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Many gas giant exoplanets orbit so close to their host star that they are heated to high temperatures, causing atmospheric gases to escape. Gas giant atmospheres are mostly hydrogen and helium, which are difficult to observe. Two papers have now observed escaping helium in the near-infrared (see the Perspective by Brogi). Allart et al. observed helium in a Neptune-mass exoplanet and performed detailed simulations of its atmosphere, which put constraints on the escape rate. Nortmann et al. found that helium is escaping a Saturn-mass planet, trailing behind it in its orbit. They combined this with observations of several other exoplanets to show that atmospheres are being lost more quickly by exoplanets that are more strongly heated. Science , this issue p. 1384 , p. 1388 ; see also p. 1360 Helium is observed in the atmosphere of a warm Neptune-mass exoplanet, constraining the atmospheric loss rate. Stellar heating causes atmospheres of close-in exoplanets to expand and escape. These extended atmospheres are difficult to observe because their main spectral signature—neutral hydrogen at ultraviolet wavelengths—is strongly absorbed by interstellar medium. We report the detection of the near-infrared triplet of neutral helium in the transiting warm Neptune-mass exoplanet HAT-P-11b by using ground-based, high-resolution observations. The helium feature is repeatable over two independent transits, with an average absorption depth of 1.08 ± 0.05%. Interpreting absorption spectra with three-dimensional simulations of the planet’s upper atmosphere suggests that it extends beyond 5 planetary radii, with a large-scale height and a helium mass loss rate of ≲3 × 10 5 grams per second. A net blue-shift of the absorption might be explained by high-altitude winds flowing at 3 kilometers per second from day to night-side.

Earth, Venus, Mars and some extrasolar terrestrial planets 1 have a mass and radius that is consistent with a mass fraction of about 30% metallic core and 70% silicate mantle 2 . At the inner frontier of the Solar System, Mercury has a completely different composition, with a mass fraction of about 70% metallic core and 30% silicate mantle 3 . Several formation or evolution scenarios are proposed to explain this metal-rich composition, such as a giant impact 4 , mantle evaporation 5 or the depletion of silicate at the inner edge of the protoplanetary disk 6 . These scenarios are still strongly debated. Here, we report the discovery of a multiple transiting planetary system (K2-229) in which the inner planet has a radius of 1.165 ± 0.066 Earth radii and a mass of 2.59 ± 0.43 Earth masses. This Earth-sized planet thus has a core-mass fraction that is compatible with that of Mercury, although it was expected to be similar to that of Earth based on host-star chemistry 7 . This larger Mercury analogue either formed with a very peculiar composition or has evolved, for example, by losing part of its mantle. Further characterization of Mercury-like exoplanets such as K2-229 b will help to put the detailed in situ observations of Mercury (with MESSENGER and BepiColombo 8 ) into the global context of the formation and evolution of solar and extrasolar terrestrial planets. The abundance of metals in Mercury’s interior is unique among the rocky planets of the Solar System. The characterization of the ‘super-Mercury’ exoplanet presented in this paper will improve our understanding of how Mercury-like planets can form and evolve.

This exoplanet looks familiar About 70 of the more than 400 known extrasolar planets transit their central star, making it possible to observe their atmospheres and determine various key parameters. The transiting extra-solar planets so far discovered have had very short or eccentric orbits, so were either very hot or subject to extreme surface temperature variations. Now the CoRoT space observatory has discovered an exoplanet rather similar to the Solar System gas giants. The planet, CoRoT-9b, is in a 95-day low eccentricity orbit — resembling that of Mercury — around a Sun-like star. Its surface temperature is between about −20 and 150 °C, and based upon its density, its internal composition appears to resemble that of Jupiter and Saturn. Of the more than 400 known exoplanets, about 70 transit their central star, most in small orbits (with periods of around 1 day, for instance). Here, observations are reported of the transit of CoRoT-9b, which orbits with a period of 95.274 days, on a low eccentricity, around a solar-like star. Its relatively large periastron distance yields a 'temperate' photospheric temperature estimated to be between 250 and 430 K, and its interior composition is inferred to be consistent with those of Jupiter and Saturn. Of the over 400 known 1 exoplanets, there are about 70 planets that transit their central star, a situation that permits the derivation of their basic parameters and facilitates investigations of their atmospheres. Some short-period planets 2 , including the first terrestrial exoplanet 3 , 4 (CoRoT-7b), have been discovered using a space mission 5 designed to find smaller and more distant planets than can be seen from the ground. Here we report transit observations of CoRoT-9b, which orbits with a period of 95.274 days on a low eccentricity of 0.11 ± 0.04 around a solar-like star. Its periastron distance of 0.36 astronomical units is by far the largest of all transiting planets, yielding a ‘temperate’ photospheric temperature estimated to be between 250 and 430 K. Unlike previously known transiting planets, the present size of CoRoT-9b should not have been affected by tidal heat dissipation processes. Indeed, the planet is found to be well described by standard evolution models 6 with an inferred interior composition consistent with that of Jupiter and Saturn.

Exoplanet follow-up with JWST requires precise masses and radii. HARPS-N is a high-resolution spectrograph on the Telescopio Nazionale Galileo (TNG), predominantly used to detect and characterize exoplanets using the radial velocity (RV) method. The HARPS-N Collaboration has been characterising exoplanets with HARPS-N for over a decade. In this short paper we highlight the contributions that the HARPS-N Collaboration has made to the characterisation of small exoplanets.

Purpose The objective of this study was to identify the most clinically relevant drug–drug interactions (DDIs) at risk of affecting acenocoumarol safety in our tertiary care university hospital, a 2,000 bed institution. Methods We identified DDIs occurring with acenocoumarol by combining two different sources of information: a 1-year retrospective analysis of acenocoumarol prescriptions and comedications from our Computerized Physician Order Entry (CPOE) system ( n = 2,439 hospitalizations) and a retrospective study of clinical pharmacology consultations involving acenocoumarol over the past 14 years (1994–2007) ( n = 407). We classified these DDIs using an original risk-analysis method. A criticality index was calculated for each associated drug by multiplying three scores based on mechanism of interaction, involvement in a supratherapeutic international normalized ratio (INR) (≥ 6) and involvement in a severe bleeding. Results One hundred and twenty-six DDIs were identified and weighted. Twenty-eight drugs had a criticality index ≥ 20 and were therefore considered at high risk for interacting with acenocoumarol by increasing its effect: 75% of these drugs involved a pharmacokinetic mechanism and 14 % a pharmacodynamic mechanism. An unknown mechanism of interaction was involved in 11 % of drugs. Conclusion Twenty-eight specific drugs were identified as being at high risk for interacting with acenocoumarol in our hospital using an original risk-analysis method. Most analyzed drugs interact with acenocoumarol via a pharmacokinetic mechanism. Actions such as the implementation of alerts in our CPOE system should be specifically developed for these drugs.

In this work, we aim at comparing formally three different interaction modes for image manipulation that are usable in a surgery setting: 1) A gesture-controlled approach using Kinect ®; 2) oral instructions to a third part dedicated to manipulate the images; and 3) direct manipulation using a mouse. Each participant used the radiology image viewer Weasis with the three interaction modes. In a crossover randomized controlled trial participants were attributed block wise to six experimental groups. For each group, the order for testing the three modes was randomly assigned. Nine standardized scenarios were used. 30 physicians and senior medical students participated in the experiment. Efficiency, measured as time used to pass the scenario, was best when using the mouse (M = 109.10s, SD = 25.96), followed by gesture-controlled (M = 214.97s, SD = 46.29) and oral instructions (M = 246.33s, SD = 76.50). Satisfaction, measured by a questionnaire, was rated highest in the condition mouse (M = 6.63, SD = 0.56), followed by gesture-controlled (M = 5.77, SD = 0.93) and oral instructions (M = 4.40, SD = 1.71). Differences in efficiency and satisfaction rating were significant. No significant difference in effectiveness, measured with error rates, was found. The study shows with formal evaluation that the use of gestures is advantageous over instructions to a third person. In particular, the use of gestures is more efficient than verbalizing instructions. The given gestures could be learned easily and reliability of the tested gesture-control system is good. Under the premise that mouse cannot be used directly during surgery, gesture-controlled approaches demonstrate to be superior to oral instructions for image manipulation.

The high-accuracy and high-precision HARPS-N spectrograph has been installed at the italian Telescopio Nazionale Galileo in La Palma approximately two years and a half ago. Eighty nights per year of Guaranteed Time of Observation are mostly dedicated to the radial-velocity (RV) follow up of Kepler small-size planetary candidates to establish their nature and to determine accurately their masses. We report on recent results of this ongoing RV campaign, including the recent characterization of the planetary system Kepler-101.

The American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) are nowadays recognized as the world's most authoritative resuscitation guidelines. Adherence to these guidelines optimizes the management of critically ill patients and increases their chances of survival after cardiac arrest. Despite their availability, suboptimal quality of CPR is still common. Currently, the median hospital survival rate after pediatric in-hospital cardiac arrest is 36%, whereas it falls below 10% for out-of-hospital cardiac arrest. Among emerging information technologies and devices able to support caregivers during resuscitation and increase adherence to AHA guidelines, augmented reality (AR) glasses have not yet been assessed. In order to assess their potential, we adapted AHA Pediatric Advanced Life Support (PALS) guidelines for AR glasses. The study aimed to determine whether adapting AHA guidelines for AR glasses increased adherence by reducing deviation and time to initiation of critical life-saving maneuvers during pediatric CPR when compared with the use of PALS pocket reference cards. We conducted a randomized controlled trial with two parallel groups of voluntary pediatric residents, comparing AR glasses to PALS pocket reference cards during a simulation-based pediatric cardiac arrest scenario-pulseless ventricular tachycardia (pVT). The primary outcome was the elapsed time in seconds in each allocation group, from onset of pVT to the first defibrillation attempt. Secondary outcomes were time elapsed to (1) initiation of chest compression, (2) subsequent defibrillation attempts, and (3) administration of drugs, as well as the time intervals between defibrillation attempts and drug doses, shock doses, and number of shocks. All these outcomes were assessed for deviation from AHA guidelines. Twenty residents were randomized into 2 groups. Time to first defibrillation attempt (mean: 146 s) and adherence to AHA guidelines in terms of time to other critical resuscitation endpoints and drug dose delivery were not improved using AR glasses. However, errors and deviations were significantly reduced in terms of defibrillation doses when compared with the use of the PALS pocket reference cards. In a total of 40 defibrillation attempts, residents not wearing AR glasses used wrong doses in 65% (26/40) of cases, including 21 shock overdoses >100 J, for a cumulative defibrillation dose of 18.7 Joules per kg. These errors were reduced by 53% (21/40, P<.001) and cumulative defibrillation dose by 37% (5.14/14, P=.001) with AR glasses. AR glasses did not decrease time to first defibrillation attempt and other critical resuscitation endpoints when compared with PALS pocket cards. However, they improved adherence and performance among residents in terms of administering the defibrillation doses set by AHA.

The majority of extra-solar planets have been discovered (or confirmed after follow-up) through radial-velocity (RV) surveys. Using ground-based spectrographs such as High Accuracy Radial Velocity Planetary Search (HARPS) and HARPS-North, it is now possible to detect planets that are only a few times the mass of the Earth. However, the presence of dark spots on the stellar surface produces RV signals that are very similar in amplitude to those caused by orbiting low-mass planets. Disentangling these signals has thus become the biggest challenge in the detection of Earth-mass planets using RV surveys. To do so, we use the star's lightcurve to model the RV variations produced by spots. Here we present this method and show the results of its application to CoRoT-7.

Over the past two years, the search for low-mass extrasolar planets has led to the detection of seven so-called ‘hot Neptunes’ or ‘super-Earths’ around Sun-like stars. These planets have masses 5–20 times larger than the Earth and are mainly found on close-in orbits with periods of 2–15 days. Here we report a system of three Neptune-mass planets with periods of 8.67, 31.6 and 197 days, orbiting the nearby star HD 69830. This star was already known to show an infrared excess possibly caused by an asteroid belt within 1  au (the Sun–Earth distance). Simulations show that the system is in a dynamically stable configuration. Theoretical calculations favour a mainly rocky composition for both inner planets, while the outer planet probably has a significant gaseous envelope surrounding its rocky/icy core; the outer planet orbits within the habitable zone of this star. It's another world As the techniques used to search for extrasolar planets have been refined, more and more have been discovered (over 170), and they get smaller. In recent years seven ‘hot Neptunes’ or ‘super-Earths’ have been detected. These have masses 5–20 times larger than the Earth and are in close-in orbits (periods of 2–15 days) around Sun-like stars. Now the first multiple system of three Neptune-mass planets has been found, with periods of 8.67, 31.6 and (in the ‘habitable’ zone) 197 days. They are orbiting the nearby star HD 69830. Theoretical calculations favour a mainly rocky composition for both inner planets. The outer planet probably has a significant gaseous envelope surrounding a rocky/icy core: it is the first Neptune-mass object detected inside the habitable zone of a Sun-like star. Simulations show that the system of three Neptune-mass planets is in a dynamically stable configuration, with theoretical calculations favouring a mainly rocky composition for both inner planets, but a significant gaseous envelope surrounding a rocky/icy core for the outer planet.