Burnout and stress-related issues are significant concerns among medical personnel involved in emergency situations due to the high demands of their work. A cross-sectional descriptive and comparative study was conducted on 266 prehospital emergency personnel across five Romanian counties, comprising 41 physicians, 74 nurses, and 151 paramedics. Data were collected through an online form, including demographic and professional characteristics, and five validated scales. This study revealed moderate (49.3%) to high (25.9%) burnout rates, with 35% showing signs of work addiction. Despite these challenges, the personnel demonstrated high levels of stress-related growth (61.2%), strong self-discipline (74.1%), and low to moderate responsive distress (100%). Physicians exhibited higher work addiction and job satisfaction, whereas paramedics faced higher burnout, self-discipline, and distress levels. Nurses showed lower burnout and self-discipline levels. These findings highlight the prevalence of burnout and work addiction among emergency medical personnel, while also underscoring the presence of protective factors like higher self-discipline, good level of stress-related growth, and low to moderate responsive distress. The distinct differences in experiences among physicians, nurses, and paramedics emphasize the need for tailored strategies to address these issues within each group.

Background/Objectives: This is a cross-sectional study designed to explore the contribution of personality factors (the Alternative Five Factor Model) and lower order characteristics (responsive distress and self-discipline) to burnout, work addiction, and stress-related growth among Romanian prehospital emergency healthcare workers. Methods: A total of 266 prehospital professionals (41 physicians, 74 nurses, and 151 paramedics) participated in the study out of the 728 invited (36.5% response rate). The age of participants ranged between 20 and 57 years and 67.3% were men. The participants completed the Oldenburg Burnout Inventory, the Dutch Work Addiction Scale (the short version), the Stress-Related Growth Scale, the Zuckerman–Kuhlman Personality Inventory, the Responsive Distress Scale, and the Self-Discipline Scale. Results: The results show that burnout was predicted by age, gender, impulsive sensation seeking, responsive distress, and self-discipline; work addiction was predicted by aggression–hostility, sociability, and responsive distress, while stress-related growth was predicted by age, activity, and self-discipline. Additionally, we found that emergency healthcare workers displayed lower impulsive sensation seeking, neuroticism–anxiety, and aggression–hostility, but displayed higher levels of activity and sociability in comparison with the general Romanian population, although these differences must be interpreted with caution as the general Romanian population tend to be significantly younger. Conclusions: This study provides new insights into the role of personality traits as risk factors for burnout and work addiction, and as protective factors for stress-related growth in prehospital emergency personnel. It is also among the few studies in this field to employ the Alternative Five Factor Model of personality.

Point-of-care ultrasound (POCUS) is an essential component of emergency medicine, enabling rapid bedside assessment across a wide spectrum of acute conditions. Its effectiveness, however, remains constrained by operator dependency, variable image quality, and time-critical decision-making. Recent advances in artificial intelligence (AI) offer opportunities to augment POCUS by supporting image acquisition, interpretation, and quantitative analysis. This narrative review synthesizes current evidence on AI-enhanced POCUS applications in emergency care, encompassing trauma, non-traumatic emergencies, integrated workflows, resource-limited settings, and education and training. Across trauma settings, AI-assisted POCUS has demonstrated promising performance for automated detection of pneumothorax, hemothorax, and free intraperitoneal fluid, supporting standardized eFAST examinations and rapid triage. In non-traumatic emergencies, AI-enabled cardiovascular, pulmonary, and abdominal applications provide automated measurements and pattern recognition that can approach expert-level performance when image quality is adequate. Integrated AI–POCUS systems and educational tools further highlight the potential to expand ultrasound access, support non-expert users, and standardize training. Nevertheless, important limitations persist, including limited generalizability, dataset bias, device heterogeneity, and uncertain impact on clinical decision-making and patient outcomes. In conclusion, AI-enhanced POCUS is transitioning from proof-of-concept toward early clinical integration in emergency medicine. While current evidence supports its role as a decision-support tool that may enhance consistency and efficiency, widespread adoption will require prospective multicentre validation, development of representative POCUS-specific datasets, vendor-agnostic solutions, and alignment with clinical, ethical, and regulatory frameworks.

Background and Objectives: Burnout is highly prevalent among emergency and acute care healthcare workers (HCWs), yet biological correlates remain debated because candidate biomarkers are strongly shaped by circadian timing, shift work, sleep loss, and overlapping affective symptoms. We mapped post-2018 evidence of biological biomarkers assessed alongside validated burnout measures in emergency department (ED), emergency medical services (EMS), and related acute care settings. Specifically, we asked whether reproducible biological correlates of burnout can be identified in emergency and acute-care healthcare workers when biomarker endpoint class and sampling context are systematically considered. Materials and Methods: We conducted a systematic scoping review with evidence mapping (PRISMA-ScR). PubMed/MEDLINE and the MDPI platform were searched for English-language studies published from 2018 onward (through January 2026). Eligible quantitative studies enrolled ED/EMS or acute care HCWs, assessed burnout using validated instruments, and reported at least one biological biomarker. Evidence was charted by biomarker domain and endpoint class (basal measures, stress reactivity paradigms, and chronic indices such as hair-based markers). Results: Overall, 19 studies were included in mapping/synthesis. Biomarker selection clustered around the hypothalamic–pituitary–adrenal axis (cortisol; n = 10/19), with fewer studies focused on autonomic function (heart rate variability; n = 2/19) and immune–inflammatory markers (n = 2/19), and single-study coverage for oxidative stress (n = 1/19), cardiometabolic candidates (n = 1/19), cellular aging (n = 1/19), neuroglial/multi-system candidates (n = 1/19), and feasibility-oriented multi-marker designs (n = 1/19). Reported associations with burnout were heterogeneous in direction and magnitude, but were more interpretable when endpoint class, timing anchors, and shift/sleep-related covariates were explicitly reported. Rates of confounder adjustment were low across studies (e.g., only 3/19 reported multivariable adjustment, and none systematically measured sleep or circadian factors), substantially limiting interpretability. Conclusions: The 2018+ literature does not support a single reproducible biomarker for burnout in emergency and acute care workforces. Evidence instead suggests multi-system dysregulation that is highly sensitive to endpoint class, sampling timing, and contextual confounding. Future studies should prioritize timing-anchored repeated-measures protocols across shift and recovery windows, jointly model sleep/circadian factors and depressive symptoms, and evaluate multi-marker panels and intervention responsiveness.

The field of emergency medicine (EM) is a high-stress medical specialty. We aim to comparatively investigate burnout, work addiction, and stress-related growth between EM physicians and EM residents. Our sample consists of 117 EM professionals, 41 physicians and 76 residents, from 5 out of the 12 EM county departments in Romania that run residency programs. Methods: An online survey was sent to 461 EM professionals (170 physicians and 291 residents), with a response rate of 25.4%. The survey comprised two sections: the first focused on sociodemographic and professional data, with the second consisting of six validated assessment instruments: the Oldenburg Burnout Inventory, Dutch Work Addiction Scale—short version, Stress-Related Growth Scale, Responsive Distress Scale, Self-Discipline Scale, and Zuckerman–Kuhlman Personality Questionnaire. Both EM physicians and residents reported moderate to high levels of burnout, disengagement, and exhaustion, but there was no significant difference between them. However, physicians exhibited significantly higher levels of work addiction, excessive work, compulsive work, and stress-related growth. No significant differences were found in compulsive work behaviors. Conclusions: Burnout levels are comparable between EM physicians and residents. However, physicians demonstrate higher work addiction but also higher stress-related growth. Personality variables and sleep duration appear to be more influential in predicting burnout than in work addiction or stress-related growth.

This study explores the antibacterial efficacy and cytotoxicity of ciprofloxacin-functionalized bioceramic implants. We synthesized hydroxyapatite-ciprofloxacin (HACPX_CS) composites and applied them to titanium substrates (Ti-HA-CPX), evaluating their performance in vitro against Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922). Antibacterial activity was assessed using the Kirby-Bauer disc diffusion method, while cytotoxicity was tested using mesenchymal stem cells. The results demonstrated that Ti-HA-CPX exhibited superior antibacterial activity, with inhibition zones of 33.5 mm (MIC 0.5 µg/mL) for Staphylococcus aureus (ATCC 25923) and 27.5 mm (MIC 0.25 µg/mL) for Escherichia coli (ATCC 25922). However, Ti-HA-CPX showed moderate cytotoxicity (80% cell viability). HACPX_CS composites, whether chemically synthesized or mechanically mixed (HACPX_MM), also displayed significant antibacterial activity, but with cytotoxicity ranging from low to moderate levels. Molecular docking studies confirmed strong binding affinities between ciprofloxacin and bacterial proteins, correlating with enhanced antibacterial efficacy. These findings suggest that Ti-HA-CPX composites offer a promising approach for single-stage surgical interventions in treating chronic osteomyelitis and infected fractures, balancing antibacterial effectiveness with manageable cytotoxicity.