***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES : High-fidelity simulation is an effective tool in teaching neonatal resuscitation skills to professionals . We aim ed to determine whether in situ simulation training ( for ∼80 % of the delivery room staff ) improved neonatal resuscitation performed by the staff at maternities . METHODS : A baseline evaluation of 12 maternities was performed : a r and om sample of 10 professionals in each unit was presented with 2 st and ardized scenarios played on a neonatal high-fidelity simulator . The medical procedures were video recorded for later assessment s. The 12 maternities were then r and omly assigned to receive the intervention ( a 4-hour simulation training session delivered in situ for multidisciplinary groups of 6 professionals ) or not receive it . All maternities were evaluated again at 3 months after the intervention . The videos were assessed by 2 neonatologists blinded to the pre-/postintervention as well as to the intervention/control groups . The performance was assessed using a technical score and a team score . RESULTS : After intervention , the median technical score was significantly higher for scenarios 1 and 2 for the intervention group compared with the control group ( P = .01 and 0.004 , respectively ) , the median team score was significantly higher ( P < .001 ) for both scenarios . In the intervention group , the frequency of achieving a heart rate > 90 per minute at 3 minutes improved significantly ( P = .003 ) , and the number of hazardous events decreased significantly ( P < .001 ) . CONCLUSIONS : In situ simulation training with multidisciplinary teams can effectively improve technical skills and teamwork in neonatal resuscitation BACKGROUND The time course of physicians ’ knowledge retention after learning activities has not been well characterized . Underst and ing the time course of retention is critical to optimizing the reinforcement of knowledge . DESIGN Educational follow-up experiment with knowledge retention measured at 1 of 6 r and omly assigned time intervals ( 0–55 days ) after an online tutorial covering 2 American Diabetes Association guidelines . PARTICIPANTS Internal and family medicine residents . MEASUREMENTS Multiple-choice knowledge tests , subject characteristics including critical appraisal skills , and learner satisfaction . RESULTS Of 197 residents invited , 91 ( 46 % ) completed the tutorial and were r and omized ; of these , 87 ( 96 % ) provided complete follow-up data . Ninety-two percent of the subjects rated the tutorial as “ very good ” or “ excellent . ” Mean knowledge scores increased from 50 % before the tutorial to 76 % among those tested immediately afterward . Score gains were only half as great at 3–8 days and no significant retention was measurable at 55 days . The shape of the retention curve corresponded with a 1/4-power transformation of the delay interval . In multivariate analyses , critical appraisal skills and participant age were associated with greater initial learning , but no participant characteristic significantly modified the rate of decline in retention . CONCLUSIONS Education that appears successful from immediate posttests and learner evaluations can result in knowledge that is mostly lost to recall over the ensuing days and weeks . To achieve longer-term retention , physicians should review or otherwise reinforce new learning after as little as 1 week Objective : The  Neonatal Resuscitation Program ( NRP ) has transitioned to a simulation-based format . We hypothesized that immersive simulation differentially impacts similar trainee population s ’ resuscitation knowledge , procedural skill and teamwork behavior . Study Design : Residents from NICU and non-NICU programs were r and omized to either control or a booster simulation 7 to 10 months after NRP . Procedural skill and teamwork behavior instruments were vali date d. Individual resident ’s resuscitation performance was assessed at 15 to 18 months . Three review ers rated videos . Result : Fifty residents were assessed . Inter-rater reliability was good for procedural skills ( 0.78 ) and team behavior ( 0.74 ) instruments . The intervention group demonstrated better procedural skills ( 71.6 versus 64.4 ) and teamwork behaviors ( 18.8 versus 16.2 ) . The NICU program demonstrated better teamwork behaviors ( 18.6 versus 15.5 ) compared with non-NICU program . Conclusion : A simulation-enhanced booster session 9 months after NRP differentiates procedural skill and teamwork behavior at 15 months . Deliberate practice with simulation enhances teamwork behaviors additively with residents ’ clinical resuscitation exposure OBJECTIVE To evaluate intervention practice s associated with hypothermia at both 5 minutes after birth and at neonatal intensive care unit ( NICU ) admission and to determine whether hypothermia at NICU admission is associated with early neonatal death in preterm infants . STUDY DESIGN This prospect i ve cohort included 1764 inborn neonates of 22 - 33 weeks without malformations admitted to 9 university NICUs from August 2010 through April 2012 . All centers followed neonatal International Liaison Committee on Resuscitation recommendations for the stabilization and resuscitation in the delivery room ( DR ) . Variables associated with hypothermia ( axillary temperature < 36.0 ° C ) 5 minutes after birth and at NICU admission , as well as those associated with early death , were analyzed by logistic regression . RESULTS Hypothermia 5 minutes after birth and at NICU admission was noted in 44 % and 51 % , respectively , with 6 % of early neonatal deaths . Adjusted for confounding variables , practice s associated with hypothermia at 5 minutes after birth were DR temperature < 25 ° C ( OR 2.13 , 95 % CI 1.67 - 2.28 ) , maternal temperature at delivery < 36.0 ° C ( OR 1.93 , 95 % CI 1.49 - 2.51 ) , and use of plastic bag/wrap ( OR 0.53 , 95 % CI 0.40 - 0.70 ) . The variables associated with hypothermia at NICU admission were DR temperature < 25 ° C ( OR 1.44 , 95 % CI 1.10 - 1.88 ) , respiratory support with cold air in the DR ( OR 1.40 , 95 % CI 1.03 - 1.88 ) and during transport to NICU ( OR 1.51 , 95 % CI 1.08 - 2.13 ) , and cap use ( OR 0.55 , 95 % CI 0.39 - 0.78 ) . Hypothermia at NICU admission increased the chance of early neonatal death by 1.64-fold ( 95 % CI 1.03 - 2.61 ) . CONCLUSION Simple interventions , such as maintaining DR temperature > 25 ° C , reducing maternal hypothermia prior to delivery , providing plastic bags/wraps and caps for the newly born infants , and using warm resuscitation gases , may decrease hypothermia at NICU admission and improve early neonatal survival Background Reducing neonatal death has been an emerging challenge in low and middle income countries in the past decade . The development of the low cost interventions and their effective delivery are needed to reduce deaths from birth asphyxia . This study will assess the impact of a simplified neonatal resuscitation protocol provided by Helping Babies Breathe ( HBB ) at a tertiary hospital in Nepal .  Perinatal outcomes and performance of skilled birth attendants on management of intrapartum-related neonatal hypoxia will be the main measurements . Methods / Design The study will be carried out at a tertiary level maternity hospital in Nepal . A prospect i ve cohort- study will include a six-month baseline a six month intervention period and a three-month post intervention period . A quality improvement process cycle will introduce the neonatal resuscitation protocol . A surveillance system , including CCD cameras and pulse oximeters , will be set up to evaluate the intervention . Discussion Along with a technique to improve health workers performance on the protocol , the study will generate evidence on the research gap on the effectiveness of the simplified neonatal resuscitation protocol on intrapartum outcome and early neonatal survival . This will generate a global interest and inform policymaking in relation to delivery care in all income setting s . Trial registration IS RCT OBJECTIVE : Poor communication and teamwork may contribute to errors during neonatal resuscitation . Our objective was to evaluate whether interns who received a 2-hour teamwork training intervention with the Neonatal Resuscitation Program ( NRP )  demonstrated more teamwork and higher quality resuscitations than control subjects . METHODS : Participants were noncertified 2007 and 2008 incoming interns for pediatrics , combined pediatrics and internal medicine , family medicine , emergency medicine , and obstetrics and gynecology ( n = 98 ) . Pediatrics and combined pediatrics/internal medicine interns were eligible for 6-month follow-up ( n = 34 ) . A r and omized trial was conducted in which half of the participants in the  team training  arm practice d NRP skills by using high-fidelity simulators ; the remaining practice d with low-fidelity simulators , as did control subjects . Blinded , trained observers viewed video recordings of high-fidelity – simulated resuscitations for teamwork and resuscitation quality . RESULTS : High-fidelity training ( HFT ) group had higher teamwork frequency than did control subjects ( 12.8 vs 9.0 behaviors per minute ; P < .001 ) . Intervention groups maintained more workload management ( control subjects : 89.3 % ; low-fidelity training [ LFT ] group : 98.0 % [ P < .001 ] ; HFT group : 98.8 % ; HFT group versus control subjects [ P < .001 ] ) and completed resuscitations faster ( control subjects : 10.6 minutes ; LFT group : 8.6 minutes [ P = .040 ] ; HFT group : 7.4 minutes ; HFT group versus control subjects [ P < .001 ] ) . Overall , intervention teams completed the resuscitation an average of 2.6 minutes faster than did control subjects , a time reduction of 24 % ( 95 % confidence interval : 12%–37 % ) . Intervention groups demonstrated more frequent teamwork during 6-month follow-up resuscitations ( 11.8 vs 10.0 behaviors per minute ; P = .030 ) . CONCLUSIONS : Trained participants exhibited more frequent teamwork behaviors ( especially the HFT group ) and better workload management and completed the resuscitation more quickly than did control subjects . The impact on team behaviors persisted for at least 6 months . Incorporating team training into the NRP curriculum is a feasible and effective way to teach interns teamwork skills . It also improves simulated resuscitation quality by shortening the duration Objective : To add a team training and human error curriculum to the  Neonatal Resuscitation Program ( NRP ) and measure its effect on teamwork . We hypothesized that teams that received the new course would exhibit more teamwork behaviors than those in the st and ard NRP course . Study design : Interns were r and omized to receive NRP with team training or st and ard NRP  , then video recorded when they performed simulated resuscitations at the end of the day-long course . Outcomes were assessed by observers blinded to study arm allocation and included the frequency or duration of six team behaviors : inquiry , information sharing , assertion , evaluation of plans , workload management and vigilance . Result : The interns in the NRP with team training group exhibited more frequent team behaviors ( number of episodes per minute ( 95 % CI ) ) than interns in the control group : information sharing 1.06 ( 0.24 , 1.17 ) vs 0.13 ( 0.00 , 0.43 ) ; inquiry 0.35 ( 0.11 , 0.42 ) vs 0.09 ( 0.00 , 0.10 ) ; assertion 1.80 ( 1.21 , 2.25 ) vs 0.64 ( 0.26 , 0.91 ) ; and any team behavior 3.34 ( 2.26 , 4.11 ) vs 1.03 ( 0.48 , 1.30 ) ( P-values < 0.008 for all comparisons ) . Vigilance and workload management were practice d throughout the entire simulated code by nearly all the teams in the NRP with team training group ( 100 % for vigilance and 88 % for workload management ) vs only 53 and 20 % of the teams in the st and ard NRP . No difference was detected in the frequency of evaluation of plans . Conclusion : Compared with the st and ard NRP , NRP with a teamwork and human error curriculum led interns to exhibit more team behaviors during simulated resuscitations Background Neonatal deaths account for over 40 % of all under-5 year deaths ; their reduction is increasingly critical for achieving Millennium Development Goal 4 . An estimated 3 million newborns die annually during their first month of life ; half of these deaths occur during delivery or within 24 hours . Every year , 6 million babies require help to breathe immediately after birth . Resuscitation training to help babies breathe and prevent/manage birth asphyxia is not routine in low-middle income facility setting s. Helping Babies Breathe ( HBB ) , a simulation-training program for babies wherever they are born , was developed for use in low-middle income countries . We evaluated whether HBB training of facility birth attendants reduces perinatal mortality in the Eunice Kennedy Shriver National Institute of Child Health and Human Development ’s Global Network research sites . Methods / design We hypothesize that a two-year prospect i ve pre-post study to evaluate the impact of a facility-based training package , including HBB and essential newborn care , will reduce all perinatal mortality ( fresh stillbirth or neonatal death prior to 7 days ) among the Global Network ’s Maternal Neonatal Health Registry births  
    Output:
    
SFNRT compared to basic newborn care or basic newborn resuscitation , in developing countries , results in a reduction of early neonatal and 28-day mortality .