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Elevated greenhouse gases (GHGs) induce adverse conditions directly and indirectly, causing decreases in plant productivity. To deal with climate change effects, plants have developed various mechanisms including the fine-tuning of metabolism. Plant respiratory metabolism is highly flexible due to the presence of various alternative pathways. The mitochondrial alternative oxidase (AOX) respiratory pathway is responsive to these changes, and several lines of evidence suggest it plays a role in reducing excesses of reactive oxygen species (ROS) and reactive nitrogen species (RNS) while providing metabolic flexibility under stress. Here we discuss the importance of the AOX pathway in dealing with elevated carbon dioxide (CO₂), nitrogen oxides (NOx), ozone (O₃), and the main abiotic stresses induced by climate change.

The use of the term “treatment resistance” (TR) in psychiatry has blossomed over the last two decades, with 20%–60% of all cases now labeled as such. Remaining effective treatment options, however, can be identified for two‐thirds of these cases. There is no consensus on definition or criteria for TR within any diagnostic category, and literature review supports a broad range of individual causes of treatment failure (TF), rather than an actual entity of TR. Application of the TR label inhibits a practitioner's search for the true cause(s) of TF, a disservice to the trust patients place in us and their hope for recovery. It also threatens to worsen prognosis by unnecessarily extending the length of an index or recurrent episode, and increases the risk of death and burden of disease by prolonging categorical and functional impairments. We must view TF as a stage of treatment, still expecting and seeking eventual remission, rather than applying TR as an endpoint and an unsanctioned pseudo diagnosis. We must always recall that the clinical tasks we face are inherently complex; routine solutions are unlikely to fit and often lead to TF. The actual value we offer our patients is our problem‐solving skill and our willingness to be with them through the difficulties of reaching their goals. We can address so‐called TR, or, rather, TF by confirming our diagnostic validity and accuracy, the thoroughness of our evaluations and monitoring efforts, the clarity of our therapeutic guidance, and the quality of our therapeutic alliances. Highlights 20%–60% of all cases in psychiatry are labeled “treatment resistant.” Effective treatment options remain in 2/3 of these cases. No consensus exists on definition or criteria for “treatment resistance.” A broad range of individual causes leads to treatment failure. Labeling a case “treatment resistant” erodes quality of care and outcome.

The internet holds the potential promise of improved patient outcomes, especially when one is faced with a critical or life-threatening disease or condition. Appropriate and timely access to health information can support informed negotiation of optimal treatments, optimal management, and expedited recovery, and to an improved outcome for a patient. However, there are many human and technical barriers that may prevent the application of the best possible information for both patient and provider alike, making the patient journey complex and potentially dangerous. In this viewpoint paper, the author (who is also a JMIR editor) reflects on a personal patient journey, where use of the internet facilitated a means of reaching a good patient outcome in the face of a variety of informational and organizational limitations and gaps. This journey illustrates the importance of human-related factors affecting access to health information. The application of a range of internet information resources at critical points can result in a positive patient outcome, as this case illustrates. This paper reflects on how the experience highlights several information needs and concerns. It also highlights the need for improved access to appropriate health information along the patient journey that can support patient and provider joint decision-making. This access to information can make the difference between positive clinical outcomes and death, illustrating how health information on the internet can be both critical and life saving.