.Nine bioactive phytochemical compounds were found in Centaurium pulchellum's vegetative and reproductive portions, according to GC-MS analysis of the chemicals. Another study reported phytochemical substances that: 1-H-Imidazole-2-carboxaldehyde, 1-methyl-;Acetaminophen; n-Hexadecanoic acid; Mercaptoacetic acid, 2TMS derivative; 1.2,3-Dimethyl-5-(trifluoromethyl)-1,4-benzenediol #; Mercaptoethanol, 2TMS derivative-; Bis-(3,5,5-trimethylhexyl) phthalate Tetrakis(trimethylsilyl) orthosilicate #;- 1.1-Isopropoxy-3,3,3-trimethyl-1-[(trimethylsilyl)oxy]disiloxanyl tris(trimethylsilyl) orthosilicate #.
The inflationary epoch, occurring shortly after the Big Bang, initiated an extraordinarily rapid exponential expansion of the universe. Following this period, the rate of cosmic expansion decelerated for approximately 9.8 billion years, until observations indicated a transition to an accelerated expansion of space-time. This paper aims to estimate the minimum possible deceleration of cosmic expansion during the post-inflationary epoch, addressing an unresolved aspect of cosmological studies. The observable universe is modeled as a spherical region defined by the particle horizon in the FLRW metric. The model operates on the principle that the speed of light cannot exceed the speed of space-time expansion, given that photons are bound by space-time constraints. This paper hypothesizes that at the end of the 9.8 billion years of deceleration, the expansion speed was at its lowest, nearly equating to the speed of light. Subsequently, this speed has increased, correlating with the current accelerated expansion. Through a graphical representation assuming a uniform rate of change in expansion speed (for minimum possible values), we apply concepts of onedimensional motion to derive our estimates. This novel approach provides a foundational calculation of the minimum deceleration, significantly contributing to the understanding of the dynamics of cosmic expansion and offering a basis for future research and observational refinement.
Svitlana Lapovska, Nicholas Chernenko and Mykola Konoplya
Published on: 26th June, 2024
Autoclaved aerated concrete is becoming an increasingly popular building material, and for good reason. It is ecological, energy efficient, strong, and durable. Studies show that the production of autoclaved aerated concrete saves 85% of energy compared to the production of heavy concrete. However, the use of steel reinforcement in large-sized aerated concrete products leads to deterioration of thermal insulation properties, corrosion, and destruction of the material. Replacing steel reinforcement with discrete fiber strands can solve this problem. The fiber does not affect the thermal insulation properties, is not prone to corrosion, and can be evenly distributed over the entire volume of the product.
The psychological burden of physicians has been the focus of many researchers since the 1950s, and some papers have found a high prevalence of anxiety and depressive disorders among medical staff. Recent studies have shown that the coronavirus pandemic didn’t go easy on healthcare workers. The fact that it has been three years since the outbreak, has motivated our study. Which aims to evaluate the intensity of anxiety among medical personnel and the risk factors that could be incriminated post-COVID pandemic and if the level of anxiety is back to normal. This is a cross-sectional study, carried out with a survey split into 2 parts sociodemographic and work-related data, and the French version of the Hamilton anxiety scale, Statistical analysis was performed using Jamovi et Microsoft Excel. About half of the 116 physicians in our study had no anxiety (55.2%), while 21.6% had mild anxiety, 10.3% had moderate anxiety, and 12.9% had severe anxiety. The identified risk factors for anxiety were female gender, personal and family history of anxiety disorder, doing night shifts, and being a general practitioner. The anxiety rate of physicians is back to normal post-COVID pandemic. But we shouldn’t stop there. The mental health status of medical personnel depends on several of the factors listed above. Determining them would imply a call for the implementation of preventive measures for anxiety and depressive disorders among physicians. Because taking care of physicians is taking care of patients.
Shams Akmal, Ibrahimi Ikramullah* and Agha Said Asif
Published on: 28th June, 2024
Urinary Tract Infection (UTI) is very common in our community most specifically in married females with numerous antecedent risk factors. The aim of the study was to find out about the current risk factors and clinical profile of urinary tract infections in patients admitted to the cardiology ward of Afghan Momand Medical Complex for various purposes.It was a cross-sectional descriptive hospital-based study including both male and female patients visiting the Afghan Momand Medical Complex from January 2022 to June 2022. Of all 960 patients, 202 (21%) patients had urinary tract infections with gender distribution as 69 (34.2%) males and 133 (65.8%) females. In fact, 33 (16.3%) patients with urinary tract infections were single while the rest 169 (83.7%) patients were married. In addition, regarding clinical profile, the following clinic was respectively more prevalent: Dysuria in 120 (59.4%) patients, flank pain in 73 (36.1%) patients, urine frequency in 67 (33.1%) patients, urgency in 36 (17.8%) patients, fever in 24 (11.8%) patients, and nausea and vomiting in 19 (9.4%) patients. Moreover, the following risk factors were respectively the most common ones: Diabetes mellitus 86 (42.5%), pregnancy 30 (14.9%), stones 15 (7.4%), 10 (4.9%) devices, 10 (4.9%) prostatic hyperplasia, and 4 (2%) anatomical anomalies.Urinary tract infection is a common disease in the admitted patients in Afghan Momand Medical Complex specifically being more common in females and early 20s of the age. In fact, diabetes, pregnancy, and kidney stones were the leading associated factors with UTI. Moreover, dysuria, bladder emptying irritative symptoms, and abdominal pain were the most prevalent clinical profile of the patients. Special attention should be paid to infectious diseases in cardiac patients since infection itself is a stress and a threat to such patients and authorities should design special measures to prevent UTI in the general population to avoid a sum of burden on the health system.
Alexandra Maloof*, David Torres Barba, Santiago Ramirez Nuño, Nainjot K Bains, Ignacio A Zepeda, Armando Gallegos, Hyeri You, Wesley Thompson, Jia Shen, Robert El-Kareh and Luis R Castellanos
Published on: 29th June, 2024
Introduction: Despite the benefits of Cardiac Rehabilitation (CR), local and national CR referral and participation rates remain low when compared to established cardiovascular therapies, especially amongst racial/ethnic groups. Objectives: This study investigated the effects of the implementation of a CR program and electronic order set (EOS) in a large health system on CR referral and participation rates among a diverse group of patients with Coronary Heart Disease (CHD). Methods: A total of 360 patients from UCSD Health who presented with ACS were prospectively evaluated during initial hospitalization and 6- and 12-weeks post-discharge. The multivariable logistic regression model assessed referral and participation rates by week 1 and -12 post-discharge, adjusting for gender, age, race, ethnicity, geography, and referring physician subspecialty. Results: UCSD CR program implementation led referral rates to increase at week 1 (Pre- 38.6% and Post-54.9%, p = 0.003) and week-12 (Pre- 54.1% and Post- 59.8%, p = 0.386). Post-CR referrals were more likely at week-1 (OR: 1.93, 95% CI 1.27-2.95) and week-12 (OR: 1.26, 95% CI 0.79-2.00). EOS implementation increased referral rates at week-1 (Pre- 40.3% and Post- 58.7%, p < 0.001) and week-12 (Pre- 54.9% and Post- 60.4%, p = 0.394) with referrals more likely at week-1 (OR: 2.1, 95% CI 1.35-3.29) and week-12 (OR: 1.25, 95% CI 0.795-1.98). Participation in CR following EOS was more likely at both week-1 and week-12. Multivariable analysis revealed disparities in referral based on race, geographic location, and referring physician subspecialty. Conclusion: A CR program and EOS implementation were shown to increase referral rates with long-term potential for increasing referral and participation rates. Condensed abstract: This prospective study investigated the implementation of a Cardiac Rehabilitation (CR) program and Electronic Order Set (EOS) within the same health system on CR referral and participation rates. 360 patients with ACS were evaluated over 12 weeks. UCSD CR program and EOS implementation led referral rates to increase at week-1 and -12. CR participation was more likely to increase at week-1 and -12 following EOS. Multivariable analysis revealed disparities in referrals disproportionally affecting racial and ethnic minority groups and rural communities. CR and EOS implementation may increase CR referral rates for diverse patients with CHD.
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