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There is paucity of evidence to support clinical decision making and counseling related to medication use in pregnancy. Despite multiple efforts from legislative bodies and advocacy groups, the inclusion of pregnant women in clinical drug trials assessing efficacy and safety remains scarce. Pregnancy can be complicated by multiple co-morbidities that require pharmacological intervention; these interventions primarily target the pregnant women but also sometimes have secondary effects for the fetus. The U.S. Food and Drug Administration has issued multiple guidance documents on incorporating pregnant women in clinical trials to aid pharmaceutical companies in designing a protocol to ensure safety and adherence to ethical standards. Advances in pediatric pharmacology studies provide lessons for researchers on the best practice of designing clinical trials with inclusion of patients from special populations. In this review, we present the status of pregnant women in clinical trials, highlighting the ethical stigma and possible future directives.

Based on the relationship between the service value of each component of agro-ecosystem and its corresponding land cover, the service value of agro-ecosystem in oasis area of lower reaches of Tarim River was analyzed. Using the land cover data of 2000, 2010 and 2020, and setting two scenarios in the FLUS model to simulate the land cover change of the study area in 2030. According to the forecast results of land cover, the the value of agro-ecological service was calculated and the sensitivity was analyzed. Results showed the following: (1) The Kappa coefficients and overall accuracy of 2010 land cover models simulated by FLUS are 0.8429 and 92.55% , indicating that the model has appropriate simulation accuracy. (2) The proportion of farmland, grassland, water body and artificial surface increased from 4.28%, 22.26%, 2.18% and 1.16% in 2000 to 6.63%, 25.86%, 10.96% and 0.48% in 2030 benchmark scenario, respectively. On the contrary, the shrub land and barren land decreased from 1.07% and 70.75% in 2000 to 0.7% and 55.44% in 2030 benchmark scenario, respectively.(3) The agro-ecosystem service value of benchmark scenario and ecological protection scenario are CN¥6.781×109 and CN¥6.937×109 in 2030, respectively. The practice has proved that the ecological water conveyance project is very necessary to improve the agricultural ecological environment in oasis area of lower reaches of Tarim River. This study can provide reference for the research on the agro-ecosystem service value of oases in inland river basins of China and Central Asia.

Abstract: Background: Effects of UGT1A1*6 and UGT1A1*28 genetic polymorphisms on irinotecan-induced severe toxicities in Asian cancer patients are inconclusive. Also, ABCC2 c.3972C>T may affect toxicity of irinotecan. It was aimed to assess the aggregated risk of neutropenia or diarrhea in Asian cancer patients taking irinotecan and inherited UGT1A1*6, UGT1A1*28 or ABCC2 c.3972C>T genetic variants. Methods: Literature was searched in PubMed for eligible studies. Odds ratios (ORs) were measured using RevMan software where P-values<0.05 were statistically significant. Results: Patients inherited both UGT1A1*6 and UGT1A1*28 genetic variants (heterozygous:UGT1A1*1/*6+*1/*28 and homozygous:UGT1A1*6/*6+*28/*28) were significantly associated with increased risk of neutropenia and diarrhea compared to patients with UGT1A1*1/*1 (Neutropenia: OR 2.89; 95% CI 1.97–4.23; P<0.00001; Diarrhea: OR 2.26; 95% CI 1.71–2.99; P<0.00001). Patients carried homozygous variants had much stronger effects in developing toxicities (Neutropenia: OR 6.23; 95% CI 3.11–12.47; P<0.00001; Diarrhea: OR 3.21; 95% CI 2.13–4.85; P<0.00001) than with heterozygous variants. However, patients carried ABCC2 c.3972C>T genetic variant were not significantly associated with neutropenia (OR 1.67; 95% CI 0.98–2.84; P=0.06) but reduced diarrhea significantly (OR 0.31; 95% CI 0.11–0.81; P=0.02). Conclusions: Both UGT1A1*6 and UGT1A1*28 genetic variants should screen in Asian cancer patients to reduce substantially irinotecan-induced severe toxicities.

Typical applications of process- or physically-based models aim to gain a better process understanding or provide the basis for a decision-making process. To adequately represent the physical system, models should include all essential processes. However, model errors can still occur. Other than large systematic observation errors, simplified, misrepresented, inadequately parametrized or missing processes are potential sources of errors. This study presents a set of methods and a proposed workflow for analyzing errors of process-based models as a basis for relating them to process representations. The evaluated approach consists of three steps: (i) training a machine learning (ml) error-model using the input data of the process-based model and other available variables, (ii) estimation of local explanations (i.e., contributions of each variable to a individual prediction) for each predicted model error using SHapley Additive exPlanations (SHAP) in combination with principal component analysis, (iii) clustering of SHAP values of all predicted errors to derive groups with similar error generation characteristics. By analyzing these groups of different error-variable association, hypotheses on error generation and corresponding processes can be formulated. That can ultimately lead to improvements in process understanding and prediction. The approach is applied to a process-based stream water temperature model HFLUX in a case study for modelling an alpine stream in the Canadian Rocky Mountains. By using available meteorological and hydrological variables as inputs, the applied ml model is able to predict model residuals. Clustering of SHAP values results in three distinct error groups that are mainly related to shading and vegetation emitted longwave radiation. Model errors are rarely random and often contain valuable information. Assessing model error associations is ultimately a way of enhancing trust in implemented processes and of providing information on potential areas of improvement to the model.

INTRODUCTION Home-based treatment of low-risk febrile neutropenia (FN) in children with cancer with oral or intravenous antibiotics is safe and effective. There are limited data on the economic impact of this model of care. We evaluated the cost-effectiveness of implementing a low-risk FN program, incorporating home-based intravenous antibiotics, in a tertiary pediatric hospital. METHODS A decision analytic model was constructed to compare costs and outcomes of the low-risk FN program, with usual in-hospital treatment with intravenous antibiotics. The program included a clinical decision rule to identify patients at low-risk for severe infection and home-based eligibility criteria using disease, chemotherapy and patient-level factors. Health outcomes (quality-of-life) and probabilities of FN risk classification and home-based eligibility were based on prospectively collected data. Patient-level costs were extracted from hospital records. Cost-effectiveness was expressed as the incremental cost per quality-adjusted life year (QALY). FINDINGS The mean healthcare cost of home-based FN treatment in low-risk patients was A$7,765 per patient compared to A$20,396 for in-hospital treatment (mean difference A$12,632 (95% CI,12,496-12,767)). Overall, the low-risk FN program was the dominant strategy, being more effective (0.0011 QALY (95% CI,0.0011-0.0012)) and less costly. Results of the model were most sensitive to proportion of children eligible for home-based care program. CONCLUSION Compared to in-hospital FN care, the low-risk FN program is cost-effective, with savings arising from cheaper cost of caring for children at home. These savings could increase as more patients eligible for home-based care are included in the program.

Microinvasive, catheter-based mitral valve repair of severe mitral regurgitation utilizes less invasive approaches with less procedural morbidity and mortality. The procedural steps and clinical benefits of the transcatheter transapical mitral valve annuloplasty (AMEND mitral repair implant) and transcatheter transapical chordal repair systems (Neochord DS 1000 device and Harpoon Mitral Valve Repair System) are reviewed in this manuscript.

Pseudo Chediak-Higashi (PCH) granules are mainly common in acute myeloid leukemia. Here we found a patient diagnosed with common-B acute lymphoblastic leukemia(ALL) with PCH cytoplasmic granules, which was rarely seen in daily diagnosis. The morphology of the granules is different in transmission electron microscope (TEM) from cases reported before. There is a vesicle with various-sized particles surrounding the nucleus, in addition to the particles, a multiple-layer membrane structure was also detected in the vesicle.

Background: Allergic rhinitis (AR) is the most common allergic disease in children and is closely associated with asthma in the context of atopic march. The development process of AR in early childhood, however, is not well understood due to the absence of definitive diagnostic criteria. We prospectively investigated the process in regard to not only the nasal symptoms and sensitization, but also the nasal cytology, in relation to asthma in a high-risk cohort. Methods: Infants under 2 years of age with atopic dermatitis (AD) and/or food allergy (FA) without a diagnosis of asthma were recruited and followed prospectively for 2 years. The phenotype of perennial AR was classified based on the presence/absence of 1) persistent nasal symptoms, 2) nasal eosinophils and 3) HDM sensitization, the most common allergen for perennial AR in Japan. AR-like phenotypes were defined as positive for at least 2 of those 3 categories. Results: A total of 304 children were enrolled, and 242 subjects (80%) completed the 2-year observation. The prevalence of eosinophilia in nasal secretions increased from 18.5% to 69.9%, while HDM-specific IgE >0.35 kUA/L increased from 30.6% to 74.8%. AR-like phenotypes increased from 18.4% to 65.0%. The cumulative incidence of physician-diagnosed asthma during the 2-year follow-up was significantly higher in the subjects with an AR-like phenotype at 1 year than in those with a non-AR phenotypes. Conclusions: The prevalence of an HDM-related AR-like phenotype was markedly increased during infancy in high-risk infants with AD/FA and was associated with asthma.

Soil salinity is emerging as a major threat to the sustainability of modern agricultural production systems and, historically, land and water degradation due to salinity has defeated civilisations whenever the cost of remediation exceeded the benefits. This work discusses the complexity inherent in working with salinity, and the opportunities where salt damaged land and water is viewed as a resource. It takes a wider look at land and waterscapes, seeing them as systems that link damage and repair across time and space to bridge the divide between the main beneficiaries of ecosystem services and the main actors, farmers, and land managers. We first discuss the mechanistic basis of crop reduction by salinity and evolution of ideas about how to shape the plant-soil-water nexus. We then discuss the needs of farmers and other land users required for adequate planning and land management within the constraints of existing policy. Lastly, an approach that provides a new technical and economic tool for the remediation of land in several land use categories is presented. We conclude that a more concerted effort is required to turn payments for ecosystem services into a true market, accepted as such by the land managers, whose agency is essential so the ‘knowledge of what can be done can be transformed into benefits’. Achieving this will require a transformation in the paradigm of how natural resources are managed.

Evaluating the factors that promote invasive ant abundance is critical to assess their ecological impact and inform their management. Many invasive ant species show reduced nestmate recognition and an absence of boundaries between unrelated nests, which allow populations to achieve greater densities due to reduced intraspecific competition. We examined nestmate discrimination and colony boundaries in introduced populations of the red imported fire ant (Solenopsis invicta; hereafter, fire ant). Fire ants occur in two social forms: monogyne (colonies with a single egg-laying queen) and polygyne (colonies with multiple egg-laying queens). In contrast with monogyne nests, polygyne nests are thought to be interconnected due to the reduced antagonism between non-nestmate polygyne workers, perhaps because polygyne workers habituate the colony to an odor unique to Gp-9b-carrying adults. However, colony boundaries and nestmate discrimination are poorly documented, particularly for worker-brood interactions. To delimit boundaries between field colonies, we correlated the exchange of a 15N-glycine tracer dissolved in a sucrose solution with social form. We also evaluated nestmate discrimination between polygyne workers and larvae in the laboratory. Counter to our expectations, polygyne colonies behaved identically to monogyne colonies, suggesting both social forms maintain strict colony boundaries. Polygyne workers also preferentially fed larval nestmates and may have selectively cannibalized non-nestmates. The levels of relatedness among workers in polygyne colonies was higher than those previously reported in North America (mean ±SE: 0.269 ± 0.037). Our study highlights the importance of combining genetic analyses with direct quantification of resource exchange to better understand the factors influencing ant invasions.

Investigating the impacts of climate and land use changes on basin’s hydrological cycle and environment is important to provide scientific evidence to manage the trade-off and synergies among water resource, agricultural production and environment protection. In this study, we quantified the contributions of climate and land-use changes to runoff, sediment, nitrogen and phosphorus losses in the Haihe River basin since the 1980s. The results showed that (1) climate and land-use changes significantly increased evapotranspiration (ET), transport loss (TL), sediment input (SI) and output (SO), and organic nitrogen (ON) and phosphorus production (OP), with ET, SI, and ON affected most. (2) The runoff, sediment and ammonia nitrogen were affected most by climate and land use changes in the Daqing River Basin (217.3 mm), Nanyun River Basin (3917.3 ton) and Chaobai River Basin (87.6 kg/ha), respectively. (3) The impacts of climate and land-use changes had explicit spatial-temporal patterns. In the Daqing River, Yongding River and Nanyun River, the contribution of climate change to runoff and sediment kept increasing and reached 88.6%~98.2% and 63%~77.2%, respectively. In the Ziya River and Chaobai River Basin, the contribution of land use was larger, reaching 88.6%~92.8% and 59.8%~92.7%, respectively. In the Yongding River Basin, Chaobai River Basin, Ziya River Basin and Daqing River Basin, the contribution of land use to nitrogen and phosphorus loss showed an increasing trend in the past 40 years (maximum: 89.7%). By contrast, in Nanyun River and Luanhe River, the contribution of climate change to nitrogen and phosphorus loss increased more obviously (maximum: 92.1%). We quantitatively evaluated the spatial and temporal impacts of climate and land-use changes on runoff, sediment, and nitrogen and phosphorus loss, which are useful to support the optimizations of land and water resources in the River Basin.

We presenting a patient suffering from a multi-focal liver abscess. Due to the corona pandemic the patient was treated conservatively using recurring out-patient visits. Follow-up was carried through dialogue with the GP, as well as daily telemedicine visits. The virtual visits were supplemented by episodical ultrasound scans.

Background. In the United States, infection with SARS-CoV-2 caused 380,000 reported deaths from March to December 2020. Methods. We adapted the Moving Epidemic Method to all-cause mortality data from the United States to assess the severity of the COVID-19 pandemic across age groups and all 50 states. By comparing all-cause mortality during the pandemic with intensity thresholds derived from recent, historical all-cause mortality, we categorized each week from March to December 2020 as either low severity, moderate severity, high severity, or very high severity. Results. Nationally for all ages combined, all-cause mortality was in the very high severity category for 9 weeks. Among people 18 to 49 years of age, there were 29 weeks of consecutive very high severity mortality. Forty-seven states, the District of Columbia, and New York City each experienced at least one week of very high severity mortality for all ages combined. Conclusions. These periods of very high severity of mortality during March through December 2020 are likely directly or indirectly attributable to the COVID-19 pandemic. This method for standardized comparison of severity over time across different geographies and demographic groups provides valuable information to understand the impact of the COVID-19 pandemic and to identify specific locations or subgroups for deeper investigations into differences in severity.

Mammals around the world face serious threats and experience massive decline in their populations and geographic ranges. The sloth bear has become extinct from two of five range countries and the existing population face serious conservation threats. Despite being endangered in Nepal, decades of conservation obliviousness have hindered their conservation and management. We assessed the distribution and habitat use by sloth bears in relation to landscape, environmental, and anthropogenic factors in Chitwan National Park, Nepal. We conducted a sign survey from March-June 2020 in 4*4 km2 grids (n=45) in a checkerboard approach. An observation was spatially replicated four times by recording information in four continuous search trails of 1 km each. We recorded presence/absence of sloth bears, termites, fruits and disturbance in the field and extracted information on tree cover, terrain ruggedness and vegetation index from remotely sensed image of the study area. The data was analyzed using single species-single season occupancy method in PRESENCE software. By using repeated observations these models account for imperfect detectability of species to provide robust estimates of species occupancy. Averaged habitat occupancy estimate obtained from the best models was Ѱ = 0.53 ± 0.04SE with detection probability p = 0.44 ± 0.1SE. Selection of variable based on summed AIC weight from the top models (AIC<2) showed that presence of termites (ƩWi=0.66) significantly influenced sloth bear habitat occupancy. Habitat occupancy was positively influenced by termites followed by fruits, disturbance, terrain ruggedness and vegetation productivity, whereas, it was negatively influenced by tree cover. We suggest that future conservation interventions and action plans aimed at sloth bear management must adequately consider these requirements and issues.

Community assembly of diverse mutualistic symbionts in host plants have recently received much attention. On the other hand, for decades, researchers have also focused on a role of genetic variation for shaping ecological communities. However, it remains unclear how local interaction networks between a host and symbionts are shaped from the pool of genetically diverse microorganisms in the natural rhizosphere. In this study, we comprehensively analyzed local and regional genetic communities of Frankia in host individuals and in surrounding soils using metabarcoding to unravel community assembly in shaping interaction networks between plants and root nodule symbionts, both of which are genetically diverse, in natural ecosystems. We found that Frankia communities in rhizosphere soil were consisted of tremendously diverse strains. The diverse Frankia communities in rhizosphere soils were heterogeneously structured by the presence of host individuals and soil nutritional status. Furthermore, quantification of the filtering forces by community analysis demonstrated that the filtering forces that shape symbiotic networks would depend on genetic variation in the host plant. This study suggests that filtering mechanisms and host genetics would have a profound role in shaping plant-bacterium symbiotic networks in natural environments.

Abstract A mediastinal carcinoid is a low-grade malignant tumor, which has low risk of metastasis, and cardiac metastasis is even rarer. When a patient has cardiac metastasis, the primary carcinoid is usually widely metastasized. In this case report, we presented occurrence of isolated left-sided cardiac metastases ten years after surgical removal of left anterior superior mediastinal carcinoid.

Objective: To assess the ability of an extended Instrumental Variable Causal Forest Algorithm (IV-CFA) to provide personalized evidence of early surgery effects on benefits and detriments for elderly shoulder fracture patients. Data Sources/Study Setting: Population of 72,751 fee-for-service Medicare beneficiaries with proximal humerus fractures (PHFs) in 2011 who survived a 60-day treatment window after an index PHF and were continuously Medicare fee-for-service eligible over the period 12 months prior to index to the minimum of 12 months after index or death. Study Design: IV-CFA estimated early surgery effects on both beneficial and detrimental outcomes for each patient in the study population. Classification and regression trees (CART) were applied to these estimates to create patient reference classes. Two-stage least squares (2SLS) estimators were applied to patients in each reference class to scrutinize the estimates relative to the known 2SLS properties. Principal Findings: This approach uncovered distinct reference classes of elderly PHF patients with respect to early surgery effects on benefit and detriment. Older, frailer patients with more comorbidities, and lower utilizers of healthcare were less likely to gain benefit and more likely to have detriment from early surgery. Reference classes were characterized by the appropriateness of early surgery rates with respect to benefit and detriment. Conclusions: Extended IV-CFA provides an illuminating method to uncover reference classes of patients based on treatment effects using observational data with a strong instrumental variable. This study isolated reference classes of new PHF patients in which changes in early surgery rates would improve patient outcomes. The inability to measure fracture complexity in Medicare claims means providers will need to discuss the appropriateness of these estimates to patients within a reference class in context of this missing information.

Background: Although well described in adults, there are scarce and heterogeneous data on the diagnosis and management of chronic urticaria (CU) in children (0-18 years) throughout Europe. Our aim was to explore country differences and identify the extent to which the EAACI/GA²LEN/EDF/WAO guideline recommendations for paediatric urticaria are implemented. Methods: The EAACI Taskforce for paediatric CU disseminated an online clinical survey among EAACI paediatric section members. Members were asked to answer 35 multiple choice questions on current practices in their respective centres. Results: The survey was sent to 2,773 physicians of whom 358 (13.8%) responded, mainly paediatric allergists (80%) and paediatricians (49.7%), working in 69 countries. For diagnosis, Southern European countries used significantly more routine tests (e.g., autoimmune testing, allergological tests, and parasitic investigation) than Northern European countries. Most respondents (60.3%) used a 2nd generation antihistamine as first- line treatment of whom 64.8% up dosed as a second- line. Omalizumab, was used as a second line treatment by 1.7% and third-line by 20.7% of respondents. Most clinicians (65%) follow EAACI/WAO/GA2LEN/EDF guidelines when diagnosing CU, and only 7.3% follow no specific guidelines. Some clinicians prefer to follow national guidelines (18.4%, mainly Northern European) or the AAAAI practice parameter (1.7%). Conclusions: Even though most members of the Paediatric Section of EAACI are familiar with the EAACI/WAO/GA2LEN/EDF guidelines, a significant number do not follow them. Also, the large variation in diagnosis and treatment strengthens the need to re-evaluate, update and standardize guidelines on the diagnosis and management of CU in children.

Abstract Background: Hepatic dysfunction (HD) is a serious complication after cardiovascular surgery. However, risk factors of developing hepatic dysfunction after acute type A aortic dissection (AAAD) are largely unclear. Methods: The clinical data of 227 patients with AAAD repaired by modified triple-branched stent graft implantation from January 2018 to January 2020 were collected retrospectively, including preoperative , surgical and postoperative information. Logistics regression was used to explore the potential risk factors of HD. Results: In the early stage after operation, a total of 57 patients were complicated with HD, accounting for 25.11%. The hospital mortality rate in these patients with HD was 19.30%, while the rate in patients without HD was only 6.5%. We found that preoperative body mass index (BMI)>30kg/㎡(OR: 7.054, 95%CI: 1.798-27.678, P=0.005), preoperative renal insufficiency(OR:7.575,95%CI:2.923-19.629, P=0.000),preoperative moderate/severe pericardial effusion(OR: 16.409, 95%CI: 2.81-93.444, P=0.002) and cardiopulmonary bypass time>180min (OR: 7.190, 95%CI: 3.113-16.608, P＝0.000) were independent risk factors for HD after AAAD repaired by modified triple-branched stent graft implantation. Conclusions: Preoperative BMI>30kg/㎡, preoperative renal insufficiency, preoperative moderate/severe pericardial effusion and cardiopulmonary bypass time>180min are independent risk factors for HD after total arch repair with modified triple-branched stent graft implantation in AAAD patients. And the occurrence of HD after operation would prolong the time of mechanical ventilation and the hospitalization time of ICU, and significantly increase the in-hospital mortality of patients. Keywords: risk factors,acute type A aortic dissection,hepatic dysfunction, modified triple-branched stent graft implantation, total arch repair

Aim: To determine pre- and post-transplant appetite and nutritional status of children undergoing stem cell transplantation. Methods: This study was conducted between November 2018 and November 2020 with 25 children, aged 8-18 years, diagnosed with cancer without secondary disease and scheduled for stem cell transplantation. Time points: seven days pre-stem cell transplant (T1); transplant day (T2); Day 1 post-transplantation (T3); Day 14 post-transplantation (T4); and Day 30 post-transplantation (T5). Measurements for treating pediatric anorexia and cachexia include: height, mid-upper arm circumference (MUAC); body mass index (BMI); and the Pediatric Functional Assessment Scale (Peds-FAACT). Results: 52% of patients were female, and mean age was 13.2 years. Acute lymphoblastic leukemia was diagnosed in 32% of the children. There was a statistically significant difference between the means of body weight over time (p<0.001). By Day 14 post-transplantation, 61% of subjects (n=14) had lost > 5% of body weight. There was a statistically significant difference between distributions of change in food taste over time, and distribution of change in food smell (p<0.001, p<0.001, respectively). Conclusions: Clinical nutrition teams should closely follow the children’s nutritional status, plan appropriate nutritional treatment, perform nutritional care, and evaluate anthropometric measurements.

Background The aim of this study was to evaluate three commercially available methods (Allplex SARS-CoV-2 Assay, Allplex SARS-CoV-2/FluA/FluB/RSV Assay and Novaplex SARS-CoV-2 Variants I Assay) for screening of the SARS-CoV-2 VOC 202012/01 B.1.1.7 variant. Methods A total of 160 nasopharyngeal samples (150 positive and 10 negative for SARS-CoV-2) were tested with all three molecular assays. Next-generation sequencing (NGS) was used as the reference method to determine analytical performance. Results Total (100%) agreement was found for SARS-CoV-2 detection with all three assays. For B.1.1.7 screening, the sensitivity of the Allplex SARS-CoV-2 Assay, the Allplex SARS-CoV-2/FluA/FluB/RSV Assay and the Novaplex SARS-CoV-2 Variants I Assay (Seegene Inc.) were 94.5%, 98.7% and 100 %, respectively, while the specificities of the assays were 98.6%, 81.7% and 100%, respectively. Conclusions Although the best results for identifying the B.1.1.7 variant in this study were achieved with the Novaplex Variants I Assay, the three approaches evaluated can be considered cost-effective primary screening tools to rapidly monitor the VOC 202012/01 B.1.1.7 variant.

Letter to the Editor RE: Modification of oxytocin use through a coaching-based intervention based on the WHO Safe Childbirth Checklist in Uttar Pradesh, India: a secondary analysis of a cluster randomized controlled trialAvir Sarkar, MD1; Shalini Venkatappa, MD1; Isha Wadhawan, MD, Diplomate to ABOG21 – Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India2 – Department of Obstetrics and Gynecology, Fortis Escorts Hospital, Faridabad, Haryana, IndiaCorresponding author: Avir SarkarAddress: House number 12, Block F, NIT-3, Faridabad, Haryana-121001, IndiaE mail: avirsarkar93@gmail.comType of article: Letter to the EditorWord count: 464Number of references: 2Conflict of interest between authors: None declared

Conspicuous female signals have recently received substantial scientific attention, but it remains unclear if their evolution is the result of selection acting on females independently of males or if mutual selection facilitates female change. Species that express female, but not male, phenotypic variation among populations represent a useful opportunity to address this knowledge gap. White-shouldered fairywrens (Malurus alboscapulatus) are tropical songbirds with a well-resolved phylogeny where female, but not male, coloration varies allopatrically across subspecies. We explored how four distinct signaling modalities, each putatively associated with increased social selection, are expressed in two populations that vary in competitive pressure on females. Females in a derived subspecies (M. a. moretoni) have evolved more ornamented plumage and have shorter tails (a signal of social dominance) relative to an ancestral subspecies (M. a. lorentzi) with drab females. In response to simulated territorial intrusions broadcasting female song, both sexes of M. a. moretoni are more aggressive and more coordinated with their mates in both movement and vocalizations. Finally, M. a. moretoni songs are more complex than M. a. lorentzi, but song complexity does not vary between sexes in either population. These results suggest that correlated phenotypic shifts in coloration and tail morphology in females as well as song complexity and aggression in both sexes may have occurred in response to changes in the intensity of social selection pressures. This highlights increased competitive pressures in both sexes can facilitate the evolution of complex multimodal signals.