Current practices and challenges in adaptation of clinical guidelines : A qualitative study based on semistructured interviews

Funding YS is funded by China Scholarship Council (No 201707040103).Altres ajuts: CSC/201707040103Objective This study aims to better understand the current practice of clinical guideline adaptation and identify challenges raised in this process, given that published adapted clinical guidelines are generally of low quality, poorly reported and not based on published frameworks. Design A qualitative study based on semistructured interviews. We conducted a framework analysis for the adaptation process, and thematic analysis for participants' views and experiences about adaptation process. Setting Nine guideline development organisations from seven countries. Participants Guideline developers who have adapted clinical guidelines within the last 3 years. We identified potential participants through published adapted clinical guidelines, recommendations from experts, and a review of the Guideline International Network Conference attendees' list. Results We conducted ten interviews and identified nine adaptation methodologies. The reasons for adapting clinical guidelines include developing de novo clinical guidelines, implementing source clinical guidelines, and harmonising and updating existing clinical guidelines. We identified the following core steps of the adaptation process (1) selection of scope and source guideline(s), (2) assessment of source materials (guidelines, recommendations and evidence level), (3) decision-making process and (4) external review and follow-up process. Challenges on the adaptation of clinical guidelines include limitations from source clinical guidelines (poor quality or reporting), limitations from adaptation settings (lacking resources or skills), adaptation process intensity and complexity, and implementation barriers. We also described how participants address the complexities and implementation issues of the adaptation process. Conclusions Adaptation processes have been increasingly used to develop clinical guidelines, with the emergence of different purposes. The identification of core steps and assessment levels could help guideline adaptation developers streamline their processes. More methodological research is needed to develop rigorous international standards for adapting clinical guidelines

Radio Sources in Low-Luminosity Active Galactic Nuclei. III. "AGNs" in a Distance-Limited Sample of "LLAGNs"

(abbreviated): This paper presents the results of a high resolution radio imaging survey of all known (96) low-luminosity active galactic nuclei (LLAGNs) at D<19Mpc. We find that almost half of all LINERs and low-luminosity Seyferts have flat-spectrum radio cores when observed at 150mas resolution. Higher (2mas) resolution observations of a flux-limited subsample have provided a 100% (16 of 16) detection rate of pc-scale radio cores, with implied brightness temperatures > 10^8 K. The five LLAGNs with the highest core radio fluxes also have pc-scale `jets.' Compact radio cores are almost exclusively found in massive ellipticals and in type1 nuclei. The core radio power is correlated with the nuclear optical `broad' Halpha luminosity, the nuclear optical `narrow' emission line luminosity and width, and with the galaxy luminosity. In these correlations LLAGNs fall close to the low-luminosity extrapolations of more powerful AGNs. About half of all LLAGNs with multiple epoch data show significant inter-year radio variability. Investigation of a sample of ~150 nearby bright galaxies, most of them LLAGNs, shows that the nuclear (<150mas size) radio power is strongly correlated with both the black hole mass and the galaxy bulge luminosity; linear regression fits to all ~150 galaxies give: log P(2cm) = 1.31 log M_blackhole + 8.77 and log P(2cm) = 1.89 log L_B(bulge) - 0.17. Low accretion rates are implied in both advection- and jet-type models. In brief, all evidence points towards the presence of accreting massive black holes in a large fraction, perhaps all, of LLAGNs.Comment: to appear in A&

Introduction to the French GEOTRACES North Atlantic transect (GA01): GEOVIDE cruise

© 2018 Author(s). The GEOVIDE cruise, a collaborative project within the framework of the international GEOTRACES programme, was conducted along the French-led section in the North Atlantic Ocean (Section GA01), between 15 May and 30 June 2014. In this special issue (https://www.biogeosciences.net/special-issue900.html), results from GEOVIDE, including physical oceanography and trace element and isotope cyclings, are presented among 18 articles. Here, the scientific context, project objectives, and scientific strategy of GEOVIDE are provided, along with an overview of the main results from the articles published in the special issue

Measurements of the Electroweak Diboson Production Cross Sections in Proton-Proton Collisions at s\sqrt{s} =5.02 TeV Using Leptonic Decays

The first measurements of diboson production cross sections in proton-proton interactions at a center-of-mass energy of 5.02 TeV are reported. They are based on data collected with the CMS detector at the LHC, corresponding to an integrated luminosity of 302 pb$^{-1}$. Events with two, three, or four charged light leptons (electrons or muons) in the final state are analyzed. The WW, WZ, and ZZ total cross sections are measured as σWW=37.0$^{+5.5}$$_{-5.2}$(stat)$^{+2.7}$$_{-2.6}$(syst)  pb , σWZ=6.4$^{+2.5}$$_{-2.1}$(stat)$^{+0.5}$$_{-0.3}$(syst) pb, and σZZ=5.3$^{+2.5}$$_{-2.1}$(stat)$^{+0.5}$$_{-0.4}$(syst)  pb

The diverse cold molecular gas contents, morphologies, and kinematics of type-2 quasars as seen by ALMA

We present CO(2−1) and adjacent continuum observations of seven nearby radio-quiet type-2 quasars (QSO2s) obtained with ALMA at ∼0.2″ resolution (370 pc at z  ∼ 0.1). These QSO2s are luminous ( L [OIII]  &gt; 10 8.5 L ⊙  ∼   M B  &lt; −23), and their host galaxies massive ( M *  ∼ 10 11   M ⊙ ). The CO morphologies are diverse, including disks and interacting systems. Two of the QSO2s are red early-type galaxies with no CO(2–1) detected. In the interacting galaxies, the central kiloparsec contains 18–25% of the total cold molecular gas, whereas in the spirals it is only ∼5–12%. J1010+0612 and J1430+1339 show double-peaked CO flux maps along the major axis of the CO disks that do not have an optical counterpart at the same angular resolution. Based on our analysis of the ionized and molecular gas kinematics and millimeter continuum emission, these CO morphologies are most likely produced by active galactic nucleus (AGN) feedback in the form of outflows, jets, and/or shocks. The CO kinematics of the QSO2s with CO(2−1) detections are dominated by rotation but also reveal noncircular motions. According to our analysis, these noncircular motions correspond to molecular outflows that are mostly coplanar with the CO disks in four of the QSO2s, and either to a coplanar inflow or vertical outflow in the case of J1010+0612. These outflows represent 0.2–0.7% of the QSO2s’ total molecular gas mass and have maximum velocities of 200–350 km s −1 , radii from 0.4 to 1.3 kpc, and outflow mass rates of 8–16 M ⊙ yr −1 . These outflow properties are intermediate between those of the mild molecular outflows measured for Seyfert galaxies and the fast and energetic outflows shown by ultra-luminous infrared galaxies. This suggests that it is not only AGN luminosity that drives massive molecular outflows. Other factors such as jet power, coupling between winds, jets, and/or ionized outflows and the CO disks, and amount or geometry of dense gas in the nuclear regions might also be relevant. Thus, although we do not find evidence for a significant impact of quasar feedback on the total molecular gas reservoirs and star formation rates, it appears to be modifying the distribution of cold molecular gas in the central kiloparsec of the galaxies

CHEOPS precision phase curve of the Super-Earth 55 Cancri e

55 Cnc e is a transiting super-Earth (radius $1.88\rm\,R_\oplus$ and mass $8\rm\, M_\oplus$) orbiting a G8V host star on a 17-hour orbit. Spitzer observations of the planet's phase curve at 4.5 $\mu$m revealed a time-varying occultation depth, and MOST optical observations are consistent with a time-varying phase curve amplitude and phase offset of maximum light. Both broadband and high-resolution spectroscopic analyses are consistent with either a high mean molecular weight atmosphere or no atmosphere for planet e. A long term photometric monitoring campaign on an independent optical telescope is needed to probe the variability in this system. We seek to measure the phase variations of 55 Cnc e with a broadband optical filter with the 30 cm effective aperture space telescope CHEOPS and explore how the precision photometry narrows down the range of possible scenarios. We observed 55 Cnc for 1.6 orbital phases in March of 2020. We designed a phase curve detrending toolkit for CHEOPS photometry which allows us to study the underlying flux variations of the 55 Cnc system. We detected a phase variation with a full-amplitude of $72 \pm 7$ ppm but do not detect a significant secondary eclipse of the planet. The shape of the phase variation resembles that of a piecewise-Lambertian, however the non-detection of the planetary secondary eclipse, and the large amplitude of the variations exclude reflection from the planetary surface as a possible origin of the observed phase variations. They are also likely incompatible with magnetospheric interactions between the star and planet but may imply that circumplanetary or circumstellar material modulate the flux of the system. Further precision photometry of 55 Cnc from CHEOPS will measure variations in the phase curve amplitude and shape over time this year.This work benefited from support from the Swiss National Science Foundation (PP00P2-163967 and PP00P2-190080). This project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (project Four Aces; grant agreement No 724427). This work was supported by FCT - Fundação para a Ciência e a Tecnologia through national funds and by FEDER through COMPETE2020 - Programa Operacional Competitividade e Internacionalização by these grants: UID/FIS/04434/2019; UIDB/04434/2020; UIDP/04434/2020; PTDC/FIS-AST/32113/2017 & POCI-01-0145-FEDER032113; PTDC/FIS-AST/28953/2017 & POCI-01-0145-FEDER-028953; PTDC/FIS-AST/28987/2017 & POCI-01-0145-FEDER-028987. S.C.C.B. and S.G.S. acknowledge support from FCT through FCT contracts nr. IF/01312/2014/CP1215/CT0004, IF/00028/2014/CP1215/CT0002. O.D.S.D. is supported in the form of work contract (DL 57/2016/CP1364/CT0004) funded by national funds through Fundação para a Ciência e Tecnologia (FCT). XB, SC, DG, MF and JL acknowledge their roles as ESA-appointed CHEOPS science team members. ACC and TW acknowledge support from STFC consolidated grant number ST/R000824/1. This project was supported by the CNES. SH gratefully acknowledges CNES funding through the grant 837319. PM acknowledges support from STFC consolidated grant number ST/M001040/1. KGI is the ESA CHEOPS Project Scientist and is responsible for the ESA CHEOPS Guest Observers Programme. She does not participate in, or contribute to, the definition of the Guaranteed Time Programme of the CHEOPS mission through which observations described in this paper have been taken, nor to any aspect of target selection for the programme

Measurements of the Electroweak Diboson Production Cross Sections in Proton-Proton Collisions at s=5.02 TeV Using Leptonic Decays

Copyright © 2021 CERN, for the CMS Collaboration. The first measurements of diboson production cross sections in proton-proton interactions at a center-of-mass energy of 5.02 TeV are reported. They are based on data collected with the CMS detector at the LHC, corresponding to an integrated luminosity of 302 pb−1. Events with two, three, or four charged light leptons (electrons or muons) in the final state are analyzed. The WW, WZ, and ZZ total cross sections are measured as σWW = 37:0 +5.5 −5.2 (stat) +2.7 −2.6(syst) pb, σWZ = 6.4 +2.5 −2.1 (stat) +0.5 −0.3 (syst) pb, and σZZ = 5.3 +2.5 −2.1(stat) +0.5 −0.4 (syst) pb. All measurements are in good agreement with theoretical calculations at combined next-to-next-to-leading order quantum chromodynamics and next-to-leading order electroweak accuracy.SCOAP3