The Covid-19 pandemic has caused a prolonged increase in workload and stress among specialists in many healthcare sectors, but this has been particularly noticeable in emergency medicine (EM). A survey carried out by the European Society for Emergency Medicine (EUSEM) among EM professionals in 89 countries showed that 62% of the responders had at least one symptom of burnout syndrome, and 31.2% had two. Results from the survey are published today in the European Journal of Emergency Medicine.

"The world remains unprepared for the next pandemic threat", The Lancet reports. "The consequences of not ending the acuity of this pandemic are more illness and death, health systems stretched to the limit, deepening social divisions, widening economic inequalities, and further losses to individual households." Lancet delivers detailed recommendations:

Some macrophages help the human body fight SARS-CoV-2 without systemic inflammation. But an aggressive subset of these immune molecules instead starts a cascade of events that can lead to multi-organ failure, researchers have discovered.

Prolonged levels of stress and depression during the COVID-19 pandemic contributed to altering key features of fetal brain development — even if the mother was not infected by the virus. This is what a study published in Communications Medicine suggests after following more than 200 pregnant women. The study, led by Children’s National Hospital experts, emphasized the need for more scientific inquiry to shed light on the long-term neurodevelopmental consequences of their findings and COVID-19 exposures on fetal brain development.

Entropy and chaos are terms used to characterize physical systems. The development of such systems with time are typically described as trajectories in phase space. In the past years these terms have been used in signal analysis, whereby one creates a trajectory in m-dimensional phase space by plotting m adjacent points of the signal as a curve in m-dimensional space as the m-points of the signal move through the entire signal.

Large amounts of energy and water are required for the dialysis treatment. Appropriate dialysis center architecture can result in significant savings. Maria Merello de Miguel and colleagues report about ecologically and economically advantageous solutions in "Dialysis Centres: an Architectural Guide".

The corona pandemic highlighted hygiene deficiencies in many dialysis facilities. The immunodeficiency of the dialysis patient and the risk of transmission of infectious diseases require that a distinct consciousness and behaviour concerning hygiene is respected by all those concerned within the facility. The "Guideline for Applied Hygiene in Dialysis Units" serves all professional groups who are directly or indirectly involved in the supply, care, nursing, and therapy of dialysis patients.

Nonadherence occurs in a sizable minority of organ transplant patients. Among adults the highest rate of noncompliance is for following diet (ca. 25%) and taking immunosuppressant medications (ca. 23%), among children attending clinic appointments (ca. 13%) and taking immunosuppressant medications (ca. 6%). Emma K. Massey describes the background in the textbook "Organ Transplantation: Ethical, Legal and Psychosocial Aspects". Nonadherence tends to increase over time after transplantation among both adults and children.

Battles for Mariupol’s Azovstal steel plant have been going on for nearly two months — Russian troops have been trying to seize this final pocket of Ukrainian resistance since mid-March. Russian President Vladimir Putin called off plans for the Russian military to storm the plant in late April, but Azovstal’s defenders regularly report renewed shelling and assaults. On May 7, Ukrainian Deputy Prime Minister Iryna Vereshchuk announced that “all” civilians had been evacuated from the besieged steel plant. The next day, soldiers from the Azov regiment, which is defending Azovstal, said in a press briefing that they too needed to be evacuated, because they had used up all of the resources they had for waging an “effective defense.” On Tuesday, May 10, the Azov regiment published photos of their wounded soldiers and urged “the entire civilized world” to help with their evacuation. “The world should see the conditions in which the wounded, mutilated defenders of Mariupol are [living] and act,” the accompanying statement said. Meduza shares these photos here....

A pig virus may have contributed to the death of a man who received a groundbreaking transplant using a pig heart, according to news reports.

The man, 57-year-old David Bennett Sr., died on March 8, two months after his pig-heart transplant surgery. The heart used in the transplant was from a pig that had been genetically modified to make its heart more acceptable to a human immune system.