Laryngopharyngeal Reflux (LPR) should be considered as part of extraesophageal reflux (EER). This
reflux involves respiratory structures other than, or in addition to, the oesophagus. A new medical ...device
for the treatment of gastric reflux, including LPR, has been launched in Italy: Marial®. Therefore, the
aim of the present survey was to analyse the prescriptive behaviour both considering the past or current
treatments and clinical features during a specialist routine visit. The current survey was conducted in
86 Otorhinolaryngological centers, distributed in all of Italy. Globally, 4.418 subjects 47% males and
53% females, 50.1 (14.5) years-of-age were visited. The visits included laryngoscopy, Reflux Finding Score
(RFS) and Reflux Symptom Index (RSI) questionnaires. The total RSI median score was 15 (12-19) and
the total median RFS value was 10 (8-12). Interestingly, a significant change in the new drug prescription
was observed (p<0.0001): over two-third of patients (67%) received Marial® as monotherapy, whereas PPI
plus add-on were prescribed to almost one-third of the patients. PPI alone was prescribed in less than 1%.
In conclusion, LPR is a common disorder characterized by typical signs and symptoms; LPR patients may
be correctly identified and scored by evidence-based criteria. In addition, the present survey reported that
LPR treatment has been considerably changed by the introduction of a new medical device.
As LPR diagnostic work-up is complex in the absence of a definitive gold standard diagnostic test,
patient symptoms have become a primary method to identify those with LPR. In this regard, Reflux
...Symptom Index (RSI) is a reliable self-administered questionnaire useful also to monitor changes after
treatment. An Italian survey on patients with LPR evaluated the effect of treatments for LPR that were
prescribed in a real-world setting, such as Otolaryngological clinics. In this part of the survey, 1,680
subjects 45.2% males, 54.8% females, 50.4 (14.7) years were visited in the 86 Italian ORL centers. About
70% of patients were treated with Marial® alone, 27% with PPI plus add-on. RSI change assessment was
the primary outcome. Both therapeutic options significantly (p<0.0001) reduced RSI score interestingly
since the second week. The inter-group comparison demonstrated the Marial® monotherapy induced a
greater reduction of RSI than PPI plus add-on since the second week. In conclusion, the present survey
reported that a new medical device (Marial®) may be considered a valid option for the treatment of LPR.
(Pre-)transitional disks show gaps and cavities that can be related with on-going planet formation. According to theory, young embedded planets can accrete material from the circumplanetary and ...circumstellar disks, so that they could be detected in accretion tracers, like the H\(_{\alpha}\) emission line. In this work, we present spectral angular differential imaging AO-assisted observations of five (pre-)transitional disks obtained with SPHERE/ZIMPOL at the Very Large Telescope (VLT). They were obtained in the H\(_{\alpha}\) line and the adjacent continuum. We have combined spectral and angular differential imaging techniques to increase the contrast in the innermost regions close to the star, and search for the signature of young accreting protoplanets. As a result, the reduced images do not show any clear H\(_{\alpha}\) point source around any of the targets. We report faint H\(_{\alpha}\) emissions around TW Hya and HD163296: while the former is most probably an artifact related with a spike, the nature of the latter remains unclear. The spectral and angular differential images yield contrasts of 6--8 magnitudes at separations of \(\sim\) 100 mas from the central stars, except in the case of LkCa15, with values of \(\sim\)3 mag. We have estimated upper limits to the accretion luminosity of potential protoplanets, obtaining that planetary models provide an average value of \(L_{\rm acc} \sim 10^{-4}\) \(L_{\odot}\) at 200 mas, which is \(\sim\)2 orders of magnitude higher than the \(L_{\rm acc}\) estimated from the extrapolation of the \(L_{H_{\alpha}}\) - \(L_{acc}\) stellar relationship. We explain the lack of protoplanet detections as a combination of different factors, like e.g. episodic accretion, extinction from the circumstellar and circumplanetray disks, and/or a majority of low-mass, low-accreting planets.
Aims. We aim to detect molecules in the atmosphere of the young forming companion PDS70 b by searching for atmospheric absorption features typical of substellar objects. Methods. We obtained ...medium-resolution (R\(\approx\)5075) spectra of the PDS70 planetary system with the SINFONI integral field spectrograph at the Very Large Telescope. We applied molecular mapping, based on cross-correlation with synthetic spectra, to identify signatures of molecular species in the atmosphere of the planet. Results. Although the planet emission is clearly detected when resampling the data to lower resolution, no molecular species could be identified with the cross-correlation technique. We estimated upper limits on the abundances of H\(_2\)O, CO and CH\(_4\) (\(\log(X_\mathrm{mol}) < -4.0\), \(-4.1\) and \(-4.9\), respectively) assuming a clear atmosphere, and we explored the impact of clouds, which increase the upper limits by a factor up to 0.7 dex. Assuming that the observations directly probe the planet's atmosphere, we found a lack of molecular species compared to other directly imaged companions or field objects. Under the assumption that the planet atmosphere presents similar characteristics to other directly imaged planets, we conclude that a dusty environment surrounds the planet, effectively obscuring any feature generated in its atmosphere. We quantify the extinction necessary to impede the detection (\(A_V\approx16-17\) mag), pointing to the possibility of higher optical thickness than previously estimated from other studies. Finally, the non-detection of molecular species conflicts with atmospheric models previously proposed to describe the forming planet. Conclusions. To unveil how giant planets form, a comprehensive approach that includes constraints from multiple techniques needs to be undertaken. Molecular mapping emerges as an alternative to more classical techniques like SED fitting.
The Medium Resolution Spectrometer on board JWST/MIRI will give access to mid-IR spectra while retaining spatial information. With the unparalleled sensitivity of JWST and the MIRI detectors, the MRS ...has the potential to revolutionise our understanding of giant exoplanet atmospheres. Molecular mapping is a promising detection and characterisation technique used to study the spectra of directly imaged exoplanets. We aim to examine the feasibility and application of this technique to MRS observations. We used the instrument simulator MIRISIM to create mock observations of resolved star and exoplanet systems. As an input for the simulator, we used stellar and planet parameters from literature, with the planet spectrum being modelled with the radiative transfer code petitRADTRANS. After processing the raw data with the JWST pipeline, we high pass filter the data to account for the stellar point spread function, and used a forward modelling approach to detect the companions and constrain the chemical composition of their atmospheres through their molecular signatures. We identified limiting factors in spectroscopic characterisation of directly imaged exoplanets with the MRS and simulated observations of two representative systems, HR8799 and GJ504. In both systems, we could detect the presence of multiple molecules that were present in the input model of their atmospheres. We used two different approaches with single molecule forward models, used in literature, that are sensitive to detecting mainly H\(_2\)O, CO, CH\(_4\), and NH\(_3\), and a log-likelihood ratio test that uses full atmosphere forward models and is sensitive to a larger number of less dominant molecular species. We show that the MIRI MRS can be used to characterise widely separated giant exoplanets in the mid-IR using molecular mapping.
A&A 633, A119 (2020) The mechanisms of planet formation are still under debate. We know little
about how planets form, even if more than 4000 exoplanets have been detected to
date. Recent ...investigations target the cot of newly born planets: the
protoplanetary disk. At the first stages of their life, exoplanets still
accrete material from the gas-rich disk in which they are embedded.
Transitional disks are indeed disks that show peculiarities, such as gaps,
spiral arms, and rings, which can be connected to the presence of substellar
companions. To investigate what is responsible for these features, we selected
all the known transitional disks in the solar neighborhood (<200 pc) that are
visible from the southern hemisphere. We conducted a survey of 11 transitional
disks (TDs) with the SPHERE instrument at the VLT. This is the largest Halpha
survey that has been conducted so far to look for protoplanets. The
observations were performed with the Halpha filter of ZIMPOL in order to target
protoplanets that are still in the accretion stage. All the selected targets
are very young stars, less than 20 Myr, and show low extinction in the visible.
We reduced the ZIMPOL pupil stabilized data by applying the method of the
angular spectral differential imaging (ASDI), which combines both techniques.
The datacubes are composed of the CntHalpha and the narrow band filter Halpha,
which are taken simultaneously to permit the suppression of the speckle
pattern. The principal component analysis (PCA) method was employed for the
reduction of the data. For each dataset, we derived the 5sigma contrast limit
and converted it in upper limits on the accretion luminosity. We do not detect
any new accreting substellar companions around the targeted transition disks
down to an average contrast of 12 magnitudes at 0.2 arcsec from the central
star (continues in the manuscript).
Abridged: Direct imaging has made significant progress over the past decade leading to the detection of several giant planets. Observing strategies and data rates vary from instrument to instrument ...and wavelength, and can result in tens of thousands of images to be combined. We here present a new approach, tailored for VLT/NaCo observations performed with the Annular Groove Phase Mask (AGPM) coronagraph at \(L'\) filter. Our pipeline aims at improving the post-processing of the observations on two fronts: identifying the location of the star behind the AGPM to better align the science frames and performing frame selection. Our method relies on finding the position of the AGPM in the sky frame observations, and correlate it with the circular aperture of the coronagraphic mask. This relationship allows us to retrieve the location of the AGPM in the science frames, in turn allowing us to estimate the position of the star. In the process we also gather additional information useful for our frame selection approach. We tested our pipeline on several targets, and find that we improve the S/N of companions around \(\beta\) Pictoris and R CrA by \(24\pm3\) \% and \(117\pm11\) \% respectively, compared to other state-of-the-art reductions. The astrometry of the point sources is slightly different but remains compatible within \(3\sigma\) compared to published values. Finally, we find that even for NaCo observations with tens of thousands of frames, frame selection yields just marginal improvement for point sources but may improve the final images for objects with extended emission such as disks. We proposed a novel approach to identify the location of the star behind a coronagraph even when it cannot easily be determined by other methods, leading to better S/N for nearby point sources, and led a thorough study on the importance of frame selection, concluding that the improvements are marginal in most case.
Accreting planets have been seen at Ha (H alpha), but targeted searches have not been fruitful. For planets, accretion tracers should come from the shock itself, exposing them to extinction by the ...accreting material. High-resolution (R>5e4) spectrographs at Ha should soon allow studying how the incoming material shapes the line profile. We calculate how much the gas and dust accreting onto a planet reduce the Ha flux from the shock at the planetary surface and how they affect line shapes. We also study the absorption-modified relationship between Ha luminosity and Mdot. We compute the high-resolution radiative transfer of the Ha line using a 1D velocity-density-temperature structure for the inflowing matter in three representative accretion geometries: spherical symmetry, polar inflow, and magnetospheric accretion. For each, we explore wide ranges of Mdot and planet mass M. We use detailed gas opacities and estimate dust opacities. At Mdot<3e-6 MJ/yr, gas extinction is negligible for spherical or polar inflow and at most A_Ha<0.5 mag for magnetospheric accretion. Up to Mdot~3e-4 MJ/yr, the gas has A_Ha<4 mag. This decreases with M. We estimate realistic dust opacities at Ha as ~0.01-10 cm^2/g, i.e., 10-1e4 times lower than in the ISM. Extinction flattens the L_Ha-Mdot relationship, which becomes non-monotonic with a maximum L_Ha~1e-4 LSun near Mdot~1e-4 MJ/yr for M~10 MJ. In magnetospheric accretion, the gas can introduce features in line profiles, but the velocity gradient smears them out in other geometries. For most of parameter space, extinction by the accreting matter should be negligible, simplifying interpretation of observations, especially for planets in gaps. At high Mdot, strong absorption reduces the Ha flux, and some measurements can be interpreted as two Mdot values. Line profiles at R~1e5 can provide complex constraints on the accretion flow's thermal-dynamical structure.
To understand how the multitude of planetary systems that have been discovered come to be, we need to study systems at different evolutionary stages, with different central stars but also in ...different environments. The most challenging environment for planet formation may be the harsh UV radiation field of nearby massive stars which quickly erodes disks by external photo-evaporation. We have observed the AT Pyx system, located in the head of a cometary globule in the Gum Nebula, to search for signs of ongoing planet formation. We used the extreme adaptive optics imager VLT/SPHERE to observe AT Pyx in polarized light as well as total intensity in the J, H and K-band. Additionally we employed VLT/NACO to observe the system in the L-band. We resolve the disk around AT Pyx in scattered light across multiple wavelengths. We find an extended (>126 au) disk, with an intermediate inclination between 35 deg and 42 deg. The disk shows complex sub-structure and we identify 2 and possibly 3 spiral-like features. Depending on the precise geometry of the disk (which we can not unambiguously infer from our data) the disk may be eccentric with an eccentricity of ~0.16 or partially self-shadowed. The spiral features and possible eccentricity are both consistent with signatures of an embedded gas giant planet equal in mass to Jupiter. Our own observations can rule out brown dwarf companions embedded in the resolved disk, but are not sensitive enough to detect gas giants. AT Pyx is the first disk in a cometray globule in the Gum Nebula which is spatially resolved. By comparison with disks in the Orion Nebula Cluster we note that the extension of the disk may be exceptional for this environment if the external UV radiation field is comparable to other cometary globules in the region. The signposts of ongoing planet formation are intriguing and need to be followed up with higher sensitivity.
