Kidney Stakes

A small team of scientists at the University of Malta is trying to determine what causes children to be born with serious kidney defects. Laura Bonnici speaks to Prof. Alex Felice, Dr Valerie Said Conti, Esther Zammit, and Alan Curry to find out more about this ground-breaking programme.

‘I’d sell a kidney for that!’ Most of us have been guilty of using this expression when faced with something desirable. But do we fully appreciate the real value of what we are offering before the words escape our lips?

Kidneys are our body’s official waste disposal system, filtering out toxic build-up from our blood, which can poison us if left unchecked. With kidney failure posing such a threat, renal research has become an ongoing global goal.

A team of scientists from the University of Malta is currently honing in on what may cause children to be born with ‘CAKUT’, or Congenital Anomalies of the Kidney and Urinary Tract.

With between three and six cases recorded per 1000 live births worldwide, CAKUT is the most common cause of end-stage kidney disease in children. Since early identification of these anomalies may reduce kidney damage later in life, the LifeCycle Malta Foundation has raised funds for a renal research programme which targets CAKUT and its causes.

‘We know that a number of children are born with a kidney defect, but in many cases, we are not sure why,’ explains the programme’s principal investigator, Dr Valerie Said Conti . ‘There are many factors that can affect the development of the kidney, both genetic and environmental. We are trying to understand those influences so that we can carry out preventative strategies, diagnose issues earlier, and target personal therapeutic interventions.’

A number of children are born with a kidney defect, but in many cases, we are not sure why.

For this team of renal researchers, the first three years of initial research has been the first step in a far longer journey. ‘We hope to contribute our data to the international literature pool,’ continues Prof. Alex Felice, consultant and supervisor on the programme. ‘We will need a massive amount of data to create a robust theory with which to progress. We hope that our findings regarding CAKUT will be useful when we come to the stage of creating new interventions.’

It’s an end-game that has kept the small team focused as they approach the programme’s expected completion date this year. Having had to start literally from scratch, they collected biological samples from patients with a range of kidney diseases, including CAKUT, nephrotic syndrome, and Bartter syndrome. This allowed them to build the renal disease collection at the Malta BioBank, a vital storehouse for scientists.

‘For research projects like this, you see what material is available and you work with it,’ explains Said Conti . ‘A big part of it so far has been sourcing the samples from families attending the clinic with their formal consent for the material to be used in this project. We are hugely grateful to those who accepted to take part in the research. Without them, it would have been impossible.’

This project has set the groundwork for renal research in Malta to continue. ‘Without funding, projects such as this one simply could not exist,’ Said Conti remarks of the €100,000 donation LifeCycle Malta Foundation made to RIDT. ‘It enabled us to employ a full-ti me Research Support Officer, involve other laboratories, attend international meetings to share insights, perform ultrasound tests, and invest in ‘Next Generation DNA Sequencing’, genetic technology that maps out genes, revolutionising our world.’ But there is much more to come.

The Founder of the LifeCycle Malta Foundation, Personal Fitness Consultant Alan Curry, agrees. ‘Renal failure is an ever-increasing problem with figures going up every year, and LifeCycle is the only NGO that is actively supporting renal patients and their families in Malta. Our annual LifeCycle Challenge, which this year is routed from Dubai to Oman, aims to raise €150,000. It’s a huge responsibility, but we are sure that, by funding research programmes such as this, we will significantly improve the lives of kidney patients.’

  Author: Laura Bonnici

English for medicine: Bridging worlds

You come to Malta to attend Medical School, and you end up in an English class. Nicola Kirkpatrick talks to Dr Isabel Stabile, Omar N’Shea, and Edward Wilkinson about the often unappreciated value of the University of Malta’s Medical Foundation Programme and its impact on international medical students’ lives.

A sea of blank faces stared him down. Omar N’Shea had asked his students a question, but no reply came. None of them wanted to be there. The University of Malta’s Medical Foundation Programme (MFP) aims to equip high school graduates with less than 13 years of formal education with the skills they need to enter Medical or Dentistry school. But its focus on academic English is what receives the most ire. N’Shea, one of the programme coordinators, understands. ‘They don’t see the value initially. They think to themselves: ‘I didn’t travel thousands of miles away to sit in an English class. No, I want to study medicine.’ The frustration is understandable,’ he nods.

Omar N’Shea

But when so many international students were struggling with the medical course due to language and communication difficulties, something clearly had to be done.

Looking back at the challenges she was facing when the Medical School opened its doors to international students, Director of Studies Professor Isabel Stabile notes the discrepancy in language skills. What was expected was quite distinct from the reality of the situation. ‘What is interesting about our student body is that their spoken level of English is really high,’ says N’Shea, ‘but their written level of English needs work to keep up with the demands of an academic course.’

English Programme Coordinator and tutor Edward Wilkinson agrees, highlighting that ‘resources were lacking. Teaching exercises and materials were sourced online and everyone did the best they could. But a gap quickly emerged as far as Medical English was concerned.’ Stabile further clarifies, ‘Most books available were aimed at teaching doctors and nurses bedside manner and care for patients, but there was little to none out there that focused on academic medical English.’

Prof. Isabel Stabile

With this philosophy in mind, Stabile, N’Shea, and Wilkinson joined forces to develop a series of books called Academic Medical English for Pathway/Foundation Programmes. These books provided a framework for students to deal with the language in which scientific subjects are taught. The material improves their academic literacy in ways important to medical students, equipping them with skills such as reviewing research papers, writing reflective essays, and answering essay questions.

The book was ‘born out of the needs of these students and the medical program,’ says N’Shea. ‘The concept is to present to the students the core skills required by the medicine and surgery degrees, so that students become aware of the differences between using English as a lingua franca and using English within the framework of academic literacy.’ To enable this, the team included topics to reflect those covered in the science classes that students attend throughout the course. ‘So if they’re doing pulmonary topics in science classes,’ N’Shea says, ‘then they’re discussing them in English classes too. We used the science as a framework for our English lessons, and that was essential. Rather than teaching two disciplines with no dialogue, we created a bridge.’

This approach saw immediate shifts in perception. Dr Hussein Alibrahim, now a house officer in Kuwait, says his primary and secondary education was all in Arabic, and the foundation course, where English and science stood side by side, ‘was an advantage and a necessity. Skimming carefully through an article, identifying keywords, summarising, criticising, asking questions, and looking for the right answers are all skills that I learned for the first time in the foundation course and are skills I still use today,’ he added.

Edward Wilkinson

But the programme was not only useful for medical school. Alibrahim noted how it changed his day-to-day life as well. It taught him important lessons on punctuality and work ethic. ‘If you don’t learn [these things in foundation school] then maybe you’re in the wrong place,’ he notes.

With time, the team refined the course. After looking into the discrepancy between spoken and written levels of English, N’Shea and Wilkinson determined that the most probable reason behind it was a lack of reading by the students. Due to this, reading is now a core element of the course and is based on science topics to keep students’ interest piqued.

Now that the coursework has been implemented, positive results can already be seen. Students are so ready and raring to go that ‘sometimes they even want to take over the sessions,’ says N’Shea. ‘A student came up to me in class one time and asked to explain a concept to the others. It was such a dramatic shift.’ This has made it a joy to be in class, he adds, saying that ‘it became an active classroom. Students are totally immersed now.’ He feels that, through this course, the students are empowered ‘because they feel they can bring into the classroom all the things they know from science, but explore them through language.’ This way, ‘English is presented as a skill set to enable them to better achieve their goal in the career path of choice. It makes English less of an extra subject and more of a tool,’ he adds.

N’Shea, Wilkinson, and Stabile all agree that they will continue to perfect the programme. Currently in the works is a coursebook dedicated to developing listening skills. It will concentrate on areas such as note writing and identifying and differentiating words even when people speak with different accents. However, before the ‘listening book’ (as they fondly call it) is released, we will see the ‘reading book’, which will provide scientific passages for the students to read and be assessed on. All editions of this book will have the added bonus of a teacher’s book, meaning that the coursework can be taught by any teacher around the world, even if their knowledge of science is lacking.

With students communicating more, isolation is less of an issue and this is immensely beneficial. ‘We have to remember the dramatic shift that these students are going through,’ Stabile says. ‘They’re moving country, dealing with culture shock, all while fending for themselves for the first time in their lives, an adjustment local students do not need to make.’ This, along with the pressure that comes with a course you only get one chance to pass, is significant.

With students communicating more, isolation is less of an issue and this is immensely beneficial.

The fruit of their hard work is evident. According to research conducted by the team, between 2008 and 2015, 86% of MFP graduates progressed through Medical School. Moreover, the proportion of MFP students who repeat Year 1 of their medical degree is only 8.2% compared with 8.8% for EU (mostly British) students between 2014 and 2017. They also found that MFP students who started in 2010 and graduated medical school in 2015 achieved the same average grade over the whole five years as did local students in that cohort.

That said, all this work is not just about grades. Stabile says the team’s intentions go beyond seeing students pass exams. What they want to do is to ‘place them on a trajectory for success.’ And that is definitely a goal they are achieving, one year at a time.

  Author: Nicola Kirkpatrick

Aspirin and Cancer

Aspirin is often considered a wonder drug due to its versatile use in treating inflammation, reducing pain, and helping to prevent heart-related disease. However, there is more to it. Aspirin is actually cancer-preventive. Studies have shown that a daily low dose of aspirin, medically prescribed for more than five years, lowers the risk of cancer-related deaths by at least 30%. So, should we all start taking aspirin on a daily basis to lower our chances of getting cancer?

No, not exactly. This is because many aspects of aspirin’s cancer-preventive effects are still poorly understood. Particularly, researchers have not yet pinpointed what enables aspirin to selectively kill early-stage cancer cells and not healthy cells. This is the scope of the research currently being carried out at the Yeast Molecular Biology and Biotechnology Laboratory (headed by Prof. Rena Balzan).

Maria Azzopardi

The secret behind aspirin’s tendency to kill certain cells but not others seems to lie in the physiology of the exposed cells. Aspirin exploits the natural differences between healthy and cancerous cells to eliminate malignant cells before they can take over.

Oxygen, if transformed into ‘Reactive Oxygen Species’, is known to cause DNA mutations that can lead to cancer. Through this research, we studied mutated yeast cells which are a relevant model of early-stage cancer cells due to their low tolerance to oxygen-associated stress. We then identified genes in these mutant yeasts which are affected by aspirin.

One of aspirin’s targets is a key metabolite required for the production of energy-rich compounds vital for cell survival. We found that aspirin creates a shortage of this metabolite in mutated yeast cells, causing them to run out of energy and die.

This implies that early-stage human cancer cells may suffer a similar fate and, more importantly, partly explains how aspirin prevents tumour formation. Such knowledge may prove useful in the development of novel anti-cancer treatments.


This research was carried out as part of Project “R&I-2015-001”, financed by the Malta Council for Science & Technology through the R&I Technology Development Programme. This research is being carried out as part of Azzopardi’s Ph.D. project at the Centre for Molecular Medicine & Biobanking and the Department of Physiology & Biochemistry, University of Malta
  Author: Maria Azzopardi

Where Humanities, Medicine, and Sciences meet

Not many Ph.D.s lead to a new programme of studies, but cardiac paediatrician Prof. Victor Grech’s did. His study on Infertility in Science Fiction inspired him and his supervisors, Prof. Ivan Callus and Prof. Clare Vassallo, (University of Malta) to start the HUMS programme: a space for researchers in the humanities, medicine, and sciences to meet and discuss the bridges between these areas.Continue reading

Science, art, academia: Star Trek

The Star Trek academic symposium will be held at the Faculty of ICT, University of Malta, on 15 and 16 July 2016. This event will be a platform for both academics from various disciplines as well as Star Trek fans to meet and explore the intersection between the humanities and the sciences. There will be inspirational presentations from national and international speakers, with the programme tailored to attract a wide audience. Contributors will be encouraged to explore contemporary issues in medicine, science, and technology as well as philosophical, psychological, and sociological issues connected with the science fiction entertainment franchise Star Trek.

A similar symposium was held in 2014 and which proved to be a worldwide first that successfully drew participation from many international scholars including American philosopher Jason Eberl, UK-based neonatologist and ethicist Neena Modi.

As a result of its success, this second event that marks the 50th anniversary from the launch of Star Trek: The Original Series is being organised. The event will be held under the auspices of the Humanities, Medicine and Sciences Programme (HUMS), a University of Malta programme set up to explore and encourage the interfaces between the humanities, medicine, and sciences. The Science Fiction Symposium will appeal to scientists and fans of science fiction alike..

For more information, visit the website.

Blood, Genes, and You

Over the course of nine months, an entire human body is sculpted from a few cells into a baby. The blueprint is the information written into our DNA. But what happens if there is a mistake in these blueprints? Decades worth of research carried out in Malta and abroad have aimed to understand how these errors lead to a disease common in Malta and prevalent worldwide.
Scott Wilcockson talks to Dr Joseph Borg (Faculty of Health Sciences, University of Malta) to find out more.

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Heartbreakers

Every person possesses the same genes within every cell. Their DNA provides the information to first create an entire functioning body and then keep it running. While all humans share more than 99.9% of their DNA, it is the subtle differences in our DNA that ensure individuality. Many differences are superficial effects, like hair colour, but some can have disastrous health effects. Scott Wilcockson talks to Dr Stephanie Bezzina-Wettinger (Faculty of Health Sciences, University of Malta) about her research on these subtle differences and how they can contribute to heart attacks.

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Seeing the unseeable

Unlocking the mysteries of the brain with MRI. Everything we think, say, or do depends on our brain. It is the most vital organ of our body but one of the least understood. Recent advances are changing things. With magnetic resonance imaging (MRI), scientists and researchers are getting an inside look into what makes us tick. Cassi Camilleri speaks to Dr Sonia Waiczies Chetcuti,  Dr Helmar Waiczies and Prof. Kenneth Camilleri about their vision for experimental MRI in Malta. Illustrations by Sonya Hallett.

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