Improvement of depression in a patient with hypothyroidism and deiodinase polymorphism with LT3 Therapy.

We report a 54-year-old man with treatment-resistant depression (TRD) and hypothyroidism who responded to LT3/LT4 combination, rather than LT4 alone. He was able to discontinue all antidepressant medications eventually. Interestingly, the patient has a DIO2 polymorphism.

Climatic refugia and reduced extinction correlate with underdispersion in mammals and birds in Africa.

Macroevolutionary patterns, often inferred from metrics of community relatedness, are often used to ascertain major evolutionary processes shaping communities. These patterns have been shown to be informative of biogeographic barriers, of habitat suitability and invasibility (especially with regard to environmental filtering), and of regions that function as evolutionary cradles (i.e.

Multimodality management of sinonasal teratocarcinosarcoma in a 76-year-old Alaska Native female during the COVID-19 pandemic.

Sinonasal teratocarcinosarcoma is a rare, highly aggressive tumor of the anterior skull base composed of malignant epithelial, mesenchymal, and neural tissue. Examination of cases in patients in minority populations is important in order to better understand the behavior of this neoplasm and outcomes of treatment in our nation's diverse population.

Emergency Medicine Around the World: Analysis of the 2019 American College of Emergency Physicians International Ambassador Country Reports.

Objective: The specialty of emergency medicine and recognition of the need for emergency care continue to grow globally. The specialty and emergency care systems vary according to context. This study characterizes the specialty of emergency medicine around the world, trends according to region and income level, and challenges for the specialty.

Predicting 30-day return hospital admissions in patients with COVID-19 discharged from the emergency department: A national retrospective cohort study.

Objectives: Identification of patients with coronavirus disease 2019 (COVID-19) at risk for deterioration after discharge from the emergency department (ED) remains a clinical challenge. Our objective was to develop a prediction model that identifies patients with COVID-19 at risk for return and hospital admission within 30 days of ED discharge.

Methods: We performed a retrospective cohort study of discharged adult ED patients (n = 7529) with SARS-CoV-2 infection from 116 unique hospitals contributing to the National Registry of Suspected COVID-19 in Emergency Care.

Local stability properties of complex, species-rich soil food webs with functional block structure.

Ecologists have long debated the properties that confer stability to complex, species-rich ecological networks. Species-level soil food webs are large and structured networks of central importance to ecosystem functioning. Here, we conducted an analysis of the stability properties of an up-to-date set of theoretical soil food web models that account both for realistic levels of species richness and the most recent views on the topological structure (who is connected to whom) of these food webs.

Adult facilitation becomes competition as juvenile soapberry bugs age.

Intraspecific interactions can change from facilitative to competitive depending on the organism's ontogeny. In plant-feeding insects, host plant defenses can be strengthened or weakened by insect feeding and can therefore be important for determining whether two insects feeding on the same plant help or harm each other's fitness. Here, I conducted two experiments looking at the direct effect of a physical seed defense and the role of intraspecific facilitation in reducing the effects of that defense for juveniles of the red-shouldered soapberry bug.

Outcome assessment of medical education fellowships in emergency medicine.

Objectives: Medical education fellowships in emergency medicine (EM) provide training in teaching, assessment, educational program administration, and scholarship. The longitudinal impact of this training is unknown. Our objective was to characterize the career outcomes of medical education fellowship graduates.

Affective, cognitive, and behavioral outcomes from a resident personal finance curriculum pilot project.

Background: The transition to residency marks a significant shift in the financial circumstances of medical trainees. Despite existing resources, residents still cite uncertainty in this domain. A personal finance curriculum is needed to close this educational gap and improve the financial well-being of trainees.

Medical student self-assessment as emergency medicine residency applicants.

Background: Emergency medicine (EM) applicants are encouraged to consider their own "competitiveness" when deciding on the number of applications to submit. Program directors rank the Standardized Letter of Evaluation (SLOE) as the most important factor when reviewing an applicant. Accurate insight into how clinical performance is reflected on the SLOE could improve medical students' ability to gauge their own competitiveness.

Evidence for spatial clines and mixed geographic modes of speciation for North American cherry-infesting (Diptera: Tephritidae) flies.

An important criterion for understanding speciation is the geographic context of population divergence. Three major modes of allopatric, parapatric, and sympatric speciation define the extent of spatial overlap and gene flow between diverging populations. However, mixed modes of speciation are also possible, whereby populations experience periods of allopatry, parapatry, and/or sympatry at different times as they diverge.

A proposal for selective resuscitation of adult cardiac arrest patients in a pandemic.

Allocation of limited resources in pandemics begs for ethical guidance. The issue of ventilator allocation in pandemics has been reviewed by many medical ethicists, but as localities activate crisis standards of care, and health care workers are infected from patient exposure, the decision to pursue cardiopulmonary resuscitation (CPR) must also be examined to better balance the increased risks to healthcare personnel with the very low resuscitation rates of patients infected with coronavirus disease 2019 (COVID-19). A crisis standard of care that is equitable, transparent, and mindful of both human and physical resources will lessen the impact on society in this era of COVID-19.

Elevation and landscape change drive the distribution of a montane, endemic grassland bird.

Context: Tropical montane habitats support high biodiversity and are hotspots of endemism, with grasslands being integral components of many such landscapes. The montane grasslands of the Western Ghats have seen extensive land-use change over anthropogenic timescales. The factors influencing the ability of grassland-dependent species to persist in habitats experiencing loss and fragmentation, particularly in montane grasslands, are poorly known.

Plastome phylogenomics and phylogenetic diversity of endangered and threatened grassland species (Poaceae) in a North American tallgrass prairie.

Native grasslands are one of the most endangered ecosystems in North America. In this study, we examined the ecological and evolutionary roles of endangered and threatened (e/t) grasses by establishing robust evolutionary relationships with other nonthreatened native and introduced grass species of the community. We hypothesized that the phylogenomic distribution of e/t species of grasses in Illinois would be phylogenetically clustered because closely related species would be vulnerable to the same threats and have similar requirements for survival.

Numerics and subgrid-scale modeling in large eddy simulations of stratocumulus clouds.

Stratocumulus clouds are the most common type of boundary layer cloud; their radiative effects strongly modulate climate. Large eddy simulations (LES) of stratocumulus clouds often struggle to maintain fidelity to observations because of the sharp gradients occurring at the entrainment interfacial layer at the cloud top. The challenge posed to LES by stratocumulus clouds is evident in the wide range of solutions found in the LES intercomparison based on the DYCOMS-II field campaign, where simulated liquid water paths for identical initial and boundary conditions varied by a factor of nearly 12.