Designing Technical-Assistance Programs: Considerations for Funders and Lessons Learned

As foundations continue to provide grantees with technical assistance in addition to financial support, it is important to understand what works well, for whom, and in what circumstances. This reflective practice article aims to help funders who have identified a problem amenable to technical assistance to develop a strong program by providing support to a group of organizations addressing similar problems or by providing customized individual support. Drawing on insights from evaluations of two technical-assistance programs, this article recommends five key issues for funders to consider when offering such a program: whose priorities will shape the agenda, how group composition might affect technical assistance, what qualities are most important for providers, what types of technical-assistance formats providers should offer, and how funders will know whether technical assistance is working. The article concludes by highlighting three lessons: (1) incorporating flexibility into programs, enabling technical assistance to be more responsive to participants’ needs and resources; (2) setting and measuring technical-assistance goals, which can help funders assess the fit of participants for programs and support ongoing learning; and (3) monitoring and collecting feedback, which helps promote quality and can offer insights as to how programs might be changed to best meet participants’ needs

A Randomized Controlled Dosing Study of Iyengar Yoga and Coherent Breathing for the Treatment of Major Depressive Disorder: Impact on Suicidal Ideation and Safety Findings

BACKGROUND: Yoga interventions offer promise for the treatment of major depressive disorder (MDD), yet their safety and potential impact on suicidal ideation (SI) have not been well documented. This study evaluated the safety of a randomized controlled dose-finding trial of Iyengar yoga plus coherent breathing for individuals with MDD, as well as the potential effects of the intervention on SI without intent. METHODS: Participants with Beck Depression Inventory-II (BDI-II) scores \u3e/=14 and a diagnosis of MDD (using DSM-IV criteria) were randomized to either a low dose group (LDG) or high dose group (HDG) and received a 12-week manualized intervention. The LDG included two 90-min yoga classes plus three 30-min homework sessions weekly. The HDG offered three 90-min classes plus four 30-min homework sessions weekly. RESULTS: Thirty-two individuals with MDD were randomized, of which 30 completed the protocol. At screening, SI without intent was endorsed on the BDI-II by 9 participants; after completing the intervention, 8 out of 9 reported resolution of SI. There were 17 adverse events possibly-related and 15 definitely-related to the intervention. The most common protocol-related adverse event was musculoskeletal pain, which resolved over the course of the study. CONCLUSIONS: The Iyengar yoga plus coherent breathing intervention was associated with the resolution of SI in 8 out of 9 participants, with mild side effects that were primarily musculoskeletal in nature. This preliminary evidence suggests that this intervention may reduce SI without intent and be safe for use in those with MDD

Potential for managing pool levels in a flood-control reservoir to increase nitrate-nitrogen load reductions

Few strategies are available to reduce nitrate-nitrogen (NO3-N) loads at larger landscape scales, but flood control reservoirs are known to reduce riverine loads. In this study, we evaluated the potential to increase nitrogen (N) loss at Lake Red Rock, a large reservoir located in central Iowa, by evaluating the inundation of sediments deposited at the reservoir inflow. Sediment samples were collected at 51 locations in the lower delta region and analyzed for particle size and nutrient content. Nitrogen loss rates in delta sediments were determined from laboratory assays, and satellite imagery was used to develop a rating curve to quantify land area inundated within the delta. The daily mass of NO3-N reduced with delta inundation was estimated by applying the mean N 24-h loss rate (0.66 g N m2 day−1) by the area of inundation (m2). Results indicated that raising pool elevations to inundate more of the delta would result in greater N losses, ranging from 2 to 377 Mg per year. Potential N loss of 102 Mg achieved by increasing pool stage by 0.5 m would be equivalent to installing nearly 650 edge-of-field practices in the watershed. Although more work is needed to integrate with an existing environmental pool management plan, study results indicate that reservoir management could achieve N reductions at a novel landscape scale.This article is published as Schilling, K. E., Streeter, M. T., Anderson, E., Merryman, J., Isenhart, T., Arenas-Amado, A., & Theiling, C. (2024). Potential for managing pool levels in a flood-control reservoir to increase nitrate-nitrogen load reductions. Journal of Environmental Quality, 1–11. https://doi.org/10.1002/jeq2.20539. © 2024 The Authors.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Ultrasound Molecular Imaging of Secreted Frizzled Related Protein-2 Expression in Murine Angiosarcoma

Angiosarcoma is a biologically aggressive vascular malignancy with a high metastatic potential. In the era of targeted medicine, knowledge of specific molecular tumor characteristics has become more important. Molecular imaging using targeted ultrasound contrast agents can monitor tumor progression non-invasively. Secreted frizzled related protein 2 (SFRP2) is a tumor endothelial marker expressed in angiosarcoma. We hypothesize that SFRP2-directed imaging could be a novel approach to imaging the tumor vasculature. To develop an SFRP2 contrast agent, SFRP2 polyclonal antibody was biotinylated and incubated with streptavidin-coated microbubbles. SVR angiosarcoma cells were injected into nude mice, and when tumors were established the mice were injected intravenously with the SFRP2 -targeted contrast agent, or a control streptavidin-coated contrast agent. SFRP2 -targeted contrast agent detected tumor vasculature with significantly more signal intensity than control contrast agent: the normalized fold-change was 1.6±0.27 (n = 13, p = 0.0032). The kidney was largely devoid of echogenicity with no significant difference between the control contrast agent and the SFRP2-targeted contrast agent demonstrating that the SFRP2-targeted contrast agent was specific to tumor vessels. Plotting average pixel intensity obtained from SFRP2-targeted contrast agent against tumor volume showed that the average pixel intensity increased as tumor volume increased. In conclusion, molecularly-targeted imaging of SFRP2 visualizes angiosarcoma vessels, but not normal vessels, and intensity increases with tumor size. Molecular imaging of SFRP2 expression may provide a rapid, non-invasive method to monitor tumor regression during therapy for angiosarcoma and other SFRP2 expressing cancers, and contribute to our understanding of the biology of SFRP2 during tumor development and progression

Projections of temperature-attributable premature deaths in 209 U.S. cities using a cluster-based Poisson approach

Background A warming climate will affect future temperature-attributable premature deaths. This analysis is the first to project these deaths at a near national scale for the United States using city and month-specific temperature-mortality relationships. Methods We used Poisson regressions to model temperature-attributable premature mortality as a function of daily average temperature in 209 U.S. cities by month. We used climate data to group cities into clusters and applied an Empirical Bayes adjustment to improve model stability and calculate cluster-based month-specific temperature-mortality functions. Using data from two climate models, we calculated future daily average temperatures in each city under Representative Concentration Pathway 6.0. Holding population constant at 2010 levels, we combined the temperature data and cluster-based temperature-mortality functions to project city-specific temperature-attributable premature deaths for multiple future years which correspond to a single reporting year. Results within the reporting periods are then averaged to account for potential climate variability and reported as a change from a 1990 baseline in the future reporting years of 2030, 2050 and 2100. Results We found temperature-mortality relationships that vary by location and time of year. In general, the largest mortality response during hotter months (April – September) was in July in cities with cooler average conditions. The largest mortality response during colder months (October–March) was at the beginning (October) and end (March) of the period. Using data from two global climate models, we projected a net increase in premature deaths, aggregated across all 209 cities, in all future periods compared to 1990. However, the magnitude and sign of the change varied by cluster and city. Conclusions We found increasing future premature deaths across the 209 modeled U.S. cities using two climate model projections, based on constant temperature-mortality relationships from 1997 to 2006 without any future adaptation. However, results varied by location, with some locations showing net reductions in premature temperature-attributable deaths with climate change

Can we believe judgements of human physical attractiveness?

A key question in attractiveness studies is the validity of the reported results outside the narrow confines of the experimental paradigm used. Does the range of physical features in a set of pictures used to test attractiveness judgments predict the individual ratings of each body? Or does each stimulus have an attractiveness value independent of the range of attractiveness found in the image set of which it is a part? An additional problem is that because participants are often shown a relatively large array of images in a short space of time, this may produce perceptual biases which could cause a short-term shift in attractiveness preferences which are not usually found in real life mate choice decisions. To address this issue we asked 20 participants (10 male and 10 female) to judge the attractiveness of 20 digital photographs of female bodies. We then asked a different set of 400 people (who had not seen the body pictures) to judge the attractiveness of one of the bodies from the set (so each body was rated in isolation by 10 male and 10 female participants). We then compared the attractiveness judgement each body received when seen independently versus when it was seen within the context of a set of bodies. The results showed no significant difference between the two conditions which suggests that each body has an attractiveness value independent of the attractiveness of the other bodies with which it is viewed

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

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Inhibition of NADPH Oxidase by Apocynin Attenuates Progression of Atherosclerosis

Abstract: Of the multiple sources of reactive oxygen species (ROS) in the blood vessel, NADPH oxidases are the primary source. Whereas several studies have implicated NADPH oxidases in the initiation of atherosclerosis, their roles in disease progression are incompletely understood. Our objective was to determine the potential clinical relevance of inhibiting NADPH oxidase in established atherosclerosis. Using a hypercholesteremic murine model of atherosclerosis (ApoE −/ − /LDLR −/ − (AS) mice on normal chow diet), we first established a time-dependent relationship between superoxide levels and lesion size in AS mice. Next, we identified NADPH oxidase as the primary source of ROS in atherosclerotic lesions. Treatment of aortic segments from AS mice with apocynin, which interferes with NADPH oxidase activation in part by preventing translocation of the subunit p47 phox, significantly reduced superoxide levels. Moreover, addition of apocynin to the drinking water of AS mice produced a decrease in lesion size as compared to untreated AS mice, with the effect most pronounced in the thoracoabdominal aorta but absent from the aortic arch. Granulocyte function in AS+apocynin mice was suppressed, confirming efficacy of apocynin treatment. We conclude that apocynin attenuates the progression o