Medical Specialties Commons^™

Dermatologic Manifestations Of Rheumatic Disease: Malignant Cutaneous Tumors, Divya Shan, Julianna S. Kang, Allison Cinats, Julia R. Nunley, Beth Rubinstein

Open and Affordable Course Content at VCU

No abstract provided.

Patient-Specific Analysis Of Aortic Hemodynamics And Wall Shear Stresses In Patients Undergoing Pediatric Bariatric Surgery Using 2d Phase-Contrast Mri, Oluwaferanmi S. Akande, Joao Soares, Nathan Hargan, Dr. Uyen Truong, Haeung Kang, David Lanning

Undergraduate Research Posters

Patient-Specific Analysis of Aortic Hemodynamics and Wall Shear Stresses in Patients Undergoing Pediatric Bariatric Surgery using 2D Phase-Contrast MRI

Feranmi Akande¹ Nathan Hargan² Haesung Kang³ David Lanning³ Uyen Truong⁴ João S. Soares¹

¹ Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University

² Department of Mechanical & Nuclear Engineering, College of Engineering, Virginia Commonwealth University

³ Department of Cardiology, Children’s Hospital of Richmond, Virginia Commonwealth University

Introduction: Severe obesity among today’s youth is a rising epidemic within the United States. Emerging research has linked childhood obesity with shortened life expectancy and early …

The Role Of The Nlrp3 Inflammasome In Alzheimer's Disease, Ethan S. Terman

Undergraduate Research Posters

This study examines the consequences of Alzheimer’s in rat and mice test subjects. The goal is to identify the effects of certain NLRP3 inhibiting drugs and to see if there are any noticeable effects in regards to impeding the pathological development of Alzheimer’s disease. The results are visualized by implementing the immunohistochemical process to identify neurodegeneration in the brain and to assess the expression levels of amyloid beta as an indicator of Alzheimer’s pathology. Other tests are also conducted on these transgenic mice to gauge cognitive functioning levels during the onset of their disease, those being behavior tests, but not …

Testing The Efficacy And Synergistic Components Of Sesamol And Black Rice Extract On Human Colon Cancer Cells, Sera Lim, Philip M. Gerk

Undergraduate Research Posters

Purpose: Systemic treatment of colorectal cancer involves chemotherapeutic agents which elicit serious and negative side effects from the toxicity of the drug. To address this issue, we are testing dietary supplements for their efficacy against human colon cancer cell lines and also their potential synergistic effects when combined with conventional chemotherapy. Dietary supplements (specifically sesamol and black rice extract) exhibit anticancer, anti-inflammatory, and chemo-preventive properties. Meanwhile, one of the cancer resistance mechanisms is the upregulation of drug elimination mechanisms, leading to multi-drug resistance. We hypothesize that dietary compounds will act as chemo-enhancers, thus enhancing potency of the chemotherapy drug(s) on …

Investigation Of The Dyrk1a Regulation By Lzts2-Sipa1l1 Complex, Rebecca Gunnin, Austin Witt B.S., Larisa Litovchick M.D.,Ph.D.

Undergraduate Research Posters

A region on chromosome 21, the Down Syndrome critical region (DSCR), is associated with major defects found in Down Syndrome, such as craniofacial malformations. DYRK1A is a gene found on chromosome 21 within the DSCR that encodes an enzyme, dual specificity tyrosine-phosphorylation-regulated kinase 1A. DYRK1A is known to phosphorylate many substrate proteins and is thought to be involved in tumor suppression, neurological development, cell cycle regulation, and aging. Recently, the Litovchick lab and others reported that DYRK1A also plays a role in the double-strand break repair of DNA, which could lead to mutations and tumorigenesis, if deregulated.

The Litovchick lab …

Isoprenylation Inhibition Significantly Reduces Ige Mediated Mast Cell Function And Allergic Disease, Jordan Dailey

Theses and Dissertations

Allergic disease is the 6^th leading cause of chronic illness in the US and accounts for billions of dollars in healthcare annually. Mast cells are tissue resident innate immune cells linked to allergic disease and activated by IgE and other ligands. Upon activation, they release histamine, cytokines, chemokines, proteases, and lipid mediators evoking allergic symptoms. New ways of targeting mast cells could greatly benefit allergic disease therapy. Previous findings supported repurposing statin drugs, such as Fluvastatin, as a therapeutic treatment of allergic disease reduced allergic symptoms in vitro and in vivo. We found that Fluvastatin suppressed IgE-mediated mast cell …

Molecular Mechanisms Of Prdm16 As A Tumor Suppressor In Pancreatic Ductal Adenocarcinoma, Eric Hurwitz

Theses and Dissertations

The transcription factor Prdm16 functions as a potent suppressor of transforming growth factor-beta (TGF-b) signaling, whose inactivation is deemed essential to the progression of pancreatic ductal adenocarcinoma (PDAC). Using the Kras^G12D-based mouse model of human PDAC, we surprisingly found that ablating Prdm16 did not block but instead accelerated PDAC formation and progression, suggesting that Prdm16 might function as a tumor suppressor in this malignancy. Subsequent genetic experiments showed that ablating Prdm16 along with Smad4 resulted in a shift from a well-differentiated and confined neoplasm to a highly aggressive and metastatic disease, which was associated with a striking deviation …

Contribution Of Metabolic Cell Swelling On Microcirculatory Perfusion In Septic Shock, Charles E. Payne

Theses and Dissertations

Sepsis, a systemic immunological response that leads to organ-dysfunction, the development of septic shock, and death has mortality rate of 15-25%. A subset of sepsis, septic shock, has an in-hospital mortality rate of 30-50%. Sepsis and its treatment are the most expensive healthcare problem in the United States with the US Agency for Healthcare Research and Quality estimating annual costs over $20 billion. Hypoxia experienced in septic shock induces metabolic cell and tissue swelling leading to further microcirculatory dysfunction and poor tissue perfusion. Reversing metabolic cell swelling corrects these perfusion defects. Two models were used in rats to induce septic …

Characterization Of A Solid-State Detector For Dosimetry In The Diagnostic Energy Range With Verification Via Monte Carlo Estimation Of Average Breast Dose In Mammography, Areej Aljabal

Theses and Dissertations

This dissertation aims to develop a simplified QA metric for estimating radiation dose in mammography. This metric, the Mid-Breast Dose (MDB) Index, maybe be proposed as an alternative dose index, consistent with average glandular dose (AGD), for routine QA. MBD was obtained using “Phantom mid-point Air Kerma (AK) measurement” for conventional mammography. The advantage of this method is that MBD can be measured directly without requiring multiple conversion factors. The accuracy of clinical measurements in computing the MBD was assessed by comparing it with the AGD estimated by the Dance formalism experimentally and Monte Carlo simulation.

MBD methodology relies on …

Addressing Death Distress In Caregivers Of Patients With Malignant Glioma, Kelcie D. Willis

Theses and Dissertations

The field of psychosocial oncology seeks to improve the quality of life of patients and families affected by cancer. This task becomes increasingly important when there are limited, non-curative treatment options, a high probability of recurrence, and rapid functional decline, such as in the case of a malignant glioma (MG). Indeed, the diagnosis of a MG is associated with negative sequalae that often translates to higher caregiver burden. Caregivers—who must manage the functional decline of the patient, changes within the family, and a complicated medical system—often feel overwhelmed, isolated, and ill-equipped to handle these myriad responsibilities. While they also report …

Role Of Histone Deacetylase (Hdac) In Epithelial To Mesenchymal Transition (Emt) In A Human Cholangiocyte Model Of Ischemic Cholangiopathy, Priyanshi Pragnesh Parikh

Theses and Dissertations

Organ transplants are a vital intervention for many diseases that result in end stage organ failure. Currently, the donation pool is not meeting the demands of the transplant list. Expanding this pool to include donation after cardiac death (DCD) is highly sought-after. However, the use of DCD livers can lead to increased odds of graft failure and ischemic cholangiopathy. The loss of epithelialization and fibrosis that occurs during ischemic cholangiopathy is characteristic of these cells undergoing epithelial-to-mesenchymal transition (EMT). The biological changes the cell experiences enhance migratory capacity, invasiveness, and increased resistance to apoptosis. Our earlier studies have shown differential …

Characterization And Investigation Of Cold Atmospheric Plasma And Its Effects On Cancer Cell Biology, Thomas M. Ritrosky

Theses and Dissertations

Modern cancer treatment uses radiation therapy in over 50% of patient cases. It is an e↵ective way of treating tumors because the mechanisms of cell killing are well known through the damage that ionizing radiation does to DNA. The amount of radiation can be tracked through measuring the dose of the clinical photon or electron beam used. However, there are limitations in the usage of radiation therapy, for example, a tumor can create hypoxic areas that become radioresistant leading to complete ine↵ectiveness of further radiation treatment. This project looks into the application of cold atmospheric plasma as an adjuvant therapy …

Characterizing The Effects Of Antiandrogens And Senolytics To Enhance The Therapeutic Response To Castration-Resistant Prostate Cancer, Justin M. Silverman

Theses and Dissertations

Prostate cancer is the most frequently diagnosed cancer in males and the second most common cause of cancer deaths. Androgen deprivation therapy, whether through surgical or chemical castration, is the mainstay for treatment of advanced prostate cancer; however, despite an initial response, most patients eventually develop a progressive PSA rise, and castration- sensitive prostate cancer gives rise to castration-resistant prostate cancer. The standard of care therapy includes the antiandrogens such as enzalutamide and abiraterone acetate as well as the microtubule poison, docetaxel, and various immunotherapies; however, while prostate cancer research is progressing, there continues to be a compelling need for …

A Learning Health System For Radiation Oncology, Rishabh Kapoor

Theses and Dissertations

The proposed research aims to address the challenges faced by clinical data science researchers in radiation oncology accessing, integrating, and analyzing heterogeneous data from various sources. The research presents a scalable intelligent infrastructure, called the Health Information Gateway and Exchange (HINGE), which captures and structures data from multiple sources into a knowledge base with semantically interlinked entities. This infrastructure enables researchers to mine novel associations and gather relevant knowledge for personalized clinical outcomes.

The dissertation discusses the design framework and implementation of HINGE, which abstracts structured data from treatment planning systems, treatment management systems, and electronic health records. It utilizes …

Predictors Of Circuit Health In Neonatal Patients Receiving Extracorporeal Membrane Oxygenation (Ecmo), Rita Hazboun, Nada Darwish, Gianna Rotyliano Sykes, Nayef Chahin, Jie Xu, John Miller, Christos Calaritis, Leroy Thacker, Russell Moores, Karen Hendricks-Muñoz

Pediatrics Publications

To identify predictors of neonatal ECMO circuit health, a retrospective analysis of circuit functional pressure and flow parameters as well as infant clotting values were collected 48 h prior to and 24 h post circuit change. Circuit impairment was defined as need for partial or total circuit change. Statistical analysis used multivariate statistics and non-parametric Mann–Whitney U-test with possible non-normality of measurements. A total of 9764 ECMO circuit and clotting values in 21 circuits were analyzed. Circuit delta-P mean, and maximum values increased from 8.62 to 48.59 mmHg (p < 0.011) and 16.00 to 53.00 mmHg (p < 0.0128) respectively prior to need for circuit change. Maximum and mean Pump Flow Revolutions per minute (RPM) increased by 75% (p < 0.0043) and 81% (p < 0.0057), respectively. Mean plasma free hemoglobin (pfHb) increased from 26.45 to 76.00 mg/dl, (p < 0.0209). Sweep, venous pressure, and clotting parameters were unaffected. ECMO circuit delta-P, RPM, and pfHb were early predictors of circuit impairment.

Cost-Effectiveness Analysis Of Combined Cognitive And Vocational Rehabilitation In Patients With Mild-To-Moderate Tbi: Results From A Randomized Controlled Trial, Emilie Isager Howe, Nada Andelic, Silje C R Fure, Cecilie Røe, Helene L. Søberg, Torgeir Hellstrøm, Øystein Spjelkavik, Heidi Enehaug, Juan Lu, Helene Ugelstad, Marianne Løvstad, Eline Aas

Family Medicine and Population Health Publications

Background

Traumatic brain injury (TBI) represents a financial burden to the healthcare system, patients, their families and society. Rehabilitation interventions with the potential for reducing costs associated with TBI are demanded. This study evaluated the cost-effectiveness of a randomized, controlled, parallel group trial that compared the effectiveness of a combined cognitive and vocational intervention to treatment as usual (TAU) on vocational outcomes.

Methods

One-hundred sixteen participants with mild-to-moderate TBI were recruited from an outpatient clinic at Oslo University Hospital, Norway. They were randomized to a cognitive rehabilitation intervention (Compensatory Cognitive Training, CCT) and Supported Employment (SE) or TAU in a …

Cystic Fibrosis And Sleep Circadian Rhythms, Mariam Louis, Peter Staiano, Lavender Micalo, Nauman Chaudary

Internal Medicine Publications

Cystic fibrosis (CF) is due to a mutation in the cystic fibrosis transmembrane conductance regulator gene (CFTR), which leads to unusual water and chloride secretion across epithelial surfaces. The lungs are responsible for most morbidity, though other organs are frequently affected. Sleep abnormalities have long been recognized in CF. Abnormal ventilation and oxygenation, sinus disease, deconditioning due to muscle weakness and recurrent infections, and inflammation have been thought to play a role in sleep disorders in CF. However, there is evidence that CFTR gene dysregulation can affect circadian rhythms in CF. Early recognition and treatment of circadian rhythms may improve …

Effect Of Interleukin-1 Blockade With Anakinra On Leukocyte Count In Patients With St-Segment Elevation Acute Myocardial Infarction, Marco Giuseppe Del Buono, Juan I. Damonte, Cory R. Trankle, Dinesh Kadariya, Salvatore Carbone, Georgia Thomas, Jeremy Turlington, Roshanak Markley, Justin M. Canada, Giuseppe G. Biondi‐Zoccai, Michael C. Kontos, Benjamin W. Van Tassell, Antonio Abbate

Internal Medicine Publications

Leukocytosis is a common finding in patients with ST elevation myocardial infarction (STEMI) and portends a poor prognosis. Interleukin 1-β regulates leukopoiesis and pre-clinical studies suggest that anakinra (recombinant human interleukin-1 [IL-1] receptor antagonist) suppresses leukocytosis in myocardial infarction. However, the effect of IL-1 blockade with anakinra on leukocyte count in patients with STEMI is unknown. We reviewed the white blood cell (WBC) and differential count of 99 patients enrolled in a clinical trial of anakinra (n = 64) versus placebo (n = 35) for 14 days after STEMI. A complete blood cell count with differential count were obtained at …

Calpain-Mediated Protein Targets In Cardiac Mitochondria Following Ischemia–Reperfusion, Ling Li, Jeremy Thompson, Ying Hu, Edward J. Lesnefsky, Belinda Willard, Qun Chen

Internal Medicine Publications

Calpain 1 and 2 (CPN1/2) are calcium-dependent cysteine proteases that exist in cytosol and mitochondria. Pharmacologic inhibition of CPN1/2 decreases cardiac injury during ischemia (ISC)–reperfusion (REP) by improving mitochondrial function. However, the protein targets of CPN1/2 activation during ISC–REP are unclear. CPN1/2 include a large subunit and a small regulatory subunit 1 (CPNS1). Genetic deletion of CPNS1 eliminates the activities of both CPN1 and CPN2. Conditional cardiomyocyte specific CPNS1 deletion mice were used in the present study to clarify the role of CPN1/2 activation in mitochondrial damage during ISC–REP with an emphasis on identifying the potential protein targets of CPN1/2. …

Evidence-Based Cardiovascular Magnetic Resonance Cost-Effectiveness Calculator For The Detection Of Significant Coronary Artery Disease, Ankur Pandya, Yuan-Jui Yu, Yin Ge, Eike Nagel, Raymond Y. Kwong, Rafidah Abu Bakar, John D. Grizzard, Alexander E. Merkler, Ntobeko Ntusi, Steffen E. Peterson, Nina Rashedi, Juerg Schwitter, Joseph B. Selvanayagam, James A. White, James Carr, Subha V. Raman, Orlando P. Simonetti, Chiara Bucciarelli-Ducci, Lilia M. Sierra-Galan, Victor A. Ferrari, Mona Bhatia, Sebastian Kelle

Radiology Publications

Background
Although prior reports have evaluated the clinical and cost impacts of cardiovascular magnetic resonance (CMR) for low-to-intermediate-risk patients with suspected significant coronary artery disease (CAD), the cost-effectiveness of CMR compared to relevant comparators remains poorly understood. We aimed to summarize the cost-effectiveness literature on CMR for CAD and create a cost-effectiveness calculator, useable worldwide, to approximate the cost-per-quality-adjusted-life-year (QALY) of CMR and relevant comparators with context-specific patient-level and system-level inputs.

Methods
We searched the Tufts Cost-Effectiveness Analysis Registry and PubMed for cost-per-QALY or cost-per-life-year-saved studies of CMR to detect significant CAD. We also developed a linear regression meta-model (CMR …

Wses/Gais/Wsis/Sis-E/Aast Global Clinical Pathways For Patients With Skin And Soft Tissue Infections, Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Goran Augustin, Miklosh Bala, Oussama Baraket, Walter L. Biffl, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola De’Angelis, Samir Delibegovic, Therese M. Duane, Paola Fugazzola, Joseph M. Galante, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Kenji Inaba, Arda Isik, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppäniemi, Andrey Litvin, Davide Luppi, Ronald V. Maier, Athanasios Marinis, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Raşa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Vishal G. Shelat, Michael Sugrue, Antonio Tarasconi, Matti Tolonen, Bruno Viaggi, Andrea Celotti, Claudio Casella, Leonardo Pagani, Sameer Dhingra, Gian Luca Baiocchi, Fausto Catena

Surgery Publications

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections.

Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs.

An extensive non-systematic review was conducted using the PubMed and MEDLINE …

The Effects Of Celiac Disease On Oral Health In Children And Adults, Marissa Balducci, Katarina Jones

Dental Hygiene Student Scholarship

Objectives: Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. To ensure affected patients receive optimal dental care, it is necessary for dental professionals to recognize the oral manifestations of celiac disease in both children and adults. Upon associating oral conditions with celiac disease, the dental provider should be able to present recommendations to the patient, contributing to an improvement in their oral health.

Methods: This review of the literature used PubMed to identify relevant professional research articles with publication after 2017. MesH terms utilized in the search process were …

Hydroxyapatite Toothpaste On Caries Prevention In Children, Samantha Richardson, Kelly Vaughan

Dental Hygiene Student Scholarship

Are Hydroxyapatite Toothpastes The Answer To Fluoride Free Patients?

Richardson, Samantha 1 and Vaughan, Kelly 2

Dental Hygiene Program, Virginia Commonwealth University

Abstract:

Objectives/Aims: With the rising trend to become more clean with our ingredient lists, we are facing more patients refusing fluoride treatments and fluoridated toothpastes. This trend has been prevalent in our younger generations due to parents only wanting the purest natural ingredients for their children and now declining fluoride application. The goal of this literature is to find a safe alternative toothpaste that will be just as effective as fluoride.

Methods: This review of literature has been …

Optimization Of An Automated Algorithm For Analysis Of Spontaneous Rhythmic Bladder Contractions During Urodynamics Testing, Isabelle Pummill, Rui Li, Zachary Cullingsworth, Adam Klausner, John Speich

Summer REU Program

No abstract provided.

Nonpharmacological Practices For Reducing Agitation In Persons With Dementia, Meghan L. Farkas

Commonwealth Scholars Program

1 in 11 people aged 45 years and older experience subjective cognitive decline, with nearly a third identifying a decline in the ability to participate in social activities, work, or volunteering. There are twelve modifiable risk factors that can either increase or decrease an individual's possibility of developing Dementia. This can include excessive alcohol consumption, head injury, air pollution, lower education level, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and infrequent social contact. These modifiable risk factors may prevent or delay up to 40% of dementias. Furthermore, many risk factors cluster around inequalities, which occur particularly in Black, …

What Matters Most: Cna Perspectives On Workforce Education, Professional Identity And Age-Friendly Care, Shannon Arnette, Annie Rhodes, Kimberly Ivey, Christian Bergman, Leland "Bert" Waters

Case Studies from Age in Action

Learning Objectives

1. Identify the gaps in current Certified Nursing Assistant (CNA) training in relation to Delirium, Dementia(s), and Depression (3D’s).

2. Identify CNA learning preferences.

3. Review the constructed tele-education training sessions that incorporate age-friendly care and What Matters Most (WMM) to participants in regards to the 3D’s.

4. Increase the CNAs’ competency and level of comfort working with individuals living with the 3D’s.

Recognizing And Responding To Abuse In Later Life: Feedback From Virginia’S Frontline, Sarah A. Marrs, Courtney O'Hara

Case Studies from Age in Action

Learning Objectives

1. To describe a research project aimed at understanding the recognition of and response to abuse in later life in the greater Richmond area

2. To discuss the structural factors that contribute to underidentification and under-resourcing of services that address abuse in later life

3. To discuss the relationship between ageism and abuse in later life

Coping With Macular Degeneration: Three Case Studies, Ajit D. Tiwari

Case Studies from Age in Action

Educational Objectives

1. Learn about the diagnosis and available treatments for Age Related Macular Degeneration (AMD).

2. Explain the differences between Dry and Wet AMD.

3. Understand the impact of vision loss on the lives of older adults.

Adult-Onset Alexander Disease Uncovered In A Previously Healthy Patient Presenting With Acute Stroke-Like Symptoms, Usaamah M. Khan, Matthew Barrett, Alex Dworetz Do

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Alexander Disease is a rare, often fatal, leukoencephalopathy of early childhood associated with a heterozygous mutation of the glial fibrillary acid protein (GFAP) gene. Adult-Onset Alexander Disease (AOAD) is an exceptionally rare leukoencephalopathy that often presents with slowly progressive brainstem and cervical cord dysfunction features. Acute onset of AOAD has only ever been reported three times in the literature. We report a case of acute onset AOAD in a patient that presented with bulbar symptoms and left hemiplegia initially concerning for acute stroke.

Patient And Provider-Level Factors That Underlie Alcohol Use Disorder Treatment Offer And Acceptance In Veterans With Cirrhosis, Nikki Duong

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Background: Untreated alcohol use disorder (AUD) is associated with poor cirrhosis outcomes. We evaluated factors associated with AUD treatment discussions and initiation in the Veterans Health Administration.

Methods: Chart reviews were conducted for veterans with International Classification of Diseases codes for both cirrhosis and AUD who were receiving care at one of three large medical centers in 2020. Factors associated with a 1-year offer of AUD treatment and its acceptance were assessed using regression models, which included as covariates demographic characteristics, comorbidities, and depression, as measured by the patient health questionnaire (PHQ-2) from the electronic health record.

Results: The cohort …