NEOGAMES: A Serious Computer Game That Improves Long-Term Knowledge Retention of Neonatal Resuscitation in Undergraduate Medical Students.

Background: Serious games are potential alternatives for supplementing traditional simulation-based education for neonatal resuscitation training. However, evidence regarding the benefits of using serious games to improve long-term knowledge retention of neonatal resuscitation in undergraduate medical students is lacking. Objective: We designed a serious computer game "NEOGAMES" to train undergraduate medical students in neonatal resuscitation in a cost-friendly and accessible way and to examine whether serious game-based training improves long-term knowledge retention in medical students. Methods: "NEOGAMES" consists of a screen with images of an incubator, a baby, visual objects, anatomy, action cards, monitors, real-time feedback, and emotional components. Undergraduate medical students from Shanghai Medical College of Fudan University were invited to participate and were allocated to a game group or a control group. Participants in the game group played the game before the training. All the participants completed three written tests, pre- and post-training knowledge tests and a follow-up test after 6 months. Results: Eighty-one medical students participated in the study. The student demographic characteristics of the groups were comparable, including sex, age, and grade point average (GPA). Significant short-term knowledge improvement was noticed only for male students in the game group based on their 5.2-point higher test scores than those of the controls (p = 0.006). However, long-term knowledge improvement at 6 months was identified for both male and female students in the game group, with test scores 21.8 and 20 points higher, respectively, than those of the controls (P < 0.001). The long-term knowledge retention in the game group was almost 3 times higher than that in the control group. Conclusions: Long-term knowledge retention was nearly 3 times higher for the game group than for the control group. The improvement in knowledge supports the use of serious games for undergraduate medical education.

Enhancing anammox resistance to low operating temperatures with the use of PVA gel beads.

Low temperatures, or a sudden decrease in operating temperature, can seriously inhibit anammox activity, it is, therefore, important to maintain anammox activities at a low temperature. In this study, the use of gel beads to enhance the resistance of anammox biomass to a low temperature was investigated. The performance of three reactors: R1 without gel beads; R2 with polyvinyl alcohol/chitosan (PVA/CS); R3 with PVA/CS/Fe, was studied and compared in a temperature transition from 35 to 8 °C. When the operating temperature was ≥25 °C, there was little difference in nitrogen removal among the three reactors. Decreasing the temperature to < 25 °C created obvious difference between R1 and R2/R3. R1 had a nitrogen removal efficiency (NRE) of 33.1 ± 25.3% at 10 °C, significantly lower than that of R2 (90.5 ± 2.5%) or R3 (87.7 ± 11.1%). Unclassified Candidatus Brocadiaceae was the dominant genus at 10 °C, with an abundance of 44.4, 56.5 and 58.7% in R1, R2 and R3, respectively. These differences were attributed to the use of gel beads, which promoted the granulation of both the non-immobilized sludge and the immobilized biomass, resulting in higher anammox activities in R2/R3. The non-immobilized sludge of R1 was dominated by small particles (<300 µm) at 10 °C, while in R2 and R3 large particles (1000-2000 µm) were the main components. Furthermore, the immobilized biomass on gel beads exhibited much higher anammox activity and maintained a relatively high level of nitrate reductase and nitrite reductase in response to the temperature decrease. The Fe2+/Fe3+ in the PVA/CS/Fe gel beads further promoted microbial aggregation and led to an improved performance in R3 compared to R2. The results of this study demonstrate an effective approach to increase anammox resistance at low operating temperatures.

Achieving reliable partial nitrification and anammox process using polyvinyl alcohol gel beads to treat low-strength ammonia wastewater.

In this study, polyvinyl alcohol (PVA) gel beads were used to aid the partial nitrification and anammox process (PN/A) for treating low-strength ammonia wastewater. When treating synthetic and municipal wastewater, the reactor amended with PVA gel beads achieved a total nitrogen removal efficiency of 75.1 ± 8.4% and 66.6 ± 7.0% respectively, while the control reactor without PVA gel beads achieved 63.2 ± 7.8% and 28.2 ± 11.5% respectively. Dissolved oxygen (<0.5 mg O2 L-1) and substrate diffusion in porous PVA gel beads facilitated the formation of microbial stratification in the gel beads. Unclassified Candidatus Brocadiaceae (major anammox bacteria) and Ignavibacterium (major ammonia oxidizing bacteria) enriched in the inside and outside layers of PVA gel beads, which benefited the synergetic cooperation of these bacteria and protecting them from environmental fluctuations. This study provides a promising solution for achieving a reliable PN/A process in mainstream wastewater treatment.

Positive impact of COVID-19 on career choice in pediatric medical students: a longitudinal study.

BACKGROUND: On March 11th, 2020, the WHO made the assessment that coronavirus disease 2019 (COVID-19) could be characterized as a pandemic. Medical students experienced a greater degree of anxiety and psychological stress than during previous pandemics. Negative emotions were related to decreased medical career interest, increased career choice regret and dropout rates in medical students, which affected academic and professional development. The goal of this study was to investigate the impact of the current COVID-19 outbreak on the career preferences of pediatric medical students and to explore the underlying factors contributing to it. METHODS: A prospective, longitudinal study was conducted among all 120 pediatric medical students from Shanghai Medical College of Fudan University on November 23rd, 2019, and February 21st, 2020 using a 7-item online questionnaire about career choice. RESULTS: A total of 106 (41 male and 65 female) students with a mean age of 21 years consented to participate in this study. The response rate was 100% in November 2019 and 98.1% in February 2020. Since the outbreak, career choices to practice medicine or pediatrics did not drop significantly, decreasing by only 4.3% and 2.2%, respectively. There was a positive impact of the COVID-19 outbreak on strengthening 66.7% of students' beliefs and choices to become good pediatricians (P<0.001). Only 14 students (13.5%) thought that COVID-19 had a negative impact on their career choices, but the majority of them were in the 3rd (28.6%) and 4th (64.3%) years of medical education and had insufficient knowledge about the hospital environment and clinics. CONCLUSIONS: The outbreak of COVID-19 might have an overall positive impact on career choice by strengthening students' belief and choice to become good doctors and may decrease the choice regret and drop rates of the next generation of doctors. Special attention should be paid to students with insufficient clinical experience. Good protection for students, sharing outstanding stories regarding fighting the pandemic, and innovations of needs-based curriculum could be helpful during this pandemic. Future studies are warranted to confirm these findings.

Current harmonics elimination control method for six-phase PM synchronous motor drives.

To reduce the undesired 5th and 7th stator harmonic current in the six-phase permanent magnet synchronous motor (PMSM), an improved vector control algorithm was proposed based on vector space decomposition (VSD) transformation method, which can control the fundamental and harmonic subspace separately. To improve the traditional VSD technology, a novel synchronous rotating coordinate transformation matrix was presented in this paper, and only using the traditional PI controller in d-q subspace can meet the non-static difference adjustment, the controller parameter design method is given by employing internal model principle. Moreover, the current PI controller parallel with resonant controller is employed in x-y subspace to realize the specific 5th and 7th harmonic component compensation. In addition, a new six-phase SVPWM algorithm based on VSD transformation theory is also proposed. Simulation and experimental results verify the effectiveness of current decoupling vector controller.