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To identify risk factors for mortality in intensive care units (ICUs) in Asia.
Prospective cohort study.
The study included 317 ICUs of 96 hospitals in 44 cities in 9 countries of Asia: China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam.
Patients aged >18 years admitted to ICUs.
In total, 157,667 patients were followed during 957,517 patient days, and 8,157 HAIs occurred. In multiple logistic regression, the following variables were associated with an increased mortality risk: central-line–associated bloodstream infection (CLABSI; aOR, 2.36; P < .0001), ventilator-associated event (VAE; aOR, 1.51; P < .0001), catheter-associated urinary tract infection (CAUTI; aOR, 1.04; P < .0001), and female sex (aOR, 1.06; P < .0001). Older age increased mortality risk by 1% per year (aOR, 1.01; P < .0001). Length of stay (LOS) increased mortality risk by 1% per bed day (aOR, 1.01; P < .0001). Central-line days increased mortality risk by 2% per central-line day (aOR, 1.02; P < .0001). Urinary catheter days increased mortality risk by 4% per urinary catheter day (aOR, 1.04; P < .0001). The highest mortality risks were associated with mechanical ventilation utilization ratio (aOR, 12.48; P < .0001), upper middle-income country (aOR, 1.09; P = .033), surgical hospitalization (aOR, 2.17; P < .0001), pediatric oncology ICU (aOR, 9.90; P < .0001), and adult oncology ICU (aOR, 4.52; P < .0001). Patients at university hospitals had the lowest mortality risk (aOR, 0.61; P < .0001).
Some variables associated with an increased mortality risk are unlikely to change, such as age, sex, national economy, hospitalization type, and ICU type. Some other variables can be modified, such as LOS, central-line use, urinary catheter use, and mechanical ventilation as well as and acquisition of CLABSI, VAE, or CAUTI. To reduce mortality risk, we shall focus on strategies to reduce LOS; strategies to reduce central-line, urinary catheter, and mechanical ventilation use; and HAI prevention recommendations.
Replacement of poly-Si and SiO2 with new gate electrode and high k gate oxide is an inevitable trend for next-generation CMOS integrated circuits. Therefore, work function (£Xm) of gate electrodes as well as the thermal stability and electrical behaviors of MOS capacitors should be understood. In this study, tungsten (W) is applied as the gate electrode and the gate dielectric materials are SiO2, SiON and HfO2. £Xm of W and electrical properties of the MOS structures are investigated. £Xm,measured of W is calculated from the flat-band voltage (VFB) of MOS capacitors with dielectrics of various thicknesse. For W/SiO2/Si structure, the £Xm,measured of W is 4.67 V; however, the £Xm,measured of W in W/SiON/Si and W/HfO2/Si structures is 4.60 V and 4.84 V, respectively. The result means that the £Xm,measured of W in W/HfO2/Si structures has extrinsic contributions to Fermi level pinning. The phase of as-deposited W is £]-W (or £]-W+£\-W) phase and transfers to £\-W+WO3 mix phase after annealing at 500°C in N2+H2 ambient for 30 min. The trapped charges and oxide charges of dielectric are reduced after annealing. However, the EOT of W/SiO2/Si increases significantly after annealing, indicating the thermal stability of this capacitor is poor.
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