Pseudomonas aeruginosa bloodstream infections in children and adolescents: risk factors associated with carbapenem resistance and mortality.

BACKGROUND: Pseudomonas aeruginosa bloodstream infections (PA-BSIs) are a serious disease and a therapeutic challenge due to increasing resistance to carbapenems. Our objectives were to describe the prevalence and risk factors associated with carbapenem resistance (CR) and mortality in children with PA-BSI. METHODS: A retrospective, multi-centre study was carried out, including patients aged <20 years with PA-BSI in four tertiary hospitals in Madrid (Spain) during 2010-2020. Risk factors for CR PA-BSIs and 30-day mortality were evaluated in a multi-variable logistic regression model. RESULTS: In total, 151 patients with PA-BSI were included, with a median age of 29 months (interquartile range: 3.5-87.1). Forty-five (29.8%) cases were CR, 9.9% multi-drug resistant and 6.6% extensively drug resistant. The prevalence of CR remained stable throughout the study period, with 26.7% (12/45) of CR mediated by VIM-type carbapenemase. Patients with BSIs produced by CR-PA were more likely to receive inappropriate empiric treatment (53.3% vs 5.7%, P<0.001) and to have been previously colonized by CR-PA (8.9% vs 0%, P=0.002) than BSIs caused by carbapenem-susceptible P. aeruginosa. CR was associated with carbapenem treatment in the previous month (adjusted odds ratio (aOR) 11.15) and solid organ transplantation (aOR 7.64). The 30-day mortality was 23.2%, which was associated with mechanical ventilation (aOR 4.24), sepsis (aOR 5.72), inappropriate empiric antibiotic therapy (aOR 5.86), and source control as a protective factor (aOR 0.16). CONCLUSION: This study shows a concerning prevalence of CR in children with PA-BSIs, leading to high mortality. Inappropriate empiric treatment and sepsis were associated with mortality. The high prevalence of CR with an increased risk of inappropriate empiric treatment should be closely monitored.

Motion-induced inertial effects and topological phase transitions in skyrmion transport.

When the skyrmion dynamics beyond the particle-like description is considered, this topological structure can deform due to a self-induced field. In this work, we perform Monte Carlo simulations to characterize the skyrmion deformation during its steady movement. In the low-velocity regime, the deformation in the skyrmion shape is quantified by an effective inertial mass, which is related to the dissipative force. When skyrmions move faster, the large self-induced deformation triggers topological transitions. These transitions are characterized by the proliferation of skyrmions and a different total topological charge, which is obtained as a function of the skyrmion velocity. Our findings provide an alternative way to describe the dynamics of a skyrmion that accounts for the deformations of its structure. Furthermore, such motion-induced topological phase transitions make it possible to control the number of ferromagnetic skyrmions through velocity effects.

Scattering modes of skyrmions in a bilayer system with ferromagnetic coupling.

Magnetic skyrmions are quasiparticle-like textures that are topologically different from a single domain magnetization state. Their topological protection, combined with the low current density needed to move them, make these objects relevant to be used as information storage structures. In such a context, the analysis of the interactions between skyrmions is interesting and relevant for future applications. In this work, through micromagnetic simulations and numerical calculations, we studied the interaction between two skyrmions living on different parallel ferromagnetic racetracks connected by an exchange-like interaction. The upper and lower racetracks are separated by a height offset and the interaction between the upper and the lower skyrmion is analyzed in terms of the magnetic and geometrical parameters. Three states are predicted, as a function of these parameters: scattered or free skyrmions, bound skymions, and annihilated skyrmions. Our results, presented in a phase diagram, demonstrate that even in the case here called free skyrmions, there is a small and brief interaction when both are close enough, but the skyrmion in the top layer does not drag the skyrmion in the bottom layer. For bound skyrmions, both keep linked during larger times. In the latter case, there are strong changes in the velocity of the skyrmions induced by the effect of a higher effective mass when both are coupled.

Ultrafast domain wall propagation due to the interfacial Dzyaloshinskii-Moriya interaction.

It is shown that the interplay between curvature and interfacial Dzyalonshinsky-Moriya interaction (DMI) is a pathway to ultrafast domain wall (DW) dynamics in ferromagnetic nanotubes. In this work, we theoretically study the effect that interfacial DMI has on the average velocity of a vortex DW in thin ferromagnetic nanotubes grown around a core composed of heavy atoms. Our main result shows that by delaying the Walker breakdown instability, the DW average velocity is of the order of 103 m s-1, which is greater than usual values for these systems. The remarkable velocities achieved through this configuration could greatly benefit the development of spintronic devices.

Spin-Wave Amplification and Lasing Driven by Inhomogeneous Spin-Transfer Torques.

We show that an inhomogeneity in the spin-transfer torques in a metallic ferromagnet under suitable conditions strongly amplifies incoming spin waves. Moreover, at nonzero temperatures the incoming thermally occupied spin waves will be amplified such that the region with inhomogeneous spin-transfer torques emits spin waves spontaneously, thus constituting a spin-wave laser. We determine the spin-wave scattering amplitudes for a simplified model and setup, and show under which conditions the amplification and lasing occurs. Our results are interpreted in terms of a so-called black-hole laser, and could facilitate the field of magnonics, which aims to utilize spin waves in logic and data-processing devices.

Domain wall manipulation in magnetic nanotubes induced by electric current pulses.

We propose that the injection of electric currents can be used to independently manipulate the position and chirality of vortex-like domain walls in metallic ferromagnetic nanotubes. We support this proposal upon theoretical and numerical assessment of the magnetization dynamics driven by such currents. We show that proper interplay between the tube geometry, magnitude of the electric current and the duration of a current pulse, can be used to manipulate the position, velocity and chirality of a vortex domain wall. Our calculations suggest that domain wall velocities greater than 1 km s(-1) can be achieved for tube diameters of the order of 30 nm and increasing with it. We also find that the transition from steady to precessional domain wall motion occurs for very high electric current densities, of the order of 10(13) A m(-2). Furthermore, the great stability displayed by such chiral magnetic configurations, and the reduced Ohmic loses provided by the current pulses, lead to highly reproducible and efficient domain wall reversal mechanisms.

Changing exchange bias in spin valves with an electric current.

We show that a high-density electric current, injected from a point contact into an exchange-biased spin valve, systematically changes the exchange bias. The bias can either increase or decrease depending upon the current direction. This observation is not readily explained by the well-known spin-transfer torque effect in ferromagnetic metal circuits, but could be evidence for the recently predicted current-induced torques in antiferromagnetic metals.

Thermally assisted current-driven domain-wall motion.

Starting from the stochastic Landau-Lifschitz-Gilbert equation, we derive Langevin equations that describe the nonzero-temperature dynamics of a rigid domain wall. We derive an expression for the average drift velocity of the domain wall r(dw) as a function of the applied current, and find qualitative agreement with recent magnetic semiconductor experiments. Our model implies that at any nonzero-temperature r(dw) initially varies linearly with current, even in the absence of nonadiabatic spin torques.

2D bands and electron-phonon interactions in polyacene plastic transistors.

We present a simple tight-binding model for the two-dimensional energy bands of polyacene field-effect transistors and for the coupling of these bands to lattice vibrations of their host molecular crystal. We argue that the strongest electron-phonon interactions in these systems originate from the dependence of intermolecule hopping amplitudes on collective molecular motion, and introduce a generalized Su-Schrieffer-Heeger model and is parameter-free once the band mass has been specified. We compute alpha(2)F(omega) as a function of two-dimensional hole density, and are able to explain the onset of superconductivity near 2D carrier density n(2D) approximately 10(14) cm(-2), observed in recent experiments.