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Abstract Background Near-peer teaching has been shown to provide diverse benefits for both tutees and tutors in senior medical student and junior trainee settings. However, junior trainees may face more obstacles in teaching including competing clinical priorities and time management. We sought to investigate the challenges and benefits of engaging in near-peer teaching for junior trainees within our local context. Our Near-Peer Medical Teaching (NPMT) teaching program is designed and facilitated by junior doctors for medical students at the Central Coast Clinical School (University of Newcastle) of the Joint Medical Program. Methods Current and past NPMT tutors participated in an online survey from October 2022 to April 2023. Tutors were asked about feasibility of teaching within a work environment, perceived benefits from their experience and attitudes towards medical education. Results Teaching experience appears to be influenced by competing clinical priorities and convenience of session times, but it does not appear to exert considerable stress on tutors likely due to self-selection of tutors with prior enjoyable teaching experience. Furthermore, this study indicates that junior doctors derived enjoyment and developed clinical skills and professional qualities, which are important factors in increasing job satisfaction and ameliorating burn-out in this cohort. Conclusions Junior doctors appear to benefit from engaging in near-peer programs in the Australian teaching hospital setting. Further research should include qualitative methodologies to explore the perspectives of Australian junior doctors’ more deeply.

Introduction: The Lloviu cuevavirus (LLOV) was the first filovirus identified in Europe and at the temperate climate region. Its first discovery was associated with a massive die-off event of Schreibers's bats in Spain. Since its discovery this virus became the second filovirus ever isolated directly from bats. Initial in vitro experiments have suggested that this virus could be a potentially zoonotic filovirus and further experiments suggested an apathogenic nature in humans. During the last decades, several more die-off events in bats were associated with the virus, which therefore might be one of the few viruses pathogenic to bats under certain circumstances. Methods & Materials: We initiated a complex monitoring program for Lloviu virus in 2013. During the last decade we collected and screened more than 2000 blood samples with PCR and serology from eight countries. In addition to blood samples, we screened urine, faeces, swab and ectoparasites from these animals. Using a mobile laboratory approach, we collected fresh blood samples from infected animals on-site to facilitate in vitro isolation experiments. We used the SuBK12-08 cell line for the establishment of novel isolates. In parallel we analysed the ectoparasite samples with sequencing and histology to get a better understanding about their potential vector role. Results: We detected the viral RNA in all sample types, except oral swabs. We generated more than 20 novel viral genomic sequences, covering the whole coding region of the virus. We established four in vitro isolates. Using the sequence data, we generated throughout the years we performed molecular modelling to understand the temporal variation regarding its receptor affinity to bats and found no evidence of adaptation to better receptor binding. Additionally, we were able to calculate the molecular evolution of the virus, describe its mutational landscape and phylogenetic tree. Discussion: Over a decade of research activities, we now possess data that allow us to evaluate the hypothesis concerning the emerging versus enzootic nature of this virus in Europe. Based on the surveillance and sequence data we believe that this virus is endemic in the whole range of this bat species. We established a hypothesis about the potential connection of die-off events, Lloviu virus infection and hibernation of these animals. Conclusion: Although we generated significant amount of data regarding the ecology and zoonotic nature of this virus, several key questions remained to be solved. These include the investigation of potential spillover hosts, other potential bat host species and the role of ectoparasites in the natural transmission cycle. In conclusion, our efforts may lead to a deeper understanding of temperate climate filoviruses and, as a model, provide insights into the ecology and spillover mechanisms of highly pathogenic African filoviruses.

Summary: Among lyssaviruses, West Caucasian bat virus (WCBV) and Lleida bat lyssavirus (LLEBV) raise concern as their divergence from rabies virus leads to the inefficacy of available prophylactic agents. Both viruses were described in the bat Miniopterus schreibersii. We investigated the European distribution of WCBV and LLEBV by screening sera from Miniopterus schreibersii across eight countries, finding widespread serological evidence and positivity up to 70%. We evaluated the intramuscular lethality of wild type isolates in Syrian hamsters. WCBV induced 100% lethality and a clinical disease compatible with furious rabies. All animals infected with LLEBV remained healthy for 40 days, despite one individual testing positive in the brain. We confirmed LLEBV’s intramuscular a-pathogenicity using mice. Infected hamsters developed antibodies by day seven, regardless the virus and the clinical outcome. This study highlights the widespread circulation of WCBV and LLEBV in Europe and suggests differences in neuro-invasiveness and/or pathogenesis that are crucial for risk assessment.

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias of clinical relevance and a major cause of cardiovascular morbidity and mortality. Following a diagnosis of AF, patients are directed towards therapy with anticoagulant drugs to reduce the thromboembolic risk and antiarrhythmics to control their cardiac rhythm, with periodic follow-up checks. Despite the great ease of handling these drugs, we soon realized the need for follow-up models that would allow the appropriateness and safety of these pharmacological treatments to be monitored over time. This pilot study was conducted at a rural pharmacy. The study comprised 47 patients (average age 71.22 years) with nonvalvular atrial fibrillation (68% being paroxysmal) on NOACs. Twenty percent of the enrolled subjects lived alone and fifty-four percent of the participants stated that they were not independent in managing their treatment. The primary aim was to describe the implementation and the outcomes of an innovative smart clinic model in which a local trained pharmacist is a case manager, and the patient carries out the required checks via telemedicine and point-of-care testing systems (POCT) under the service pharmacy regime; the results of the checks could be shared in real time with the attending general practitioner and the relevant specialist. The secondary aims of this study were to evaluate adherence to the planned controls, the prescriptive appropriateness of the dosages and drugs and adherence to the prescribed therapy, the occurrence of pharmacological problems linked to drug type interactions, the occurrence of hemorrhagic and/or thromboembolic complications, the acceptance by the general practitioners and/or the specialists of the reports made by the pharmacist on the subsequent actions undertaken, the economic and social impact of this model on the National Health Service and on the patient, and the impact on the quality perceived by the patients involved in this innovative monitoring process. Compliance with the planned checks was 93%. The dosage of the anticoagulant drug during enrollment was found to be inappropriate, without apparent clinical reasons, in 11% of the sample. Adherence to the anticoagulant therapy was found to be 98%. In total, 214 drug–drug interactions of varying clinical relevance were detected. No embolic events were detected; however, 13% of the sample reported a major hemorrhagic event, which came to light thanks to the close monitoring of hemoglobinemia. A total of 109 reports were made to the patients’ referring doctors in relation to the summarized anomalies, and 84% were accepted by the referring clinicians. Therefore, community pharmacists and pharmacy services represent ideal actors and contexts that, when integrated into the care network, can really favor individual care plan adherence and achieve daily morbidity reductions and cost savings through proper disease control and the early diagnosis of complications.

Abstract Background Bats are recognized as reservoir species for multiple viruses. However, little is known on bats’ health and mortality. Thus, this study aimed to investigate the main causes of death of bats from Turin province (North-western Italy) and to describe gross and histopathological lesions potentially associated with the presence of selected bat viruses. Results A total of 71 bats belonging to 9 different species of the families Vespertilionidae and Molossidae were necropsied and samples of the main organs were submitted to histopathological examination. Also, aliquots of the small intestine, liver, spleen, lung, and brain were collected and submitted to biomolecular investigation for the identification of Coronaviridae, Poxviridae, Reoviridae (Mammalian orthoreovirus species), Rhabdoviridae (Vaprio ledantevirus and Lyssavirus species) and Kobuvirus. The majority of bats died from traumatic lesions due to unknown trauma or predation (n = 40/71, 56.3%), followed by emaciation (n = 13/71,18.3%). The main observed gross lesions were patagium and skin lesions (n = 23/71, 32.4%), forelimbs fractures (n = 15/71, 21.1%) and gastric distension (n = 10/71,14.1%). Histologically, the main lesions consisted of lymphoplasmacytic pneumonia (n = 24/71, 33.8%), skin/patagium dermatitis (n = 23/71, 32.4%), liver steatosis and hepatitis (n = 12, 16.9%), and white pulp depletion in the spleen (n = 7/71, 9.8%). Regarding emergent bat viruses, only poxvirus (n = 2, 2.8%) and orthoreovirus (n = 12/71, 16.9%) were detected in a low percentage of bats. Conclusions Trauma is the main lesion observed in bats collected in Turin province (North-western Italy) associated with forelimb fractures and the detected viral positivity rate seems to suggest that they did not represent a threat for human health.

Many of the world's most pressing issues, such as the emergence of zoonotic diseases, can only be addressed through interdisciplinary research. However, the findings of interdisciplinary research are susceptible to miscommunication among both professional and non-professional audiences due to differences in training, language, experience, and understanding. Such miscommunication contributes to the misunderstanding of key concepts or processes and hinders the development of effective research agendas and public policy. These misunderstandings can also provoke unnecessary fear in the public and have devastating effects for wildlife conservation. For example, inaccurate communication and subsequent misunderstanding of the potential associations between certain bats and zoonoses has led to persecution of diverse bats worldwide and even government calls to cull them. Here, we identify four types of miscommunication driven by the use of terminology regarding bats and the emergence of zoonotic diseases that we have categorized based on their root causes: (1) incorrect or overly broad use of terms; (2) terms that have unstable usage within a discipline, or different usages among disciplines; (3) terms that are used correctly but spark incorrect inferences about biological processes or significance in the audience; (4) incorrect inference drawn from the evidence presented. We illustrate each type of miscommunication with commonly misused or misinterpreted terms, providing a definition, caveats and common misconceptions, and suggest alternatives as appropriate. While we focus on terms specific to bats and disease ecology, we present a more general framework for addressing miscommunication that can be applied to other topics and disciplines to facilitate more effective research, problem-solving, and public policy.

Abstract Lloviu cuevavirus (LLOV) was the first identified member of Filoviridae family outside the Ebola and Marburgvirus genera. A massive die-off of Schreibers’s bats (Miniopterus schreibersii) in the Iberian Peninsula in 2002 led to its initial discovery. Recent studies with recombinant and wild-type LLOV isolates confirmed the zoonotic nature of the virus in vitro. We examined bat samples from Italy for the presence of LLOV in an area outside of the currently known distribution range of the virus. We detected one positive sample from 2020, sequenced the complete coding region of the viral genome and established an infectious isolate of the virus. In addition, we performed the first comprehensive evolutionary analysis of the virus, using the Spanish, Hungarian and the Italian sequences. The most important achievement of this study is the establishment of an additional infectious LLOV isolate from a bat sample using the SuBK12-08 cells, demonstrating that this cell line is highly susceptible to LLOV infection and confirming the previous observation that these bats are effective hosts of the virus in nature. This result further strengthens the role of bats as the natural hosts for zoonotic filoviruses.

Over the last years, the exponential progress of technology introduced a broader population of researchers and developers to the use of Virtual Reality (VR) devices in numerous contexts, e.g., gaming, simulations, and culture dissemination. Recently, cultural heritage has also been supported by motivational experiences and other improvements designed explicitly for specific users (visitors, researchers, and domain experts). In this context, we propose a protocol within a digital environment, using innovative, non-invasive, and non-destructive methods for the technological enhancement, education, and dissemination of ancient human remains. The presented case study is focused on sexual dimorphism in the human skull; several 3D models are digitally generated from female and male skull references exploiting an algorithmic approach with statistical analysis, e.g., Principal Component Analysis (PCA); then, the models are made available in a virtual environment with a Head Mounted Display (HMD) and can also be interacted with via a touchless approach (hands-free). Tests conducted with segmented populations provided promising results.

Abstract Background Several approaches have been described for the excision of parapharyngeal space tumors (PPSTs). Advances in endoscopy gave a further stimulus to the use of the transoral route. Aims We present our experience with the endoscopy‐assisted transoral approach (EATA) in this regard and a review of the most recent literature about EATA for PPSTs excision. Materials and Methods We retrospectively analyzed our experience and systematically reviewed the literature about the outcomes of this technique. Results Seven PPSTs were completely excised, with three of them requiring a combined transcervical approach. Only one case of postoperative wound dehiscence was registered, and the mean length of stay was 3.9 days. Final histopathological examination confirmed the results obtained with preoperative fine‐needle aspiration biopsy in all cases and no recurrences were apparent after a mean follow‐up of 28.1 months. Discussion Magnetic resonance imaging, the modified Mallampati score and the 8 Ts criteria are useful instruments for the choice of the most appropriate surgical approach. Conclusion In light of our experience and following other published series in the literature, we believe that EATA may represent a safe and effective approach for the treatment of the majority of PPSTs.

Rabies is an acute and lethal encephalomyelitis caused by lyssaviruses, among which rabies virus (RABV) is the most prevalent and important for public health. Although preventable through the post-exposure administration of rabies vaccine and immunoglobulins (RIGs), the disease is almost invariably fatal since the onset of clinical signs. Two human neutralizing monoclonal antibodies (mAbs), RVC20 and RVC58, have been shown to be effective in treating symptomatic rabies. To better understand how these mAbs work, we conducted structural modeling and in vitro assays to analyze their mechanisms of action, including their ability to mediate Fc-dependent effector functions. Our results indicate that both RVC20 and RVC58 recognize and lock the RABV-G protein in its pre-fusion conformation. RVC58 was shown to neutralize more potently the extra-cellular virus, while RVC20 mainly acts by reducing viral spreading from infected cells. Importantly, RVC20 was more effective in promoting effector functions compared to RVC58 and 17C7-RAB1 mAbs, the latter of which is approved for human rabies post-exposure treatment. These results provide valuable insights into the multiple mechanisms of action of RVC20 and RVC58 mAbs, offering relevant information for the development of these mAbs as treatment for human rabies.

Background: Near-peer teaching has been shown to provide diverse benefits for both tutees and tutors in senior medical student and junior trainee settings. However, junior trainees may face more obstacles in teaching including competing clinical priorities and time management. We sought to investigate the challenges and benefits of engaging in near-peer teaching for junior trainees within our local context. Our Near-Peer Medical Teaching (NPMT) teaching program is designed and facilitated by junior doctors for medical students at the Central Coast Clinical School (University of Newcastle) of the Joint Medical Program. Methods: Current and past NPMT tutors participated in an online survey from October 2022 to April 2023. Tutors were asked about feasibility of teaching within a work environment, perceived benefits from their experience and attitudes towards medical education. Results: Teaching experience appears to be influenced by competing clinical priorities and convenience of session times, but it does not appear to exert considerable stress on tutors likely due to self-selection of tutors with prior enjoyable teaching experience. Furthermore, this study indicates that junior doctors derived enjoyment and developed clinical skills and professional qualities, which are important factors in increasing job satisfaction and ameliorating burn-out in this cohort. Conclusions: Junior doctors appear to benefit from engaging in near-peer programs in the Australian teaching hospital setting. Further research should include qualitative methodologies to explore the perspectives of Australian junior doctors’ more deeply. [ABSTRACT FROM AUTHOR]

This poster delves into the integration of Artificial Intelligence (AI) with both the marketing and cultural heritage realms. By examining case studies, we elucidate AI’s pivotal role in personalizing consumer experiences within marketing. In the domain of cultural heritage, AI is instrumental in crafting bespoke experiences, such as the “Hermes—a trip as you like it” project. By utilizing AI algorithms, this initiative tailors customized itineraries for visitors based on data analysis and user input. This approach aims to predict and meet individual preferences, redefining engagement and outreach strategies in cultural settings.