Publisher Correction: Very-high-energy particle acceleration powered by the jets of the microquasar SS 433.

In this Letter, owing to a production error, the penultimate version of the PDF was published. The HTML version was always correct. The PDF has been corrected online.

Very-high-energy particle acceleration powered by the jets of the microquasar SS 433.

SS 433 is a binary system containing a supergiant star that is overflowing its Roche lobe with matter accreting onto a compact object (either a black hole or neutron star)1-3. Two jets of ionized matter with a bulk velocity of approximately 0.26c (where c is the speed of light in vacuum) extend from the binary, perpendicular to the line of sight, and terminate inside W50, a supernova remnant that is being distorted by the jets2,4-8. SS 433 differs from other microquasars (small-scale versions of quasars that are present within our own Galaxy) in that the accretion is believed to be super-Eddington9-11, and the luminosity of the system is about 1040 ergs per second2,9,12,13. The lobes of W50 in which the jets terminate, about 40 parsecs from the central source, are expected to accelerate charged particles, and indeed radio and X-ray emission consistent with electron synchrotron emission in a magnetic field have been observed14-16. At higher energies (greater than 100 gigaelectronvolts), the particle fluxes of γ-rays from X-ray hotspots around SS 433 have been reported as flux upper limits6,17-20. In this energy regime, it has been unclear whether the emission is dominated by electrons that are interacting with photons from the cosmic microwave background through inverse-Compton scattering or by protons that are interacting with the ambient gas. Here we report teraelectronvolt γ-ray observations of the SS 433/W50 system that spatially resolve the lobes. The teraelectronvolt emission is localized to structures in the lobes, far from the centre of the system where the jets are formed. We have measured photon energies of at least 25 teraelectronvolts, and these are certainly not Doppler-boosted, because of the viewing geometry. We conclude that the emission-from radio to teraelectronvolt energies-is consistent with a single population of electrons with energies extending to at least hundreds of teraelectronvolts in a magnetic field of about 16 microgauss.

Discovery of Gamma Rays from the Quiescent Sun with HAWC.

We report the first detection of a TeV γ-ray flux from the solar disk (6.3σ), based on 6.1 years of data from the High Altitude Water Cherenkov (HAWC) observatory. The 0.5-2.6 TeV spectrum is well fit by a power law, dN/dE=A(E/1 TeV)^{-γ}, with A=(1.6±0.3)×10^{-12} TeV^{-1} cm^{-2} s^{-1} and γ=3.62±0.14. The flux shows a strong indication of anticorrelation with solar activity. These results extend the bright, hard GeV emission from the disk observed with Fermi-LAT, seemingly due to hadronic Galactic cosmic rays showering on nuclei in the solar atmosphere. However, current theoretical models are unable to explain the details of how solar magnetic fields shape these interactions. HAWC's TeV detection thus deepens the mysteries of the solar-disk emission.

Breaking Down Barriers: Easter Island's First Telestroke Thrombolysis Experience and Case Report.

Easter Island (Rapa Nui), Chile, is remote, located in the Polynesian Triangle in Oceania. The closest continental point is Chile, 3,512 km east. It has a population of 7,750 inhabitants, who are Chilean citizens, and receives more than 60,000 tourists a year. For this entire population, there is a medium complexity hospital without a neurology specialist. In 2019, local professionals were trained in a Telestroke program with remote clinical support conducted by neurologists located on mainland Chile. We present a 50-year-old native male, with unknown medical history, who suddenly presented right-half-body weakness and aphasia. He was evaluated via Telestroke consultation, and thrombolysis with tenecteplase was indicated. The patient improved rapidly and 45 min later the NIHSS score was 0 points. To our knowledge, this is the first reported case of Telestroke treatment in such a remote area, highlighting the importance of telemedicine to overcome geographical and technological stroke care barriers and to improve patients' outcome, no matter where they live.

Survival of the nematophagous fungus Duddingtonia flagrans to in vitro segments of sheep gastrointestinal tract.

The nematophagous fungus Duddingtonia flagrans is used in integrated management of gastrointestinal nematodes in ruminants. The chlamydospores of the fungus, orally administered, pass through the segments of the ruminant digestive tract and, in the feces, capture the nematodes preventing their migration to grasslands. The drastic conditions of the gastrointestinal segments can negatively affect the fungus' biocontrol activity. The aim of this study was to assess the effect of in vitro conditions of the sheep's main gastrointestinal segments on the concentration, viability and nematode predatory ability of D. flagrans chlamydospores. The segments evaluated separately in vitro were the oral cavity, rumen, abomasum, and small intestine. The results showed that chlamydospores concentration was not affected by exposure to the different segments. The viability of the chlamydospores after exposure to the oral cavity (2.53 × 106 CFU/mL) and small intestine (1.24 × 105 CFU/mL) was significantly lower than its control treatment, with values of 6.67 × 106 CFU/mL and 2.31 × 105 CFU/mL respectively. Nematode predatory ability after rumen exposure was reduced by 7% compared to the control treatment, by 25% after abomasum exposure and by 17% after small intestine. This study revealed the individual in vitro effect of each segment of ovine gastrointestinal tract on the integrity of this strain of the fungus D. flagrans affecting its viability and nematode predatory ability under the evaluated conditions. Delivery systems could be designed to protect chlamydospores considering the impact of each gastrointestinal segment.

Constraints on Lorentz Invariance Violation from HAWC Observations of Gamma Rays above 100 TeV.

Because of the high energies and long distances to the sources, astrophysical observations provide a unique opportunity to test possible signatures of Lorentz invariance violation (LIV). Superluminal LIV enables the decay of photons at high energy. The high altitude water Cherenkov (HAWC) observatory is among the most sensitive gamma-ray instruments currently operating above 10 TeV. HAWC finds evidence of 100 TeV photon emission from at least four astrophysical sources. These observations exclude, for the strongest of the limits set, the LIV energy scale to 2.2×10^{31} eV, over 1800 times the Planck energy and an improvement of 1 to 2 orders of magnitude over previous limits.

Multiple Galactic Sources with Emission Above 56 TeV Detected by HAWC.

We present the first catalog of gamma-ray sources emitting above 56 and 100 TeV with data from the High Altitude Water Cherenkov Observatory, a wide field-of-view observatory capable of detecting gamma rays up to a few hundred TeV. Nine sources are observed above 56 TeV, all of which are likely galactic in origin. Three sources continue emitting past 100 TeV, making this the highest-energy gamma-ray source catalog to date. We report the integral flux of each of these objects. We also report spectra for three highest-energy sources and discuss the possibility that they are PeVatrons.

Al2O3, Al doped ZnO and SnO2 encapsulation of randomly oriented ZnO nanowire networks for high performance and stable electrical devices.

Two-dimensional randomly oriented nanowire (NW) networks, also called nanonets (NNs), have remarkable advantages including low-cost integration, good reproducibility and high sensitivity, which make them a promising material for electronic devices. With this work, we focus on the study of ZnO NNs as channel materials in field effect transistors (FETs). In our process, ZnO NWs were assembled in NNs by the liquid filtration method and were integrated in transistors, with the bottom-gate configuration, using simple technological steps. Non-encapsulated devices exhibited state of the art performances but their stability toward air exposure was poor. Using a proper encapsulation of the nanonets, with cheap, abundant and non-toxic oxides, we demonstrate our ability not only to stabilize their electrical properties, but also to enhance performance to values never reach before for ZnO NW-based transistors. Our best FETs exhibit a low Off-current while maintaining a very good On-current, which results in a I on/I off ratio exceeding 106 for a drain voltage of 5 V. The behavior of these ZnO NN-based FETs was studied for three different encapsulation materials, alumina (Al2O3), tin oxide (SnO2) and Al-doped ZnO (AZO). These results prove that ZnO NNs are highly promising materials for an easy and low-cost integration into FETs.

Quality Standards for Allergen Immunotherapy Clinics in Spain: Consensus Document.

BACKGROUND AND OBJECTIVE: Allergen immunotherapy clinics (AITCs) in Spain differ widely in terms of structure, organization, resources, and portfolio of services. Therefore, it is essential to unify treatment criteria and define quality standards for the most complex AITCs. Objective: To establish a series of recommendations that make it possible to guarantee quality and safety in the administration of immunotherapy and define quality standards for the most complex AITCs. METHODS: This project began with an online survey of 65 allergy departments/units throughout Spain in 2013. Next, a 2-phase consensus process was carried out. In the first phase, 10 experts defined and agreed on the standards using the RAND/UCLA Appropriateness method; in the second, the agreements were validated by means of a 2-round Delphi consultation with 84 experts. RESULTS: Consensus was reached on minimum safety and quality criteria in the administration of allergen immunotherapy, and 2 levels of highly complex AITCs were defined: accredited AITCs and accredited AITCs with excellence. Consensus was also reached on quality standards and accreditation criteria for both levels. CONCLUSIONS: This project is pioneering in terms of its purpose (the definition of quality standards for AITCs) and of the use of structured participation techniques (combination of the RAND/UCLA and Delphi methods). It enabled the design of minimum standards for quality and safety in administering AIT, as well as quality criteria for accreditation of AITCs supported by a broad panel of experts from the Spanish Society of Allergology and Clinical Immunology.

Case series on multiple prostate re-irradiation for locally recurrent prostate cancer: something ventured, something gained.

The aim is to present the technical feasibility and efficacy of multiple re-irradiation (re-EBRT) for local recurrence of prostate cancer (PCa) using retrospective analysis of an updated series of patients who received ablative re-EBRT with stereotactic image-guided technique for isolated local recurrence of PCa. Eight patients received three RT courses (2 re-RTs); of those 2 received 4 RT courses (3 re-RTs). Local relapse in the prostate was assessed by multiparametric magnetic resonance and/ or choline positron emission tomography. Before treatment planning, all patients had been evaluated for late toxicity from previous RT according to RTOG/EORTC. Biochemical control was assessed according to Phoenix definition. Mean age at the third RT course was 68 (standard deviation, SD: 7.2); all patients had a good performance status. At diagnosis, four cases were classified as high risk PCa, three as intermediate and one as low per NCCN 2017. Biochemical progression free interval after first and second RT-course were 74 (IQR: 59.3-133.6) months and 33 (IQR: 20.8-53.1) months, respectively. Biochemical and radiological response was registered in all patients. At present, seven out of eight patients are disease free. Overall toxicity profile was good; no severe acute or late genitourinary or gastrointestinal events were recorded. Multiple RT courses with high precision technology and image guidance can be proposed as a possible salvage therapy for locally recurrent, low-burden PCa recurrence in adequately selected patients. Deeper understanding of radiobiological effects of hypofractionation and larger series of patients are warranted to fully evaluate the applicability of multiple RT courses in the setting of locally recurrent PCa.

Synthesis of Copper Nanowires and Their Antimicrobial Activity on Strains Isolated Persistent Endodontic Infections.

Copper nanowires, Cu-NWs may have a good antimicrobial effect in endodontic treatment. The objective of this work was to synthesize, characterize and evaluate the antibacterial activity of Cu-NWs on strains obtained from human root canal. A wide distribution of Cu-NWs diameters from 30 to 90 nm was obtained with lengths ranging from 5 to 40 µm. Structural analysis of Cu-NWs showed crystalline planes, which corresponded to Cu, with preferential growth in the direction [110]. The geometric mean MICs was of 289.30 µg/mL, with a MIC50 of 256 µg/mL and a MIC90 of 512 µg/mL for Cu-NWs. Cellular viability of 28 a biofilm tends to decrease the longer it is exposed to Cu-NWs. Synthesized and characterized Cu-NWs have a good antimicrobial effect against clinical strains used in the present study and has a potential to be used for disinfection of the root canal system.

The effect of stress on haematologic response and physicochemical parameters of muscle meat in rabbits.

Ante-mortem studies of stress in rabbits are few and can potentially impact the haematologic response and physicochemical parameters of muscle meat. The aim of this study was to investigate the induction of stress by transport and simulation at two different times. Two hundred rabbits divided in a similar proportion of male and female were stressed by vehicular transportation and with motion simulation, using a vibration platform. They were divided into five groups: Control (without stress), Stress with Short Transportation (30 min), Stress with Long Transportation (60 min), Stress with Short Vibration Platform (30 min) and Stress with Long Vibration Platform (60 min). Transportation caused a decrease in the haematic potassium in both sexes (<5.2 mmol/L). The glucose and lactate concentrations increased in the transported rabbits (>219 and >61 mg/dl respectively). The differences between sexes showed that the P CO2 in males decreased <8.5 mmHg in stress groups compared to without stress group. Glucose concentration was 61.5 mg/dl for females and 38.0 mg/dl for males (p < .01). We concluded that in rabbits induced stress by transport increased the energetic metabolites in the blood tissue. This increase did not affect the production parameters and the quality of muscle meat.

Nanotechnology: the scope and potential applications in orthopedic surgery.

Nanotechnology involves manipulation of matter measuring 1-100 nm in at least one of its dimensions at the molecular level. Engineering and manipulation of matter at the molecular level has several advantages in the field of medicine (nanomedicine) since most of the biological molecules exist and function at a nanoscale. Though promising, questions still remain on how much of this will ultimately translate into achieving better patient care. Concerns of cost-effectiveness and nanotechnology safety still remain unclear. Orthopedics is an attractive area for the application of nanotechnology since the bone, and its constituents such as hydroxyapatite, Haversian systems, and the collagen fibrils are nanocompounds. The major orthopedic applications of nanotechnology involve around (i) effective drug delivery systems for antibiotics and chemotherapeutic agents, (ii) surface preparation of implants and prosthesis to improve osteointegration and reduce biofilm formation, (iii) controlled drug eluting systems to combat implant-related infections, (iv) tissue engineering for scaffolds preparation to deal with bone and cartilage defects, and (v) diagnostic applications in the field of oncology and musculoskeletal infections.

Understanding the mechanisms leading to failure in metallic nanowire-based transparent heaters, and solution for stability enhancement.

Silver nanowire (AgNW) networks are emerging as one of the most promising alternatives to indium tin oxide (ITO) for transparent electrodes in flexible electronic devices. They can be used in a variety of optoelectronic applications such as solar cells, touch panels and organic light-emitting diodes. Recently they have also proven to be very efficient when used as transparent heaters (THs). In addition to the study of AgNW networks acting as THs in regular use, i.e. at low voltage and moderate temperature, their stability and physical behavior at higher voltages and for longer durations should be studied in view of their integration into real devices. The properties of AgNW networks deposited by spray coating on glass or flexible transparent substrates are thoroughly studied via in situ measurements. The AgNW networks' behavior at different voltages for different durations and under different atmospheric conditions, both in air and under vacuum, has been examined. At low voltage, a reversible electrical response is observed while irreversibility and even failure are observed at higher voltages. In order to gain a deeper insight into the behavior of AgNW networks used as THs, simple but realistic physical models are proposed and are found to be in fair agreement with the experimental data. Finally, as the stability of AgNW networks is a key issue, we demonstrate that coating AgNW networks with a very thin layer of TiO2 using atomic layer deposition (ALD) improves the material's resistance against electrical and thermal instabilities without altering optical transmittance. We show that the critical annealing temperature associated to network breakdown increases from 270 °C for the as-deposited AgNW networks to 420 °C for AgNW networks coated with TiO2. Similarly, the electrical failure which occurs at 7 V for the as-deposited networks increases to 13 V for TiO2-coated networks. TiO2 is also proved to stabilize AgNW networks during long duration operation and at high voltage. Temperature higher than 235 °C was achieved at 7 V without failure.

Characterization of mesenchymal stem cells in bovine endometrium during follicular phase of oestrous cycle.

Stem cells have been postulated as responsible for cell regeneration in highly and continuously regenerative tissues such as the endometrium. Few studies in cattle have identified and specified the presence of stem cells in the endometrium during the oestrous cycle. The aim of this study was to investigate the presence of mesenchymal stem cells (MSCs) in the bovine endometrium during the follicular phase (FP) of the oestrous cycle. Uterine tissue was collected in the time-frame comprising day 18 of the cycle and ovulation (day 0). We isolated, cultured and expanded four primary cell lines from endometrium and identified byRT-qPCR the expression of OCT4, SOX2 but not NANOG (undifferentiated/embryonic markers), CD44 (MSCs marker) and c-KIT (stem cell marker) genes; and the encoded Oct4, Sox2 and Cd44 proteins by Western blot or immunostaining of paraffin-embedded tissue in endometrium. We demonstrated that cells isolated from bovine endometrium displayed essentially the same gene expression pattern; however, at the protein level, Oct4 and Cd44 were not detected. Besides, they showed typical functional characteristics of MSCs such as fibroblast-like morphology, plastic adherence, high proliferative capacity, clone formation in vitro and the ability to differentiate into chondrogenic, osteogenic and adipogenic lineages. We obtained for the first time an extensive characterization of undifferentiated cells populations contained in the bovine endometrium during the FP of the oestrous cycle.

Esophageal dysfunction and immunological changes induced by grass sublingual immunotherapy.

Sublingual immunotherapy frequently causes local oropharyngeal adverse events which are usually of mild severity, and tend to be self-limited and disappear within the first weeks of therapy. The mechanism of action involves changes in the specific humoral response to allergens, with increases in allergen-specific immunoglobulin G4 (IgG4) and blunting of the seasonal increase in allergen-specific IgE. We describe the case of a 25-year-old man diagnosed with grass pollen induced allergic rhinoconjunctivitis, who was treated with a lyophilisate of Phleum pratense by sublingual route. After 5 weeks of therapy he developed repeatedly intense symptoms of esophageal dysfunction immediately after the administration. Symptoms recurred every day, subsided in some hours without treatment and disappeared with the termination of therapy. The episode coincided with a marked elevation of total and specific IgE. The immunological changes gradually declined during the three years of follow up. The reported case suggests the need to evaluate the role of the immunological changes detected after the first weeks of sublingual therapy with Phleum pratense, in the induction of esophageal disorders.

"Shoot and Sense" Janus Micromotors-Based Strategy for the Simultaneous Degradation and Detection of Persistent Organic Pollutants in Food and Biological Samples.

A novel Janus micromotor-based strategy for the direct determination of diphenyl phthalate (DPP) in food and biological samples is presented. Mg/Au Janus micromotors are employed as novel analytical platforms for the degradation of the non-electroactive DPP into phenol, which is directly measured by difference pulse voltammetry on disposable screen-printed electrodes. The self-movement of the micromotors along the samples result in the generation of hydrogen microbubbles and hydroxyl ions for DPP degradation. The increased fluid transport improves dramatically the analytical signal, increasing the sensitivity while lowering the detection potential. The method has been successfully applied to the direct analysis of DPP in selected food and biological samples, without any sample treatment and avoiding any potential contamination from laboratory equipment. The developed approach is fast (∼5 min) and accurate with recoveries of ∼100%. In addition, efficient propulsion of multiple Mg/Au micromotors in complex samples has also been demonstrated. The advantages of the micromotors-assisted technology, i.e., disposability, portability, and the possibility to carry out multiple analysis simultaneously, hold considerable promise for its application in food and biological control in analytical applications with high significance.

Pet serine protease from enteroaggregative Escherichia coli stimulates the inflammatory response activating human macrophages.

BACKGROUND: Pet is a toxin from the family of Serine Protease Autotransporters of Enterobacteriaceae which was initially identified in Enteroaggregative Escherichia coli strains. This protease exhibits enterotoxin properties, damages the cell cytoskeleton and induces intestinal epithelium alterations, which are associated with a severe inflammatory process. An in-vitro study was conducted to evaluate the effect of Pet on the migration of human peripheral blood monocytes-derived macrophages and its participation in the activation of the early inflammatory response and cytokine expression. RESULTS: In the macrophage migration activation assay, Pet produced a similar effect to that induced by opsonized zymosan (ZAS). Regarding the cytokine expression, an increase of IL-8, TNF-α (pro-inflammatory) and IL-10 (anti-inflammatory) was identified. In addition to the above results, the nuclear translocation of NF-kB pp65 was also identified. These events are probably related to the inflammatory response identified in the histological examination of intestine rat samples inoculated with Pet during a ligated loop assay. CONCLUSION: The results showed that Pet participates as an immunostimulant molecule for macrophages, which activates both their mobility and cytokine expression. These observations suggest that the toxin participates in the inflammatory process that is observed during the host infection by EAEC Pet producing.