ExoClock Project: An open platform for monitoring the ephemerides of Ariel targets with contributions from the public

The Ariel mission will observe spectroscopically around 1000 exoplanets to further characterise their atmospheres. For the mission to be as efficient as possible, a good knowledge of the planets' ephemerides is needed before its launch in 2028. While ephemerides for some planets are being refined on a per-case basis, an organised effort to collectively verify or update them when necessary does not exist. In this study, we introduce the ExoClock project, an open, integrated and interactive platform with the purpose of producing a confirmed list of ephemerides for the planets that will be observed by Ariel. The project has been developed in a manner to make the best use of all available resources: observations reported in the literature, observations from space instruments and, mainly, observations from ground-based telescopes, including both professional and amateur observatories. To facilitate inexperienced observers and at the same time achieve homogeneity in the results, we created data collection and validation protocols, educational material and easy to use interfaces, open to everyone. ExoClock was launched in September 2019 and now counts over 140 participants from more than 15 countries around the world. In this release, we report the results of observations obtained until the 15h of April 2020 for 119 Ariel candidate targets. In total, 632 observations were used to either verify or update the ephemerides of 83 planets. Additionally, we developed the Exoplanet Characterisation Catalogue (ECC), a catalogue built in a consistent way to assist the ephemeris refinement process. So far, the collaborative open framework of the ExoClock project has proven to be highly efficient in coordinating scientific efforts involving diverse audiences. Therefore, we believe that it is a paradigm that can be applied in the future for other research purposes, too

ExoClock Project III: 450 new exoplanet ephemerides from ground and space observations

The ExoClock project has been created with the aim of increasing the efficiency of the Ariel mission. It will achieve this by continuously monitoring and updating the ephemerides of Ariel candidates over an extended period, in order to produce a consistent catalogue of reliable and precise ephemerides. This work presents a homogenous catalogue of updated ephemerides for 450 planets, generated by the integration of $\sim$18000 data points from multiple sources. These sources include observations from ground-based telescopes (ExoClock network and ETD), mid-time values from the literature and light-curves from space telescopes (Kepler/K2 and TESS). With all the above, we manage to collect observations for half of the post-discovery years (median), with data that have a median uncertainty less than one minute. In comparison with literature, the ephemerides generated by the project are more precise and less biased. More than 40\% of the initial literature ephemerides had to be updated to reach the goals of the project, as they were either of low precision or drifting. Moreover, the integrated approach of the project enables both the monitoring of the majority of the Ariel candidates (95\%), and also the identification of missing data. The dedicated ExoClock network effectively supports this task by contributing additional observations when a gap in the data is identified. These results highlight the need for continuous monitoring to increase the observing coverage of the candidate planets. Finally, the extended observing coverage of planets allows us to detect trends (TTVs - Transit Timing Variations) for a sample of 19 planets. All products, data, and codes used in this work are open and accessible to the wider scientific community.Comment: Recommended for publication to ApJS (reviewer's comments implemented). Main body: 13 pages, total: 77 pages, 7 figures, 7 tables. Data available at http://doi.org/10.17605/OSF.IO/P298

ExoClock Project. III. 450 New Exoplanet Ephemerides from Ground and Space Observations

The ExoClock project has been created to increase the efficiency of the Ariel mission. It will achieve this by continuously monitoring and updating the ephemerides of Ariel candidates, in order to produce a consistent catalog of reliable and precise ephemerides. This work presents a homogenous catalog of updated ephemerides for 450 planets, generated by the integration of ∼18,000 data points from multiple sources. These sources include observations from ground-based telescopes (the ExoClock network and the Exoplanet Transit Database), midtime values from the literature, and light curves from space telescopes (Kepler, K2, and TESS). With all the above, we manage to collect observations for half of the postdiscovery years (median), with data that have a median uncertainty less than 1 minute. In comparison with the literature, the ephemerides generated by the project are more precise and less biased. More than 40% of the initial literature ephemerides had to be updated to reach the goals of the project, as they were either of low precision or drifting. Moreover, the integrated approach of the project enables both the monitoring of the majority of the Ariel candidates (95%), and also the identification of missing data. These results highlight the need for continuous monitoring to increase the observing coverage of the candidate planets. Finally, the extended observing coverage of planets allows us to detect trends (transit-timing variations) for a sample of 19 planets. All the products, data, and codes used in this work are open and accessible to the wider scientific community

Ectopic GH-secreting pituitary adenoma of the clivus: systematic literature review of a challenging tumour

Purpose: Acromegaly is usually due to growth hormone (GH)-secreting pituitary adenomas, but it may be exceptionally caused by GH-secreting ectopic pituitary adenomas (EPA). EPA are defined as extra-sellar pituitary tumours, extra- or intra-cranially sited, entirely separated from the pituitary stalk and gland. The aim of the study is to address the challenges in the management of clival GHEPA. Methods: We reported a case of a 53-year-old acromegalic patient with a primary clival GHEPA and reviewed systematically the relevant English literature between 1975 and 2019, in keeping with the PRISMA guidelines. Results: Four cases of primary clival GHEPA have been described in literature apart from ours. All patients presented with acromegalic features, elevated circulating GH and/or insulin-like growth factor-1 levels. Hyperprolactinemia and empty sella were described in two cases, respectively. These tumours show the typical imaging characteristics of pituitary adenomas, but their neuroradiological diagnosis may be challenging due to their sizes and the difficulty in defining the absence of connections with the pituitary fossa. Conclusion: Although primary clival GHEPA are exceedingly rare, even if likely under-reported in literature, they should be considered in the differential diagnosis of clival tumours because of their specific management. Surgery represents the first-line treatment option, while medical and radiation therapies can be adopted as neo-adjuvant, adjuvant or primary treatments according to tumour and patient characteristics

Endoscopic-assisted multi-portal compartmental resection of the masticatory space in oral cancer: Anatomical study and preliminary clinical experience

Objectives: To present an anatomical cadaver dissection study and our preliminary surgical experience with endoscopic-assisted multi-portal compartmental resection of the masticatory space (MS) in locally advanced oral squamous cell carcinoma (OSCC) of the retromolar area. Materials and methods: Two fresh-frozen cadaver heads were dissected in the Laboratory of Anatomy to define the surgical steps of an endoscopic-assisted multi-portal compartmental approach to the MS. After this preclinical anatomical study, patients affected by locally advanced OSCC originating from the retromolar area with extension to the MS were prospectively enrolled and operated at two Italian referral centers for head and neck cancer between October 2019 and May 2020. Results: Surgical technique of endoscopic-assisted multi-portal compartmental resection of the MS was preclinically defined step by step in 3 phases: transnasal, transoral/trancervical, and multi-portal. Compartmental resection of the MS was successfully completed in all specimens (4 MSs dissected). The surgical technique was subsequently applied in 3 patients affected by primary OSCC of the retromolar area, providing satisfactory results in terms of negative resection margins and local control. Conclusions: Multi-portal compartmental resection of the MS combining the transnasal and transoral/transcervical corridors is technically feasible. Such an approach to the MS in locally advanced OSCC provides different angles of incidence to the target and full control of tumor margins

ExoClock project: an open platform for monitoring the ephemerides of Ariel targets with contributions from the public

The Ariel mission will observe spectroscopically around 1000 exoplanets to further characterise their atmospheres. For the mission to be as efficient as possible, a good knowledge of the planets’ ephemerides is needed before its launch in 2028. While ephemerides for some planets are being refined on a per-case basis, an organised effort to collectively verify or update them when necessary does not exist. In this study, we introduce the ExoClock project, an open, integrated and interactive platform with the purpose of producing a confirmed list of ephemerides for the planets that will be observed by Ariel. The project has been developed in a manner to make the best use of all available resources: observations reported in the literature, observations from space instruments and, mainly, observations from ground-based telescopes, including both professional and amateur observatories. To facilitate inexperienced observers and at the same time achieve homogeneity in the results, we created data collection and validation protocols, educational material and easy to use interfaces, open to everyone. ExoClock was launched in September 2019 and now counts over 140 participants from more than 15 countries around the world. In this release, we report the results of observations obtained until the 15h of April 2020 for 120 Ariel candidate targets. In total, 632 observations were used to either verify or update the ephemerides of 84 planets. Additionally, we developed the Exoplanet Characterisation Catalogue (ECC), a catalogue built in a consistent way to assist the ephemeris refinement process. So far, the collaborative open framework of the ExoClock project has proven to be highly efficient in coordinating scientific efforts involving diverse audiences. Therefore, we believe that it is a paradigm that can be applied in the future for other research purposes, too

Relieving laryngopharingeral reflux (relief) survey in otolaryngology - The viewpoint of the otorhinolaryngologist

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

Relieving laryngopharingeral reflux (relief) survey in otolaryngology - The viewpoint of the otorhinolaryngologist

none94noLaryngopharyngeal 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.noneGelardi M.; Silvestri M.; Ciprandi G.; Aielli F.; Alessandrini P.; Allosso G.; Angelillo S.; Anni A.; Antoniacomi G.; Aragona S.E.; Armone Caruso A.; Asprea F.; Azzaro R.; Balata G.; Bellini C.; Benedetto D.; Bernardi R.; Buccolieri M.; Caligo G.; Campobasso G.; Canevari F.R.M.; Cantaffa A.; Capone A.; Carboni S.; Castagna G.; Castellani C.; Clemente I.; Cordier A.; Cossu D.; Costanzo M.; Cugno Garrano A.; Cupido G.; Danteo M.; De Luca C.; Degli Innocenti M.; Dei A.; Denuli G.; Di Bartolo L.; Dolores A.; Falcetti S.; Falciglia R.; Fera G.; Ferraro G.; Fini O.; Giangregorio F.; Grazioli F.; Grillo C.; Guiso M.L.; Ianniel Lo F.; Lerace M.; Lngria F.; La Mantia I.; La Pietra G.; Lambertoni C.; Lauletta R.; Lazzoni D.; Leo S.; Leone M.; Lo Iacono V.; Maio M.; Mangiatordi F.G.; Maniscalco F.; Matricciani A.; Mirra N.; Montanaro S.C.; Montesi P.; Moro D.; Muia F.; Mure C.; Nacci A.; Nipo T.; Pace A.; Panetti G.; Paoletti M.; Pasquarella G.; Pedrotti I.; Pellegrino A.; Petrone D.; Pinto P.; Pizzolante M.C.; Pollastrini L.; Poma S.; Quaranta N.; Reale G.; Rigo S.; Scarpa A.; Scelsi F.; Sellari L.; Serraino E.G.; Spano G.; Stufano V.; Tomacelli G.; Tombolini A.; Zirone A.Gelardi, M.; Silvestri, M.; Ciprandi, G.; Aielli, F.; Alessandrini, P.; Allosso, G.; Angelillo, S.; Anni, A.; Antoniacomi, G.; Aragona, S. E.; Armone Caruso, A.; Asprea, F.; Azzaro, R.; Balata, G.; Bellini, C.; Benedetto, D.; Bernardi, R.; Buccolieri, M.; Caligo, G.; Campobasso, G.; Canevari, F. R. M.; Cantaffa, A.; Capone, A.; Carboni, S.; Castagna, G.; Castellani, C.; Clemente, I.; Cordier, A.; Cossu, D.; Costanzo, M.; Cugno Garrano, A.; Cupido, G.; Danteo, M.; De Luca, C.; Degli Innocenti, M.; Dei, A.; Denuli, G.; Di Bartolo, L.; Dolores, A.; Falcetti, S.; Falciglia, R.; Fera, G.; Ferraro, G.; Fini, O.; Giangregorio, F.; Grazioli, F.; Grillo, C.; Guiso, M. L.; Ianniel Lo, F.; Lerace, M.; Lngria, F.; La Mantia, I.; La Pietra, G.; Lambertoni, C.; Lauletta, R.; Lazzoni, D.; Leo, S.; Leone, M.; Lo Iacono, V.; Maio, M.; Mangiatordi, F. G.; Maniscalco, F.; Matricciani, A.; Mirra, N.; Montanaro, S. C.; Montesi, P.; Moro, D.; Muia, F.; Mure, C.; Nacci, A.; Nipo, T.; Pace, A.; Panetti, G.; Paoletti, M.; Pasquarella, G.; Pedrotti, I.; Pellegrino, A.; Petrone, D.; Pinto, P.; Pizzolante, M. C.; Pollastrini, L.; Poma, S.; Quaranta, N.; Reale, G.; Rigo, S.; Scarpa, A.; Scelsi, F.; Sellari, L.; Serraino, E. G.; Spano, G.; Stufano, V.; Tomacelli, G.; Tombolini, A.; Zirone, A