Introduction Bacterial and fungal infections, such as skin and soft tissue infections (SSTIs) and infective endocarditis (IE), are increasing among people who use drugs in the United States. Traditional healthcare settings can be inaccessible and unwelcoming to people who use drugs, leading to delays in getting necessary care. The objective of this study was to examine SSTI treatment experiences among people utilizing services from syringe services programs. This study was initiated by people with lived experience of drug use to improve quality of care. Methods We conducted a cross-sectional survey among participants of five syringe services programs in North Carolina from July through September 2020. Surveys collected information on each participant’s history of SSTIs and IE, drug use and healthcare access characteristics, and SSTI treatment experiences. We examined participant characteristics using counts and percentages. We also examined associations between participant characteristics and SSTI history using binomial linear regression models. Results Overall, 46% of participants reported an SSTI in the previous 12 months and 10% reported having IE in the previous 12 months. Those with a doctor they trusted with drug use-related concerns had 27 fewer (95% confidence interval = − 51.8, − 2.1) SSTIs per every 100 participants compared to those without a trusted doctor. Most participants with a SSTI history reported delaying (98%) or not seeking treatment (72%) for their infections. Concerns surrounding judgment or mistreatment by medical staff and self-treating the infection were common reasons for delaying or not seeking care. 13% of participants used antibiotics obtained from sources other than a medical provider to treat their most recent SSTI. Many participants suggested increased access to free antibiotics and on-site clinical care based at syringe service programs to improve treatment for SSTIs. Conclusions Many participants had delayed or not received care for SSTIs due to poor healthcare experiences. However, having a trusted doctor was associated with fewer people with SSTIs. Improved access to non-judgmental healthcare for people who use drugs with SSTIs is needed. Expansion of syringe services program-based SSTI prevention and treatment programs is likely a necessary approach to improve outcomes among those with SSTI and IE.

Goals: This report aims to present a clear protocol to (a) deploy proximal canopy sensors into single high-wire trellis Concord (Vitis labruscana cv Bailey) vineyards and (b) to convert the canopy sensor response into an indication of vine size (pruning weight). The protocol is designed to be robust and practical for easy adoption in commercial systems. Evidence will be presented of the efficacy of vine size prediction using the protocol in multiple research and commercial vineyards. Key Findings: Using different vineyards and pruning crews the protocol performed well in over 80 % of vineyards. It permitted growers to generate maps of actual vine size within vineyards. These maps provide a valuable indication of the current site-specific production potential and a baseline to assess changes in vine size over time. In a few vineyards, the proposed simplified calibration process did not generate a clear relationship between the canopy response and vine size, which may be due to changes