Electives in undergraduate medical education: AMEE Guide No. 88

This Guide outlines the scope and potential roles an elective can contribute to undergraduate medical training and identifies ways to maximize learning opportunities, including within global health. The types of educational activity available for electives range from meeting individual educational need through to exploration of potential career pathways, with many factors influencing choice. Key areas of organization underpinning a successful elective before, during and after the placement include developing clarity of the intended educational outcomes as well as addressing practicalities such as travel and accommodation. Risk management including the implications for the participating schools as well as the student and their elective supervisors is crucial. This Guide would not be complete without some discussion around ethics and professional conduct during an elective, with consideration of the impact of elective placements, particularly in low-middle income countries

Prolyl hydroxylase inhibitor desidustat improves anemia in erythropoietin hyporesponsive state

Many anemic chronic kidney disease (CKD) patients are refractory to erythropoietin (EPO) effects due to inflammation, deranged iron utilization, and generation of EPO antibodies. This work assessed the effect of desidustat, an inhibitor of hypoxia inducible factor (HIF) prolyl hydroxylase (PHD), on EPO-refractory renal anemia. Sprague Dawley rats were made anemic by cisplatin (5 ​mg/kg, IP, single dose) and turpentine oil (5 ​mL/kg, SC, once a week). These rats were given recombinant human EPO (rhEPO, 1 ​μg/kg) and desidustat (15 or 30 ​mg/kg) for eight weeks. Separately, rhEPO (1–5 ​μg/kg) was given to anemic rats to sustain the normal hemoglobin levels and desidustat (15 ​mg/kg) for eight weeks. In another experiment, the anemic rats were treated rhEPO (5 ​μg/kg) for two weeks and then desidustat (15 ​mg/kg) for the next two weeks. Dosing of rhEPO was thrice a week, and for desidustat, it was on alternate days. Desidustat inhibited EPO-resistance caused by rhEPO treatment, decreased hepcidin, IL-6, IL-1β, and increased iron and liver ferroportin. Desidustat reduced EPO requirement and anti-EPO antibodies. Desidustat also maintained normal hemoglobin levels after cessation of rhEPO treatment. Thus, novel prolyl hydroxylase inhibitor desidustat can treat EPO resistance via improved iron utilization and decreased inflammation

Soil resistance to penetration in an oxisol under integrated and non-integrated grazing systems in southeast Brazil.

In order to learn more about soil physical quality in integrated systems, this study proposed comparing soil penetration resistance in two different depths, 0 - 5 cm and 12.5 - 17.5 cm, in areas under different managements. The systems evaluated were continuous grazing (CONT), rotational grazing (ROT), integrate livestock-forest system (ICL), integrated crop-livestock system (ILF), integrated crop-livestock-forest system (ICLF), and native vegetation (NV). The study site was in an experimental unit in the Brazilian Agricultural Research Corporation located in São Carlos, Brazil, where the climate is humid subtropical, and the soil is classified as an Oxisol. Undisturbed soil samples were collected with four replicates in each system. Soil resistance to penetration (SRP) was assessed with a benchtop electronic penetrometer in which the water content was previously standardized to be equivalent to a tension of -6 kPa. Data were statistically analyzed with a two-way analysis of variance (ANOVA) followed by Tukey tests (significance level: α=0.05). Significant differences were found among the studied systems. NV presented the lowest SRP. All the agricultural systems had SRP means higher than the limit of 2 MPa.WCCLF. Evento online