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Mathews, A.

Publications and source records attributed to Mathews, A..

2 recordsLinked to original sources

Reduced fibrous capsule elastic fibers of biologic ECM-enveloped CIEDs in minipigs fitted with a compression mechanics model

BACKGROUNDFibrous capsules (Fb) in response to cardiovascular implantable electronic devices (CIEDs), including a pacemaker (P) system, can produce patient discomfort and difficulties in revision surgery due partially to their increased compressive strength, previously linked to elevated tissue fibers. OBJECTIVETo quantify structural proteins, determine if biologic extracellular matrix-enveloped CIEDs (PECM) caused differential Fb properties, and to implement a realistic mechanical model. METHODSRetrieved Fb (-P and -PECM) from minipigs were subjected to biomechanical (shear oscillation and uniaxial compression) and histological (collagen I and elastin) analyses. RESULTSFb-PECM showed significant decreases compared to Fb-P in: low strain-loss modulus (390 vs. 541 Pa) across angular frequencies, high strain-compressive elastic modulus (1043 vs. 2042 kPa), and elastic fiber content (1.92 vs. 3.15 g/mg tissue). Decreases in elastin were particularly noted closer to the implants surface (Fb-PECM = 71% vs. Fb-P = 143% relative to dermal elastin at mid-tangential sections) and verified with a solid mechanics hyperelasticity with direction-dependent fiber viscoelasticity compression simulation (r2 [≥] 98.9%). CONCLUSIONSThe biologic envelope composed of decellularized porcine small intestine submucosa ECM for CIEDs promoted fibrous tissues with less elastic fibers. Novel compression modeling analyses directly correlated this singular reduction to more desirable subcutaneous tissue mechanics.

bioengineering↗

Aspirin Compliance for Cardiovascular Disease and Colorectal Cancer Prevention in the Uninsured Population

Aspirin is an effective anti-inflammatory and antiplatelet agent as an irreversible inhibitor of cyclooxygenase. In 2016, the U.S. Preventive Services Task Force recommended aspirin for primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in patients aged 50 to 69 with a 10% or greater 10-year CVD risk. Due to the lack of literature describing compliance with these recommendations in the uninsured patient population, we studied the aspirin adherence for CVD and CRC prevention in several free medical clinics. We investigated the records of 8857 uninsured patients who visited nine free medical clinics in the Tampa Bay Area in 2016-2017. Aspirin compliance was assessed for patients with prior myocardial infarction (MI) or coronary artery disease (CAD). 54% (n=1467) of patients met the criteria to take aspirin for primary prevention of CVD and CRC, but just 17% of these patients aged 50-59 were on the medication. 16% percent of patients aged 60-69 were taking aspirin and significantly more men than women were on aspirin (p=0.025). Of the 306 patients who had prior MI or CAD, 50% were on the medication for secondary prevention. Among the uninsured population, there is low compliance with recommendations for aspirin usage to reduce the risk of CVD and CRC. This study demonstrates that further improvements are needed to increase adherence to current guidelines and address barriers uninsured patients may face in maintaining their cardiovascular and colorectal health.

epidemiology↗