Photoinduced intramolecular electron-transfer events of the newly synthesized subphthalocyanine-triphenylamine-fullerene triad (SubPc-TPA-C60) and subphthalocyanine-triphenylamine-bisfullerene tetrad (SubPc-TPA-(C(60))(2)) were studied. The geometric and electronic structures of the triad were probed by ab initio B3LYP/3-21G method, which predicts SubPc-TPA(*+)-C(60)(*-) as a stable charge-separated state. The photoinduced events via the excited singlet state of SubPc were monitored by time-resolved emission measurements as well as transient absorption techniques. Efficient charge-separations via the excited states of SubPc were observed with the rates of approximately 10(10) s(-)1. Compared with the SubPc-TPA dyad, a long-lived charge-separated state was observed for the SubPc-TPA-C(60) triad with the lifetime of the radical ion pairs (tau(RIP)) of 670 ns in benzonitrile. Interestingly, further charge stabilization was achieved in the charge-separated state of SubPc-TPA-(C(60))(2), in which the tau(RIP) was found to be 1050 ns in benzonitrile.

PurposeThis study aimed to evaluate the autonomic imbalance in syncope by comparing the baseline heart rate variability (HRV) between healthy children and those with vasovagal syncope.MethodsTo characterize the autonomic profile in children experiencing vasovagal syncope, we evaluated the HRV of 23 patients aged 7-18 years and 20 healthy children. These children were divided into preadolescent (<12 years) and adolescent groups. The following time-domain indices were calculated: root mean square of the successive differences (RMSSD); standard deviation of all average R-R intervals (SDNN); and frequency domain indices including high frequency (HF), low frequency (LF), normalized high frequency, normalized low frequency, and low frequency to high frequency ratio (LF/HF).ResultsHRV values were significantly different between healthy children and those with syncope. Student t test indicated significantly higher SNDD values (60.46 ms vs. 37.42 ms, P=0.003) and RMSSD (57.90 ms vs. 26.92 ms, P=0.000) in the patient group than in the control group. In the patient group, RMSSD (80.41 ms vs. 45.89 ms, P=0.015) and normalized HF (61.18 ms vs. 43.19 ms, P=0.022) were significantly higher in adolescents, whereas normalized LF (38.81 ms vs. 56.76 ms, P=0.022) and LF/HF ratio (0.76 vs. 1.89, P=0.041) were significantly lower in adolescents. In contrast, the control group did not have significant differences in HRV values between adolescents and preadolescents.ConclusionThe results of this study indicated that children with syncope had a decreased sympathetic tone and increased vagal tone compared to healthy children. Additionally, more severe autonomic imbalances possibly occur in adolescents than in preadolescents.

Rapid advances in clinical education in response to the COVID-19 pandemic are taking place globally. This scoping review updated the educational strategies which could be applied by clinical educators in their practice to effectively maintain clinical attachment programs for medical students amidst public health crises. Almost all elements of clinical teaching were deliverable, whether it was online, onsite, virtual or blended, their educational effectiveness should be further examined. Increase in the number of telemedicine related publications were remarkable, and they could serve as a scalable model for future educational programs to be incorporated into the medical student curricula.

Although congenital syphilis can be prevented with prenatal screening, the disease remains problematic. Currently, there are no cases that describe hematuria and pneumonia related to congenital syphilis. We report a case of congenital syphilis that involved nephrotic syndrome and pneumonia alba in a 22-day-old male infant whose mother did not receive adequate prenatal care. The congenital syphilis diagnosis was confirmed with a serologic test and the patient recovered with penicillin treatment. Clinical findings may be subtle in neonates and delayed recognition occurs frequently, thus complete prenatal screening is critical for congenital syphilis prevention. Immediate serologic testing should be performed to obtain a differential diagnosis if an infant is delivered by a mother that has not received appropriate prenatal examinations.

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Objectives: A high-dose (2g/kg) intravenous immunoglobulin (IVIG) has been generally incorporated into the acute treatment protocols for Kawasaki disease (KD), with ongoing debates on this issue. The aim of this study was to assess the effectiveness of medium-dose (1g/kg) IVIG as an initial treatment of KD in Korean children. Methods: A retrospective study was done in a total of 255 children with KD, in whom 91 patients (group 1, mean age; 2.8 ± 2.5 years) had 2g/kg of IVIG and 164 patients (group 2, mean age; 2.7 ± 1.7 years) had 1g/kg of IVIG as an initial treatment of KD, along with 30-50 mg/kg of aspirin. Echocardiography (Echo) was done during admission, around 2 weeks, 2 months, and 1 year after the onset of fever according to our protocol. Patients who completed one-year Echo study were included in this study. Patients’ demographic, laboratory, and Echo findings were recorded, and compared between groups. Coronary artery lesions (CAL) were defined as a coronary artery diameter > 2 SD of normal mean for age or coronary artery stenosis. The primary end point was the incidence of CAL at 1 year after treatment. The secondary end points were the incidence of CAL at 2 weeks and 2 months study, and clinical outcomes. Comparisons between groups were done using an unpaired t-test or Fisher’s exact test. Results: There was no significant difference in age, gender, and laboratory findings before treatment between the two groups. Group 1 had higher incidence of CAL at 2 weeks (32/91, 35.2 % vs. 33/164, 20.2 %, p = 0.011), but similar incidence of CAL at 2 months (18/91, 19.8% vs. 24/164, 14.6%, p > 0.05) and 1 year (6/91, 6.6% vs. 10/164, 6.1%, p > 0.05) compared with group 2. Group 1 had a higher proportion of patients needed additional dose of IVIG (23/91, 25.3% vs. 15/164, 9.1%, p = 0.001), but received significantly lower total dose of IVIG (1.3 ± 0.7 g/kg vs. 2.1 ± 0.5 g/kg, p < 0.001) compared with group 2. There was no difference in duration of fever after IVIG and duration of hospital stay between the two groups. Conclusion: This study demonstrated that medium-dose IVIG is as effective as high-dose IVIG for the treatment of KD in terms of CAL prevention, defervescence, and duration of hospital stay. Further prospective and randomized study is needed to verify this.