For each unknown case, eight similar images of benign lesions and

For each unknown case, eight similar images of benign lesions and eight similar images of malignant lesions were preselected with a computerized scheme. From these preselected images, a breast radiologist subjectively selected the four most similar images of benign lesions

and the four most similar images of malignant lesions. Five attending breast radiologists and three breast-imaging fellows participated in the observer study. Observers provided their confidence level regarding malignancy of the unknown case before and after they viewed the similar images. The results were evaluated with multireader multicase receiver operating characteristic (ROC) analysis.

Results: For all observers, the areas under the ROC curves (AUCs) were improved when similar images were used. The LBH589 order average AUC for all observers increased from 0.692 without use of similar images to 0.790 with use of similar images (P = .0009).

Conclusion: The presentation

of similar images can improve radiologists’ performance in the differential diagnosis of clustered microcalcifications on mammograms. (C) RSNA, 2009″
“Objective: Anastomosis of ureteropelvic junction with a laparoscope for the treatment of ureteropelvic junction obstruction (UPJO) is a time-consuming and technically challenging procedure. We present our experience of laparoscopic dismembered pyeloplasty and compare clinical outcomes of two different suture techniques. Methods: From September 2003 AZD1208 price to June 2010, 105 laparoscopic dismembered pyeloplasties were performed in our department. All procedures

were done using the retroperitoneal approach. According to the suture methods (interrupted or running), the patients were divided into two groups. An indwelling XMU-MP-1 cell line stent was placed intraoperatively in an antegrade manner. Data on operation time, blood loss and complications were collected. Results: All procedures were completed without open conversion. Mean operation time and anastomotic time were 96 (55-150) and 36 min (15-70), respectively. A significant decrease of operation and anastomosis time was seen when running sutures were applied. Mean blood loss was 54 ml (30-100). The total complication rate was 7.6%. No anastomotic stricture occurred. The average hospitalization stay was 7 days. During 5-85 months of follow-up, hydronephrosis was alleviated in all cases. Conclusions: Laparoscopic dismembered pyeloplasty for the treatment of UPJO can provide satisfactory clinical outcomes. Higher surgical efficiency and lower complication rates can be obtained by using the running suture method. Copyright (C) 2011 S. Karger AG, Basel”
“Purpose: To examine changes in screening mammogram interpretation as radiologists with and radiologists without fellowship training in breast imaging gain clinical experience.

A

two-way multiple analysis of variance also found that w

A

two-way multiple analysis of variance also found that when comparing those who progress through stages with those who stagnate or regress, “”progressors”" show significantly more improvement in measures of mood and functionality but not pain. The treatment groups did not appear to have significantly different outcomes in terms of stage of change.

Conclusions.

These findings suggest that the PSOCQ may be useful in making treatment more efficient, both by predicting who is less likely complete treatment and by providing targeted treatments according to patients’ readiness to engage in self-management.”
“Objective.

Improvements in clinical pain find more care have not matched advances in scientific knowledge, and innovations in medical education are needed. Several streams of evidence indicate that pain education needs to address both the affective and cognitive dimensions

of pain. Our aim was to design and deliver a new course in pain establishing foundation-level knowledge while comprehensively addressing the emotional development needs in this area.

Setting.

One hundred eighteen first-year medical students at Johns Hopkins School of Medicine.

Outcome Measures.

Performance was measured by multiple-choice tests of pain knowledge, attendance, reflective pain portfolios, and satisfaction measures.

Results.

Domains LY294002 in vitro of competence in pain knowledge included central and peripheral pain signalling, pharmacological management of pain with standard analgesic medications, neuromodulating agents, and opioids; cancer pain, musculoskeletal pain, nociceptive, inflammatory, neuropathic, geriatric, and pediatric pain. Socio-emotional Nepicastat development (portfolio) work focused on increasing awareness of pain affect in self and others, and on enhancing the commitment to excellence in pain care. Reflections included observations on a brief pain experience (cold pressor test), the multidimensionality of pain, the role of empathy and compassion in medical care, the positive

characteristics of pain-care role models, the complex feelings engendered by pain and addiction including frustration and disappointment, and aspirations and commitments in clinical medicine. The students completing feedback expressed high levels of interest in pain medicine as a result of the course.

Discussion.

We conclude that a 4-day pain course incorporating sessions with pain specialists, pain medicine knowledge, and design-built elements to strengthen emotional skills is an effective educational approach.

Summary.

Innovations in medical education about pain are needed. Our aim was to design and deliver a new course for medical students addressing both the affective and cognitive dimensions of pain. Combining small-group sessions with pain specialists, active-learning approaches to pain knowledge, and design-built elements to strengthen emotional skills was highly effective.

5% w/w of sodium carbonate for pomace The microwave assisted ext

5% w/w of sodium carbonate for pomace. The microwave assisted extractions gave significantly higher yields as compared to traditional extraction and could be recommended as an alternative method for extraction of phenolic compounds from grape residues in water medium. (C) Selleckchem BMS-777607 2013 Elsevier B.V. All rights reserved.”
“Biodegradable copolymer alpha-TCP/poly(amino acid) composite

artificial lamina was prepared and used in goat cervical vertebra resection repair. Cervical 4 was removed by laminectomy, and a vertebra defect of 27 x 9 mm was made. alpha-TCP/poly(amino acid) composite artificial lamina was inserted in the test group. The efficiency of the copolymer during repair and reconstruction of the goats’ vertebra was tested

by using X-ray, CT scanning, and histological and biomechanical measurements. Apoptosis Compound Library In the 24 weeks following the operation, the artificial lamina refrained from shifting, and no dural adhesion pressure was observed. In contrast, the control group suffered from infiltration of soft tissue in the spinal canal, dural pressure and alpha-TCP/poly(amino acid) degradation. In conclusion, alpha-TCP/poly(amino acid) composite artificial lamina can significantly prevent scar tissue from infiltrating the spinal canal.”
“Low-level laser therapy (LLLT) has been used with the aim of improving vascular perfusion of the skin and musculocutaneous flaps. This study evaluated the effect of LLLT on transverse rectus abdominis musculocutaneous flap (TRAM) viability, vascular angiogenesis, and

VEGF release. Eighty-four Wistar rats were randomly divided into seven groups with 12 rats in each group. Group 1 received sham laser treatment; group 2, 3 J/cm(2) at 1 point; group 3, 3 J/cm(2) at GDC-0973 order 24 points; group 4, 72 J/cm(2) at 1 point; group 5, 6 J/cm(2) at 1 point; group 6, 6 J/cm(2) at 24 points; and group 7, 144 J/cm(2) at 1 point. All experimental groups underwent LLLT immediately after the TRAM operation and on the following 2 days; thus, animals underwent 3 days of treatment. The percentage of skin flap necrosis area was calculated on the fourth postoperative day using the paper template method, and two skin samples were collected using a 1-cm(2) punch to evaluate alpha smooth muscle actin (1A4) and VEGF levels in blood vessels. Significant differences were found in necrosis percentage, and higher values were seen in group 1 than in the other groups. Statistically significant differences were not found among groups 3 to 7 (p < 0.292). Groups 5 and 7 showed significantly higher VEGF levels compared to other groups. Groups 3 and 5 had an increase in levels of blood vessels compared to other groups. LLLT at energy densities of 6 to 144 J/cm(2) was efficient to increase angiogenesis and VEGF levels and promote viability in TRAM flaps in rats.

We examine the sex-specific issues related to myocardial ischemia

We examine the sex-specific issues related to myocardial ischemia in women in terms of prevalence and prognosis, traditional and novel risk factors, diagnostic testing, as well as therapeutic management strategies for IHD. (c) 2012 Wiley Periodicals, Inc.”
“Gamboge is a dry resin secreted from Garcinia hanburryi, and gambogenic acid (GNA) is one of the main active compounds of gamboge. We have previously demonstrated the anticancer activity of GNA in A549 cells selleck compound and pointed out its potential effects in anticancer therapies. Previous studies reported that GNA induced apoptosis in many cancer cell lines and inhibited A549 tumor

growth in xenograft of nude mice in vivo. However, the anticancer mechanism of GNA has still not been well studied. In this paper, we have investigated whether GNA-induced apoptosis is critically mediated by the p38 mitogen-activated protein kinase (MAPK) pathway. Our findings revealed that GNA could induce apoptosis, inhibit proliferation, down-regulate the expression of p38 and MAPK, increase the activations of caspase-9, caspase-3, and cytochrome c release. Furthermore, using SB203580, an adenosine triphosphate-competitive inhibitor RG-7388 of p38 MAPK, inhibit the expression of p-p38 and the experimental results show that it may promote the occurrence of

apoptosis induced by GNA. Taken together, these results suggested that up-regulation of the p38 MAPK cascade may account for the activation of GNA-induced apoptosis.”
“Background: Ischemic/hypoxic myocardial damage

and functional impairment of the myocardium occurs immediately after major burns. This experimental study investigated whether GSK923295 mw the prompt cardiac dysfunction initiates hepatic, renal, and intestinal injuries soon after a severe burn.

Methods: Wistar rats were randomized to a sham burn group, a burn group (subjected to 30% total body surface area third-degree burn) that was subdivided into two groups: a simple burn group, observed at 0.5 hour, 1 hour, 3 hours, 6 hours, 12 hours, 24 hours postburn and a group medicated with propranolol (a cardiac inhibitor), cedilanid (a cardiotonic agent), enalaprilat (an angiotensin converting enzyme inhibitor), and cedilanid plus enalaprilat injected at 0.5 hour postburn and observed at 6 hours later. Serum cardiac troponin I, total bile acid, beta2-microglobulin concentrations, and diamine oxidase activity were measured to reflect the severity of cardiac, hepatic, renal, and intestinal injuries that were confirmed by histopathologic observations. Cardiac function and organs’ blood flow were also recorded.

Results: Histopathologic changes and serum cardiac troponin I increase occurred significantly earlier than the other organs, and the organ damage developments followed a similar pattern.

0 g m-2 web area density exhibited a 85 3% reduction in Klebsiell

0 g m-2 web area density exhibited a 85.3% reduction in Klebsiella pneumoniae. Titanium dioxide nanocomposite fiber webs containing 3 wt % TiO2 nanoparticles

at 3.0 g m-2 web area density exhibited a formaldehyde decomposition efficiency of 40% after 2 h, 60% after 4 h, and 80% after 15 h under UV irradiation. The same system showed an ammonia deodorization efficiency of 32.2% under UV irradiation for 2 h. These results demonstrate that TiO2 nanocomposite fibers can be used to produce advanced textile Galardin materials with multifunctional properties. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2012″
“The discharge current and voltage waveforms have been measured in a reactive high power impulse magnetron sputtering (HiPIMS) Ar/N-2 discharge with a Ti target for 400 mu s long pulses. We observe that the current waveform in the reactive Ar/N-2 HiPIMS discharge selleck inhibitor is highly dependent on the pulse repetition frequency, unlike the non-reactive Ar discharge. The current is found to increase significantly as the frequency is lowered. This is attributed to an increase in the secondary electron emission yield during the self-sputtering phase, when

the nitride forms on the target at low frequencies. In addition, self-sputtering runaway occurs at lower discharge voltages when nitrogen is added to the discharge. This illustrates the crucial role of self-sputtering in the behavior of the reactive HiPIMS discharge. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3653233]“
“Background/aims: To evaluate the ability of the model for end-stage liver disease (MELD) in predicting the post-hepatectomy outcome for hepatocellular carcinoma (HCC).

Methods: Between 2001 and 2004, 69 cirrhotic patients with HCC underwent hepatectomy and the results were retrospectively analysed. MELD score was associated with post-operative mortality and morbidity, hospital stay and 3-year survival.

Results:

Seventeen major and 52 minor resections were performed. Thirty-day mortality rate was 7.2%. MELD <= 9 was associated with no peri-operative mortality vs. 19% when MELD > 9 (P < 0.02). Overall morbidity rate was 36.23%; 48% when MELD > 9 vs. 25% when MELD <= 9 (P < 0.02). Median hospital stay was 12 days [8.8 BAY 80-6946 clinical trial days, when MELD <= 9 and 15.6 days when MELD > 9 (P = 0.037)]. Three-year survival reached 49% (66% when MELD <= 9; 32% when MELD > 9 (P < 0.01). In multivariate analysis, MELD > 9 (P < 0.01), clinical tumour symptoms (P < 0.05) and American Society of Anesthesiologists (ASA) score (P < 0.05) were independent predictors of peri-operative mortality; MELD > 9 (P < 0.01), tumour size > 5 cm (P < 0.01), high tumour grade (P = 0.01) and absence of tumour capsule (P < 0.01) were independent predictors of decreased long-term survival.

Conclusion: MELD score seems to predict outcome of cirrhotic patients with HCC, after hepatectomy.

We evaluated 518 post-LT protocol biopsies and at least 98 urgent

We evaluated 518 post-LT protocol biopsies and at least 98 urgent liver biopsies regarding graft fibrosis stages, inflammation grades, and evidence for rejection within MBL-2 genotype groups. Result No association of MBL-2 polymorphisms was observed regarding inflammation, fibrosis, and antiviral treatment outcome. However, the C allele of the MBL-2 gene (P = 0.001) and gender compatibility (P = 0.012) were factors significantly associated with the incidence of ACR. Conclusion MBL-2

polymorphisms and gender are involved in the development of ACR after LT. CC genotype and gender match may be regarded as risk factors for ACR in HCV-positive graft recipients. Further studies are needed to confirm and verify this observation in non-HCV groups as well.”
“Introduction: leptospirosis is a zoonosis this website of worldwide importance. The disease is endemic in Brazil. This study was conducted to describe the clinical and laboratory presentation of leptospirosis in a metropolitan city of Brazil. Methods: this is a retrospective study including 201 consecutive patients with

leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil, between 1985 and 2006. All patients had clinical and epidemiological data suggestive of leptospirosis, and positive laboratorial test for leptospirosis (microscopic agglutination test, MAT, higher than 1: 800). Results: a total of 201 patients were included, with Selleck Epigenetic inhibitor mean age of 38.9 +/- 15.7 years; 79.1% were male. The mean length from onset of symptoms Roscovitine to admission was 7 +/- 3 days. The main clinical signs and symptoms at admission were fever (96.5%), jaundice (94.5%), myalgia (92.5%), headache (74.6%), vomiting (71.6%) and dehydration (63.5%). Hemorrhagic manifestations were present in 35.8%. Acute kidney injury was found in 87% of the patients. Platelet count was less than 100,000/mm(3) in 74.3%. Hematuria was found in

42.9%. Death occurred in 31 cases (15.4%). Conclusions: leptospirosis is a globally relevant disease with potential fatal outcome. Signs and symptoms suggestive of leptospirosis must be known by any physician in order to institute early adequate treatment to improve outcome. Early indication and daily hemodialysis seems to be beneficial in this group of patients.”
“The incidence of drug-resistant pathogens differs greatly between countries according to differences in the usage of antibiotics. The purpose of this study was to investigate the phenotypic resistance of 321 methicillin resistance Staphylococcus aureus (MRSA) and 195 methicillin susceptible S. aureus (MSSA) in a total of 516 S. aureus strains to macrolide, lincosamide, streptogramin B (MLS(B)), ketolid, and linezolid. Disk diffusion method was applied to determine MLS(B) phenotype and susceptibility to different antibiotic agents. It was found that 54.

The efficacy

of the transferred medium depended on the pr

The efficacy

of the transferred medium depended on the presence of serum during cell conditioning. LDR priming eliminated HRS even in the presence of protein synthesis inhibitor BG.

Conclusions: LDR LY3023414 mw priming of T-47D cells as well as LDR priming of medium conditioned on T-47D cells induce a factor in the medium which cause the early G(2)-checkpoint to be activated in recipient cells by doses normally in the HRS dose-range.”
“A 74-year-old man with metastatic renal cell carcinoma and a history of cardiac failure was treated with sunitinib malate. MUGA echocardiography could not detect a relevant change in the ejection fraction although the clinical situation of the patient worsened dramatically. The only parameter to hint at the deteriorated cardiac function was plasma N-terminal pro-brain natriuretic peptide (BNP). Finally, the patient died after only one cycle of sunitinib treatment. We propose to prospectively include BNP for the early detection of cardiovascular decompensation in high-risk patients. Future studies concerning the relevance of BNP in drug-related cardiotoxicity are urgently needed. Copyright (C) 2010 S. Karger AG, Basel”
“Purpose: Postmenopausal osteoporosis causes bone fracture as well as pain, physical, psychological and

socially adverse effects, which affects a patient’s quality of life (QOL). The effect of alendronate on QOL was investigated compared with that of Angiogenesis inhibitor alfacalcidol in postmenopausal osteoporotic women.

Patients and methods: A total of 44 postmenopausal osteoporotic women (mean age 69.8 years) with back or joint pain, although capable of walking, were randomly assigned to two groups; group A (n = 25) received 5 mg/day of alendronate, and group B (n = 19) received 0.5 mu g/day of alfacalcidol, for the first 4 months. For the following 2 months, the group A received 0.5 mu g/day of alfacalcidol and the

group B received 5 mg/day of alendronate in a crossover design. The patient’s QOL was evaluated by score of Japanese Osteoporosis Quality of Life Questionnaire (JOQOL), and pain intensity using a visual analog scale (VAS). Bone metabolism was measured by bone mineral density (BMD) and a biomarker for bone resorption, urinary crosslinked N-terminal telopeptide of type I GSK461364 inhibitor collagen (NTX).

Results: With 4-month treatment, alendronate, but not alfacalcidol, improved pain-related QOL, reduced joint pain by VAS, and increased bone mineral density. Both treatments significantly reduced bone resorption, the inhibition was significantly higher with alendronate (-56.5%) compared with alfacalcidol (-18.1%). After crossover, the patients in group A received alfacalcidol and had a reduced total and daily living activity-related QOL scores, and increased upper back pain by VAS. The group B received alendronate had significantly reduced bone resorption after the 2 months.

Mass spectrometric analyses of the trimeric His-tagged complex in

Mass spectrometric analyses of the trimeric His-tagged complex indicated that it is composed of FcpA and FcpE polypeptides. It is confirmed here that

a trimer is the basic organizational unit of Fcps selleck chemicals in P. tricornutum. From circular dichroism spectra, it is proposed that the organization of the pigments on the polypeptide backbone of Fcps is a conserved feature in the case of chlorophyll a/c containing algae.”
“The spherical silica powders were prepared by using an oxygen-acetylene flame method. After spheroidization, a scanning electron microscope investigation revealed that the spheroidization efficiency of the powder was nearly 100%, XRD patterns indicated that the raw crystal silica became amorphous silica. In this study, composites of spherical silica and an epoxy resin were prepared with Nepicastat in vitro a homogenizer, followed by a stepwise thermal curing process. The thermal stability and thermal degradation behavior of the composites were studied by a thermogravimetric analyzer. Meanwhile, the effects of spherical silica powder on dynamic mechanical, coefficient of thermal expansion, and mechanical properties of epoxy/silica composites were also investigated. The initial decomposition temperature

and mechanical properties increased significantly after adding the spherical silica into the composite. The maximum properties of thermal stability and mechanical properties were observed when spherical silica accounted for 30% of the system. The thermal expansion had been significantly reduced by the addition of silica. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 121: 648-653, 2011″
“The polaritons in a two-dimensional artificial ionic-type crystal have been proposed and experimentally demonstrated from the two-dimensional periodically poled LiTaO3. In this artificially micro-structured materials, the anisotropic piezoelectric coefficients and the two-dimensional symmetric result in strong and complex

couplings of the incident electromagnetic waves and the two-dimensional superlattice vibrations. We studied the dielectric anomalies, the coupling and transforming between GDC0068 two ordinary polariton modes etc., which reveal that, by engineering the ferroelectric domain’s distribution, the artificial ionic-type crystal may establish a new member of meta-materials, and will facilitate access to the device applications such as multi-directional and frequency transducers.(c) 2011 American Institute of Physics. [doi:10.1063/1.3554831]“
“An investigation was carried out on the application of dilute chitosan solutions modified by a tyrosinase-catalyzed reaction with 3,4-dihydroxyphenetylamine (dopamine) to the adhesion of low-density polyethylene (LDPE) and high-density polyethylene (HDPE) plates photografted with carboxyl-group-containing hydrophilic monomers, such as methacrylic acid (MAA) and acrylic acid (AA).

For comparisons, patients were classified in 3 groups: with posit

For comparisons, patients were classified in 3 groups: with positive, negative, and no viral studies performed.

Results: A total of 129 patients were admitted to CMCD with IPD during the 3 year study; 57% were male. Ages ranged from 2 months to 18 years (median 25 months) and 48% were <2 years. Viral studies were performed in 82 (63%) patients, and 28 (34%) had positive results. The most common viruses isolated were influenza (7, 25%), rhinoviruses (6, 21%), adenoviruses (6, 21%), and RSV (5, 18%). Peaks of positive viral studies occurred in February and November which coincided with the peak numbers of patients admitted with IPD. Of 6 with adenovirus coinfection, 5 were admitted to Pediatric

Intensive Care Unit (PICU). The most common pneumococcal serotypes were 19A (41, 32.5%), 7F (14, 11%), and LY2835219 23A

(13, 10.3%). Pneumonia (42%), bacteremia (22%), SNX-5422 cell line and meningitis (17%) were the most common clinical syndromes. There were no differences in duration of fever before admission, maximum temperatures during hospitalization and white blood cell counts, duration of fever and hospitalization between patients with positive and negative viral studies, but there was a trend for patient with positive viral studies to be admitted to PICU more frequently and to have longer PICU stay. Three of the 6 patients who died had documented viral coinfections (2 adenovirus, 1 parainfluenza 3), and all 3 had no underlying conditions. The other 3 patients who died had no viral studies performed. Duration of treatment ranged from 1 to -210 days (median 14), with no differences among GNS-1480 solubility dmso the groups.

Conclusions: Viral coinfections were common in children with IPD. Future prospective studies should include new PCR assays to characterize better the impact of viral coinfections in the occurrence and outcome of

IPD.”
“The experimental phonon dispersion relations in NixPt1-x alloys reveal anomalous features in the phonon branches which are dependent upon their composition and phonon propagation directions. We investigate the origin of the anomalous features by computing the lattice dynamics for the alloy system at various compositions with the newly developed first-principles based methodology which takes into account the disorders in the mass, the force-constant, and the environment. The physics behind the anomalous features is discussed using the coherent scattering structure factors, the disorder-induced widths, and the vibrational densities of states. Our results agree well with the experimental observations both qualitatively and quantitatively for most of the compositions. We demonstrate that the anomalous features arise due to the correlated vibrations of the unlike pairs of species. For Ni0.25Pt0.75 alloy, our calculations do not find a resonance like behavior in the phonon branches, as observed in the experiments.

Study Design: Retrospective case review and histopathologic analy

Study Design: Retrospective case review and histopathologic analysis.

Setting: Tertiary referral center.

Patients: Records of 17 patients PU-H71 with surgically managed PA cholesterol granulomas were reviewed. Histopathologic analysis was performed on temporal bones of 11 patients with PA cholesterol granulomas from the Temporal Bone repository at the House Research Institute.

Interventions: Surgical drainage of PA cholesterol granulomas; follow-up radiologic

imaging (computed tomography or magnetic resonance imaging), when available.

Main Outcome Measures: Primary outcome is demonstrated maintenance of a PA outflow drainage pathway after the surgical drainage procedure as assessed by radiologic imaging, available histopathology, and/or recurrence of symptoms indicating failure of maintenance. Other measures include need for revision surgery and histopathology findings.

Results: A majority (65%) of patients exhibited maintenance of their PA drainage pathway. Histopathologic evidence suggests that the PA drainage pathway can be maintained for many years after surgical drainage. Recurrence of symptoms was related to obstruction of the drainage pathway by fibrous tissue and/or granulomatous tissue. Placement of a stent improved the patient’s chance of remaining

symptom-free, with recurrence of symptoms and revision surgery required in only 2 stent cases (18%) as compared with 83% of those with no stent (p <= 0.035). Histopathologic evidence for the exposed marrow theory of PA cholesterol granulomas was found.

Conclusion: learn more The majority of patients

who undergo surgical drainage of PA cholesterol granulomas remain symptom-free after surgical drainage. Histopathologic analysis of temporal bone specimens provides evidence supporting the exposed marrow theory of PA cholesterol granuloma formation. Loss of patency of the PA drainage pathway may be an important predictor for symptomatic recurrence of PA cholesterol granulomas. Placement of a ABT737 stent may decrease the likelihood of symptomatic recurrence.”
“Objective: “”Helping Babies Breathe”" (HBB) is a simulation-based one-day course developed to help reduce neonatal mortality globally. The study objectives were to (1) determine the effect on practical skills and management strategies among providers using simulations seven months after HBB training, and (2) describe neonatal management in the delivery room during the corresponding time period before/after a one-day HBB training in a rural Tanzanian hospital.

Methods: The one-day HBB training was conducted by Tanzanian master instructors in April 2010. Two simulation scenarios; “”routine care”" and “”neonatal resuscitation”" were performed by 39 providers before (September 2009) and 27 providers after (November 2010) the HBB training.