GeV Photons from Ultra High Energy Cosmic Rays accelerated in Gamma Ray Bursts

Gamma-ray bursts are produced by the dissipation of the kinetic energy of a highly relativistic fireball, via the formation of a collisionless shock. When this happens, Ultra High Energy Cosmic Rays up to 10^20 eV are produced. I show in this paper that these particles produce, via synchrotron emission as they cross the acceleration region, photons up to 300 GeV which carry away a small, ~0.01, but non-negligible fraction of the total burst energy. I show that, when the shock occurs with the interstellar medium, the optical depth to photon-photon scattering, which might cause energy degradation of the photons, is small. The burst thusly produced would be detected at Earth simultaneoulsy with the parent gamma-ray burst, although its duration may differ significantly from that of the lower energy photons. The expected fluences, ~10^{-5}-10^{-6} erg/cm^2 are well within the range of planned detectors. A new explanation for the exceptional burst GRB 940217 is discussed.Comment: Accepted for publication in The Physical Review Letters. 4 pages, RevTeX needed, no figure

Usefulness of bronchoalveolar lavage in suspect COVID-19 repeatedly negative swab test and interstitial lung disease

The diagnosis of coronavirus disease 2019 (COVID-19) relies on nasopharyngeal swab, which shows a 20–30% risk of false negativity [1]. Bronchoalveolar lavage (BAL) is reported to be useful in patients with pulmonary interstitial infiltrates on high-resolution computed tomography (HRCT). We investigated the usefulness of BAL in symptomatic patients with positive HRCT and a repeatedly negative swab test (‘grey zone’)

Von Willebrand factor with increased binding capacity is associated with reduced platelet aggregation but enhanced agglutination in COVID-19 patients: another COVID-19 paradox?

Patients with Coronavirus-associated disease-2019 (COVID-19) display alterations of the hemostatic system and the presence of a prothrombotic status frequently leading to vascular complications. However, the impact of COVID-19 on platelet activity, aggregation and agglutination still needs to be clarified. We measured total levels of von Willebrand factor (vWF) and vWF binding to the platelet glycoprotein (Gp) complex (GPIb-IX-V), in a cohort of COVID-19 patients admitted to the intensive care unit of our Institution. Moreover, we evaluated platelet aggregation in response to agonists (ADP, collagen, arachidonic acid) and platelet agglutination in response to ristocetin. We found that levels of vWF antigen and the active form of vWF binding to platelets (vWF:RCo), were markedly increased in these patients. These results were associated with higher agglutination rates induced by ristocetin, thereby indirectly indicating an increased capability of vWF to bind to platelets. Conversely, we found that platelet aggregation in response to both ADP and collagen was lower in COVID-19 patients compared to healthy volunteers. This study shows that COVID-19 is associated with increased vWF-induced platelet agglutination but reduced platelet responsivity to aggregation stimuli. Our findings have translational relevance since platelet adhesion to vWF may represent a marker to predict possible complications and better delineate therapeutic strategies in COVID-19 patients

Effect of low or high doses of low-molecular-weight heparin on thrombin generation and other haemostasis parameters in critically ill patients with COVID-19

The clinical picture of the coronavirus 2 (SARS‐CoV‐2)/COVID‐19‐related acute respiratory syndrome is often associated with a coagulopathy. An elevated D‐dimer has been linked with an unfavorable prognosis in COVID‐19 patients