Quantum Informational Dark Energy: Dark energy from forgetting

We suggest that dark energy has a quantum informational origin. Landauer's principle associated with the erasure of quantum information at a cosmic horizon implies the non-zero vacuum energy having effective negative pressure. Assuming the holographic principle, the minimum free energy condition, and the Gibbons-Hawking temperature for the cosmic event horizon we obtain the holographic dark energy with the parameter $d\simeq 1$, which is consistent with the current observational data. It is also shown that both the entanglement energy and the horizon energy can be related to Landauer's principle.Comment: revtex,8 pages, 2 figures more detailed arguments adde

The Relationship of Amelogenesis Imperfecta and Nephrocalcinosis Syndrome

Aim: To analyze the prevalence and associated oral findings of nephrocalcinosis in a group of patients affected with amelogenesis imperfecta (AI). The relationship between types of AI and nephrocalcinosis were also evaluated. Design: This study examines patients who were referred to Pediatric Dentistry Department of SDU between the years of 2002-2007 and who, upon clinical and radiological examination, were diagnosed with AI and treated. Patients were offered information about the possibility of nephrocalcinosis syndrome. Patients who agreed to have tests carried out on their renal system were advised to visit the department of nephrology at the clinic. Results: Suspicious radiopacity was observed during renal ultrasonography of a controlled number of patients with hypoplastic type AI. Laboratory results revealed low Ca values (100-300 mg/days) and normal P values (0.4-1.3 g/days). Delayed eruption, gingival hyperplasia, pulp stones and orthodontic problems were also observed in the same patient groups. Conclusion: Although renal findings were observed in a few patients, pediatric dentists are the doctors who are the first to have early contact with this patient group. Because of the potential risk of nephrocalcinosis, early diagnosis may offer good prognosis

The EEG signature of sensory evidence accumulation during decision formation closely tracks subjective perceptual experience

How neural representations of low-level visual information are accessed by higher-order processes to inform decisions and give rise to conscious experience is a longstanding question. Research on perceptual decision making has revealed a late event-related EEG potential (the Centro-Parietal Positivity, CPP) to be a correlate of the accumulation of sensory evidence. We tested how this evidence accumulation signal relates to externally presented (physical) and internally experienced (subjective) sensory evidence. Our results show that the known relationship between the physical strength of the external evidence and the evidence accumulation signal (reflected in the CPP amplitude) is mediated by the level of subjective experience of stimulus strength. This shows that the CPP closely tracks the subjective perceptual evidence, over and above the physically presented evidence. We conclude that a remarkably close relationship exists between the evidence accumulation process (i.e. CPP) and subjective perceptual experience, suggesting that neural decision processes and components of conscious experience are tightly linked

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Zaburzenia przewodzenia przedsionkowego u chorych na łuszczycę zwyczajną

Background: Psoriasis vulgaris is one of the most common chronic inflammatory skin disorders. Patients with psoriasis are at risk of developing atrial fibrillation (AF). The electromechanical delay (EMD) is the time interval from the onset of the P wave on surface electrocardiography (ECG) to the beginning of the A wave. Prolonged atrial EMD is an independent risk factor for the development of AF. Aim: This study investigated the intra- and interatrial EMD in patients with psoriasis. Methods: This study included 85 adults with psoriasis vulgaris (Group 1) and 46 age- and sex-matched healthy individuals (Group 2). ECGs were obtained from all subjects, and atrial EMD variables were calculated. Results are reported as means ± standard deviations and percentages. Continuous variables were analysed using Student’s t-test. A p-value &lt; 0.05 was considered statistically significant. Results: Interatrial electromechanical delay (IA-EMD) and intra-left atrial electromechanical delay (ILA-EMD) were significantly longer in the psoriasis group compared with controls. A correlation analysis between psoriasis severity (PASI score) and the atrial conduction parameters revealed a significant positive correlation between PASI and IA-EMD (r = 0.261, p &lt; 0.001). In addition, there was a positive correlation between high-sensitivity C-reactive protein (hsCRP) and IA-EMD (p = 0.022). Conclusions: The atrial conduction time was longer in patients with psoriasis vulgaris and it correlated with the severity of disease and hsCRP. Since the association between delayed conduction and AF is known, the measurement of intra-atrial conduction times could be a practical tool to estimate the AF risk in these patients.Wstęp: Łuszczyca zwyczajna jest jedną z najczęstszych przewlekłych zapalnych chorób skóry. U pacjentów z łuszczycą występuje ryzyko migotania przedsionków (AF). Opóźnienie elektromechaniczne (EMD) to odstęp czasowy od początku załamka P w elektrokardiogramie (EKG) powierzchniowym do początku załamka A. Cel: W niniejszym badaniu oceniono wewnątrz- i międzyprzedsionkowe EMD u chorych na łuszczycę zwyczajną. Metody: Do badania włączono 85 dorosłych pacjentów z łuszczycą zwyczajną (Grupa 1) oraz 46 dopasowanych pod względem wieku i płci zdrowych osób (Grupa 2). U wszystkich uczestników wykonano badanie EKG I obliczono przedsionkowe zmienne EMD. Wyniki przedstawiono jako średnie ± odchylenie standardowe i wartości procentowe. Do analizy zmiennych ciągłych zastosowano test t Studenta. Wartość p &lt; 0,05 przyjęto za istotną statystycznie. Wyniki: Międzyprzedsionkowe opóźnienie elektromechaniczne (IA-EMD) i opóźnienie elektromechaniczne w obrębie lewego przedsionka (ILA-EMD) były istotnie dłuższe w grupie chorych na łuszczycę niż w grupie kontrolnej. Analiza korelacji między stopniem ciężkości łuszczycy (skala PASI) a parametrami przewodzenia przedsionkowego wykazała istotną dodatnią korelację między PASI a IA-EMD (r = 0,261; p &lt; 0,001). Ponadto stwierdzono dodatnią korelację między stężeniem białka C oznaczanego metodą wysokoczułą (hsCRP) a IA-EMD (p = 0,022). Wnioski: U pacjentów z łuszczycą zwyczajną czas przewodzenia przedsionkowego był dłuższy i korelował ze stopniem ciężkości choroby oraz stężeniem hsCRP. Z uwagi na to, że związek między opóźnieniem przewodzenia i AF jest znany, pomiar czasu przewodzenia wewnątrzprzedsionkowego mógłby być praktycznym narzędziem służącym do oceny ryzyka AF u tych chorych