Male signals that provide information to females about mating benefits are often of low reliability. It is thus not clear why females often express strong signal preferences. We tested the hypothesis that females can distinguish between males with preferred signals that provide lower and higher quality direct benefits. In the field cricket, , females usually prefer higher male chirp rates, but chirp rate is positively correlated with the fecundity benefits females will receive from males only for males that have experienced low quality diets. We paired females with muted males that were maintained on low or high nutrition diets, during the interactions we broadcast a replacement high chirp rate, and we observed whether females mated with the assigned male. Females were more likely to mate when paired with low nutrition males. These results suggest that females have evolved assessment mechanisms that allow them distinguish between males with preferred signals that provide high quality benefits (low nutrition males with high chirp rates) and males with preferred signals that provide low quality benefits (high nutrition males with high chirp rates).
Background
Umbilical discharge in an adult is rare and generates broad diagnostic considerations. Umbilical anatomy is variable owing to congenital abnormalities and acquired pathology such as umbilical hernias. The umbilicus can be a site of primary or metastatic malignancy or endometriosis.
Case presentation
A 40-year-old white American woman came to the clinic with a 2-day history of spontaneous umbilical bleeding. She reported periumbilical pain associated with nausea and emesis. There were no visible skin abnormalities, but deep palpation of the abdomen produced a thin, watery, serosanguineous fluid from the umbilicus. She experienced a similar episode of umbilical bleeding 5 years prior without clear cause. Laboratory workup was notable for mildly elevated C-reactive protein . Computed tomography imaging revealed a fat-containing umbilical hernia with fat necrosis, necessitating complete surgical resection of the umbilicus.
Conclusions
Umbilical hernia with fat necrosis is a rare condition that should be considered in adults with umbilical discharge. Additional diagnostic considerations in adults with spontaneous umbilical bleeding/discharge include embryonal remnants, omphalitis, and metastasis. If the cause is not readily apparent on physical exam, imaging with computed tomography should be considered to assess for hernia and embryonal anomalies.
Background: Many hospitalized patients do not understand or agree with their clinicians about their discharge plan. However, the effect of disagreement on discharge outcomes is unknown.Objective: To measure the correlation between patient-clinician care agreement and discharge outcomes.
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