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  1. Stiffness and Anisotropy Effect on Shear Wave Elastography: A Phantom and in Vivo Renal Study
    Leong SS, Wong JHD, Md Shah MN, Vijayananthan A, Jalalonmuhali M, Mohd Sharif NH, et al.
    Ultrasound Med Biol, 2020 01;46(1):34-45.
    PMID: 31594681 DOI: 10.1016/j.ultrasmedbio.2019.08.011
    Tissue elasticity is related to the pathologic state of kidneys and can be measured using shear wave elastography (SWE). However, SWE quantification has not been rigorously validated. The aim of this study was to evaluate the accuracy of SWE-measured stiffness and the effect of tissue anisotropy on SWE measurements. Point SWE (pSWE), 2-D SWE and dynamic mechanical analysis (DMA) were used to measure stiffness and evaluate the effect of tissue anisotropy on the measurements. SWE and DMA were performed on phantoms of different gelatin concentrations. In the tissue anisotropy study, SWE and DMA were performed on the outer cortex of sheep kidneys. In the in vivo study, 15 patients with different levels of interstitial fibrosis were recruited for pSWE measurements. Another 10 healthy volunteers were recruited for tissue anisotropy studies. SWE imaging revealed a non-linear increase with gelatin concentration. There was a significant correlation between pSWE and 2-D SWE, leading to the establishment of a linear regression equation between the two SWE ultrasound measurements. In the anisotropy study, the median difference in stiffness between shear waves oriented at 0° and 90° towards the pyramid axis was significant. In the in vivo study, there was a strong positive linear correlation between pSWE and the percentage of interstitial fibrosis. There was a significant difference in the Young's modulus (YM) between severities of fibrosis. The mean YM values were lower in control patients than in patients with mild, moderate and severe fibrosis. YM values were also significantly higher when shear waves were oriented at 0° toward the pyramid axis. Tissue stiffness and anisotropy affects SWE measurements. These factors should be recognized before applying SWE for the interpretation of measured values.
  2. The Impact of Educational Intervention on Attitude Toward Organ Donation Among Health Care Workers in Malaysia
    Wan Muhd Shukeri WF, Mazlan MZ, Kamaruzaman L, Budiman M, Mohamad Yusof A, Ramly NF, et al.
    Transplant Proc, 2022 Jan 28.
    PMID: 35094885 DOI: 10.1016/j.transproceed.2021.12.035
    BACKGROUND: The attitudes of the health care workers (HCWs) are essential in influencing organ donation rate. The aim of this study was to assess the effects of an educational intervention on attitudes toward organ donation among HCWs.

    METHODS: A questionnaire-based interventional study was conducted with 458 HCW from 5 hospitals in Malaysia. A 26-item self-administered questionnaire was distributed online as a preintervention test. Respondents then went through website-based educational materials followed by a post-intervention questionnaire.

    RESULTS: A total of 345 (75.3%) respondents completed the tests. Their attitude toward organ donation was positive preintervention. After the intervention, respondents expressed an increase willingness to donate their own organs (P = .008) and their relatives' organs (P < .001) after death; were more willing to adopt organ donation as part of end-of-life care (P =.002); were more comfortable talking to relatives about organ donation (P =.001); and expressed an increase consideration to execute the action at any time (P =.001). There was increased willingness to admit to the intensive care unit for facilitating organ donation (P =.007); to employ the same resources to maintain a potential brain-dead donor (P < .001); and to support organ donation in case they or their relatives were diagnosed with end-stage organ failure (P =.008). However, there was an increase in negative attitudes regarding the association between organ donation with health care failure (P =.004) and with pain (P =.003). Positive attitude scores were higher after the intervention (P < .001).

    CONCLUSION: An educational website-based intervention was able to improve the attitudes of HCWs toward organ donation.

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