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Laís Gabriela Yokota,1 Beatriz Mota Sampaio,1 Erica Pires Rocha,1 André Luís Balbi,1 Iara Ranona Sousa Prado,1 Daniela Ponce1,2 1Botucatu School of Medicine, São Paulo State University (UNESP), Sao Paulo, Brazil; 2Course of Medicine, University of Sao Paulo (USP), Sao Paulo, Brazil Abstract: Acute kidney injury (AKI) is characterized by a sudden renal dysfunction with consequent increase of nitrogenous products, hydroelectrolytic and acid–base disorders. Its prevalence is high in hospitalized populations (4.9%–7.2%), especially in intensive care units (ICUs). Despite all the technical and therapeutic advances that have occurred in the last few decades, the overall mortality of AKI patients remains high, reaching 80% in ICU patients. Several conditions predispose a patient to progress with AKI, including age, sepsis, surgeries, and comorbidities, such as systemic arterial hypertension, diabetes mellitus, heart disease, neoplasia, and chronic renal disease. Among these risk factors, age is emphasized, since, due to advances in the health area, there has been an increase in life expectancy, hence an increase in the demand of the elderly population for health services. At the same time, the elderly present a greater predisposition to the development of AKI, either due to kidney senility, or because of the high prevalence of comorbidities present, and medical interventions such as the use of contrasts and medications, which can also trigger AKI. Considering the relevance of the social role of the elderly and the scarcity of studies on AKI in the elderly admitted to the ICU, further studies are needed. This review article was elaborated considering the purpose: to assess incidence, risk factors, and mortality of AKI in elderly patients admitted to ICUs. Published studies were collected using the following inclusion criteria: be accessible in online databases (Lilacs, Scielo, and PubMed), have been published since 2000 and written in English, Portuguese, or Spanish. The descriptors used for the survey were “Acute Kidney Injury”, “Aging”, and “Elderly”. All items that did not fit in the above inclusion criteria were discarded. We have also presented a synthesis of the knowledge acquired during this review. Keywords: comorbidities, risk factors, elderly, acute kidney injury, mortality, intensive care unit

Laís Gabriela Yokota, Beatriz Motta Sampaio, Erica Rocha, André Luís Balbi, Daniela Ponce Internal Medicine Department, University São Paulo State-UNESP, Distrito de Rubiao Junior, Botucatu, Sao Paulo, Brazil Aim: The elderly are at high risk of acute kidney injury (AKI) because of structural and functional degeneration over time and with the aging of the population, the demand for intensive care unit (ICU) admission for older patients has risen recently. However, data from developing countries are scarce. This study aimed to describe the incidence of AKI in elderly patients admitted to ICU from a developing country, to determine the most frequent etiologies for renal impairment and identify its risk factors and outcome. Methods: All patients admitted to the ICU at a Brazilian teaching hospital for 12 consecutive months were followed prospectively from the time of admission until ICU discharge. Elderly was defined as aged >60 years and AKI was defined according to the Kidney Disease Improving Global Outcomes 2012 criteria. Multivariable logistic regression was used to adjust confounding and selection bias. Results: Two hundred elderly patients were included in the study. AKI incidence was 27% and the main etiology was sepsis (48.1%). At logistic regression, baseline creatinine (odds ratio [OR]=5.17, p

Background: Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career., Objective: To develop and evaluate the psychometric properties of the ' Ge nder Mi sconceptions of me N in nurs I ng (GEMINI) Scale., Design: Cross-sectional survey., Methods: Pre-registration nursing students enrolled in undergraduate nursing programmes across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing., Results: Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach's alpha of 0.892). Men were found to have higher gender misconceptions ( p  < 0.001) while respondents who: (a) identified nursing as their first career choice ( p  = 0.002); (b) were in their final year of programme enrolment ( p  = 0.016); and (c) engaged in health-related paid work ( p  = 0.002) had lower gender misconceptions., Conclusion: The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students., Impact Statement: Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society.

We collected 729 Hypanus guttatus from the northern coast of the state of Rio Grande do Norte (RN), of which 196 were used to estimate age and growth. Ninety-five were male (12.7 to 57.0 cm disc width; W D ) and 101 were female (13.0 to 88.5 cm W D ); females were significantly larger than males. Cross sections of vertebrae showed band-pairs ranging from 0 to > 14 in females and from 0 to 9 in males. New-borns presented an opaque edge at birth in vertebrae without a birthmark. The average percentage of error (APE; %E) for the entire sample provided evidence that ages were repeatable. The mean monthly marginal increment (I M ) indicates annual band-pair formation from August to November. The annual cycle model for one band-pair deposition provided the best fit to data based on the AIC, with peaks between August and October, similar to that found in the I M analysis, suggesting an annual formation pattern. A multi-model approach that included four models based on the observed mean W D at age indicated a modified von Bertalanffy growth model as the best for describing the species growth: W 0 (W D at birth) = 14.6 cm for both sexes; females W ∞ = 98.61 cm (95% CI = 87.34-114.61 cm); k = 0.112 year -1 (CI = 0.086-0.148 year -1 ); males W ∞ = 60.22 cm (CI = 55.66-65.35 cm); k = 0.219 year -1 (CI = 0.185-0.276 year -1 ). The age-at-maturity in males and females is 5 years and 7 years, respectively. The age composition shows that most (84%) specimens were aged 0 to 2 years. The information provided here is essential for analytical assessments of H. guttatus, which is subject to significant fishing pressure mainly on new-borns and juveniles., (© 2019 The Fisheries Society of the British Isles.)

An extensive taxonomic revision of Gymnura micrura based on external and internal morphology, and considering specimens from its entire geographical distribution in the Atlantic Ocean, is presented. Gymnura micrura is redescribed and a neotype is designated; its distributional range is limited to the Southwestern Atlantic. Two new species of butterfly rays are described: Gymnura lessae, sp. nov., occurring in the North and Central Western Atlantic, and Gymnura sereti, sp. nov., found in the Eastern Central Atlantic. The three species are morphologically very similar (with G. micrura most similar to G. lessae, sp. nov.) and cannot be distinguished based on the primary diagnostic characters typically utilized for butterfly rays. The dorsal color, smaller size and eventual presence of a dorsal fin in some males may be helpful to distinguish G. micrura, whereas the size and morphology of the clasper are the main external characters separating G. sereti, sp. nov., from the other two species, although the shape of disc (especially among adult males) and contour of the lower lip are also helpful. Despite the skeleton being conservative among the species, we found consistent variations that support the validity of the new species described. Due to similarity in external morphology these internal characters were fundamental to discriminate the new species. The scapulocoracoid was an important diagnostic skeletal structure, exhibiting a series of variations that separated the three species. Variations in the synarcual, outline of the dorsal cranial fontanelle, number and shape of mesopterygia, and small differences in the mandibular arches and pelvic girdle were useful to diagnose G. sereti, sp. nov. The contour of the hyomandibula was an important diagnostic character distinguishing G. lessae, sp. nov., from the other two species. Meristic data were also useful, with G. sereti, sp. nov., presenting a lower number of radials in the second element of the mesopterygium and a higher number of diplospondylous vertebrae. In contrast, G. lessae, sp. nov., presented a higher number of pectoral-fin radials. Subtle, but consistent differences, were also found in the design of the ventral lateral-line system. A Canonical Discriminant Analysis provides strong statistical support for the validity of the new species, significantly distinguishing the three species groupings (p < 0.00001). External morphology, ventral lateral-line system and skeleton are described and illustrated for all three valid species.