Implementation of a clinical guideline to decrease laboratory tests in newborns evaluated for early onset sepsis.

BACKGROUND: Creation of a clinical guideline to reduce the number of complete blood counts (CBCs) obtained on healthy term infants for early onset sepsis (EOS) evaluation secondary to maternal chorioamnionitis. METHODS: A clinical guideline was introduced at four neonatal intensive care units (NICU) to reduce laboratory tests during EOS evaluation. Measures include frequency and timing of CBCs, culture negative sepsis, length of stay, and readmission rate. RESULTS: Mean number of CBCs per patient significantly decreased (2.31±0.62 versus 1.52±0.65) without increasing trends for patients with culture negative sepsis, length of stay, or re-admission. CONCLUSION: The clinical guideline demonstrated a significant reduction in the number of CBCs obtained in well-appearing infants admitted to the NICU secondary to maternal chorioamnionitis.

Human milk macronutrient analysis using point-of-care near-infrared spectrophotometry.

OBJECTIVE: To demonstrate that the real-time nutritional analysis of human milk carbohydrate, fat and protein with near-infrared (NIR) spectrophotometric methods is accurate. STUDY DESIGN: A prospective study of the measurement of the macronutrient content of human milk. Milk was first analyzed on the SpectraStar 2400 Near Infrared Analyzer (Unity Scientific, Columbia, MD, USA), and then sent for primary chemical analysis for fat, protein and carbohydrate. Forty-two samples were used to create a calibration file. Ten samples were then used to validate the machine. RESULT: After logistic regression analysis, the validation set had a correlation (r (2)) of 0.91 for carbohydrates, 0.95 for fat and 0.95 for protein. CONCLUSION: This study demonstrates the feasibility of the use of NIR for nutrient analysis of human milk. NIR offers the potential for analysis and adjustable fortification of human milk to optimize nutrient intake for the high-risk neonate.

Perceived depth of 3-D objects in 3-D scenes.

Effects of information specifying the position of an object in a 3-D scene were investigated in two experiments with twelve observers. To separate the effects of the change in scene position from the changes in the projection that occur with increased distance from the observer, the same projections were produced by simulating (a) a constant object at different scene positions and (b) different objects at the same scene position. The simulated scene consisted of a ground plane, a ceiling plane, and a cylinder on a pole attached to both planes. Motion-parallax scenes were studied in one experiment; texture-gradient scenes were studied in the other. Observers adjusted a line to match the perceived internal depth of the cylinder. Judged depth for objects matched in simulated size decreased as simulated distance from the observer increased. Judged depth decreased at a faster rate for the same projections shown at a constant scene position. Adding object-centered depth information (object rotation) increased judged depth for the motion-parallax displays. These results demonstrate that the judged internal depth of an object is reduced by the change in projection that occurs with increased distance, but this effect is diminished if information for change in scene position accompanies the change in projection.