Is biased mutation sufficient to save runaway sexual selection?

In the 1980s, groundbreaking theoretical studies showed that orna- ments displayed during courtship can coevolve with preferences for such ornaments, leading to extreme exaggeration of both traits. Later mod- els cast doubt on such 'runaway' sexual selection, showing that even a small cost of preferences can prevent exaggerated ornaments from per- sisting long-term. It was subsequently shown that if mutations acting on the ornament are biased - tending to produce smaller rather than larger ornaments - then exaggeration can persist even in the presence of pref- erence costs, seemingly vindicating the original models. Here, we unpack an implicit assumption of these 'biased mutation' models: Mutations are assumed to lead, on average, to both smaller and less costly ornaments. Biased mutation consequently generates both a fitness cost (due to re- duced mating success) and a fitness benefit (due to increased survival). We lift this assumption by separating an individual's investment in an or- nament from their efficiency in converting such investment into ornament size. We assume that biased mutation acts only on efficiency, but not on investment, and discuss the plausibility of this alternative assumption. Our model predicts that exaggerated ornaments and preferences can per- sist stably once they arise, but that strong initial preferences are needed to kick-start the runaway process. Consequently, biased mutation alone may not always be sufficient to save runaway sexual selection.

Gender differences in happiness in Chinese society: The role of parental preference for sons over daughters.

OBJECTIVE: This paper studies the relationship between Chinese parents' preference for sons over daughters in childhood and these children's happiness in adulthood. BACKGROUND: Happiness is an important dimension for measuring a society's well-being and a lifelong goal for many Chinese citizens deeply influenced by Confucianism. However, China's relatively low world ranking on happiness is worrisome for Chinese policymakers and prompts the question of whether the concept of "preference for sons" is related to lower adult happiness. METHODS: This study used the 2018 China Health and Retirement Longitudinal Study to analyze the relationship between parents' preference for sons over daughters in one's childhood and adult happiness using the least squares method. An instrumental variable method was used to address endogeneity concerns. In addition, the Karlson-Holm-Breen method was used to analyze the mediating effects of childhood educational opportunities and health resources. RESULTS: Parents' preference for sons over daughters in one's childhood was positively related to the happiness of male adults but negatively for female adults. Childhood education opportunities and childhood health resources have a mediating effect on the relationship between parental preference for boys and children's happiness in adulthood. CONCLUSIONS: Parents' preference for sons over daughters substantially explains the gender gap in happiness in adult Chinese citizens. Reducing the idea of prioritizing boys over girls has the potential to improve the happiness level of adults.

When the "Scytale" of Alcohol Runs in a Family and Alcohol Use Becomes a Transgenerational Issue: Case Report of a Father and Son Attending the Same Therapeutic Program.

Children whose parents are diagnosed with alcohol use problems are exposed to genetic and environmental risk factors and face a greater risk of developing mental health and behavioral problems and a higher risk of alcohol use. In this study, we present the case of a father and his son, both diagnosed with alcohol use disorder, who both attended, 12 years apart, the Inpatient Alcohol Treatment Program of the Alcohol Treatment Unit, in the Psychiatric Hospital of Attica, in Athens. The Alcohol Treatment Unit offers two inpatient treatment programs that have been operating since 1996 and are based on the principles of the Therapeutic Community. It was the first time that both a father and son coming from the same family attended one of these programs. The aim of this study is to extract useful information regarding the dynamics of a family in which alcohol dependence is transferred from generation to generation. Therapists try to decode this transference and interpret attitudes and behaviors under these circumstances.

Una aproximación a la satisfacción con la alimentación en familias monoparentales con jefatura femenina / An approach to satisfaction with food-related life in female-headed single parent households

Resumen 1Los hogares monoparentales se ven enfrentados a compatibilizar la generación de ingresos con las tareas de cuidado en el hogar, como la alimentación familiar, la cual se configura como un dominio clave en el bienestar. Es por ello, que el objetivo de este estudio buscó explorar los significados acerca de la satisfacción con la alimentación que tienen madres e hijos de familias monoparentales con jefatura femenina. A partir de un estudio de caso de método mixto, mediante la participación de 47 familias monoparentales de jefatura femenina, tanto madres como hijos adolescentes, cuyas edades fluctuaban entre 10 y 17 años de edad, completaron individualmente una tarea de asociación de palabras con "estar satisfecho con mi alimentación" y una tarea de finalización de palabras con "estaría más satisfecho con mi alimentación si...". Los resultados evidenciaron que los significados de la satisfacción con la alimentación son atribuibles a la conceptualización formal del constructo y que no existiría diferencias estadísticamente significativas entre las respuestas dadas por madres e hijos, en base a los determinantes de comportamiento en la alimentación. Así se concluyó que las similitudes en los significados, en torno a los determinantes que se identifican con la satisfacción con la alimentación y con los aspectos que podrían aumentarla, permiten constatar la influencia de la familia en las construcciones y significados que forman parte de la identidad individual y cultural de los adolescentes, lo cual se convierte en un insumo necesario para el diseño de prácticas y estrategias que propicien una mayor satisfacción con la alimentación.

Abstract Numerous female-headed single parent households face increased pressure when attempting to balance income generation with household responsibilities, such as family nutrition, which is critical given its greater influence on children's nutrition and diet quality (Hebestreit et al., 2017). This situation is critical in light of the fact that food is positioned as a critical domain of human well-being (Schnettler et al., 2014, 2017; Denegri et al., 2014, 2016). Satisfaction with food-related life is conceptualized as an individual's global cognitive evaluation of his or her diet (Grunert, Dean, Raats, Nielsen, y Lumbers, 2007); its formal definition is connected to other facets of life such as health, family, and social relationships (Grunert et al., 2007). According to the literature, satisfaction with food-related life is defined in terms of three primary determinants of eating behavior: the food consumed, the individual, and the diet's context (Köster, 2009). The purpose of this study is to contribute to our understanding of female-headed single-parent families and their meanings by examining the importance placed on the family as the first social space in which people construct and shape their social representations in various spheres of daily life (Moscovici, 1984). The overall objective is to investigate the meanings of satisfaction with food-related life for mothers and adolescent children in female-headed single-parent families. The specific objectives are to i) define the semantic entities of food satisfaction in relation to mothers and adolescent children, ii) identify factors that contribute to mothers' and adolescent children's food satisfaction, and iii) compare how mothers and adolescent children perceive their food satisfaction and the factors that contribute to it increasing. To accomplish these goals, a mixed case study research design was used. This entails combining quantitative and qualitative research methods in order to gain a better understanding of the research issues (Cresswell y Plano Clark, 2011). A total of 47 Chilean single-parent families with a female head of household participated in this study. It consists of a fee-paying mother that has at least one adolescent child between the ages of 10 and 17. The data collection method was an interview developed and tested in the Chilean population by Schnettler et al. (2020), based on a projective technique (Mesas y Escribano, 2018), in which mothers and adolescent children individually responded to the first words, terms, or phrases associated with the expression "being satisfied with my food-related life" with the goal of determining the meaning of satisfaction with food-related life. They were then asked to complete the sentence "I would be more satisfied with my food-related life if...". In order to identify factors that could improve their satisfaction with food-related life. The data was textually analyzed by segmenting and coding it. Subsequently, by establishing conceptual relationships, categories and supracategories were generated deductively (Krippendorff, 2004). Following that, the information expressed in the results and plotted in frequency tables is synthesized and interpreted. The Chi-square test was used to compare mothers' and adolescent children's responses (Agresti, 1990). In conclusion, the findings indicate that the meanings of satisfaction with food-related life can be ascribed to the construct's formal conceptualization. Thus, this study provides evidence that the construct is valid. There were also similarities in the meanings of mothers and adolescent children when it came to the determinants associated with food satisfaction, as well as the factors that could increase their satisfaction with food-related life. This finding is critical for establishing the family's influence on the constructs and meanings associated with adolescents' cultural identities.

"Mi viaje": Procesos de revelación y aceptación de la orientación sexual en las familias / "My journey": Processes of disclosure and acceptance of the sexual orientation in families

Resumen Según el informe realizado por la Asociación Internacional de Lesbianas, Gays, Bisexuales, Trans e Intersex (ILGA) en el año 2017, menos del 25 % de los territorios del planeta reconocen a la población Lesbianas, Gays, Bisexuales, Transexuales e Intersexuales (LGBTI+) y, de igual forma, aún hay numerosos países, en su mayoría del continente africano, que penalizan, discriminan y rechazan la homosexualidad. Además, diferentes estudios han evidenciado que para muchas familias es difícil separarse de la tradición heteronormativa y aceptar la orientación sexual de un hijo gay o una hija lesbiana o bisexual. Esta investigación buscó comprender el proceso de revelación y aceptación de la orientación sexual en 15 familias con integrantes gays, lesbianas y bisexuales en Cali-Colombia, a través de una entrevista semiestructurada y una línea de tiempo denominada Mi viaje en la que los participantes plasmaban sus narrativas en dibujos. En el presente estudio participaron 15 familias, las cuales estuvieron conformadas tanto por hijos/as entre los 19 y 26 años como por padres/cuidadores entre 41 y 64 años. A partir del análisis temático de las entrevistas realizadas de manera individual, se evidencia que los procesos de revelación de la orientación sexual se generan durante la adolescencia temprana, media y tardía, y la madre fue aquella integrante de la familia a quien le revelaron en un primer momento. Además, se presentan las formas a través de las cuales se dio la revelación, que fueron directas o indirectas y en algunos casos derivaron en secretos familiares. Se concluye que los procesos que atraviesan las familias frente a la revelación y aceptación de la orientación sexual de un hijo gay o una hija lesbiana o bisexual cuentan con fases dinámicas que pueden presentarse en distintos momentos y de diferentes formas, según las características particulares de cada familia y su contexto.

Abstract According to the report carried out by the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA) in 2017, less than 25 % of the territories of the planet recognize Lesbian, Gay, Bisexual, Transgender and Intersex (the LGBTI + population) and, in the same way, there are still numerous countries, mostly from the African continent, who penalize, discriminate and reject homosexuality. In Colombia, between the years 2016, 2017 and until February 2018, 139 homicides of LGBTI+ people were reported. Additionally, in several of its cities, among which are Barranquilla, Medellín, Bogotá and Cali, there has been violence by the National Police against LGBTI+ people because of their sexual orientation and gender identity. In this regard, 21 cases have been reported between 2008 and 2017, of which two were against gay men and three against lesbian women. In addition, in Valle del Cauca, 195 homicides were reported up to the year 2017 which were related to the sexual orientation and gender identity of the victims, specifically located in the city of Santiago de Cali, in which nine murders were reported, four of which were gay men, two lesbian women and three trans women (Colombia Diversa, 2018). Furthermore, different studies have shown that it is difficult for many families to separate from the heteronormative tradition and accept the sexual orientation of a gay son or a lesbian or bisexual daughter. This research sought to characterize the process of disclosure and acceptance of sexual orientation in 15 families with gay sons and lesbian and bisexual daughters in Cali-Colombia, using a semi-structured interview and a timeline called My Journey in which the participants reflected their narratives in drawings. The research was qualitative, with a narrative design by topics (Hernández, Fernández & Baptista, 2014). The results are articulated to the macro project called "Family dynamics in the process of disclosure and acceptance of the sexual orientation of gay sons and lesbian daughters in the city of Cali-Colombia" In the present study, 15 families participated, which were made up of both children and parents / caregivers. From the thematic analysis of the interviews carried out individually, the descriptions made by the families of the moment in which the sons and daughters revealed their sexual orientation are mentioned. This moment corresponds to early, middle and late adolescence, and the mother was the one to whom the sexual orientation was revealed at first. In addition, the forms through which the revelation was given are presented, which were direct or indirect and, in some cases, led to family secrets. It is concluded that the processes that families go through in the face of the disclosure and acceptance of the sexual orientation of a gay son or a lesbian or bisexual daughter have dynamic phases that can occur at different times and in different ways depending on the particular characteristics of each family and its context. It is recommended to promote associations of families and friends united in favor of gender diversity, in such a way that they are configured as elements for decision-making in public policies and actions, which generate care routes for other families that require guidance in any of the stages they are going through and that can provide social support to gay sons, lesbian daughters and their families. From the field of health professionals who accompany families in affirmative processes, it is necessary to strengthen training with a gender perspective and in future studies address the experiences of families with transgender members, taking into account their specific needs and from an intersectional perspective.

Long-term persistence of exaggerated ornaments under Fisherian runaway despite costly mate search.

Exaggerated ornaments often evolve due to the mating preferences of the opposite sex. Genetic correlations between preferences and ornaments can lead both traits to elaborate dramatically in tandem, in a process known as 'Fisherian runaway'. However, in most previous models of Fisherian runaway, elaborate ornaments are not expected to persist when preferences are consistently costly to the choosing sex. In contrast, we show here that exaggerated male ornaments can be maintained long term even when females must pay a cost to choose their mates. Preferences per se are not costly in our model, but females can only act on their preferences by investing resources in mate search. We predict that mate search effort should decrease with the cost of sampling additional mates and increase with the number of possible ornaments that females can choose from. The potential for multiple exaggerated ornaments to coexist depends on subtleties of their cost structure: strict trade-offs (additive costs) favour sequential ornament evolution, whereas looser trade-offs (multiplicative costs) allow for coexistence. Lastly, we show that pleiotropy affecting both ornaments and preferences makes it difficult for Fisherian runaway to initiate, increasing the evolutionary time until ornamentation. Our model highlights the important but neglected role of mate search effort in sexual selection.

Alterations in deglutition in children with congenital Zika virus syndrome / Alterações na deglutição em crianças com síndrome congênita do vírus Zika

ABSTRACT Purpose To characterize swallowing in children with congenital Zika virus syndrome in comparison to typical children. Methods This cross-sectional study enrolled 45 children diagnosed with congenital Zika virus syndrome and 45 others with typical development. Swallowing was evaluated through clinical feeding evaluations Protocolo de Avaliação Clínica da Disfagia Pediátrica and using acoustic swallowing parameters (Doppler sonar). Results The mean age of children with congenital Zika virus syndrome was 26.69 ± 4.46 months and the mean head circumference was 29.20 ± 1.98 cm. Moderate/severe oropharyngeal dysphagia was found in 32(71.1%) of the children with congenital Zika virus syndrome. Significant differences were found between the groups on clinical evaluation: Children with congenital Zika virus syndrome presented insufficient lip closure 42(93.3%) and altered tonus of the tongue 35(77.8%) and cheeks 34(75.6%). In the children in the comparison group, only 6(13.3%) presented insufficient lip closure and 1(2.2%) had inadequate tongue posture. Changes during swallowing with liquid and spoonable food were not observed in the comparison group. When liquid/food was offered, affected children presented difficulties in sipping movements 14(77.8%) and lip/spoon contact 35(75%). The presence of residual food in the oral cavity after swallowing 38(86.4%) and clinical signs indicative of laryngotracheal penetration/aspiration, such as coughing, gagging and/or labored breathing, were also notable. No differences were found between the groups with regard to the acoustic parameters evaluated instrumentally. Conclusion Children with congenital Zika virus syndrome present alterations in the oral phase of swallowing, as well as clinical signs indicative of pharyngeal phase impairment.

RESUMO Objetivo Caracterizar a deglutição das crianças com síndrome congênita do Zika vírus e comparar com crianças típicas. Método Estudo de delineamento transversal, com 45 crianças diagnosticadas com síndrome congênita do Zika vírus e 45 típicas. A deglutição foi avaliada por meio de avaliações clínicas da alimentação através do Protocolo de Avaliação Clínica da Disfagia Pediátrica e dos parâmetros acústicos da deglutição (sonar Doppler). Resultados A idade média das crianças com síndrome congênita do vírus Zika foi de 26,69 ± 4,46 meses e o perímetro cefálico médio foi de 29,20 ± 1,98 cm. Disfagia orofaríngea de moderada a grave foi observada em 32(71,1%) das crianças com síndrome congênita do Zika vírus, ao contrário do grupo comparação que não revelou alterações na deglutição. Nas crianças com síndrome congênita do Zika vírus foram verificados lábios entreabertos 42(93,3%) e tônus alterado em língua 35(77,8%) e bochechas 34(75,6%). Nas crianças do grupo comparação apenas 6(13,3%) apresentaram fechamento labial insuficiente e 1(2,2%) postura de língua inadequada. Alterações durante a deglutição com líquido e alimento pastoso não foram observadas no grupo comparação. Durante a oferta do alimento ocorreram dificuldades no movimento de sorver 14(77,8%), na captação da colher 35(75%), resíduo em cavidade oral 38(86,4%) e sinais clínicos indicativos de penetração/aspiração laringotraqueal como tosse, engasgo e respiração com esforço. Não foram encontradas diferenças nos parâmetros acústicos da avaliação instrumental. Conclusão as crianças com síndrome congênita do Zika vírus têm alterações nas fases oral e faríngea da deglutição, com sinais clínicos indicativos de penetração/aspiração laringotraqueal quando comparadas a crianças típicas.

Raising sons or daughters for old age? Influence of children's gender on intergenerational family support in rural families.

Background: Under the background of miniaturization of family size and a growing number of young and middle-aged population outflow in rural China, the study of family pension mechanism in rural China from the perspective of changes in the pension functions of son and daughter will not only help to deepen the understanding of the change rules of China's family system, but also provide important reference for the future design of rural pension system. Data and method: The data come from the China Family Tracking Survey (CFPS), a nationwide social survey project runs by the Social Science Research Centre of Peking University. After excluding missing data, we obtained a valid sample of 11,207 sons and 2028 daughters in four data periods. We applied a fixed effects model for the analysis. Results: In rural areas, sons mainly provide economic support, while daughters mainly provide life care, thus forming a gender-based division of labor. With increasing off-farm job opportunities for daughters, they provide more economic support for their parents, but the time they spend on housework for their parents is reduced. As the number of children in a family has increased, daughters' role in supporting their parents has decreased. This research shows that although the traditional son-centered pension mode in China has not completely disintegrated, it has changed significantly. The findings reveal that changes in family size and improvements in women's status are important factors in changing family support patterns. Discussion: Different from the thought research about intergenerational relationship for a whole model, this article from the family internal different subjects role identity, shows the characteristics of the individual in the family, is conducive to theoretically explore the tension in the intergenerational relationship, individual and family which is helpful to understand the contemporary China's rural family generation ethics and intergenerational solidarity model. Families are classified more carefully according to the number, size and gender of children in the family, so as to fully show the heterogeneity and complexity of intergenerational relationships and old-age care models in rural families with different structural types. The discussion of the above issues has refined the description of rural family pension resources in China, which has certain reference significance for improving rural pension policies and actively dealing with the aging population.

Factors associated with recurrent wheezing in the first year of life among premature newborns from Neonatal Intensive Care Units / Fatores associados à sibilância recorrente no primeiro ano de vida entre recémnascidos prematuros provenientes de Unidades de Terapia Intensiva Neonatais

Abstract Objectives: to determine the prevalence and factors associated with recurrent wheezing in the first year of life among premature newborns from Neonatal Intensive Care Units, in the city of Montes Claros, northern Minas Gerais. Methods: cross-sectional study, with data collection from medical records of a follow-up clinic, interviews with mothers and, eventually, search in hospital records. Bivariate analyzes were carried out between sociodemographic and clinical characteristics and recurrent wheezing. Variables associated up to the level of 20% were analyzed by binary logistic regression, and associations defined by the Odds Ratio and respective 95% confidence intervals. Only variables associated with a 5% significance level were maintained in the final model of logistic regression. Results: among 277 infants studied, about one fifth (21.3%) were extremely low birth weight preterm and more than half (60.7%) had birth weight below 1500 grams. The prevalence of recurrent wheezing was 14.4% (CI95% = 10.3-18.4). Mechanical ventilation (OR = 2.12; CI95% = 1.09-4.76; p = 0.030) and oxygen therapy time ≥ 15 days (OR = 2.49; CI95%= 1.12-5.00; p = 0.010) were the risk factors for the event. Conclusions: there is a high prevalence of recurrent wheezing in the evaluated group and the associated variables reiterate the risk of prolonged oxygen therapy and mechanical ventilation for premature newborns.

Resumo Objetivos: determinar a prevalência e fatores associados à sibilância recorrente no primeiro ano de vida entre recém-nascidos prematuros egressos de Unidades de Terapia Intensiva Neonatais, na cidade de Montes Claros, norte de Minas Gerais. Métodos: estudo transversal, com coleta de dados em prontuários de ambulatório de seguimento, entrevistas com mães e, eventualmente, consultas aos prontuários hospitalares. Foram realizadas análises bivariadas entre as características sociodemográficas e clínicas e a sibilância recorrente. As variáveis associadas ao desfecho até um nível de significância de p ≤20% foram analisadas por regressão logística binária e as associações definidas pelas Odds Ratios e respectivos intervalos de confiança de 95%. Somente variáveis associadas a um nível de significância de 5% foram mantidas no modelo final de regressão logística. Resultados: entre 277 crianças estudadas, cerca de um quinto (21,3%) eram prematuros de extremo baixo peso e mais da metade (60,7%) tinha peso de nascimento abaixo de 1500 gramas. A prevalência de sibilância recorrente foi de 14,4% (IC95%=10,3-18,4). Ventilação mecânica (OR=2,12; IC95%= 1,09-4,76; p=0,030) e tempo de oxigenioterapia ≥15 dias (OR=2,49; IC95%=1,12-5,00; p=0,010) foram os fatores de risco para o evento. Conclusão: existe uma elevada prevalência de sibilância recorrente no grupo avaliado e as variáveis associadas reiteram o risco do uso prolongado de oxigenioterapia e da ventilação mecânica para recém-nascidos prematuros.

Immune responses to injury and their links to eye disease.

The eye is regarded as an immune privileged site. Since the presence of a vasculature would impair vision, the vasculature of the eye is located outside of the central light path. As a result, many regions of the eye evolved mechanisms to deliver immune cells to sites of dysgenesis, injury, or in response to the many age-related pathologies. While the purpose of these immune responses is reparative or protective, cytokines released by immune cells compromise visual acuity by inducing inflammation and fibrosis. The response to traumatic or pathological injury is distinct in different regions of the eye. Age-related diseases impact both the anterior and posterior segment and lead to reduced quality of life and blindness. Here we focus attention on the role that inflammation and fibrosis play in the progression of age-related pathologies of the cornea and the lens as well as in glaucoma, the formation of epiretinal membranes, and in proliferative vitreoretinopathy.

Risk factors for recurrent wheezing in preterm infants who received prophylaxis with palivizumab / Fatores de risco para sibilância recorrente em crianças pré-termo que receberam profilaxia com palivizumabe

ABSTRACT Objective: To determine the prevalence of recurrent wheezing (RW) in preterm infants who received prophylaxis against severe infection with respiratory syncytial virus (RSV) and to identify genetic susceptibility (atopy or asthma) and risk factors for RW. Methods: This was a cross-sectional study involving preterm infants who received prophylaxis with palivizumab at a referral center in Brazil during the first two years of age. A structured questionnaire was administered in a face-to-face interview with parents or legal guardians. Results: The study included 410 preterm infants (median age = 9 months [0-24 months]). In the sample as a whole, 111 children (27.1%; [95% CI, 22.9-31.5]) had RW. The univariate analysis between the groups with and without RW showed no differences regarding the following variables: sex, ethnicity, maternal level of education, gestational age, birth weight, breastfeeding, number of children in the household, day care center attendance, pets in the household, and smoking caregiver. The prevalence of RW was twice as high among children with bronchopulmonary dysplasia (adjusted OR = 2.08; 95% CI, 1.11-3.89; p = 0.022) and almost five times as high among those with a personal/family history of atopy (adjusted OR = 4.96; 95% CI, 2.62-9.39; p < 0.001) as among those without these conditions. Conclusions: Preterm infants who received prophylaxis with palivizumab but have a personal/family history of atopy or bronchopulmonary dysplasia are more likely to have RW than do those without these conditions.

RESUMO Objetivo: Determinar a prevalência de sibilância recorrente (SR) em crianças pré-termo que receberam profilaxia contra infecção grave pelo vírus sincicial respiratório (VSR) e identificar susceptibilidade genética (atopia ou asma) e fatores de risco para SR. Métodos: Estudo transversal envolvendo crianças pré-termo que receberam profilaxia com palivizumabe em um centro de referência no Brasil durante os primeiros dois anos de vida. Um questionário estruturado foi aplicado em entrevista presencial com os pais ou responsáveis. Resultados: O estudo incluiu 410 crianças pré-termo (mediana de idade = 9 meses [0-24 meses]). Na amostra total, 111 crianças (27,1%; IC95%: 22,9-31,5) apresentavam SR. A análise univariada entre os grupos com e sem SR não mostrou diferenças em relação às seguintes variáveis: sexo, etnia, escolaridade materna, idade gestacional, peso ao nascer, aleitamento materno, número de crianças no domicílio, frequência em creche, presença de animais de estimação no domicílio e cuidador tabagista. A prevalência de SR foi duas vezes maior entre crianças com displasia broncopulmonar (OR ajustada = 2,08; IC95%: 1,11-3,89; p = 0,022) e quase cinco vezes maior entre aquelas com história pessoal/familiar de atopia (OR ajustada = 4,96; IC95%: 2,62-9,39; p < 0,001) do que entre aquelas sem essas condições. Conclusões: Crianças pré-termo que receberam profilaxia com palivizumabe, mas apresentam história pessoal/familiar de atopia ou displasia broncopulmonar, têm maior probabilidade de apresentar SR do que aquelas sem essas condições.

Influence of the preference for sons on contraceptive use in Bangladesh: A multivariate analysis.

The preference for sons has been documented not only in Bangladesh but also in many Asian and African countries across various religions and social strata. This paper examines the levels, trends, and differentials in the use of contraceptives and investigates the effects of the preference for sons on contraception in Bangladesh. This research project extracted data from the last four nationally representative Bangladesh Demographic and Health Survey datasets (BDHS: 2004, 2007, 2011, and 2014) to examine the trends of preference for sons. The use of contraceptives among the respondents who had only daughters was comparatively lower than among those who had only sons due to a preference for sons. The analysis also reveals that the preference for sons was invariant with regards to various demographic and socioeconomic factors. Moreover, the analysis of religion in all four survey datasets indicates that Muslim women had stronger preferences for sons than their non-Muslim counterparts. Furthermore, the analysis showed that the preference for sons was strongest among women who had no education, did not work, and lived in rural areas.

Evaluation of treatment of the exacerbation of asthma and wheezing in a pediatric emergency department

SUMMARY OBJECTIVES: To evaluate the treatment of wheezing and exacerbation of asthma in a pediatric emergency unit (ED), comparing it to that recommended by the guidelines for this purpose. METHODS: Descriptive cross-sectional study through medical records survey of children and adolescents (0-15 years of age) who received medication for wheezing or asthma exacerbation from January to April 2015 in the ED. The selected treatment was compared to that recommended by the guidelines, being analyzed the variables related to the medication (number and dose of short-acting β2 agonist, associated or not with anticholinergic, oral or parenteral corticosteroid) and the length of stay in ED (≤1 h, ≥8 h and hospital admission). RESULTS: One-thousand eleven patients were selected with 56.7% between 3 and 15 years and 56% male. Although the selected drugs were in accordance with what was recommended, errors were observed in relation to dose, drug of choice, and method and time of use with the most frequent finding being incorrect dose (short-acting β2 agonist: 66% and ipratropium bromide: 95.2%). CONCLUSION: The level of use of the measures recommended by the guidelines was low but compatible with other studies, leading to an increased risk of treatment failure and higher costs. Despite wide dissemination, the established concepts have not been sufficiently incorporated into clinical practice, suggesting the need for more effective educational actions for this process to occur.

RESUMO OBJETIVOS: Avaliar o tratamento da sibilância e da exacerbação da asma em unidade de emergência pediátrica (DE), comparando-o ao recomendado pelas diretrizes para esse fim. MÉTODOS: Estudo descritivo transversal, por meio do levantamento de prontuários de crianças e adolescentes (0 - 15 anos de idade) que receberam medicação para sibilância ou exacerbação da asma, no período de janeiro a abril de 2015, em DE. O tratamento empregado foi comparado ao preconizado pelas diretrizes sendo analisadas as variáveis referentes à medicação (número e dose de β2 agonista de curta ação, associado ou não a anticolinérgico, corticosteroide oral ou parenteral) e ao tempo de permanência na DE (≤1 h, ≥8 h e internação hospitalar). RESULTADOS: Foram selecionados 1011 pacientes, 56,7% com idades entre 3 e 15 anos e 56 % do sexo masculino. Embora os fármacos utilizados estivessem de acordo com o preconizado, foram observados erros com relação a dose, droga de escolha, forma de utilização, tempo de uso, sendo dose incorreta o achado mais frequente (β2 agonista de curta ação: 66% e brometo de ipratrópio: 95,2%). CONCLUSÃO: O nível de utilização das medidas recomendadas pelas diretrizes foi baixo e compatível com outros estudos, levando a risco aumentado de falha no tratamento e maior custo. Apesar da ampla divulgação, os conceitos estabelecidos não são suficientemente incorporados à prática clínica, sugerindo a necessidade de ações educativas mais efetivas para que isso ocorra.

Fatores associados ao sexo para sibilância recorrente e asma / Sex-related factors for recurrent wheezing and asthma

Nas últimas décadas, consolidou-se o conhecimento da heterogeneidade de fatores associados à asma. Sexo, condições ambientais, genética, raça, obesidade, questões hormonais e imunológicas influenciam sintomas e resposta ao tratamento da asma. Associação entre asma e obesidade é observada em adultos e crianças e parece ser muito mais consistente no sexo feminino. As mulheres adultas também apresentam maior prevalência de asma em comparação aos homens, e têm três vezes mais chances de hospitalização, o que é mantido até a menopausa. Mulheres são mais afetadas quando expostas ao tabagismo passivo e ativo, e, nos meninos, a exposição intrauterina ao tabaco tem maior influência negativa no crescimento de vias aéreas. Homens e mulheres apresentam diferenças em relação ao envolvimento de pequenas vias aéreas. Os homens apresentaram mais aprisionamento aéreo induzido pela metacolina, enquanto as mulheres têm frações mais elevadas de óxido nítrico exalado. Mulheres apresentam maior diversidade de polimorfismos genéticos associados à asma. Quanto à resposta ao tratamento, homens respondem melhor funcionalmente, com aumento do VEF1, quando utilizam corticoides inalatórios. Meninos entre 2-9 anos respondem melhor aos antagonistas de leucotrienos, resposta que se inverte e passa a ser mais significativa em meninas entre 10-14 anos. O enfoque do manejo atual da sibilância recorrente e da asma deve levar em consideração aspectos individuais específicos, que variam entre homens e mulheres, e que impactam no tratamento e prognóstico da doença.

In recent decades, knowledge of the heterogeneity of asthma-related factors has been consolidated. Sex, environmental conditions, genetics, race, obesity, and hormonal and immunological factors influence symptoms and response to the treatment of asthma. The association between asthma and obesity is seen in adults and children and appears to be much more consistent in women. Adult women also have a higher prevalence of asthma compared to men and are three times more likely to be hospitalized, which persists until menopause. Women are more affected when exposed to passive and active smoking and, in boys, intrauterine tobacco exposure has a greater negative influence on airway growth. Men and women differ in terms of involvement of small airways. Men present with greater methacholine-induced air trapping, while women have higher fractions of exhaled nitric oxide. Women show a greater diversity of genetic polymorphisms associated with asthma. As for treatment response, men respond better functionally, with increased forced expiratory volume in 1 second (FEV1) when using inhaled corticosteroids. Boys aged 2-9 years respond better to leukotriene antagonists, a response that is then reversed and becomes more significant in girls aged 10-14 years. The current approach to recurrent wheezing and asthma must take specific aspects into account, which vary between men and women and impact the treatment and prognosis of the disease.

[Pitch perception modification due to antiepileptics: A literature and pharmacovigilance databases review]. / Modification de la perception des sons sous antiépileptiques : une revue de la littérature et des bases de pharmacovigilance.

Pitch perception modifications are among the little-known adverse effects observed with antiepileptics, mainly affecting patients treated with carbamazepine (CBZ). Here, we describe an original French case of pitch perception modification due to CBZ resulting in perfect pitch loss. We also reviewed the literature as well as French and world health organisation global pharmacovigilance database. The case report concerns a 22-year-old patient with perfect pitch with untreated left temporal partial epilepsy. Following a generalized seizure, the introduction of CBZ prolonged release (200mg twice a day) is decided. As soon as CBZ is introduced, the patient notices a change in pitch perception, about a semitone lower. This adverse effect persisted despite a gradual decrease in doses. The patient reported a total recovery of his perfect pitch when CBZ stopped completely 11 years later. In the French pharmacovigilance database, only one other case of pitch perception modification under CBZ was recorded (no cases were found with oxcarbazepine, lacosamide, sodium valproate, lamotrigine, levetiracetam, phenobarbital, phenytoin, primidone, ethosuximide, vigabatrine, felbamate, gabapentin, tiagabine and topiramate). In the literature, 27 cases of pitch perception modification have been published with CBZ, 1 case with oxcarbazepine and 1 case with lacosamide. Pitch perception modification is a very rare adverse effect of CBZ, oxcarbazepine and lacosamide, identified in the literature mainly in the Japanese population, in experienced musicians. A rapid onset after the introduction of treatment, a complete resolution of symptoms, in most cases upon discontinuation of treatment, is observed, with no sequelae reported. Due to the impact on quality of life, especially in patients whose profession is related to music, knowledge of this adverse event seems important to evoke this diagnosis.

Fisher's lost model of runaway sexual selection.

The bizarre elaboration of sexually selected traits such as the peacock's tail was a puzzle to Charles Darwin and his 19th century followers. Ronald A. Fisher crafted an ingenious solution in the 1930s, positing that female preferences would become genetically correlated with preferred traits due to nonrandom mating. These genetic correlations would translate selection for preferred traits into selection for stronger preferences, leading to a self-reinforcing process of ever-elaborating traits and preferences. It is widely believed that Fisher provided only a verbal model of this "runaway" process. However, in correspondence with Charles Galton Darwin, Fisher also laid out a simple mathematical model that purportedly confirms his verbal prediction of runaway sexual selection. Unfortunately, Fisher's model contains inconsistencies that render his quantitative conclusions inaccurate. Here, we correct Fisher's model and show that it contains all the ingredients of a working runaway process. We derive quantitative predictions of his model using numerical techniques that were unavailable in Fisher's time. Depending on parameter values, mean traits and preferences may increase until genetic variance is depleted by selection, exaggerate exponentially while their variances remain stable, or both means and variances may increase super-exponentially. We thus present the earliest mathematical model of runaway sexual selection.

Papilomatosis respiratoria: un reto diagnóstico y terapéutico. A propósito de un caso / Respiratory papillomatosis: a diagnostic and therapeutic challenge / Papilomatose respiratória: um desafio diagnóstico e terapêutico. Relato de caso / Case study

Resumen: La papilomatosis respiratoria es una neoplasia benigna infrecuente causada por el virus del papiloma humano, principalmente los tipos 6 y 11. Típicamente la papilomatosis laríngea se manifiesta con disfonía y estridor. La presentación clínica de la papilomatosis traqueobronquial es inespecífica. Esta enfermedad tiene un curso clínico impredecible y tendencia a la recurrencia. El objetivo de esta publicación es describir un caso poco frecuente en pediatría, que se presenta inicialmente con sintomatología inespecífica. Caso clínico: escolar de 6 años que requiere ingreso al sector de internación por insuficiencia respiratoria tipo 2 para estudio. Presenta un cuadro de dos meses de evolución dado por dificultad respiratoria progresiva, estridor y ronquido. Instala en forma aguda síntomas respiratorios altos, con intenso funcional respiratorio y tendencia al sueño, destacándose de la valoración inicial una acidosis respiratoria crónica descompensada, con hipercapnia severa, que requiere intubación orotraqueal. Mejora el funcional respiratorio, pero persiste al examen tiraje supraesternal, estridor e hipercapnia. Se realiza fibrolaringoscopía que evidencia una lesión supraglótica y otra a nivel traqueal con características de papiloma. Se realiza resección quirúrgica de éstas, tratamiento con bevacizumab y aciclovir intralesional. Se envían muestras para anatomía patológica e inmunohistoquímica, en la cual se detecta el virus del papiloma humano genotipo 11. Presenta buena evolución posoperatoria con retroceso de la sintomatología. Al mes, asintomático y fibrolaringoscopía de control normal. Conclusiones: el diagnóstico y tratamiento de la papilomatosis respiratoria constituyen un desafío debido a su manifestación clínica inespecífica y naturaleza recurrente.

Summary: Respiratory papillomatosis is an uncommon benign neoplasia caused by the Human Papilloma Virus, mainly by types 6 and 11. The typical symptoms of the larynx papillomatosis are dysphonia and stridor. For tracheobronchial papillomatosis, the symptoms are unspecific. This disease has an unpredictable clinical course and it tends to be recurrent. The objective of this paper is to describe one infrequent pediatric case, which initially showed unspecific symptomatology. Clinical case: six-year old child admitted due to a type 2 respiratory insufficiency. He had had clinical symptoms of progressive respiratory difficulty, stridor and snoring for two months. He developed acute high respiratory symptoms with intense functional respiratory and sleep tendency, and the initial check-up showed decompensated chronic respiratory acidosis with severe hypercapnia that required mechanical ventilation assistance. The respiratory function improved, but the suprasternal retraction, stridor and hypercapnia continued. The fibro laryngoscopy showed a supraglottic and a tracheal lesion with papilloma characteristics. Both were surgically resected and intralesional medical treatment with Bevacizumab and Acyclovir was administered. Samples for immunohistochemistry and pathology anatomy were taken, and the HPV type 11 was detected. Post-Surgical evolution was positive and after one month of follow-up the patient was asymptomatic and the control fibro laryngoscopy was normal. Conclusion: respiratory papillomatosis diagnosis and treatment is a challenge, due to its unspecific clinical manifestation and recurrent nature.

Resumo: A papilomatose respiratória é uma neoplasia benigna rara causada pelo vírus do papiloma humano, principalmente pelos tipos 6 e 11. Os sintomas típicos da papilomatose da laringe são disfonia e estridor. Para papilomatose traqueobrônquica, os sintomas são inespecíficos. Esta doença tem um percurso clínico imprevisível e tende a ser recorrente. O objetivo deste artigo é descrever um caso pediátrico pouco frequente, que inicialmente apresentava sintomatologia inespecífica. Caso clínico: criança de seis anos internada por insuficiência respiratória tipo 2. Ela apresentava sintomas clínicos de dificuldade respiratória progressiva, estridor e ronco por dois meses. Desenvolveu sintomas respiratórios agudos altos com intensa tendência respiratória e do sono funcional, e o controle inicial mostrou acidose respiratória crônica descompensada com hipercapnia grave que exigia assistência de ventilação mecânica. A função respiratória melhorou, mas a retração supraesternal, estridor e hipercapnia continuaram. A fibrolaringoscopia mostrou lesão supraglótica e traqueal com características de papiloma. Ambas foram ressecadas cirurgicamente e administrou-se tratamento intralesional com Bevacizumabe e Aciclovir. Coletaram-se amostras para teste imuno-histoquímico e anatomia patológica e detectou-se o HPV tipo 11. A evolução pós-cirúrgica foi positiva e, após um mês de acompanhamento, o paciente estava assintomático e a fibroaringoscopia de controle foi normal. Conclusão: o diagnóstico e tratamento da papilomatose respiratória é um desafio, devido à sua manifestação clínica inespecífica e a sua natureza recorrente.

Movimentos de língua na produção do /l/ em crianças com e sem distúrbios dos sons da fala em diferentes faixas etárias / Tongue movements in the production of /l/ in children with and without speech sound disorders in different ages

RESUMO Objetivo: este estudo utilizou a ultrassonografia dos movimentos de língua e modelos dinâmicos de produção de fala para caracterizar os gestos articulatórios na produção do /l/ no Português Brasileiro (PB) em diferentes faixas etárias, comparando-os entre crianças típicas e atípicas. Método: a amostra foi constituída por 30 crianças típicas e 30 atípicas, com idades entre 4 e 8 anos, submetidas a avaliações fonoaudiológica e ultrassonográfica. A avaliação foi realizada mediante gravação da produção de palavras com o som /l/ nos contextos vocálicos de /a/, /i/ e /u/, com seis repetições de cada palavra. O software utilizado foi o Articulate Assistant Advanced (AAA). Para as análises quantitativas foram considerados: os 42 pontos que interceptaram as curvas de língua em cada imagem para descrição dos gestos articulatórios; o cálculo das linhas médias de cada curva e os intervalos de confiança entre os grupos; e o cálculo das diferenças entre as curvas médias dos contornos de língua de acordo com a faixa etária. Resultados: houve elevação de ponta de língua e retração de dorso e raiz na articulação do /l/. As crianças típicas, independentemente da idade, apresentaram maior refinamento dos gestos articulatórios de língua do que as atípicas. Nas crianças mais velhas, houve maior delimitação nos contornos médios de língua desde a ponta até a raiz. Conclusão: a ultrassonografia dos movimentos de língua é uma importante ferramenta para a caracterização dos gestos articulatórios do /l/, para diferenciação entre as produções típica e atípica deste som, e observação do desenvolvimento dos gestos articulatórios.

ABSTRACT Purpose: this study used the ultrasonography of the tongue movements and the dynamic models of speech production to characterize the articulatory gestures of in the production of /l/ at the Brazilian Portuguese in different age groups, comparing them between typical and atypical children. Methods: the sample consisted of 30 typical and 30 atypical children between ages of four and eight-years-old, who underwent speech-language and ultrasonographic evaluations. The evaluation was realized by recording words reproduction with the sound /l/ and the following vocalic contexts: /a/, /i/ and /u/, repeating six times for each word. The software for recording and analysis was Articulate Assistant Advanced (AAA). The quantitative analysis considered the 42 points that intercepted the tongue curves in each image to describe the articulatory gestures; the estimation of the mean lines of each curve and the confidence intervals between typical and atypical children groups; and the differences between the mean tongue contours curves according to age group. Results: the results presented a tongue tip elevation and dorsal and root retraction in /l/. Typical children, regardless of age, showed a greater refinement of articulatory tongue gestures than the atypical ones. In older children, there was more delimitation in the mean tongue contours from the tongue tip to the root. Conclusion: the ultrasonography of the tongue movements is a substantial implement to characterize the articulatory gestures of /l/, to the differentiation between typical and atypical productions in this sound, and observation of the development of the articulatory gestures.

Recurrent wheezing in preterm infants: Prevalence and risk factors / Sibilância recorrente em prematuros: prevalência e fatores de risco

ABSTRACT Objective: To evaluate the prevalence and risk factors associated with progression to recurrent wheezing in preterm infants. Methods: The cross-sectional study was carried out in 2014 and 2015 and analyzed preterm infants born between 2011 and 2012. The search for these children was performed in a university maternity hospital and a Special Immunobiological Reference Center. The evaluation was performed through a questionnaire applied during a telephone interview. Results: The study included 445 children aged 39 (18-54) months. In the univariate analysis, the risk factors with the greatest chance of recurrent wheezing were birth weight <1000 g, gestational age <28 weeks, living with two or more siblings, food allergy, and atopic dermatitis in the child, as well as food allergy and asthma in the parents. In the multivariate analysis, there was a significant association between recurrent wheezing and gestational age at birth <28 weeks, food allergy and atopic dermatitis in the child, and living with two or more children. Of the 445 analyzed subjects, 194 received passive immunization against the respiratory syncytial virus, and 251 preterm infants were not immunized. There was a difference between the gestational age of these subgroups (p < 0.001). The overall prevalence of recurrent wheezing was 27.4% (95% CI: 23.42-31.70), whereas in the children who received passive immunization it was 36.1% (95% CI: 29.55-43.03). Conclusions: Personal history of atopy, lower gestational age, and living with two or more children had a significant association with recurrent wheezing. Children with lower gestational age who received passive immunization against the respiratory syncytial virus had a higher prevalence of recurrent wheezing than the group with higher gestational age.

RESUMO Objetivo: Avaliar a prevalência e os fatores de risco associados à evolução para sibilância recorrente em prematuros. Métodos: O estudo transversal foi feito em 2014 e 2015 e analisou crianças prematuras nascidas entre 2011 e 2012. A busca dessas crianças foi feita em maternidade de hospital universitário e em um Centro de Referência para Imunobiológicos Especiais. A avaliação foi feita por questionário dirigido em entrevista telefônica. Resultados: O estudo incluiu 445 crianças com 39 (18-54) meses de vida. Na análise univariada, os fatores de risco com maior chance de sibilância recorrente foram peso de nascimento menor do que 1.000 g, idade gestacional menor do que 28 semanas, convivência com dois ou mais irmãos, alergia alimentar e dermatite atópica na criança e alergia alimentar e asma nos pais. Na análise multivariada houve associação significativa entre sibilância recorrente e idade gestacional ao nascer menor do que 28 semanas, alergia alimentar e dermatite atópica na criança e a convivência com duas ou mais crianças. Dos 445 sujeitos analisados, 194 receberam imunização passiva contra vírus sincicial respiratório e 251 eram prematuros não imunizados. Houve diferença entre a idade gestacional desses subgrupos (p < 0,001). A prevalência geral de sibilância recorrente foi 27,4% (IC 95%: 23,42-31,70) e nas crianças que receberam a imunização passiva foi 36,1% (IC 95%: 29,55-43,03). Conclusões: História pessoal de atopia, menor idade gestacional e convivência com duas ou mais crianças apresentaram associação significativa com sibilância recorrente. As crianças com menor idade gestacional, que receberam a imunização passiva contra o vírus sincicial respiratório, apresentaram maior prevalência de sibilância recorrente que o grupo de maior idade gestacional.

Sibilância em lactentes: o que mudou? / Wheezing in infants: what has changed?

O objetivo deste artigo foi avaliar a prevalência e fatores de risco para sibilância recorrente e asma em lactentes. Foi realizada pesquisa de artigos originais, revisões, consensos indexados e publicações on-line, nos últimos 15 anos, nos bancos de dados PubMed, MEDLINE, LILACS e SciELO. Conhecer a prevalência de sibilância recorrente e os fatores a ela associados é imprescindível, visto a sibilância recorrente ser uma das principais manifestações clínicas da asma na infância, sendo inclusive considerada por alguns autores como sinônimo desta doença, somado ao fato de que alguns dos fatores associados à sibilância no primeiro ano de vida também o são ao desenvolvimento de asma em crianças e adolescentes. A realização e aprofundamento de pesquisas sobre a sibilância e a asma na infância se fazem necessárias, e podem colaborar com a implantação de políticas públicas de saúde e programas educacionais objetivando o diagnóstico precoce de asma, e a adoção de medidas preventivas que favoreçam seu controle e evolução.

The objective of this study was to evaluate the prevalence and risk factors of recurrent wheezing and asthma in infants. MEDLINE (via PubMed), LILACS, and SciELO databases were searched for original articles, reviews, indexed guidelines, and online resources published in the past 15 years. It is essential to know the prevalence of recurrent wheezing and its associated factors, since recurrent wheezing is one of the main clinical manifestations of childhood asthma, being considered by some authors a synonym of this disease. Also, some factors associated with wheezing in the first year of life may influence the development of asthma in children and adolescents. Further research on wheezing and asthma in childhood is needed and may contribute to the implementation of public health policies and educational programs aimed at the early diagnosis of asthma and to the adoption of preventive measures to improve asthma control and reduce disease burden.