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1.
Sci Rep ; 13(1): 3867, 2023 03 08.
Artículo en Inglés | MEDLINE | ID: mdl-36890192

RESUMEN

Central line-related bloodstream infection (CRBSI) is a common complication during hospital admissions; however, there is insufficient data regarding CRBSI in the emergency department. Therefore, we evaluated the incidence and clinical impact of CRBSI using a single-center retrospective study to analyze medical data of 2189 adult patients (median age: 65 years, 58.8% males) who underwent central line insertion in ED from 2013 to 2015. CRBSI was defined if the same pathogens were identified at peripheral and catheter tips or the differential time to positivity was > 2 h. CRBSI-related in-hospital mortality and risk factors were evaluated. CRBSI occurred in 80 patients (3.7%), of which 51 survived and 29 died; those with CRBSI had higher incidence of subclavian vein insertion and retry rates. Staphylococcus epidermidis was the most common pathogen, followed by Staphylococcus aureus, Enterococcus faecium, and Escherichia coli. Using multivariate analysis, we found that CRBSI development was an independent risk factor for in-hospital mortality (adjusted odds ratio: 1.93, 95% confidence intervals: 1.19-3.14, p < 0.01). Our findings suggest that CRBSI after central line insertion in the emergency department is common and associated with poor outcomes. Infection prevention and management measures to reduce CRBSI incidence are essential to improve clinical outcomes.


Asunto(s)
Bacteriemia , Infecciones Relacionadas con Catéteres , Cateterismo Venoso Central , Sepsis , Masculino , Adulto , Humanos , Anciano , Femenino , Estudios Retrospectivos , Incidencia , Cateterismo Venoso Central/efectos adversos , Servicio de Urgencia en Hospital , Sepsis/complicaciones , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/etiología , Bacteriemia/epidemiología , Bacteriemia/etiología
2.
Nanotechnology ; 34(15)2023 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-36649644

RESUMEN

Vertical channel thin film transistors (VTFTs) have been expected to be exploited as one of the promising three-dimensional devices demanding a higher integration density owing to their structural advantages such as small device footprints. However, the VTFTs have suffered from the back-channel effects induced by the pattering process of vertical sidewalls, which critically deteriorate the device reliability. Therefore, to reduce the detrimental back-channel effects has been one of the most urgent issues for enhancing the device performance of VTFTs. Here we show a novel strategy to introduce an In-Ga-Zn-O (IGZO) bilayer channel configuration, which was prepared by atomic-layer deposition (ALD), in terms of structural and electrical passivation against the back-channel effects. Two-dimensional electron gas was effectively employed for improving the operational reliability of the VTFTs by inducing strong confinement of conduction electrons at heterojunction interfaces. The IGZO bilayer channel structure was composed of 3 nm-thick In-rich prompt (In/Ga = 4.1) and 12 nm-thick prime (In/Ga = 0.7) layers. The VTFTs using bilayer IGZO channel showed high on/off ratio (4.8 × 109), low SS value (180 mV dec-1), and high current drivability (13.6µAµm-1). Interestingly, the strategic employment of bilayer channel configurations has secured excellent device operational stability representing the immunity against the bias-dependent hysteretic drain current and the threshold voltage instability of the fabricated VTFTs. Moreover, the threshold voltage shifts of the VTFTs could be suppressed from +5.3 to +2.6 V under a gate bias stress of +3 MV cm-1for 104s at 60 °C, when the single layer channel was replaced with the bilayer channel. As a result, ALD IGZO bilayer configuration could be suggested as a useful strategy to improve the device characteristics and operational reliability of VTFTs.

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