Improving primary care access for rural women Veterans: the Boost Team.

Objectives: To improve healthcare access for rural cisgender women and gender diverse Veterans, we created the "Boost Team," a clinician-driven telehealth outreach service to connect this population to Veterans Health Administration (VHA) services.

Methods: Between 9/2021 and 2/2022, we conducted a needs assessment in the Veterans Integrated Service Network (VISN) 21 and used those data to develop an outreach intervention. We piloted a clinician-led outreach intervention in 3/2022, and formally deployed an outreach team in 9/2022.

Terminal Pleistocene epoch human footprints from the Pacific coast of Canada.

Little is known about the ice age human occupation of the Pacific Coast of Canada. Here we present the results of a targeted investigation of a late Pleistocene shoreline on Calvert Island, British Columbia. Drawing upon existing geomorphic information that sea level in the area was 2-3 m lower than present between 14,000 and 11,000 years ago, we began a systematic search for archaeological remains dating to this time period beneath intertidal beach sediments.

No Ifs, Ands, or Buts: Leveraging Population Health to Focus on the Care of Patients Who Smoke.

We developed a multidisciplinary curriculum to improve our residents' proficiency with smoking cessation counseling and prescribing of nicotine replacement therapy (NRT). The curriculum included a didactic portion, informational handouts, and a panel management component during which residents did telephone outreach and clinic in-reach to address high rates of smoking among patients. Residents rated their confidence with smoking cessation counseling and clinical knowledge before and after the intervention.

The late presenting STEMI: How ECG scores can be used to estimate event time.

Introduction: Patients presenting with ST elevation myocardial infarction (STEMI) derive significant benefit from timely percutaneous coronary intervention (PCI). Electrocardiogram (ECG) scoring systems can complement history to estimate the infarction age and inform clinical decision-making.

Case: A 76year old man presented with eight days of dyspnea on exertion and chest pain.

Nationwide increase in hospitalizations for heroin-related soft tissue infections: Associations with structural market conditions.

Introduction: Little is known about trends in national rates of injection-related skin and soft tissue infections (SSTI) and their relationship to the structural risk environment for heroin users. Use of Mexican-sourced "Black Tar" heroin, predominant in western US states, may have greater risk for SSTI compared with eastern US powder heroin (Colombian-sourced) due to its association with non-intravenous injection or from possible contamination.

Methods: Using nationally representative hospital admissions data from the Nationwide Inpatient Sample and heroin price and purity data from the Drug Enforcement Administration, we looked at rates of hospital admissions for opiate-related SSTI (O-SSTI) between 1993 and 2010.

Regular clinic attendance in two large San Francisco HIV primary care settings.

Although poor clinic attendance is associated with increased morbidity and mortality among HIV-infected individuals, less is known about predictors of retention and the acceptability of targeted interventions to increase regular clinic attendance. To better understand which patients are at risk for irregular clinic attendance and to explore interventions to aid in retention to care, we surveyed patients attending two outpatient HIV clinics affiliated with the University of California, San Francisco. A total of 606 participants were surveyed, and the analysis was restricted to the 523 male respondents.

Pheochromocytoma crisis is not a surgical emergency.

Context: Pheochromocytoma crisis is a feared and potentially lethal complication of pheochromocytoma.

Objective: We sought to determine the best treatment strategy for pheochromocytoma crisis patients and hypothesized that emergency resection is not indicated.

Design: Retrospective cohort study (1993-2011); literature review (1944-2011).

Interaction with amyloid beta peptide compromises the lipid binding function of apolipoprotein E.

Apolipoprotein (apo) E is an exchangeable apolipoprotein that plays an integral role in cholesterol transport in the plasma and the brain. It is also associated with protein misfolding or amyloid proteopathy of the beta amyloid peptide (Abeta) in Alzheimer's disease (AD) and cerebral amyloid angiopathy. The C-terminal domain (CT) of apoE encompasses two types of amphipathic alpha helices: a class A helix (residues 216-266) and a class G* helix (residues 273-299).

Structure-guided protein engineering modulates helix bundle exchangeable apolipoprotein properties.

Apolipoprotein (apo) E plays a major role in lipid metabolism by mediating cellular uptake of lipoprotein particles through interaction with members of the low density lipoprotein (LDL) receptor family. The primary region of apoE responsible for receptor binding has been limited to a cluster of basic amino acids between residues 134 and 150, located in the fourth helix of the N-terminal domain globular helix bundle structure. To investigate structural and functional requirements of this "receptor binding region" we engineered an apolipoprotein chimera wherein residues 131-151 of human apoE were substituted for residues 146-166 (helix 5) of Manduca sexta apolipophorin III (apoLp-III).