International Collaborations; USA: SEER, St.Jude Children’s Research Hospital, Harvard University, Germany: Ulm University, Robert Koch Institute, DKFZ,
Egypt: Cairo University, Ain Shams University, (and others), Tanzania: Ocean Road Cancer Insititute, Dar es Salaam
Teaching Experience: Didactic Programs: eLearning content development (Prof. M Fouad Ahmed 2006, IBM 2007, GIZ 2009, Cardiff U 2010). Developed Courses and content: VR Museums 2002-2008, University eLearning Portal 2003-2008, CCHE research eLearning portal 2009-2014, Blended Learning courses for researchers, pharmacists and nurses 2009-2014. Face-to-face courses: R for clinical researchers, clinical research methods, Scientific writing, Referencing, Image editing in photoshop.
Statement and Contribution
My longterm goals included the integration of computational methods in the study of human diseases and building new insights into their understanding and management. Moreover, I believed that investigating the best methods of teaching research methods and public education is the way to widen the base which applies such methods reaching an ultimate goal of improve community health.
My first objective as a medical student was to have a website for my school of medicine that reflect the true leadership of the university among the world and middle-eastern medical schools and provide learning resources and support for its students. Therefor, I proposed a long-term plan for it to the dean. Supported by the director of Medical Education Development Center, Prof. Nadia Badrawi, The website was up and running within a month. It provided me the encouragement to investigate the best methods for interactive and social learning. I have created a team of my colleagues who started a long path of self-learning to specialize in different media and eLearning production lines. We have produced different learning modules that gained national awards. The School of Medicine eLearning portal was awarded a special mention in the National eContent Award 2007. Our Virtual Reality experience was written in preprint and presented in OnlineEduca Berlin 2012. Over these years I have developed my information technology and project management skills.
- Alfaar AS, Alasmar M, Abdelhameed M, et al (2018) Virtual Reality in Medical Education: Students-Led Efforts in Egypt. (Preprint)
Research and Education
Following medical school, I decided to specialize in ophthalmology as a field with a huge potential to apply biometric methods and start my Informatics classic learning track. So, I registered for MSc Ophthalmology, Cairo University, and Diploma in Medical and Biomedical Informatics, Helwan University, at the same time. I finished the first year of the ophthalmology residency to start another project in September 2008 co-initiating, with 6 awesome team members, the research department at Children Cancer Hospital Egypt 57357 which was opened in July 2007. I carried the responsibilities of setting up the infrastructure for ocular and renal tumors research, and the research education and informatics bases for the department. Starting by examining the research training needs in my department and for undergraduates and fresh postgraduate students, my experiences in these fields started to evolve. I have published the following papers in this context:
- Amgad M, AlFaar AS (2014) Integrating Web 2.0 in Clinical Research Education in a Developing Country. J Cancer Educ 29:536–540. https://doi.org/10.1007/s13187-013-0595-5
- Alfaar AS, Hassan WM, Bakry MS, Ezzat S (2017) Clinical Research Recession: Training Needs Perception Among Medical Students. J Cancer Educ 32:728–733. https://doi.org/10.1007/s13187-016-0995-4
- Hassan WM, Mehanna M, Nour R, et al (2015) Association between quality of clinical trials and human development index in heart failure using JADAD scale. Princ Pract Clin Res 1:40–46 Link
- AlFaar AS, Kamal S, AbouElnaga S, et al (2012) International Telepharmacy Education: Another Venue to Improve Cancer Care in the Developing World. Telemed e-Health 18:470–474. https://doi.org/10.1089/tmj.2011.0182
- Alfaar A, Nour R (2014) What a reference manager can add for a physician in web 2.0 era. Egypt J Cardiothorac Anesth 8:55. https://doi.org/10.4103/1687-9090.143253
Research and Informatics
During that time I was developing a system for facilitating the follow-up of cancer patients on clinical /research protocols as part of my Informatics diploma so I reached a blueprint with my colleagues, Mohamed Sabry and Mohamed Kamal, and implemented it. The organization of the clinical data and integrating it with radiologic and pathologic elements resulted in accelerating the research in the hospital. It allowed the hospital to be the core of the national childhood cancer registry. My colleague, Mohamed Sabry, became responsible for this project and I moved to think about facilitating the integration between the system modules and initiating system for managing the evolving biorepository.
- Labib RM, Mostafa MM, Alfaar AS, et al (2016) Biorepository for Pediatric Cancer with Minimal Resources: Meeting the Challenges. Biopreserv Biobank 14:9–16. https://doi.org/10.1089/bio.2015.0004
- Alfaar AS, Nour R, Bakry MS, et al (2017) A change roadmap towards research paradigm in low-resource countries: retinoblastoma model in Egypt. Int Ophthalmol 37:111–118. https://doi.org/10.1007/s10792-016-0233-4
Inspired by our teams’ discussions, I have started analyzing the data we either created or developed agreements to analyze with help of the medical students and graduates we taught. After 6 years of the start of the research education program, students formed many groups in the medical schools developing their own research projects. Dr. Sameera Ezzat,,the professor of Public Health and the director of research departmet, involvement has helped me to shape my first thinking about the epidemiology of cancer. My interests in ocular diseases and visual pathway were evident in many of my publications. I was trying to shed light upon regions of knowledge that were minimally investigated before.
I have had a special interest in retinoblastoma as an ocular tumor and genetic disease and it was my gateway to think about other genetic diseases. Beside being my main theme for many publications that resulted from real-life questions, retinoblastoma was my topic of choice for the MSc Ophthalmology thesis.
- Elzomor H, Taha H, Nour R, et al (2017) A multidisciplinary approach to improving the care and outcomes of patients with retinoblastoma at a pediatric cancer hospital in Egypt. Ophthalmic Genet 38:345–351. https://doi.org/10.1080/13816810.2016.1227995
- ElZomor H, Taha H, Aleieldin A, et al (2015) High Risk Retinoblastoma: Prevalence and Success of Treatment in Developing Countries. Ophthalmic Genet 36:287–289. https://doi.org/10.3109/13816810.2015.1016241
- Taha H, Amer HZ, El-Zomor H, et al (2015) Phthisis Bulbi: Clinical and Pathologic Findings in Retinoblastoma. Fetal Pediatr Pathol 34:176–184. https://doi.org/10.3109/15513815.2015.1014951
- Zomor H El, Nour R, Alieldin A, et al (2015) Clinical presentation of intraocular retinoblastoma; 5-year hospital-based registry in Egypt. J Egypt Natl Canc Inst 27:195–203. https://doi.org/10.1016/j.jnci.2015.09.002
- Alfaar AS, Chantada G, Qaddoumi I (2018) Survivin is high in retinoblastoma, but what lies beneath? J Am Assoc Pediatr Ophthalmol Strabismus 22:482. https://doi.org/10.1016/j.jaapos.2017.02.021
Many general questions evolved during our discussions that needed the mining of quality population-based cancer registries, So I developed many collaborations to answer these questions. My first publication in the year 2019 included collaboration between Ainshams University, Egypt, Harvard Universit and Cleaveland Clinic, USA, to answer important questions about the risk of suicide after the diagnosis of cancer. This paper was given a press release and was highlighted in many news gates like Reuters, US News, Aerzteblatt, MedScape, and others.
- Hassan WM, Alfaar AS, Bakry MS, Ezzat S (2014) Orbital tumors in USA: Difference in survival patterns. Cancer Epidemiol 38:515–522. https://doi.org/10.1016/j.canep.2014.07.001
- Hassan WM, Bakry MS, Hassan HM, Alfaar AS (2016) Incidence of orbital, conjunctival and lacrimal gland malignant tumors in USA from Surveillance, Epidemiology and End Results, 1973-2009. Int J Ophthalmol 9:1808–1813. https://doi.org/10.18240/ijo.2016.12.18
- Alfaar AS, Zamzam M, Abdalla B, et al (2015) Childhood Ewing Sarcoma of the Orbit. J Pediatr Hematol Oncol 37:433–7. https://doi.org/10.1097/MPH.0000000000000346
- Alfaar AS, Zamzam M, Abdalla B, et al (2016) Childhood Ewing Sarcoma of Orbit: Is it So Fatal? J Pediatr Hematol Oncol 38:493. https://doi.org/10.1097/MPH.0000000000000600
- Saad AM, Gad MM, Al-Husseini MJ, et al (2019) Suicidal death within a year of a cancer diagnosis: A population-based study. Cancer. https://doi.org/10.1002/cncr.31876
- Alfaar AS, Hassan WM, Bakry MS, Qaddoumi I (2017) Neonates with cancer and causes of death; lessons from 615 cases in the SEER databases. Cancer Med 6:1817–1826. https://doi.org/10.1002/cam4.1122
- Al-Husseini MJ, Saad AM, El-Shewy KM, et al (2018) Prior malignancy impact on survival outcomes of glioblastoma multiforme; population-based study. Int J Neurosci 0:1–8. https://doi.org/10.1080/00207454.2018.1538989
- Chamdine O, Elhawary GAS, Alfaar AS, Qaddoumi I (2018) The incidence of brainstem primitive neuroectodermal tumors of childhood based on SEER data. Child’s Nerv Syst 34:431–439. https://doi.org/10.1007/s00381-017-3687-4
- Rashed WM, Saad AM, Al-Husseini MJ, et al (2018) Incidence of adrenal gland tumor as a second primary malignancy: SEER-based study. Endocr Connect 7:1040–1048. https://doi.org/10.1530/EC-18-0304
- Rashed WM, Zekri W, Awad M, et al (2017) Nonfunctioning Adrenocortical Carcinoma in Pediatric Acute Lymphoblastic Leukemia. J Pediatr Hematol Oncol 39:150–152. https://doi.org/10.1097/MPH.0000000000000699
Other Childhood Cancers
- Zekri W, Yehia D, Elshafie MM, et al (2015) Bilateral clear cell sarcoma of the kidney. J Egypt Natl Canc Inst 27:97–100. https://doi.org/10.1016/j.jnci.2015.03.002
- Zekri W, Alfaar AS, Yehia D, et al (2014) Clear cell sarcoma of the kidney: Patients’ characteristics and improved outcome in developing countries. Pediatr Blood Cancer 61:2185–2190. https://doi.org/10.1002/pbc.25192
- Adly MH, Sobhy M, Rezk MA, et al (2018) Risk of second malignancies among survivors of pediatric thyroid cancer. Int J Clin Oncol 23:625–633. https://doi.org/10.1007/s10147-018-1256-9
- Meselhy GT, Sallam KR, Elshafiey MM, et al (2012) Sonographic guidance for tunneled central venous catheters insertion in pediatric oncologic patients: guided punctures and guide wire localization. Chinese-German J Clin Oncol 11:484–490. https://doi.org/10.1007/s10330-012-1011-z
After pursuing the previous experiences, I believed that understanding the driving factors of diseases goes beyond the clinical and environmental factors and has to be supported by a deepened understanding of underlying cellular structure and functional changes. I started a new track by studying the master of advanced oncology at Ulm University in Germany and combined this with strengthening my computational skills. This was coined in a thesis titled “Ordinal Classification of Pediatric Tumors Samples” that investigated an aspect of the underlying processes in Retinoblastoma and Neuroblastoma using Perceptron ranking algorithm which was not used before in this field. This inspired me to go deeper in cells and plan to have my own data and get a wider perspective of the field. This is why I started my second doctorate degree (MD/PhD Neuroscience) under the supervision of Professor Dr. Olaf Strauss investigating the effect of immunomodulators in two eye diseases; Age-related Macular Degeneration and Best Disease.
- Reichhart N, Schöberl S, Keckeis S, et al (2019) Anoctamin-4 is a bona fide Ca2+-dependent non-selective cation channel. Sci Rep 9:2257. https://doi.org/10.1038/s41598-018-37287-y
- Shohdy KS, Alfaar AS (2013) Nanoparticles targeting mechanisms in cancer therapy: current limitations and emerging solutions. Ther Deliv 4:1197–1209. https://doi.org/10.4155/tde.13.75
Ongoing and Future Projects
- Time series analysis in oncology and correlation with environmental time series.
- Secondary ocular and orbital tumors in USA.
- Comparing ocular and orbital cancers between USA and Germany
- Genetic and Environmental drivers of ocular and childhood cancers.
- Effect of Head and Neck cancers on neurologic diseases.