ABSTRACT
Pediatric primary health care (PPHC) is of principal importance to the health and development of all children, helping them reach their true potential. Pediatricians, as the clinicians most intensively trained and experienced in child health, are the natural leaders of PPHC within the context of the medical home. Given the rapidly evolving models of pediatric health care delivery, including the explosion of telehealth in the wake of the COVID-19 pandemic, pediatricians, together with their representative national organizations such as the American Academy of Pediatrics (AAP), are the most capable clinicians to guide policy innovations on both the local and national stage.
Subject(s)
Pediatrics , Physician's Role , Primary Health Care , Child Health , Health Policy , Humans , Pediatricians , Policy Making , United StatesABSTRACT
It is important to consider antisynthetase syndrome in the differential diagnosis of patients presenting with weakness, respiratory distress, and a constellation of complaints spanning multiple organ systems, as this will change clinical management.
ABSTRACT
Deprotonation of the methylpyridines 2,6-lutidine, 2-picoline, 4-dimethylamino-2,6-dimethylpyridine as well as 2,6-dimethyl-4-(piperidine-1-yl)pyridine with n-butyllithium or n-butyllithium/KO-t-Bu at the methyl positions led to the corresponding organolithium or -potassium compounds. Treatment with ClB(C6F5)2 resulted in formation of the 2-borylmethylpyridines py-CH2-B(C6F5)2. They are monomeric and form intramolecular B-N bonds and four-membered rings. A short intramolecular B-N distance was observed in the crystal structure of the dimethylamino-functionalized derivative and proposed to be responsible for the low reactivity of the products towards hydrogen, thf, acetonitrile and CO2. Hydroboration of 6-tert-butyl-2-but-4'-enylpyridine with HB(C6F5)2 led to the corresponding hydroboration product t-Bu-py-(CH2)4-B(C6F5)2 which shows no intramolecular B-N bond formation due to steric crowding. H/D-scrambling experiments with a H2/D2 mixture revealed its reactivity towards hydrogen.
ABSTRACT
The generation of electricity through hydropower can, along with other anthropogenic activities, degrade river hydromorphology and ecosystems. In this case, water for power generation is diverted from the River Durance to a canal, which services a chain of 17 power stations, with the lower three being in the catchment of the Etang de Berre. This means that excess water and sediments are discharged into the salt-water lagoon with enormous consequences for ecosystems there. This paper summarizes the impacts of HEP and other human activities on both the river and lagoonal systems. It also considers agency and government attempts to understand and counter the degradation of these systems, both to date and in the future, with the latter catering for the potential impacts of future human development and global warming.
