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Background: The ongoing novel coronavirus disease 2019 (COVID-19) pandemic has a significant mortality rate of 3–5%. The principal causes of multiorgan failure and death are cytokine release syndrome and immune dysfunction. Stress, anxiety, and depression has been aggravated by the pandemic and its resultant restrictions in day-to-day life which may contribute to immune dysregulation. Thus, immunity strengthening and the prevention of cytokine release syndrome are important for preventing and minimizing mortality in COVID-19 patients. However, despite a few specific remedies that now exist for the SARS-CoV-2virus, the principal modes of prevention include vaccination, masking, and holistic healing methods, such as yoga. Currently, extensive research is being conducted to better understand the neuroendocrinoimmunological mechanisms by which yoga alleviates stress and inflammation. This review article explores the anti-inflammatory and immune-modulating potentials of yoga, along with its role in reducing risk for immune dysfunction and impaired mental health. Methods: We conducted this narrative review from published literature in MEDLINE, EMBASE, COCHRANE databases. Screening was performed for titles and abstracts by two independent review authors; potentially eligible citations were retrieved for full-text review. References of included articles and articles of major non-indexed peer reviewed journals were searched for relevance by two independent review authors. A third review author checked the excluded records. All disagreements were resolved through discussion amongst review authors or through adjudication by a fourth review author. Abstracts, editorials, conference proceedings and clinical trial registrations were excluded. Observations: Yoga is a nonpharmacological, cost-effective, and safe intervention associated with several health benefits. Originating in ancient India, this vast discipline consists of postures (asanas), breathing techniques (pranayama), meditation (dhyana/dharana), and relaxation. Studies have demonstrated yoga’s ability to bolster innate immunity and to inhibit cytokine release syndrome. As an intervention, yoga has been shown to improve mental health, as it alleviates anxiety, depression, and stress and enhances mindfulness, self-control, and self-regulation. Yoga has been correlated with numerous cardioprotective effects, which also may play a role in COVID-19 by preventing lung and cardiac injury. Conclusion and relevance: This review paves the path for further research on yoga as a potential intervention for enhancing innate immunity and mental health and thus its role in prevention and adjunctive treatment in COVID-19. CA extern

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro Tecnológico, Programa de Pós-Graduação em Engenharia Química, Florianópolis, 2021. Introdução: Preocupações globais com as crescentes demandas energéticas resultaram na emergência de processos químicos intensificados e mais sustentáveis. Na vanguarda deste compromisso está a destilação, uma vez que esta operação é reconhecidamente intensiva no consumo de energia, podendo ser responsável por mais de 40% do gasto total de uma planta industrial (MELLO et al., 2020). É consenso que a intensificação de processos compreende modificações com intuito de reduzir o tamanho dos equipamentos, aumentar o seu desempenho, diminuir o uso de utilidades e matérias-primas, e aumentar a eficiência dos processos (PONCE-ORTEGA; AL-THUBAITI; EL-HALWAGI, 2012). Comprometido com essas diretrizes, nosso grupo de pesquisa vem desenvolvendo uma unidade de destilação por filme líquido descendente, assistida energeticamente por um termossifão, denominada tecnologia Destubcal. Este aparato incorpora a destilação por filme líquido descendente, tecnologia já consolidada e estudada há décadas, com o fornecimento de calor por meio de um termossifão bifásico. Enquanto uma configuração de destilação convencional fornece calor apenas no refervedor e retira o calor no condensador de topo, a abordagem Destubcal possui uma distribuição uniforme de energia ao longo de todo o comprimento do tubo de destilação, sendo assim um equipamento mais compacto, seguro e eficiente termicamente (BATTISTI; MACHADO; MARANGONI, 2020). Estudos experimentais consolidados apontam que essa tecnologia é eficaz na separação e purificação de diversas misturas, com menor consumo de energia em relação à destilação convencional, tais como etanol-água (MARANGONI et al., 2019b, 2019a), mistura aromática de tolueno, para-xileno, meta-xileno, orto-xileno e etilbenzeno (SILVA FILHO et al., 2018), monoetilenoglicol-água (PIRES et al., 2020), e nafta petroquímica sintética (QUERINO; MACHADO; MARANGONI, 2019). Estes trabalhos apontam que a unidade Destubcal é uma opção tecnológica promissora, o que motiva a continuidade e aprofundamento dos estudos em direção a consolidar esta tecnologia como um processo de destilação avançada viável economicamente. Para isso, há uma demanda crucial em entender o comportamento dinâmico desse aparato a fim de avançar nas estratégias de controle, visando minimizar custos e maximizar a produtividade. A compreensão do comportamento da influência e interação das variáveis operacionais e, consequentemente, a otimização desses parâmetros também se mostra necessária para viabilizar futuras aplicações. Além disso, o conhecimento dos custos de capital e operação tonam-se imprescindíveis para análise da viabilidade econômica do processo e sua consolidação estratégica. Objetivo: O escopo norteador deste trabalho é oferecer contribuições científicas no campo da modelagem, do controle, da otimização e da avaliação técnico-econômica de uma unidade de destilação por filme líquido descendente em escala piloto assistida por um termossifão bifásico fechado, visando consolidar e difundir esta tecnologia como um processo viável de destilação intensificada energeticamente. Metodologia: Este estudo está dividido em capítulos, sendo que cada capítulo representa uma das contribuições propostas nos tópicos abordados. Em cada um dos capítulos utiliza-se uma metodologia particular, a fim de atingir os objetivos previamente delineados. A parte comum a todos os capítulos é execução experimental na unidade em escala piloto, que foi utilizada para realização dos ensaios experimentais, coleta de dados e validação dos modelos matemáticos desenvolvidos. O capítulo de revisão da literatura traz uma perspectiva histórica dos fundamentos conceituais, dos tipos de processos e das diferentes formas de operação já utilizadas, além dos avanços tecnológicos produzidos ao longo dos anos a respeito dos múltiplos e complexos fatores que influenciam a eficiência da destilação por filme líquido descendente. Para isso foi realizado um amplo levantamento nas bases bibliográficas Scopus e Google Scholar de trabalhos publicados e patentes depositadas relacionadas aos tópicos \"colunas de filme líquido descendente\" e/ou \"colunas de parede molhada\" desde meados do início do século XX, mais especificadamente no ano de 1942, até os dias atuais, no ano de 2020. Em seguida, para elucidar o comportamento dinâmico do aparato, uma modelagem transiente baseada em rede térmica com extensa validação experimental foi proposta. Após o modelo estar validado experimentalmente, o projeto de um controlador PID foi executado, e o modelo simulado em ambiente Simulink® a fim de avaliar o sistema de controle feedback da temperatura do termossifão atuando na potência das resistências elétricas. Posteriormente, com o intuito de avaliar o desempenho da unidade, um modelo preditivo de aprendizado de máquina baseado em redes neurais foi implementado para separação da mistura etanol-água. A temperatura de alimentação, a temperatura do evaporador e a vazão de alimentação foram as três variáveis de entrada do modelo, enquanto a fração mássica de etanol no destilado, a vazão mássica de destilado, o fator de recuperação e o fator de separação foram os quatro indicadores de desempenho avaliados. Uma vez que a topologia ideal do modelo de redes neurais foi estabelecida, uma otimização baseada em algoritmo genético foi realizada utilizando-se a modelagem de aprendizado de máquina, a fim de otimizar as variáveis operacionais do processo. Por fim, uma avaliação técnico-econômica e energética da unidade Destubcal em escala piloto foi realizada, aplicada à recuperação de etanol em grau desinfetante de 70 vol% em álcool. Essa análise foi motivada pelo aumento dramático da demanda por sanitizantes à base de etanol devido à emergência da pandemia de COVID-19, que chegou a levar à escassez em muitas cidades do Brasil. A performance da unidade foi avaliada experimentalmente com base em 64 corridas na unidade piloto, e a avaliação de custos de capital e custos operacionais foi realizada a fim de verificar a viabilidade técnica e econômica da planta como uma alternativa frente à destilação convencional de etanol. Resultados e discussão: A revisão da literatura demostrou que as colunas de filme líquido descendente representam cerca de 10,9% do total de trabalhos publicados nos últimos 80 anos. Estas colunas têm sido predominantemente usadas para pesquisas fundamentais de transferência de calor e massa. Apesar desta configuração não estar entre as maiores demandas de aplicação, ao longo dos anos vários dispositivos de película líquida descendente foram projetados, aprimorados e patenteados, tais como colunas monotubulares, colunas multitubulares, colunas verticais de placas planas, e colunas integradas energeticamente. No entanto, no que diz respeito à aplicação industrial, os conceitos de destilação de filme descendente ainda são relativamente pouco utilizados. Estudos em estado estacionário de eficiência de separação já estão bem consolidados, sendo que a maioria dos trabalhos publicados confirma a minimização do consumo de energia quando comparados às colunas de destilação convencionais. Ficou evidenciado que há lacunas de conhecimento no que tange o comportamento dinâmico destes processos de destilação. Desta forma, os desafios daqui a diante devem ser focalizados em esclarecer a dinâmica do processo, para que se avance no sentido de melhorar as estratégias de controle e otimização. Isso permitirá avançar nas melhorias operacionais da coluna para elevar essa tecnologia a um nível mais alto de viabilidade econômica. Considerando a complexidade do processo e a quantidade de variáveis que podem sofrer distúrbios ao longo do tempo, além da sensibilidade do filme descendente, o modelo transiente proposto baseado em rede térmica foi capaz de descrever o comportamento dinâmico da temperatura do termossifão com boa precisão. Os coeficientes de transferência de calor experimental e predito mostraram concordância satisfatória dentro da faixa de desvio de ± 25%, considerada admissível segundo a literatura. O controlador PID com parâmetros de sintonia ajustados pelo método Ziegler-Nichols mostrou-se mais eficiente em atingir o setpoint de temperatura desejado mais rapidamente, com menor overshoot e menor oscilação na variável manipulada, consequentemente, reduzindo o consumo de energia elétrica da unidade em 3,1%. O modelo de aprendizado de máquina baseado em redes neurais foi capaz de prever com precisão os quatro principais parâmetros de desempenho da unidade, com um coeficiente de correlação geral satisfatório de 0,95 para todos os dados. A topologia ideal do modelo de redes neurais feed-forward foi alcançada com um arranjo de 10 neurônios dentro de uma camada oculta (3:10:4). De acordo com os gráficos de generalização, as variáveis operacionais influenciaram de forma individual e sinérgica as respostas analisadas. Há uma relação de compromisso com a pureza do produto de topo, representada pela fração mássica do etanol no destilado, e a produtividade, representada pela vazão mássica do destilado. Geralmente, alta pureza é alcançada com vazões de destilado mais baixas, e alta produtividade leva à redução da pureza. Buscando extrair o máximo desempenho da unidade frente a todas as respostas simultaneamente, a otimização baseada em algoritmo genético levou a uma fração mássica de 50,6% de etanol no destilado, 4,91 kg/h de destilado, com um fator de recuperação de 84,9%, e um fator de separação de 57,4. Com relação à avaliação técnico-econômica, a análise de desempenho mostrou que sob uma vazão de alimentação de 14 L/h, uma temperatura de alimentação de 80 °C e uma temperatura de evaporador de 93 °C a unidade atinge o consumo específico mínimo de energia de 571,12 W·h/kg, com uma recuperação máxima de etanol de 40,66%. O impacto dos elementos na parcela do custo de capital mostrou que a instrumentação e controle (27,8%) e tubulação e equipamentos auxiliares (27,6%) são os custos predominantes, enquanto que o custo dos principais equipamentos de processo representa apenas 6,2%, revelando-se uma tecnologia de baixo custo e de fácil implementação. O maior gerador de custos operacionais foi a mão de obra (51,3%), visto que a unidade em escala piloto tem capacidade inferior às plantas industriais. No entanto, a unidade Destubcal gasta com utilidades cerca de 31,6 $/m3alimentado, o que representa uma economia total de 43,8% em comparação com as destilarias convencionais. Além disso, a unidade Destubcal economiza cerca de 1,78 MJ/kg (46,4%), aliada a uma redução de 59,2% na altura da coluna em comparação a uma coluna convencional, sendo considerada economicamente viável para a recuperação de etanol em grau sanitizante. Considerações finais: A integração das técnicas de destilação por filme descendente com fornecimento de calor por meio de um termossifão bifásico, que resultou na tecnologia Destubcal, representa melhorias notáveis para o campo das separações térmicas, uma vez que a combinação dessas duas tecnologias bem estabelecidas deu origem a um novo aparato de destilação, mais compacto, mais seguro e mais econômico. Como consequência dos desafios e perspectivas identificados foi possível planejar estratégias para preencher as lacunas encontradas na tecnologia Destubcal, e avançar na consolidação deste processo de destilação intensificada. O modelo baseado em rede térmica conseguiu descrever com boa precisão a dinâmica do fornecimento de calor e pode ser aplicado para o projeto de equipamentos futuros com maior capacidade de processamento e diferentes fins de separação. A modelagem de aprendizado de máquina baseada em redes neurais foi aplicada com sucesso mostrando boa capacidade preditiva, e a técnica de otimização via algoritmo genético conseguiu extrair um desempenho satisfatório da unidade em escala piloto. Por fim, a análise técnico-econômica indicou que a unidade Destubcal em escala piloto tem potencial para ser uma alternativa viável na recuperação de etanol em grau desinfetante, 70 vol% em álcool, e pode ajudar a evitar escassez deste produto causada pela pandemia atual e futuros eventos. Abstract: Worldwide efforts in process intensification led to innovative designs for distillation, notably known as an energy-intensive process. Engaged in the global trend towards more energy-efficient and sustainable technologies, our research team has been developing a novel thermosyphon-assisted falling film distillation technology, patented as Destubcal. This apparatus combines the falling film distillation, a well-consolidated technology, with the innovative supply of heat through a two-phase closed thermosyphon. Previous experimental studies by the research group pointed out that the Destubcal unit is a promising technology in separating different mixtures with energy gains, motivating the continuity towards consolidating this technology as an economically-feasible advanced distillation process. A broad and deep survey in bibliographical bases of published works and deposited patents from the beginning of the 20th Century until nowadays was realized and pointed out knowledge gaps that still limit the popularization of this technology, which must be elucidated. Based on this, the guiding goal of this work is to offer scientific contributions on modeling, control, optimization, and techno-economic evaluation of the pilot-scale thermosyphon-assisted falling film distillation unit to move forward in operational and design improvements, aiming to raise this technology to a higher level of feasibility for chemical separations. The thermal network-based dynamic modeling proposed and validated by dedicated experimental campaigns with the pilot-scale unit accurately predicted the transient behavior and steady-state temperature of the two-phase closed thermosyphon. The experimental and predicted heat transfer coefficients showed reasonable agreement within the ± 25% deviation band. A feedback control of the thermosyphon's evaporator temperature was performed in Simulink® to manage the steam chamber temperature. PID technique was adopted to achieve faster and smoother the control target, with the secondary effect to reduce mechanical stresses, increasing life cycle, and reducing energy consumption by 3.1%. From a total dataset of 64 experimental runs carried out in the pilot-scale unit, a machine learning predictive model based on artificial neural networks was developed for ethanol-water separation. Despite the high non-linearity, the machine learning approach was capable of modeling the process accurately. The optimal topology was achieved with a network arrangement of 10 neurons within one hidden layer (3:10:4), with a correlation coefficient higher than 0.95 for all data. The optimal operating conditions achieved by the genetic algorithm technique were a feed temperature of 90.6 °C, an evaporator temperature of 109.6 °C, and a feed flow rate of 26.3 L/h. The cost impact of the components associated with the construction and installation of the Destubcal unit revealed that instrumentation and control, and piping and auxiliary equipment are the predominant cost elements (more than 55%) of the capital cost, while major process equipment represent a small portion (6.2%), indicating a low capital investment cost when compared to other unconventional distillation devices. The major operating cost-driver is the labor (51.3%) since the pilot-scale unit has a lower capacity than industrial plants. However, the Destubcal unit spends on utility costs about 31.6 $/m3feed, which represents a total saving of 43.8% compared to conventional distilleries. Furthermore, the Destubcal unit saves about 1.78 MJ/kg (46.4%), with 59.2% less column height than a conventional column, being considered techno-economically feasible for sanitizer-grade ethanol (70 vol%) recovery.

This COBENEFITS Policy Report for India compiles key findings from the COBENEFITS India Assessment series, quantifying the co-benefits of decarbonising India’s power sector in view of future-oriented employment and skills development, economic prosperity in rural areas, and health benefits related to a less carbon-intensive power sector, which can be instrumental in reviving the national health system. The COBENEFITS India Assessment series can be accessed at: www.cobenefi ts.info. Building on the opportunities presented, the report formulates a set of policy actions to allow government institutions to create an enabling political environment to unlock the social and economic co-benefits of the new energy world of renewables for the people of India. The policy options were generated through a series of roundtable dialogues and government consultations involving government institutions, industry associations, and expert and civil society organisations in the years 2019 and 2020. In light of the current crisis, the study findings indicate that recovering from the economic shocks of the COVID-19 pandemic and avoiding severe future shocks triggered through the climate crisis do not represent conflicting interests but instead a mutually reinforcing coping strategy. The Paris Agreement and the 2030 Agenda on Sustainable Development offer important internationally agreed frameworks to ensure economic recovery in the shorter term and for building resilient economies and health systems in the long run.

Background: As novel coronavirus disease (COVID-19) cases continue to steeply rise globally within an unprecedented short period of time, solid evidence from large randomised controlled trials is still lacking. Currently, numerous trials testing potential treatment and preventative options are undertaken globally. Objectives: We summarised all currently registered clinical trials examining treatment and prevention options for COVID-19 pneumonia. Additionally, we evaluated the quality of the retrieved interventional studies. Data sources: The ClinicalTrials.gov, the Chinese Clinical Trial Registry and the European Union Clinical Trials Register were systematically searched. Study eligibility criteria: Registered clinical trials examining treatment and/or prevention options for COVID-19 were included. No language, country or study design restrictions were applied. Withdrawn, cancelled studies and trials not reporting therapeutic or preventative strategies for COVID-19 were excluded. Participants and interventions: No restrictions in terms of participants age and medical background or type of intervention were enforced. Methods: The registries were searched using the term "coronavirus" or "COVID-19" from their inception until 26th March 2020. Additional manual search of the registries was also performed. Eligible studies were summarised and tabulated. Interventional trials were methodologically analysed, excluding expanded access studies and trials testing Traditional Chinese Medicine. Results: In total, 309 trials evaluating therapeutic management options, 23 studies assessing preventive strategies and 3 studies examining both were retrieved. Interventional treatment studies were mostly randomised (n=150, 76%) and open-label (n=73, 37%) with a median number of planned inclusions of 90 (IQR 40-200). Major categories of interventions that are currently being investigated are discussed. Conclusion: Numerous clinical trials have been registered since the onset of the COVID-19 pandemic. Summarised data on these trials will assist physicians and researchers to promote patient care and guide future research efforts for COVID-19 pandemic containment. However, up to the end of March, 2020, significant information concerning reported trials was lacking.

The emergence of severe acute respiratory disease (SARS-CoV-2) variants that causes coronavirus disease (COVID-19) is of global concern. SARS-Cov-2 variants of concern (VOC) exhibiting greater transmissibility, and potentially increased risk of hospitalization, severity and mortality, are attributed to molecular mutations in outer viral surface spike proteins. Thus, there is a reliance on using appropriate counter-disease measures including non-pharmaceutical interventions and vaccination. Best evidence suggests that use of frontline biocides effectively inactivate coronavirus similarly, including VOC, such as 202012/01, 501Y.V2 and P.1 that have rapidly replaced the wild-type variant in the United Kingdom, South Africa and Brazil, respectively. However, this review highlights that efficacy of VOC-disinfection will depend on type of biocide and parameters governing activity. VOC are likely to be similar in size to the wild-type strain, thus implying that existing guidelines for use and re-use of face masks post disinfection remain relevant. Monitoring to avoid injudicious use of biocides during COVID-19 era is required as prolonged and excessive biocide usage may negatively impact our receiving environments; thus, highlighting the potential for alternative more environmental-friendly sustainable biocide solutions. Traditional biocides may promote cross-antimicrobial resistance (AMR) to antibiotics in problematical bacteria. Existing filtration efficacy of face masks is likely to perform similarly for VOC due to similar viral size; however, advances in face mask manufacturing by way incorporating new anti-viral materials will potentially enhance their design and functionality for existing and potentially future pandemics. Graphical abstract Image 1

This research report looks at leadership and wellbeing in Primary Schools two months after the COVID-19 school closures, in total 939 leaders completed the survey. It follows a previous report on practice in Primary Schools two weeks after school closures (Burke and Dempsey, 2020). It reports on the changes in communication, concerns and wellbeing from week two to month two after the COVID-19 school closure; the wellbeing of school leaders in the middle of the COVID-19 school closure; and, investigates the intricacies in wellbeing between teaching and administrative principals, given that their daily duties differ significantly. Quantitative data was analysed using SPSS, and qualitative data was analysed using MAXQDA. It found that principals are adapting to the impact of the pandemic, both professionally and personally, however there have been significant challenges noted. It was noted that social wellbeing is the biggest challenge for principals, however seven out of 10 principals have taken specific actions to address this challenge during the lockdown. Lack of time was an issue for those principals who have not taken positive action regarding their wellbeing, with some fulfilling multiple professional and personal roles. While there have been challenges associated with the adaptation and implementation of new online practices, and some schools lack technology, there has been a positive move to online learning.

News-based indicators are in vogue in economics. But they tend to be applied with little consideration for the properties of news itself. In this paper, we try to shed light on the nature of this type of data. Drawing from established findings in communication science and journalism studies we argue that news-based indicators should be taken with a pinch of salt, since news is a somewhat biased representation of political and social reality. Contrary to economics and other social sciences, journalism tends to be driven by outliers, the outrageous, and the outraged. This structural dissonance between journalism and other disciplines needs to be born in mind when dealing with news content as data, and it is of particular concern in the context of economic developments. While economics and statistics are inherently backward looking, trying to make sense of the (immediate) past using models and probability distributions derived from bygone observations, journalism is about the present, and sometimes about the future. What’s going on right now? And where does it lead us? Seeking answers to these questions makes news a valuable data input, as a measure of what drives society at a given point in time. We show how taking the properties of news into consideration influences the entire process of large-scale news analysis. As an example, we update our Uncertainty Perception Indicator (Müller and Hornig 2020), setting it on a firmer footing by enlarging the newspaper corpus considerably. The new version of the UPI for Germany yields some remarkable results. At the trough of the Covid-19-induced economic crisis in Q2 of 2020, the overall indicator already decreased considerably, although it stayed at elevated levels. Deconstructing the UPI by applying the topic modelling approach Latent Dirichlet Allocation (LDA), shows that the coverage of the pandemic has merged with the issue of climate change and its mitigation. In the past decade or so incalculable politics was the main driver of economic uncertainty perception. Now truly exogenous developments, neither elicited by the economy nor by politics, come to the fore, adding to the sense of an inherently unstable world. DoCMA Working Paper;2-2020

Rugby players often experience risk exposure that has potentially very serious long-term health implications. Safety and risk awareness in rugby has thus become crucial especially considering the COVID-19 pandemic. This study aimed to advance understanding of safety awareness within elite rugby by exploring relationships between players, their behaviors, and the role stakeholders play in support and management. This study explored safety awareness in the context of elite rugby by utilizing document analysis, and an ethnographic approach incorporating observation, and semi-structured interviews. Participants were from rugby teams in Ireland. Observations occurred between August 2017 and May 2018, focusing on training sessions and competitive games. Data gathered were analyzed by thematic analysis using software NVivo. The findings identified three key themes: first, the risk to rugby players long-term health consequences tended to be underestimated; second, risk may be aggregated by players’ risk-taking behavior as a result of social exposure from stakeholders; third, safety practices in rugby, such as injury reporting, need to become more proactive rather than reactive. The dilemma that rugby players who prioritize their performance have to compromise their health-and-wellbeing can be ameliorated by safety culture cultivation, initiating with an encouragement of open communication on safety concerns.

Abstract Background The COVID-19 pandemic poses a huge challenge for clinical teaching due to contact restrictions and social distancing. Medical teachers have to balance potential risks and benefits of bedside teaching, especially in course formats intended to foster practical clinical skills. In this context, we aimed to address the question, whether presence-based teaching formats without patient involvement are suitable to teach practical skills. Methods In this quasi-experimental study, presence-based teaching formats with and without patient contact were retrospectively compared regarding their effects on medical students’ theoretical knowledge and practical skills, i.e. the performance and clinical interpretation of the neurological exam. To this end, evaluations from 102 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and April 2021 were obtained. Students were initially randomly assigned to course dates. However, 53 students assigned to courses in November and December 2020, were not able to go bedside due to contact restrictions. These students formed the interventional group and the remaining 49 students the control group. The primary outcome measures were students’ overall grading of the course (school grades, 1–6) as well as ratings of knowledge and skills provided by the students themselves and their lecturers on a numerical rating scale (0–10). Comparison between groups was performed using frequentist and Bayesian t-statistics. Results The teaching format without patient contact received a significantly poorer overall grade by the students (p = 0.018). However, improvements in the students’ self-ratings of knowledge and skills did not differ between the two formats (all p > 0.05, BF10max = 0.42). Moreover, especially practical skills were even rated significantly better in the group without patient contact by the lecturers (p < 0.001). Conclusions Teaching formats without patient contact are less well-received by the students. However, they are able to teach practical skills regarding the performance and clinical interpretation of examination techniques. Still, the evaluations obtained might not adequately capture the importance of bedside teaching in preparing future physicians for their practice. Perspectively, hybrid teaching approaches including flipped-classroom concepts hold considerable potential to enhance effectiveness of bedside teaching in the present pandemic situation and in the future.

Objective: To determine the relative risk of drug-induced Long QT Syndrome (LQTS) associated with SARS-CoV-2 (COVID-19) proposed repurposed drugs compared to well-known torsadogenic compounds. Setting: Computer calculations and simulations were performed using primary pharmacokinetic and pharmacodynamic data for each proposed drug. Seven different LQTS indices were calculated and compared. The U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database was queried with specific key words relating to arrhythmogenic events. Interventions: A thorough literature search was performed to gather information on the pharmacological properties of six drugs (azithromycin, chloroquine, favipiravir, hydroxychloroquine, lopinavir/ritonavir, and remdesivir) repurposed to treat COVID-19. Researchers emphasized the affinity of these drugs to block the rapid component of the delayed rectifier cardiac potassium current (IKr) encoded by the human ether-a-go-go gene (hERG), their propensity to prolong cardiac repolarization (QT interval), and cause torsade de pointes (TdP). The risk of drug-induced LQTS for these drugs was quantified by comparing six indices that assess such risk. Primary and secondary outcome measures: Level of risk estimated for the six COVID-19 drugs being proposed compared to 23 torsadogenic drugs. Number of proarrhythmic adverse events identified for these drugs in the FAERS. Results: Estimators of LQTS risk levels indicated a very high or high risk for all COVID-19 repurposed drugs with the exception for azithromycin, although cases of TdP have been reported with this drug. There was excellent agreement among the various indices used to assess risk of drug-induced LQTS for the six repurposed drugs and 23 torsadogenic compounds. Conclusion: The risk-benefit assessment for the use of repurposed drugs to treat COVID-19 is complicated since benefits are currently anticipated, not proven. Mandatory monitoring of the QT interval shall be performed, as such monitoring is possible for hospitalized patients or with the use of biodevices for outpatients prescribed these drugs.