Retention in primary care among unstably housed residents of a low-income, inner-city neighborhood with a high prevalence of substance use and related disorders.

Introduction: Access to and engagement with primary healthcare can be difficult for marginalized low-income populations residing in inner cities in high-income countries. We designed a study to examine retention in primary care among clients of a novel interdisciplinary primary care clinic in the Downtown Eastside of Vancouver, Canada who did not previously have access to care.

Methods: Beginning in June 2021, clients of the Hope to Health clinic were offered enrolment in a cohort study which involved a baseline and follow-up surveys every six months, and linking their data to information from the clinic's electronic medical records.

Characterizing opioid agonist therapy uptake and factors associated with treatment retention among people with HIV in British Columbia, Canada.

Accidental overdoses are now the leading cause of death among people with HIV (PWH) in British Columbia (BC). We examined the utilization and retention of opioid agonist therapy (OAT). Adult PWH (≥19 years) with ≥ 1 OAT dispensation in BC between 2008 and 2020 were included (n = 1,515).

Interest in using buprenorphine-naloxone among a prospective cohort of street-involved young people in Vancouver, Canada.

Introduction: Limited research examines buprenorphine-naloxone interest among adolescents and young adults (AYA). This longitudinal study examined factors associated with initial buprenorphine-naloxone interest and the time to a positive change in buprenorphine-naloxone interest or enrollment, in addition to identifying reasons for buprenorphine-naloxone disinterest.

Methods: The study derived data from a cohort of street-involved AYA in Vancouver, Canada between December 2014 and June 2018.

Long-term outcomes and prognostic factors for survival of patients with ANCA-associated vasculitis.

Background: Despite newer treatments with immunosuppressive agents, there still exists a considerable morbidity and mortality risk among patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Since 1994 the European Vasculitis Society (EUVAS) has aimed for an improved outcome for patients with AAV, conducting several prospective randomized controlled trials (RCTs). The aim for the present study was to further evaluate the long-term survival of patients with AAV included in seven RCTs conducted by the EUVAS as well as to identify potential prognostic factors.

Methadone Maintenance Treatment Discontinuation Among Young People who use Opioids in Vancouver, Canada.

Objective: Retaining adolescents and young adults (AYA) in medications for opioid use disorder (MOUD), like methadone maintenance treatment (MMT), is critical to reducing toxic drug fatalities. This analysis sought to identify factors associated with MMT discontinuation among AYA.

Method: Data were derived from the At-Risk Youth Study, a prospective cohort study of street-involved AYA in Vancouver, Canada, between December 2005 and June 2018.

Navigating Opioid Agonist Therapy among Young People who use Illicit Opioids in Vancouver, Canada.

Background: Opioid agonist therapy (OAT) has been shown to reduce opioid use and related harms. However, many young people are not accessing OAT. This study sought to explore how young people navigated OAT over time, including periods of engagement, disengagement, and avoidance.

Initiation of opioid agonist treatment and subsequent substance use and other patterns among adolescents and young adults in Vancouver, Canada.

Background: Opioid agonist treatments (OAT) are effective interventions for reducing illicit opioid use; however, less is known about OAT among adolescents and young adults (AYA). This study sought to examine OAT retention and discontinuation among AYA.

Methods: Data were derived from the At-Risk Youth Study, a prospective cohort of street-involved AYA in Vancouver, Canada, between September 2005 and December 2018.

The nucleolar δ isoform of adapter protein SH2B1 enhances morphological complexity and function of cultured neurons.

The adapter protein SH2B1 is recruited to neurotrophin receptors, including TrkB (also known as NTRK2), the receptor for brain-derived neurotrophic factor (BDNF). Herein, we demonstrate that the four alternatively spliced isoforms of SH2B1 (SH2B1α-SH2B1δ) are important determinants of neuronal architecture and neurotrophin-induced gene expression. Primary hippocampal neurons from Sh2b1-/- [knockout (KO)] mice exhibit decreased neurite complexity and length, and BDNF-induced expression of the synapse-related immediate early genes Egr1 and Arc.

The Vancouver Community Analytics Tool (VCAT): Software Enabling Operationalization of the Building Blocks of High-Performing Primary Care at Community Health Centers in British Columbia, Canada.

Background: Community health centers (CHCs) in British Columbia, Canada, are using a data-driven approach to enable functions related to the design, organization, management, delivery, and evaluation of primary health care services for complex populations.

Methods: Descriptive study leveraging case studies from 4 CHCs in Vancouver, Canada, to provide an overview and examples of the functions and outputs of the Vancouver Community Analytics Tool (VCAT). Quantitative data were derived from electronic medical record data and regional emergency department data.

Moving into an urban drug scene among people who use drugs in Vancouver, Canada: Latent class growth analysis.

Background: Urban drug scenes are characterized by high prevalence of illicit drug dealing and use, violence and poverty, much of which is driven by the criminalization of people who use illicit drugs (PWUD) and the associated stigma. Despite significant public health needs, little is understood about patterns of moving into urban drug scenes among PWUD. Therefore, we sought to identify trajectories of residential mobility (hereafter 'mobility') among PWUD into the Downtown Eastside (DTES), an urban neighbourhood with an open drug scene in Vancouver, Canada, as well as characterize distinct trajectory groups among PWUD.

A community-based innovative model of care for the management of severe bacterial infections in persons who use injection drugs.

The opioid crisis and complications related to injection drug use are a public health emergency. The combination of addiction and injection drug use is a devastating double-edged sword: it predisposes patients to severe life-threatening infections like endocarditis, and epidural abscess, as well as to disorganized behaviour and impaired decision-making that interferes with the completion of prolonged courses of required antibiotic therapy. Poverty and stigma add further fuel to the fire.

Crucial Role of the SH2B1 PH Domain for the Control of Energy Balance.

Disruption of the adaptor protein SH2B1 (SH2-B, PSM) is associated with severe obesity, insulin resistance, and neurobehavioral abnormalities in mice and humans. Here, we identify 15 variants in severely obese children. Four obesity-associated human variants lie in the Pleckstrin homology (PH) domain, suggesting that the PH domain is essential for SH2B1's function.

A Multi-sourced Data Analytics Approach to Measuring and Assessing Biopsychosocial Complexity: The Vancouver Community Analytics Tool Complexity Module (VCAT-CM).

Operationalization of the fundamental building blocks of primary care (i.e. empanelment, team-based care and population management) within the context of Community Health Centers requires accurate and real-time measures of biopsychosocial complexity, at both client and population-levels.

Changing risk and presentation of overdose associated with consumption of street drugs at a supervised injection site in Vancouver, Canada.

Background: British Columbia is experiencing a public health emergency due to overdoses resulting from consumption of street drugs contaminated with fentanyl. While the risk of overdoses appears to be increasing, the overdose rate and severity of overdose presentations have yet to be quantified.

Methods: Insite is a supervised injection site in Vancouver.

Phosphorylation of the Unique C-Terminal Tail of the Alpha Isoform of the Scaffold Protein SH2B1 Controls the Ability of SH2B1α To Enhance Nerve Growth Factor Function.

The scaffold protein SH2B1, a major regulator of body weight, is recruited to the receptors of multiple cytokines and growth factors, including nerve growth factor (NGF). The β isoform but not the α isoform of SH2B1 greatly enhances NGF-dependent neurite outgrowth of PC12 cells. Here, we asked how the unique C-terminal tails of the α and β isoforms modulate SH2B1 function.

Treatment of opioid use disorder in an innovative community-based setting after multiple treatment attempts in a woman with untreated HIV.

Opioid use disorder is associated with significant health and social harms. Various evidence-based interventions have proven successful in mitigating these harms, including harm reduction strategies and pharmacological treatment such as methadone. We present a case of a 35-year-old HIV-positive woman who was off antiretroviral therapy due to untreated opioid use disorder, and had a history of frequently self-discharging from hospital against medical advice.

A Case of Lagochilascariasis in Suriname with the Involvement of the ENT System and the Skull Base.

We describe a case of human lagochilascariasis, with skull-base involvement and a chronic and relapsing course after treatment. This rare parasitic infection is usually manifested in the head and neck area, characterized by progressive granulomatous inflammation and the formation of abscesses. Transmission to humans most likely occurs by the consumption of undercooked meat of wild rodents.

The 'Expanded HIV care in opioid substitution treatment' (EHOST) cluster-randomized, stepped-wedge trial: A study protocol.

The public health response to HIV/AIDS has turned its focus onto optimizing health care system delivery to maximize case identification, access and sustained engagement in antiretroviral treatment (ART). Opioid Agonist Treatment (OAT) provides a critical opportunity for HIV testing and linkage to ART. The EHOST study is a cluster-randomized, stepped-wedge trial to evaluate a prescriber-focused intervention to increase HIV testing rates, and optimize ART engagement and retention outcomes among individuals engaged in OAT.

A Community Care Model of Intravenous Antibiotic Therapy for Injection Drug Users with Deep Tissue Infection for "Reduce Leaving Against Medical Advice".

Deep tissue infection is a serious sequela that often demands intravenous (IV) antibiotic treatment. With respect to IV drug users (IDU's), research and lived experience demonstrates a trend of failed treatment outcomes, most notably associated with leaving hospital against medical advice (LAMA) prior to treatment completion, increased adverse outcomes and patient hardship. This paper examines an alternative model for delivering and completing IV antibiotic treatment to IDU's in a community care setting.

Functional characterization of obesity-associated variants involving the α and β isoforms of human SH2B1.

We have previously reported rare variants in sarcoma (Src) homology 2 (SH2) B adaptor protein 1 (SH2B1) in individuals with obesity, insulin resistance, and maladaptive behavior. Here, we identify 4 additional SH2B1 variants by sequencing 500 individuals with severe early-onset obesity. SH2B1 has 4 alternatively spliced isoforms.

The proteomics of quiescent and nonquiescent cell differentiation in yeast stationary-phase cultures.

As yeast cultures enter stationary phase in rich, glucose-based medium, differentiation of two major subpopulations of cells, termed quiescent and nonquiescent, is observed. Differences in mRNA abundance between exponentially growing and stationary-phase cultures and quiescent and nonquiescent cells are known, but little was known about protein abundance in these cells. To measure protein abundance in exponential and stationary-phase cultures, the yeast GFP-fusion library (4159 strains) was examined during exponential and stationary phases, using high-throughput flow cytometry (HyperCyt).

Bringing electronic patient records into health professional education: software architecture and implementation.

This paper describes the implementation of an Electronic Medical Record (EMR) which has been redesigned specifically for the purposes of teaching medical and other health professional students. Currently available EMR software is designed specifically for use in actual practice settings and not for the needs of students and educators. The authors identified many unique requirements of an EMR in order to satisfy the educational goals unique to the electronic medium.

Bringing electronic patient records into health professional education: towards an integrative framework.

In this paper we discuss our approach for integrating electronic patient records into health professional education. Electronic patient record (EPR) use is increasing globally. The EPR is considered the cornerstone of the modernization and streamlining of healthcare worldwide.

Technical and architectural issues in deploying electronic health records (EHRs) over the WWW.

In this paper technical and architectural issues are described in deploying electronic health records (EHRs) over the WWW. The project described involved deployment of EHRs that have been designed to serve in the education of health professionals and health/biomedical informaticians. In order to allow for ubiquitous access to a range of EHRs remotely an architecture was designed with three layers: (a) the "Internet" or remote user access layer (2) the "Perimeter Network", or middle firewall security and authentication layer (3) the "HINF EHR Network", consisting of the internal servers hosting EHR applications and databases.