1.Pushing the Boundaries for Evidenced-Based Practice: Can Online Training Enhance Andrology Research Capacity Worldwide? An Exploration of the Barriers and Enablers - The Global Andrology Forum
Walid El ANSARI ; Mohamed ARAFA ; Rupin SHAH ; Ahmed HARRAZ ; Ahmed SHOKEIR ; Wael ZOHDY ; Missy SAVIRA ; Ashok AGARWAL ;
The World Journal of Men's Health 2024;42(2):394-407
Purpose:
This is the first study to design and assess a research capacity building (RCB) specifically tailored for clinical and non-clinical andrology practitioners worldwide. We appraised: 1) the barriers and enablers to research among these practitioners; 2) attendees’ satisfaction with the webinar; and 3) research knowledge acquisition as a result of the webinar (before/after quiz).
Materials and Methods:
A online RCB webinar was designed, comprising two presentations in research design and systematic review/meta-analysis (SR/MA). An online survey using validated published questionnaires assessed the three above-stated objectives. Paired t-test compared the means of the pre- and post-webinar scores. Subgroup analysis was performed on the participants’ professional background, sex, and number of years in practice.
Results:
A total of 237 participants attended the webinar, of which 184 completed the survey and are included in the current analysis. Male participants were about double the females and 60.9% were from Asian countries. The most common research enablers were to publish scientific papers (14.8%) and to develop research (14.7%) or new skills (12.7%). The most common barriers were the lack of training in research (12.4%), training in research software (11.8%), and time for research (11.8%). Satisfaction with the webinar was considerably high (86.3%–88.4%) for the different features of the webinar. Compared to the pre-webinar knowledge level, there were significant improvements in participants’ research knowledge acquisition after the webinar in terms of the total score for the quiz (13.7±4.31 vs. 21.5±4.7), as well as the scores for the study design (7.12±2.37 vs. 11.5±2.69) and SR/MA sessions (6.63±2.63 vs. 9.93±2.49) (p<0.001 for each).
Conclusions
Clinical and non-clinical andrology webinar attendees recognized the importance of research and exhibited a range of research skills, knowledge and experience. There were significant improvements in the participants’ knowledge and understanding of the components of scientific research. We propose an RCB model that can be implemented and further modeled by organizations with similar academic research goals.
2.Histological and Physiological Studies of the Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Bleomycin Induced Lung Fibrosis in Adult Albino Rats
Dina Mohamed ZAKARIA ; Noha Mahmoud ZAHRAN ; Samia Abdel Aziz ARAFA ; Radwa Ali MEHANNA ; Rehab Ahmed ABDEL-MONEIM
Tissue Engineering and Regenerative Medicine 2021;18(1):127-141
BACKGROUND:
Lung fibrosis is considered as an end stage for many lung diseases including lung inflammatory disease, autoimmune diseases and malignancy. There are limited therapeutic options with bad prognostic outcome. The aim of this study was to explore the effect of mesenchymal stem cells (MSCs) derived from bone marrow on Bleomycin (BLM) induced lung fibrosis in albino rats.
METHODS:
30 adult female albino rats were distributed randomly into 4 groups; negative control group, Bleomycin induced lung fibrosis group, lung fibrosis treated with bone marrow-MSCs (BM-MSCs) and lung fibrosis treated with cell free media. Lung fibrosis was induced with a single dose of intratracheal instillation of BLM. BM-MSCs or cell free media were injected intravenously 28 days after induction and rats were sacrificed after another 28 days for assessment. Minute respiratory volume (MRV), forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) were recorded using spirometer (Power lab data acquisition system). Histological assessment was performed by light microscopic examination of H&E, and Masson’s trichrome stained sections and was further supported by morphometric studies. In addition, electron microscopic examination to assess ultra-structural changes was done. Confocal Laser microscopy and PCR were used as tools to ensure MSCs homing in the lung.
RESULTS:
Induction of lung fibrosis was confirmed by histological examination, which revealed disorganized lung architecture, thickened inter-alveolar septa due excessive collagen deposition together with inflammatory cellular infiltration. Moreover, pneumocytes depicted variable degenerative changes. Reduction in MRV, FVC and FEV1 were recorded. BM-MSCs treatment showed marked structural improvement with minimal cellular infiltration and collagen deposition and hence restored lung architecture, together with lung functions.
CONCLUSION
MSCs are promising potential therapy for lung fibrosis that could restore the normal structure and function of BLM induced lung fibrosis.
3.Histological and Physiological Studies of the Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Bleomycin Induced Lung Fibrosis in Adult Albino Rats
Dina Mohamed ZAKARIA ; Noha Mahmoud ZAHRAN ; Samia Abdel Aziz ARAFA ; Radwa Ali MEHANNA ; Rehab Ahmed ABDEL-MONEIM
Tissue Engineering and Regenerative Medicine 2021;18(1):127-141
BACKGROUND:
Lung fibrosis is considered as an end stage for many lung diseases including lung inflammatory disease, autoimmune diseases and malignancy. There are limited therapeutic options with bad prognostic outcome. The aim of this study was to explore the effect of mesenchymal stem cells (MSCs) derived from bone marrow on Bleomycin (BLM) induced lung fibrosis in albino rats.
METHODS:
30 adult female albino rats were distributed randomly into 4 groups; negative control group, Bleomycin induced lung fibrosis group, lung fibrosis treated with bone marrow-MSCs (BM-MSCs) and lung fibrosis treated with cell free media. Lung fibrosis was induced with a single dose of intratracheal instillation of BLM. BM-MSCs or cell free media were injected intravenously 28 days after induction and rats were sacrificed after another 28 days for assessment. Minute respiratory volume (MRV), forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) were recorded using spirometer (Power lab data acquisition system). Histological assessment was performed by light microscopic examination of H&E, and Masson’s trichrome stained sections and was further supported by morphometric studies. In addition, electron microscopic examination to assess ultra-structural changes was done. Confocal Laser microscopy and PCR were used as tools to ensure MSCs homing in the lung.
RESULTS:
Induction of lung fibrosis was confirmed by histological examination, which revealed disorganized lung architecture, thickened inter-alveolar septa due excessive collagen deposition together with inflammatory cellular infiltration. Moreover, pneumocytes depicted variable degenerative changes. Reduction in MRV, FVC and FEV1 were recorded. BM-MSCs treatment showed marked structural improvement with minimal cellular infiltration and collagen deposition and hence restored lung architecture, together with lung functions.
CONCLUSION
MSCs are promising potential therapy for lung fibrosis that could restore the normal structure and function of BLM induced lung fibrosis.
5.Modifiable Risk Factors for Cardiovascular Disease in Korea and Japan
Ahmed ARAFA ; Hyeok-Hee LEE ; Ehab S. ESHAK ; Kokoro SHIRAI ; Keyang LIU ; Jiaqi LI ; Naharin Sultana ANNI ; Sun Young SHIM ; Hyeon Chang KIM ; Hiroyasu ISO
Korean Circulation Journal 2021;51(8):643-655
Cardiovascular disease (CVD) is the leading cause of death and a major contributor to disability worldwide. Since the majority of cardiovascular events are preventable, identification of modifiable CVD risk factors and implementation of primordial prevention strategies should be a public health priority. In this aspect, the American Heart Association declared a strategic goal to reduce total CVD mortality in the US by 20% within 10 years via eliminating 7 major CVD risk factors (hypertension, diabetes, dyslipidemia, cigarette smoking, physical inactivity, obesity, and poor-quality diet) in 2010, and their strategy has been achieving. However, the applicability of similar metrics to prevent CVD among East Asians requires an in-depth investigation of the modifiable CVD risk factors based on national and regional evidence-based findings. Herein, this review article aims to discuss several modifiable risk factors for CVDs, using epidemiological evidence from cohort studies and nationally representative data of 2 East Asian countries: Korea and Japan.
6.Modifiable Risk Factors for Cardiovascular Disease in Korea and Japan
Ahmed ARAFA ; Hyeok-Hee LEE ; Ehab S. ESHAK ; Kokoro SHIRAI ; Keyang LIU ; Jiaqi LI ; Naharin Sultana ANNI ; Sun Young SHIM ; Hyeon Chang KIM ; Hiroyasu ISO
Korean Circulation Journal 2021;51(8):643-655
Cardiovascular disease (CVD) is the leading cause of death and a major contributor to disability worldwide. Since the majority of cardiovascular events are preventable, identification of modifiable CVD risk factors and implementation of primordial prevention strategies should be a public health priority. In this aspect, the American Heart Association declared a strategic goal to reduce total CVD mortality in the US by 20% within 10 years via eliminating 7 major CVD risk factors (hypertension, diabetes, dyslipidemia, cigarette smoking, physical inactivity, obesity, and poor-quality diet) in 2010, and their strategy has been achieving. However, the applicability of similar metrics to prevent CVD among East Asians requires an in-depth investigation of the modifiable CVD risk factors based on national and regional evidence-based findings. Herein, this review article aims to discuss several modifiable risk factors for CVDs, using epidemiological evidence from cohort studies and nationally representative data of 2 East Asian countries: Korea and Japan.
7.The Lifelong Health Support 10: a Japanese prescription for a long and healthy life.
Ahmed ARAFA ; Yoshihiro KOKUBO ; Rena KASHIMA ; Masayuki TERAMOTO ; Yukie SAKAI ; Saya NOSAKA ; Youko M NAKAO ; Emi WATANABE
Environmental Health and Preventive Medicine 2022;27(0):23-23
BACKGROUND:
Although the age-adjusted incidence and mortality of cancer and cardiovascular disease (CVD) have been decreasing steadily in Japan, both diseases remain major contributors to morbidity and mortality along with the aging society. Herein, we aim to provide a prescription of 10 health tips for long and healthy life named the "Lifelong Health Support 10 (LHS10)."
METHOD:
The LHS10 was developed by the preventive medicine specialists at the National Cerebral and Cardiovascular Center in Suita, where it has been used for health guidance to prevent CVD, cancer, and cognitive decline in addition to their major risk factors such as hypertension, diabetes, and obesity. It consisted of the lifestyle modification recommendations of the 2014 Japanese Society of Hypertension guidelines and the 2017 Japan Atherosclerosis Society Guidelines for preventing atherosclerotic CVD. Further, it came in line with other international lifestyle modification guidelines. In this narrative review, we summarized the results of several Japanese epidemiological studies investigating the association between the LHS10 items and the risk of cancer, CVD, and other chronic diseases including dementia, diabetes, and chronic kidney disease.
RESULTS:
The LHS10 included avoiding smoking and secondhand smoke exposure, engaging in physical activity, refraining from excessive alcohol drinking, reducing fried foods and sugary soft drinks, cutting salt in food, consuming more vegetables, fruits, fish, soy foods, and fibers, and maintaining proper body weight. All items of the LHS10 were shown to reduce the risk of cancer, CVD, and other chronic diseases.
CONCLUSIONS
The LHS10 can be a helpful tool for health guidance.
Cardiovascular Diseases/prevention & control*
;
Humans
;
Hypertension/prevention & control*
;
Japan/epidemiology*
;
Life Style
;
Neoplasms
;
Prescriptions
;
Risk Factors
8.Impact of Varicocele on Testicular Oxidative Stress and Sperm Parameters in Experimental Animals: A Systematic Review and Meta-Analysis
Giorgio Ivan RUSSO ; Ramadan SALEH ; Federica FINOCCHI ; Almas Ramadhani JUMA ; Damayanthi DURAIRAJANAYAGAM ; Oguzhan KAHRAMAN ; Emrullah SÖĞÜTDELEN ; Ioannis SOKOLAKIS ; Ranjit B. VISHWAKARMA ; Fahmi BAHAR ; Ahmed M. HARRAZ ; Parviz KAVOUSSI ; Widi ATMOKO ; Eric CHUNG ; Naveen KUMAR ; Wael ZOHDY ; Amarnath RAMBHATLA ; Mohamed ARAFA ; Nguyen Ho Vinh PHUOC ; Gianmaria SALVIO ; Aldo E. CALOGERO ; Tuncay TOPRAK ; Germar-Michael PINGGERA ; Rossella CANNARELLA ; Giovanni COLPI ; Taha Abo-Almagd Abdel-Meguid HAMODA ; Rupin SHAH ; Ashok AGARWAL
The World Journal of Men's Health 2024;42(3):563-573
Purpose:
Varicocele has been associated with high seminal oxidative stress (OS), impaired semen quality, and reduced male fertility potential. However, the exact mechanism(s) underlying the development of varicocele-mediated infertility and the cause-effect relationship between varicocele and testicular dysfunction are not fully understood. The aim of this systematic review and meta-analysis (SRMA) is to investigate the impact of varicocele on testicular OS markers and sperm parameters in experimental animals with varicocele as compared to animals without varicocele.
Materials and Methods:
A literature search was performed using the Scopus and PubMed databases on studies that investigated testicular OS markers and sperm parameters in animals with varicocele. The primary outcomes included malondialdehyde (MDA) (nmol/mg) levels whereas the secondary outcomes included total sperm count (×106), sperm vitality (%), total sperm motility (%), and sperm DNA fragmentation (SDF) (%). Standardized mean difference (SMD) (95% confidence interval [CI]) was chosen to express the effect size. The quality of the included studies was evaluated using the Cambridge Quality Checklist.
Results:
Out of 76 identified articles, 6 studies on rats were included in the meta-analysis. The analysis showed a significant increase of MDA (SMD: 15.61 [1.93, 29.29]; p=0.03) in rats with varicocele vs. controls. We also observed a significant decrease in total sperm count (SMD: -17.45 [-28.97, -5.93]; p<0.01), sperm vitality (SMD: -16.41 [-26.30, -6.52]; p<0.01), total sperm motility (SMD: -17.67 [-24.90, -10.44]; p<0.01), and a significant increase of SDF (SMD: 7.41 [1.23, 13.59]; p=0.02), in rats with varicocele vs. controls. The quality of the included studies was ranked as high.
Conclusions
This SRMA indicates a significant increase in levels of testicular MDA and SDF and a reduction of sperm quality in experimental animals with varicocele. These findings support the potential role of testicular OS in the development of varicocele-induced testicular damage.
9.Stair climbing and incident atrial fibrillation: a prospective cohort study.
Ahmed ARAFA ; Yoshihiro KOKUBO ; Keiko SHIMAMOTO ; Rena KASHIMA ; Emi WATANABE ; Yukie SAKAI ; Jiaqi LI ; Masayuki TERAMOTO ; Haytham A SHEERAH ; Kengo KUSANO
Environmental Health and Preventive Medicine 2022;27(0):10-10
BACKGROUND:
A protective role for physical activity against the development of atrial fibrillation (AF) has been suggested. Stair climbing is a readily available form of physical activity that many people practice. Herein, we investigated the association between stair climbing and the risk of AF in a Japanese population.
METHODS:
In this prospective cohort study, we used data of 6,575 people registered in the Suita Study, aged 30-84 years, and had no history of AF. The frequency of stair climbing was assessed by a baseline questionnaire, while AF was diagnosed during the follow-up using a 12-lead ECG, health records, check-ups, and death certificates. We used the Cox regression to calculate the hazard ratios and 95% confidence intervals of AF incidence for climbing stairs in 20-39%, 40-59%, and ≥60% compared with <20% of the time.
RESULTS:
Within 91,389 person-years of follow-up, 295 participants developed AF. The incidence of AF was distributed across the stair climbing groups <20%, 20-39%, 40-59%, and ≥60% as follows: 3.57, 3.27, 3.46, and 2.63/1,000 person-years, respectively. Stair climbing ≥60% of the time was associated with a reduced risk of AF after adjustment for age and sex 0.69 (0.49, 0.96). Further adjustment for lifestyle and medical history did not affect the results 0.69 (0.49, 0.98).
CONCLUSION
Frequent stair climbing could protect from AF. From a preventive point of view, stair climbing could be a simple way to reduce AF risk at the population level.
Adult
;
Aged
;
Aged, 80 and over
;
Atrial Fibrillation/etiology*
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Humans
;
Incidence
;
Middle Aged
;
Prospective Studies
;
Risk Factors
;
Stair Climbing
10.Impact of Varicocele Repair on Semen Parameters in Infertile Men: A Systematic Review and Meta-Analysis
Ashok AGARWAL ; Rossella CANNARELLA ; Ramadan SALEH ; Florence BOITRELLE ; Murat GÜL ; Tuncay TOPRAK ; Gianmaria SALVIO ; Mohamed ARAFA ; Giorgio I. RUSSO ; Ahmed M. HARRAZ ; Rajender SINGH ; Nicolas GARRIDO ; Taha Abo-Almagd ABDEL-MEGUID HAMODA ; Amarnath RAMBHATLA ; Parviz KAVOUSSI ; Shinnosuke KURODA ; Gökhan ÇALIK ; Pallavi SAINI ; Erman CEYHAN ; Fotios DIMITRIADIS ; Ralf HENKEL ; Andrea CRAFA ; Ayad PALANI ; Mesut Berkan DURAN ; Evangelos MAZIOTIS ; Émine SAÏS ; Marion BENDAYAN ; Mahsa DARBANDI ; Tan V. LE ; Sezgin GUNES ; Petroula TSIOULOU ; Pallav SENGUPTA ; Berk HAZIR ; Gökhan ÇEKER ; Sara DARBANDI ; Damayanthi DURAIRAJANAYAGAM ; Azin AGHAMAJIDI ; Noora ALKHALIDI ; Emrullah SOGUTDELEN ; Kristian LEISEGANG ; Abdullah ALARBID ; Christopher C. K. HO ; Vineet MALHOTRA ; Federica FINOCCHI ; Luís CRISÓSTOMO ; Raghavender KOSGI ; Haitham ELBARDISI ; Armand ZINI ; Ponco BIROWO ; Giovanni COLPI ; Hyun Jun PARK ; Ege Can SEREFOGLU ; Quang NGUYEN ; Edmund KO ; Jean de la ROSETTE ; Germar M. PINGGERA ; Ho Vinh Phuoc NGUYEN ; Hussein KANDIL ; Rupin SHAH
The World Journal of Men's Health 2023;41(2):289-310
Purpose:
Despite the significant role of varicocele in the pathogenesis of male infertility, the impact of varicocele repair (VR) on conventional semen parameters remains controversial. Only a few systematic reviews and meta-analyses (SRMAs) have evaluated the impact of VR on sperm concentration, total motility, and progressive motility, mostly using a before-after analytic approach. No SRMA to date has evaluated the change in conventional semen parameters after VR compared to untreated controls. This study aimed to evaluate the effect of VR on conventional semen parameters in infertile patients with clinical varicocele compared to untreated controls.
Materials and Methods:
A literature search was performed using Scopus, PubMed, Embase, and Cochrane databases following the Population Intervention Comparison Outcome (PICOS) model (Population: infertile patients with clinical varicocele; Intervention: VR [any technique]; Comparison: infertile patients with clinical varicocele that were untreated; Outcome: sperm concentration, sperm total count, progressive sperm motility, total sperm motility, sperm morphology, and semen volume; Study type: randomized controlled trials and observational studies).
Results:
A total of 1,632 abstracts were initially assessed for eligibility. Sixteen studies were finally included with a total of 2,420 infertile men with clinical varicocele (1,424 patients treated with VR vs. 996 untreated controls). The analysis showed significantly improved post-operative semen parameters in patients compared to controls with regards to sperm concentration (standardized mean difference [SMD] 1.739; 95% CI 1.129 to 2.349; p<0.001; I2=97.6%), total sperm count (SMD 1.894; 95% CI 0.566 to 3.222; p<0.05; I2=97.8%), progressive sperm motility (SMD 3.301; 95% CI 2.164 to 4.437; p<0.01; I2=98.5%), total sperm motility (SMD 0.887; 95% CI 0.036 to 1.738; p=0.04; I2=97.3%) and normal sperm morphology (SMD 1.673; 95% CI 0.876 to 2.470; p<0.05; I2=98.5%). All the outcomes showed a high inter-study heterogeneity, but the sensitivity analysis showed that no study was sensitive enough to change these results. Publication bias was present only in the analysis of the sperm concentration and progressive motility. No significant difference was found for the semen volume (SMD 0.313; 95% CI -0.242 to 0.868; I2=89.7%).
Conclusions
This study provides a high level of evidence in favor of a positive effect of VR to improve conventional semen parameters in infertile men with clinical varicocele. To the best of our knowledge, this is the first SRMA to compare changes in conventional semen parameters after VR with changes in parameters of a control group over the same period. This is in contrast to other SRMAs which have compared semen parameters before and after VR, without reference to a control group. Our findings strengthen the available evidence and have a potential to upgrade professional societies’ practice recommendations favoring VR to improve conventional semen parameters in infertile men.