Objective. We evaluated whether the methylenetetrahydrofolate reductase (MTHFR) 677C>T marker influences the risk and severity of Alzheimer's disease (AD) and whether AD is associated with homocysteine, vitamin B12, and cholesterol levels in Egypt.Methods. Forty-three Alzheimer's cases and 32 non-AD controls were genotyped for the 677C>T polymorphism. Clinical characteristics and levels of homocysteine, vitamin B12, and cholesterol were assessed.Results. No significant differences in the frequencies of theMTHFRalleles or genotypes between AD cases and controls (P=0.14) were identified. The 677T mutant allele was significantly overrepresented in AD cases compared to controls (OR=2.22;P=0.03). The 677T/T frequency was three times higher in AD patients than in controls, which could increase plasma homocysteine levels. Severe cases of AD were the most frequent in patients with the T/T genotype (11.6%). The effect of theMTHFRpolymorphism on the risk of AD may be independent of homocysteine, vitamin B12, or even cholesterol levels.Conclusions. TheMTHFR677C>T polymorphism—especially the presence of one copy of the T allele—appears to confer a potential risk for the development of AD. The T/T genotype may contribute to hypercysteinemia as a sensitive marker.

Introduction Maintaining research ethics within a university and monitoring the campus Institutional Review Board (IRB) are essential responsibilities not to be taken lightly. IRBs occasionally need to be reviewed to see that they, as well as researchers, are adhering to rules and regulations on ethics through their submission and review procedures. Since there are no established measures for assessing IRB quality, it is unclear how to determine whether IRBs are achieving their intended aims. This study used the feedback and input of campus members at a newly-established, private, non-profit university within the Kingdom of Saudi Arabia (KSA) to evaluate their campus IRB. Methods Following the university’s IRB approval, and in close collaboration with the Saudi National Committee of Bioethics (NCBE), this cross-sectional study was conducted from February through May of 2019. Self-administered surveys were sent out via university emails to faculty and students at Alfaisal University in Riyadh of Saudi Arabia. The questions in the surveys included inquiries on participants’ demographics, their familiarity with campus IRB research ethics, their satisfaction with IRB procedures, the challenges encountered during the IRB submission and review process, the effectiveness of a recent IRB-coordinated research ethics campaign, and any suggestions for IRB improvement. Surveys were sent to faculty members and students at five colleges on campus. Results Of the campus members who were sent surveys, 8% responded (175). Of those who responded, 29.7% had submitted at least one research proposal for IRB review during the past three years (2016-2019), and more than half of this group were satisfied with the IRB submission and review procedures. For those who had submitted at least one research proposal, respondents reported the more usual challenges that researchers tend to encounter, such as time-consuming and tedious IRB review processes and ambiguous IRB guidelines and regulations. The less typical IRB challenges that were reported, and that are unique to academia, include the IRB tendency to deny undergraduate student requests to serve as principal investigators of their research projects. Concerning IRB efforts to educate and train campus members on research ethics, only 26.3% of the participants were aware of the recently performed research ethics campaign, and 7.6% of the participants attended the end-of-campaign workshop. Of those who attended the workshop, 76.9% reported that the campaign and workshop effectively met their expectations. Conclusions This study revealed several issues encountered by university faculty and students seeking campus IRB approval for their research projects. The main academia-specific challenge was over whether undergraduate students could serve as PIs for research projects, and a universal one was that they find the IRB process to be very time-consuming and tedious, which is a situation that has already been relayed in several other articles on IRB issues. About two-thirds of respondents reported a lack of familiarity with the topic of research ethics. This challenge makes it clear that information on research ethics is not effectively reaching enough campus members in the busy environment of academia.

Peer-assisted learning enhances conceptual understanding in anatomy education; however, its impact on structured cognitive outcomes remains unclear. We evaluated the effect of the Peer-Assisted Uniform Learning (PAUL) program on musculoskeletal (MSK) anatomy objective structured practical examination (OSPE) performance. We used a cross-sectional, controlled, observational design to analyse the OSPE scores of 304 students. Seventy-nine students who attended at least two PAUL sessions formed the exposure group, while 225 served as the control group. The PAUL participants alternated between tutor and tutee roles during the sessions. The OSPE items were divided into Cluster 1 (identification/recall) and Cluster 2 (application/analysis). A validated survey was used to assess the participants perceived learning outcomes and satisfaction. PAUL participants outperformed non-participants in Cluster 1 (78.4 vs. 73.7, p = 0.01) and Cluster 2 (87.2 vs. 82.8, p = 0.02). The relative gain was greater for application-based items (interaction effect: F = 8.37, p = 0.004), supporting the program's effect on higher-order reasoning. Survey responses (91 % response rate) showed high satisfaction (mean 4.3 ± 0.6) and perceived learning gains (mean 4.1 ± 0.7); 85 % of students reported improved understanding of the subject. The PAUL program, grounded in social constructivist principles and supported by faculty oversight, improved performance in both recall and application of MSK anatomy OSPE items, with the strongest impact on application-based learning.

Medical education faces increasing demand for scalable grading solutions. Large language models have been proposed as automated graders for high-stakes assessments, but evidence for their reliability in multimodal practical examinations remains limited. This retrospective inter-rater reliability study compared three LLMs: ChatGPT-4o, Gemini 2.5 Flash, and Claude 3.5 Haiku with original human reference scores on 19 integrated anatomy, histology, and physiology objective structured practical examination items completed by 309 pre-medical students. Human reference scores were assigned during live summative grading by two content experts who divided items, with each item marked by one expert across all students; no human inter-rater reliability estimate was available. Items required simultaneous image interpretation and short-answer responses. Models were evaluated using zero-shot prompting reflecting deployment-realistic conditions. Agreement was assessed using Spearman's ρ, Cohen's κ, intraclass correlation coefficients, and Bland-Altman analysis. Item-level gap analysis compared student success rates with LLM performance across items. Rank-order correlations were strong across all models (ρ = 0.784-0.921), but categorical agreement diverged substantially. Pass/fail agreement ranged from 52.1% (ChatGPT; κ = 0.067, slight) to 84.1% (Claude; κ = 0.680, substantial). Bland-Altman analysis showed inconsistent systematic bias: Claude over-scored by +2.5 points, Gemini under-scored by -5.0 points, and ChatGPT by -10.0 points. Item-level gap analysis highlighted three recurring divergence patterns: non-standard histological staining, three-dimensional spatial reasoning from two-dimensional images, and semantic inflexibility in short-answer evaluation. The most extreme case was a pelvic three-dimensional model item on which 93.3% of students succeeded by human grading but all three LLMs assigned a mean score of zero. Strong rank-order correlation alone does not support LLM grading for categorical decisions in high-stakes assessment contexts. LLMs may serve as assessment assistants for first-pass ranking and discrepancy flagging, but item-level human review of flagged discordances, error-profile monitoring, and preserved human authority over pass/fail decisions are required before high-stakes deployment.

Pakistan has one of South Asia’s highest maternal mortality ratios, a problem exacerbated by cultural sensitivities that influence health professions education (HPE) in obstetrics and gynecology (O&G) clerkships. These factors may ultimately affect women’s health outcomes. This study aimed to evaluate gender-based differences in health professions education during O&G clerkships in Pakistan. This retrospective cross-sectional study analyzed examination records of 1572 medical students (795 males, 777 females) from Liaquat University of Medical and Health Sciences, Pakistan. The written, practical/clinical skills, and overall O&G clerkship scores were compared using independent-samples t tests. Male students achieved significantly higher scores in written O&G examinations (70.46 ± 6.32 vs 68.69 ± 7.28; P < .001), while female students performed better in practical/clinical skills assessments (69.05 ± 10.39 vs 65.98 ± 10.47; P < .001). No significant differences were observed in total O&G scores (68.23 ± 6.79 vs 68.40 ± 7.47; P = .64). Male students performed better in written O&G examinations, while female students excelled in practical assessments; however, overall scores were comparable. This study highlights differences in educational outcomes, which may be influenced by cultural perceptions of gender within the medical specialty.

Amyloid-β (Aβ) protein, a cleavage product of the amyloid precursor protein (APP), is the main component of neuritic plaques in Alzheimer’s disease (AD), and its accumulation has been considered as the molecular driver of Alzheimer’s pathogenesis. Aβ has been a primary target for therapy since the amyloid cascade theory was put forth, with methods designed to prevent the generation of Aβ. The APP 5′-untranslated region (UTR) mRNA encodes a functional structured iron-responsive element (IRE) that represents a potential target for small molecule inhibitors as an anti-amyloid therapy for AD. Here, we offer a comprehensive strategy that uses RNA-targeted binding to inhibit APP translation. The IRE family is among the few 3-D mRNA regulatory elements with a known 3-D structure. Accordingly, we exploit these structural and functional characteristics as our strategy to target APP IRE structured mRNA to identify anti-amyloid drugs. The mRNA encoding proteins involved in iron metabolism are regulated by this family of similar nucleotide sequences. Post-transcriptional control of cytoplasmic mRNA is a rapidly developing area of biomedicine. Across animals, evolutionarily conserved IRE mRNAs serve as a model system for 3-D mRNAs. IRE mRNAs have shown great promise for chemical manipulation of mRNA and protein expression in biological systems by yielding “proof of principle” data for small molecules targeting mRNA structures. A novel approach to identifying RNA-directed therapeutics to regulate APP expression and Aβ-peptide generation for AD treatments is exemplified by APP 5′-UTR-directed small molecule inhibitors.