Publications by authors named "McGuire S"

Importance: There is a clear benefit to body armor against firearms; however, it remains unclear how these vests may influence day-to-day patient encounters when worn by emergency medical services (EMS).

Objective: To determine the association of ballistic vests worn by EMS clinicians with workplace violence (WPV) and disparities in care among racial and/or ethnic minority patients.

Design, Setting, And Participants: Prospective cohort study of a volunteer-based sample of EMS clinicians at a large, multistate EMS agency encompassing 15 ground sites across the Midwest from April 1, 2023, to March 31, 2024.

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This study aimed to systematicically evaluate and quantify the prevalence of weapons in the health care setting. A systematic search of MEDLINE, Embase, Scopus, Web of Science, CINAHL, and EBSCO MegaFILE was performed from inception to January 12, 2024. The primary outcome was the prevalence of weapons in the health care setting on patients and/or visitors.

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Background: To determine outcomes of MRI-assisted radiosurgery (MARS) for salvage brachytherapy using the radioisotope Pd after various upfront treatments including surgery, external beam radiotherapy, and brachytherapy.

Methods: We retrospectively reviewed data for patients who underwent salvage MARS for intraprostatic lesions or prostate bed recurrences from 2016 to 2022. Biochemical recurrence, prostate cancer-specific, and overall survival, and the cumulative incidences of toxicities, were determined by Kaplan-Meier estimates.

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Objective: Acts of violence occurring in the healthcare setting that involve weapons result in significant morbidity and mortality. New passive weapons screening technology (PWST) offers a potential protective measure. Our objective was to quantify the volume of weapons detected and deterred from our emergency department (ED) over a 12-month period and determine whether it led to weapon-carrier hostility towards frontline staff.

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Objectives: Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes.

Methods: Multicenter, retrospective cohort study of patients enrolled in hospice who presented to an ED within a health system between 2018 and 2023.

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Background: Bacterial and viral respiratory coinfections are common, but the prevalence of SARS-CoV-2 infections among pertussis cases has not been estimated. We examine the prevalence and temporality of SARS-CoV-2 infections among pertussis patients and describe pertussis clinical severity among patients with and without SARS-CoV-2 coinfections.

Methods: Confirmed and probable pertussis cases among individuals with cough onset between January 1, 2020 and February 15, 2023 were identified through surveillance in seven Enhanced Pertussis Surveillance (EPS) sites.

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Objectives: Non-functioning Pancreatic Neuroendocrine Tumors (NF-PNET) are rare tumors with heterogeneous biology. Radiology and serum biomarkers are used for post-resection surveillance; however, no universally established protocol exists. Serum Chromogranin A (CgA) concentration is elevated in NF-PNET, and generally correlates with burden of disease; many CgA studies include mixed gastrointestinal and pancreatic populations.

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Background: To protect infants aged <2 months against pertussis, the United States recommends Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination during each pregnancy. Data are limited on the strategy's effectiveness against pertussis in infants aged ≥2 months.

Methods: Pertussis case infants aged 2 to <6 months with cough onset between 1 January 2011 and 31 December 2014 were identified in 6 US states.

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Accumulation of triacylglycerols (TAGs) is crucial during various stages of plant development. In Arabidopsis, two enzymes share overlapping functions to produce TAGs, namely acyl-CoA:diacylglycerol acyltransferase 1 (DGAT1) and phospholipid:diacylglycerol acyltransferase 1 (PDAT1). Loss of function of both genes in a dgat1-1/pdat1-2 double mutant is gametophyte lethal.

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Background: While the estimated number of U.S. influenza-associated deaths is reported annually, detailed data on the epidemiology of influenza-associated deaths, including the burden of in-hospital versus post-hospital discharge deaths are limited.

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Objective: We report the results of a quality improvement initiative to reduce the time to full enteral feeds and number of central line and parenteral nutrition days in premature infants in a level IV neonatal intensive care unit (NICU) by 20%.

Study Design: In 2020, a multidisciplinary team at our NICU initiated a quality improvement project to improve enteral feeding in infants with a birthweight <1800 g. The key drivers were early donor human milk consent, trophic feeds initiation, and modification of the enteral feeding guidelines.

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Purpose: Trimodality therapy for muscle-invasive bladder cancer (MIBC) yields similar oncologic outcomes compared to radical cystectomy in appropriately selected patients; however, data regarding locally advanced MIBC (LA-MIBC) is limited. We explored our experience with LA-MIBC undergoing radiation therapy (RT).

Methods: We retrospectively identified 30 patients from an institutional prospectively collated database with non-metastatic, LA-MIBC.

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Objectives: To determine the prevalence and associated risk factors of workplace violence (WPV) experienced by emergency medical services (EMS) clinicians across a large, multistate ground/air EMS agency.

Methods: We used a prospective cohort study design from 1 December 2022 to 30 November 2023. A checkbox was added within the electronic medical record (EMR) asking staff to indicate whether WPV occurred.

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Background: Individuals with persistent symptoms following a mild traumatic brain injury (mTBI) demonstrate improved satisfaction with their performance of self-identified rehabilitation goals after completing a combined occupational therapy and physiotherapy group intervention. However, the relationship between factors associated with developing persistent symptoms following an mTBI and satisfaction with their performance of self-identified goals after completing an intervention are unknown.

Objective(s): To evaluate whether factors associated with developing persistent symptoms influence satisfaction with the performance of self-identified goals after completing a combined occupational therapy and physiotherapy group intervention.

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Background: Proton therapy (PT) has unique biologic properties with excellent clinical outcomes for the management of localized prostate cancer. Here, we aim to characterize the toxicity of PT for patients with localized prostate cancer and propose mitigation strategies using a large institutional database.

Methods: We reviewed medical records of 2772 patients with localized prostate cancer treated with definitive PT between May 2006 through January 2020.

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Article Synopsis
  • Pneumonia is frequent among adults hospitalized with confirmed influenza, but the impact of how quickly antiviral treatment is given on severe outcomes is not well understood.
  • The study analyzed data from over 26,000 adults hospitalized between 2012-2019 to see how the timing of antiviral treatment (given on the day of admission vs. later) affected 30-day mortality rates.
  • Results showed that those who received treatment later (days 2-5) had a significantly higher risk of death compared to those treated on the same day of admission, emphasizing the need for prompt treatment.
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Objective: Emergency Medical Services (EMS) clinicians desire performance feedback (PF) and patient outcome follow-up (POF). Within our agency, both a peer-review and feedback/outcome (PF/POF) process exist. Our objective was to determine whether receiving feedback and outcome data improved future clinical care amongst EMS, based upon peer-review scores.

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Objectives: The objectives of this study were to: (1) understand the personal impact of workplace violence (WPV) on staff within a large multistate emergency medical services (EMS) agency, (2) describe the impact of WPV on subsequent patient interactions, examining how experiences of violence affect the quality of care provided by EMS clinicians, (3) examine the influence of WPV on perceived workplace safety among prehospital personnel and its correlation with retention in the EMS field, and (4) solicit recommendations from staff for the prevention and mitigation of WPV in the future.

Methods: We conducted virtual focus groups and individual interviews with 22 prehospital personnel using a descriptive qualitative design within a large multistate Midwest EMS agency between 4/5/2023-6/20/2023. Data were analyzed using Thematic Analysis to identify common perceptions among and across participants.

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Objective: Surgical transgastric pancreatic necrosectomy (STGN) has the potential to overcome the shortcomings (ie, repeat interventions, prolonged hospitalization) of the step-up approach for infected necrotizing pancreatitis. We aimed to determine the outcomes of STGN for infected necrotizing pancreatitis.

Materials And Methods: This observational cohort study included adult patients who underwent STGN for infected necrosis at two centers from 2008 to 2022.

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Reducing foodborne disease incidence is a public health priority. This report summarizes preliminary 2023 Foodborne Diseases Active Surveillance Network (FoodNet) data and highlights efforts to increase the representativeness of FoodNet. During 2023, incidences of domestically acquired campylobacteriosis, Shiga toxin-producing Escherichia coli infection, yersiniosis, vibriosis, and cyclosporiasis increased, whereas those of listeriosis, salmonellosis, and shigellosis remained stable compared with incidences during 2016-2018, the baseline used for tracking progress towards federal disease reduction goals.

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Background: Emergency medicine (EM) trainee comfort level with lumbar puncture (LP) has decreased over time due to changing practice guidelines, particularly amongst pediatric patients. We implemented a "just in time" (JIT) brief educational video based on a previously published LP Performance Scoring Checklist to improve trainee efficiency and competence in LP performance.

Methods: Our pilot quasi-experimental study took place January-June 2022 within a large, academic Midwestern emergency department (ED) with an established 3-year EM residency program.

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Article Synopsis
  • This text indicates that there is a correction issued for the article with the DOI 10.1002/emp2.13143.
  • It implies that there were errors or inaccuracies in the original article that need to be addressed.
  • The correction is necessary for ensuring the accuracy and reliability of the published work.
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Background: A self-assembling SARS-CoV-2 WA-1 recombinant spike ferritin nanoparticle (SpFN) vaccine co-formulated with Army Liposomal Formulation (ALFQ) adjuvant containing monophosphoryl lipid A and QS-21 (SpFN/ALFQ) has shown protective efficacy in animal challenge models. This trial aims to assess the safety and immunogenicity of SpFN/ALFQ in a first-in-human clinical trial.

Methods: In this phase 1, randomised, double-blind, placebo-controlled, first-in-human clinical trial, adults were randomly assigned (5:5:2) to receive 25 μg or 50 μg of SpFN/ALFQ or saline placebo intramuscularly at day 1 and day 29, with an optional open-label third vaccination at day 181.

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Article Synopsis
  • Patients in custody represent a vulnerable group that poses unique ethical and logistical challenges for emergency physicians (EPs), who must navigate their constitutional right to healthcare.
  • EPs need to balance their duty to care for patients with security concerns, adhering to institutional policies and applicable laws, while also utilizing resources like legal counsel for support.
  • Communication with law enforcement is crucial to maintain safety, and EPs should use the least restrictive means of restraint, prioritize patient privacy, and recognize potential interactions between medical care and the legal system.
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