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Geometric effects can play a pivotal role in streamlining quantum manipulation. We demonstrate a geometric diabatic control, that is, perfect tunneling between spin states in a diamond by a quadratic sweep of a driving field. The field sweep speed for the perfect tunneling is determined by the geometric amplitude factor and can be tuned arbitrarily. Our results are obtained by testing a quadratic version of Berry's twisted Landau-Zener model. This geometric tuning is robust over a wide parameter range. Our work provides a basis for quantum control in various systems, including condensed matter physics, quantum computation, and nuclear magnetic resonance.

Balloon pulmonary angioplasty (BPA) is a robust treatment and has been performed among patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). A lung perfusion scan (LPS) is required for inspection in deciding the curative effect judgment and treatment lesion of BPA. Nevertheless, the impact of BPA in the improvement of right heart system function is not well known. We investigated whether BPA improves right heart function alongside other parameters.We studied 20 patients with CTEPH (mean age 63.6 ± 15.9 years, male 30.0%) who underwent BPA. All study sets including right heart catheter, pulmonary angiography, 6-minute walk test (6MWT), blood gas analysis, and LPS were performed before BPA treatment. All parameters using right heart catheter and oxygenation level were measured at room air temperature. Regarding LPS, right ventricular ejection fraction (RVEF) was calculated using the first-pass method. These parameters before BPA were compared with those after BPA.In total, 120 BPAs were performed (mean number of procedures/patient; 6.0 ± 2.4 sessions). Per BPA session, 6.0 ± 2.4 areas and 10.0 ± 4.3 lesions were treated with a volume of 181.3 ± 53.5 mL of contrast media. No complication required an invasive procedure. World Health Organization functional class, 6MWT, pulmonary artery pressure, pulmonary vascular resistance, and oxygenation level were significantly improved after BPA. RVEF via LPS was also significantly improved after BPA (45.0 ± 6.2% to 50.6 ± 2.9%, P0.001).In the present study, we found that RVEF via LPS was improved through appropriate BPA alongside the other parameters. It would be useful to be able to evaluate right heart function.

Dynamical conductivity contains information of dissipative and nondissipative processes induced by ac-electric fields. In the integer quantum Hall (QH) effect where the nondissipative Hall current is the most prominent feature, its robustness is assured by localized states within the Landau levels. We establish a noncontact method with a circular cavity resonator and detect the real and imaginary parts of the longitudinal and Hall conductivities at a microwave frequency in magnetic fields. The conventional Shubnikov-de Haas oscillations and QH plateaus are observed in the real parts of longitudinal and Hall conductivities, respectively, while periodic structures can be seen in the imaginary parts which are scaled by the QH filling factor. The latter originates from intra-Landau level transitions between different orbital angular momenta. The results demonstrate that the dynamical conductivity measurement provides microscopic information which is not accessible by conventional static methods. The present noncontact method would pave the way to reveal the electron dynamics in other two-dimensional systems such as twisted bilayer graphene.

Background Elderly patients with heart failure (HF) have been observed to decrease activities of daily living (ADL) during hospitalization. Prevention of ADL decline from shortening of hospital stays is especially important in the elderly, because decreasing ADL is associated with poor prognosis. We investigated the relationship between the early initiation of tolvaptan (TLV) after hospitalization and the length of hospital stay in patients with HF aged younger than 80 years and aged 80 years and older. Methods We analyzed 146 patients younger than 80 years ( Results A significant correlation was observed between time to TLV initiation and the length of hospital stay (P P P P Conclusions The early initiation of TLV after hospitalization was associated with a shorter length of hospital stay in patients with HF regardless of age.

The sudden increase in blood pressure by vascular dysfunction is associated with the development of acute decompensated heart failure (ADHF) categorized in clinical scenario (CS) 1. However, the relationship between vascular function and prognosis in ADHF patients with CS1 is unclear. 3239 consecutive ADHF patients between January 2012 and June 2018 were enrolled. ADHF patients with CS1 undergoing ankle brachial index/cardio-ankle vascular index (CAVI) were included and patients with peripheral artery disease were excluded. Finally, 113 patients were analyzed. The primary endpoint of the present study was composite endpoint at 1 year (the cardiac death or re-hospitalization by ADHF). Cox proportional hazard analysis was conducted to identify independent predictors of composite endpoint. 25 patients (22.1%) were developed composite endpoint. CAVI in patients who have composite endpoint were significantly higher than without non-composite endpoint (composite endpoint group: 9.9 ± 1.3 non-composite endpoint group 8.7 ± 1.7, P = 0.001). The composite endpoint group was elderly and had higher ejection fraction, lower hemoglobin, and less used beta blockers, and renin angiotensin aldosterone system inhibitors. After adjustment by these confounding factors, CAVI was independently associated with the occurrence of composite endpoint (hazard ratio 1.69, 95% CI 1.05-2.73, P = 0.032). A cut-off value of CAVI for predicting composite endpoint was 8.65 (sensitivity 0.444, specificity 0.920, area under the curve 0.724, 95% CI 0.614-0.834). High CAVI was associated with the occurrence of composite endpoint after CS1 ADHF.

β blockers (BBs) play an important role in heart failure (HF) treatment. However, orthostatic hypotension (OH) is sometimes caused by BBs. The bisoprolol transdermal patch works more slowly and is long acting compared with the bisoprolol fumarate tablet. The risk of OH may be reduced by using the bisoprolol transdermal patch. We evaluated 57 consecutive patients who were taking the bisoprolol fumarate tablet for chronic HF with hypertension from November 2016 to September 2017. We switched the patients to the bisoprolol transdermal patch. Because 12 of 57 subjects could not continue using the bisoprolol transdermal patch, we analyzed the remaining 45 patients. We investigated BP, blood tests, and changes in BP from supine to standing positions before and after 6 months of switching from tablet to patch. OH was diagnosed by observing a systolic/diastolic BP drop of at least 20/10 mmHg or an absolute systolic BP (sBP) of

Farmland has various beneficial functions, such as flood control, water purification, and habitat provision, in addition to food production. These functions are highly compatible with green infrastructure, and the use of farmland as green infrastructure has been discussed in recent years. In order to utilize these functions of farmland, it is preferable to include their usefulness and utilization measures in administrative plans and link them to actual projects. In this research, we collected eight types of administrative plans from local governments across Japan that could be related to the multifunctionality of farmland and reviewed the extent to which they contain descriptions of the multifunctionality of farmland as basic information for promoting the utilization of the multifunctionality of farmland. As a result, we discovered that farmland’s multifunctionality was incorporated into the plans of many municipalities. Municipalities with a certain population size and a high financial strength index, in particular, tended to mention the multifunctional role of farmland in their plans more frequently. In addition, we found that some of the functions were mentioned less frequently in the plans. While descriptions of “conservation of natural environment” and “landscape/culture formation and recreation” were common in many plans, descriptions of “disaster mitigation and response” and “water and food supply” in times of disaster were less common. Finally, we drew some recommendations that can be used as a reference for future planning and project promotion, including dissemination of knowledge and information of farmland’s multifunctionality to government and citizens.

The paddy field is a typical ecosystem in monsoon Asia. The main purpose of a paddy field is food production (i.e., a provisioning ecosystem service), but it also has several other ecosystem services. Therefore, we can consider paddy fields as components of green infrastructure (GI) that are already widely distributed. To maintain and improve the value of paddy fields as GI, we should strive to maintain and improve other ecosystem services besides provisioning services. However, issues that reduce the value of paddy fields as GI remain, and these are related to the consolidation and abandonment of paddy fields in recent years. In this paper, we focus on two ecosystem services of paddy fields, other than the provisioning service: (1) the habitat service and (2) the regulating service. Both these services are relatively well-evaluated ecosystem services of paddy fields in Japan. We discuss the effects of both consolidation and abandonment on these ecosystem services as well as their corresponding countermeasures. Based on this, we also discuss the challenges in applying and expanding the idea of paddy fields as GI.

Background The aim of this study was to evaluate the effect of balloon pulmonary angioplasty (BPA) using lung perfusion single-photon emission computed tomography (SPECT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods and Results 20 consecutive patients (64 ± 15 years) who were diagnosed with CTEPH and underwent BPA were included in this study. All patients underwent lung perfusion SPECT before and after BPA. The relationship between functional %volume of the lung calculated from the lung perfusion SPECT (FVL-LPSPECT), and other clinical parameters before and after BPA was assessed using the Wilcoxon signed-rank test. The correlation between each parameter and mean pulmonary artery pressure (mPAP) using the Spearman’s correlation was performed. To determine predictors of mPAP for evaluating treatment effectiveness, significant parameters were included in multiple regression analysis. After BPA, world health organization functional classification, six-minute walk distance (6MWD), mPAP, and FVL-LPSPECT significantly improved. FVL-LPSPECT (r = − 0.728, P r = − 0.571, P = 0.009) were significant correlation of mPAP. In the multiple regression analysis, FVL-LPSPECT was the most significant predictor of improvement in mPAP after BPA (P Conclusions This study demonstrated that the lung perfusion SPECT could be a potential measurement of the effectiveness of BPA in patients with CTEPH.

We study the tunneling mechanism of nonlinear optical processes in solids induced by strong coherent laser fields. The theory is based on an extension of the Landau-Zener model with nonadiabatic geometric effects. In addition to the rectification effect known previously, we find two effects, namely perfect tunneling and counterdiabaticity at fast sweep speed. We apply this theory to the twisted Schwinger effect, i.e., nonadiabatic pair production of particles by rotating electric fields, and find a nonperturbative generation mechanism of the opto-valley polarization and photo-current in Dirac and Weyl fermions., Comment: 24 pages, Accepted by SciPost

Background In recent years, there has been growing interest in exploring ways to facilitate positive psychological dispositions, including resilience. The goal of the present study was to explore the possibility that trait mindfulness facilitates attachment security and thus enhances resilience. Methods We conducted two studies based on cross-sectional surveys. In Study 1, data of 207 students studying in Japan was collected. In Study 2, we used a different sample of 203 participants and different measurements to replicate the findings of Study 1. Results The results of Study 1 revealed that mindfulness positively predicted resilience, while attachment anxiety and avoidance were mediators between mindfulness and resilience. The results of Study 2 showed that mindfulness positively predicted resilience, and the mediating effect of attachment avoidance was significant, but the mediating effect of attachment anxiety was not significant. Conclusions It is possible to facilitate attachment security through cultivating trait mindfulness, and in this way, resilience could be enhanced. The effect of different components of mindfulness on attachment and resilience requires further studies.

Bipolar disorder is a severe mental illness characterized by recurrent manic and depressive episodes. To better understand its genetic architecture, we analyze ultra-rare de novo mutations in 354 trios with bipolar disorder. For germline de novo mutations, we find significant enrichment of loss-of-function mutations in constrained genes (corrected-P = 0.0410) and deleterious mutations in presynaptic active zone genes (FDR = 0.0415). An analysis integrating single-cell RNA-sequencing data identifies a subset of excitatory neurons preferentially expressing the genes hit by deleterious mutations, which are also characterized by high expression of developmental disorder genes. In the analysis of postzygotic mutations, we observe significant enrichment of deleterious ones in developmental disorder genes (P = 0.00135), including the SRCAP gene mutated in two unrelated probands. These data collectively indicate the contributions of both germline and postzygotic mutations to the risk of bipolar disorder, supporting the hypothesis that postzygotic mutations of developmental disorder genes may contribute to bipolar disorder., The significance of rare and de novo variants in bipolar disorder is not well understood. Here, the authors have analyzed whole exome/genome data from trios to identify deleterious de novo variants associated with bipolar disorder.

We study non-perturbatively the anomalous Hall current and its high harmonics generated in Weyl and Dirac semimetals by strong elliptically polarized laser fields, in the context of kinetic theory. We find a novel crossover between perturbative and non-perturbative regimes characterized by the electric field strength $\mathcal{E}^{*}= \frac{\mu \omega}{ 2 e v_F}$ ($\omega$: laser frequency, $\mu$: Fermi energy, $v_F$: Fermi velocity). In the perturbative regime, the anomalous Hall current quadratically depends on the field strength ($\mathcal{E}$), whereas the higher order corrections, as well as high harmonics, vanish at zero temperature. In the non-perturbative regime, the anomalous Hall current saturates and decays as $(\log{\mathcal{E}})/\mathcal{E}$, while even-order high harmonics are generated when inplane rotational symmetry is broken. Based on the analytical solution of the Boltzmann equation, we reveal the topological origin of the sharp crossover: the Weyl monopole stays inside or moves outside of the Fermi sphere, respectively, during its fictitious motion in the pertubative or non-pertubative regimes. Our findings establish a new non-linear response intrinsically connected to topology, characteristic to Weyl and Dirac semimetals., Comment: 6 pages, 4 figures

We propose a local detection scheme for the Majorana zero mode (MZM) carried by a vison in Kitaev's chiral spin liquid (CSL) using scanning tunneling microscopy (STM). The STM introduces a single Majorana into the system through hole-charge injection and the Majorana interacts with the MZM to form a stable composite object. We derive the exact analytical expression of single-hole Green's function in the Mott insulating limit of Kitaev's model, and show that the differential conductance has split peaks, as a consequence of resonant tunneling through the vison-hole composite. The peak splitting turns out comparable to the Majorana gap in CSL, well within the reach of experimental observation.

An intrinsically nonmagnetic spectroscopy is shown to have strong magnetic sensitivity in Kondo-coupled PdCrO2., A nearly free electron metal and a Mott insulating state can be thought of as opposite ends of the spectrum of possibilities for the motion of electrons in a solid. Understanding their interaction lies at the heart of the correlated electron problem. In the magnetic oxide metal PdCrO2, nearly free and Mott-localized electrons exist in alternating layers, forming natural heterostructures. Using angle-resolved photoemission spectroscopy, quantitatively supported by a strong coupling analysis, we show that the coupling between these layers leads to an “intertwined” excitation that is a convolution of the charge spectrum of the metallic layer and the spin susceptibility of the Mott layer. Our findings establish PdCrO2 as a model system in which to probe Kondo lattice physics and also open new routes to use the a priori nonmagnetic probe of photoemission to gain insights into the spin susceptibility of correlated electron materials.

Harmonic generation is a general characteristic of driven nonlinear systems, and serves as an efficient tool for investigating the fundamental principles that govern the ultrafast nonlinear dynamics. Here, we report on terahertz-field driven high-harmonic generation in the three-dimensional Dirac semimetal Cd3As2 at room temperature. Excited by linearly-polarized multi-cycle terahertz pulses, the third-, fifth-, and seventh-order harmonic generation is very efficient and detected via time-resolved spectroscopic techniques. The observed harmonic radiation is further studied as a function of pump-pulse fluence. Their fluence dependence is found to deviate evidently from the expected power-law dependence in the perturbative regime. The observed highly non-perturbative behavior is reproduced based on our analysis of the intraband kinetics of the terahertz-field driven nonequilibrium state using the Boltzmann transport theory. Our results indicate that the driven nonlinear kinetics of the Dirac electrons plays the central role for the observed highly nonlinear response., The mechanism and scaling of high harmonic generation in solids is a highly compelling ongoing area of research. Here the authors show a non-perturbative behavior of HHG in terahertz regime from 3D Dirac semimetal, Cd3As2, at room temperature, and reveal the underlying nonlinear kinetics.

Ipragliflozin is the first SGLT2 inhibitor approved in Japan. Reported here is a case where long-term administration of ipragliflozin decreased the rate of re-hospitalization due to heart failure (HF). An 83-year-old man with chronic HF and diabetes mellitus (DM) was hospitalized four times in the last five years. He was discharged six months after his last hospitalization, but he continued to have class III HF according to the New York Heart Association classification (NYHA), and his DM was also not properly managed. Therefore, he received ipragliflozin. One year after initiation of ipragliflozin, he lost weight (body weight (BW): 79.0 to 76.2 kg), his levels of brain natriuretic peptide (BNP) decreased (191.4 to 122.5 mg/dL), and the class of his HF improved (class III to class II). The management of DM also improved (fasting blood glucose: 100 to 110 mg/dL; hemoglobin A1C: 6.8 to 6.6%). In addition, cardiac sympathetic nerve function evaluated with 123I-metaiodobenzylguanidine cardiac-scintigraphy (123I-MIBG) also improved (the average of the heart-to-mediastinum ratio in early and delayed phases; 1.44 to 2.17 in the early phase, 1.41 to 1.92 in the delayed phase, washout rate; 43.3 to 35.6). The patient was not re-hospitalized due to HF two years after administration of ipragliflozin started. A reduction in cardiac sympathetic nerve hyperactivity by an SGLT2 inhibitor might be one of the mechanisms of its cardio-protective effect, but clinical studies need to be conducted to verify this finding.

Natural disturbances, which are important events that are inherent in any ecosystem, can cause disasters to human society. To address these, ecosystem-based disaster risk reduction (Eco-DRR) is investigated as a future infrastructure because of its lower cost of implementation and maintenance as well as its provision of different additional ecosystem services. Studies have proposed at least two types of Eco-DRR functions: inhibition, which reduces the potential occurrence of hazards, and mitigation, which reduces a hazard's damage in its aftermath. This study evaluated the latter type for paddy fields in the inland regions of central Japan. Using separate long-term statistical records of urban and agricultural inundated areas, we tested the relations between these areas and their land-use conditions. We predicted that paddy fields having a large area and that are low-lying are effective for flood mitigation. The results showed that local areas with paddy fields that potentially store large amounts of surface water, namely, latter pattern namely low-lying paddy fields, tend to reduce urban area inundation. Interestingly, the total paddy field area did not reduce inundation; nevertheless, the condition of the paddy field location is essential. This result suggests that such specifically located paddy fields could effectively lessen residential area inundation. This type of seminatural land-use could be used as a green infrastructure (GI) for Eco-DRR.

The effect of early use of tolvaptan (TLV) for acute decompensated heart failure (ADHF) is unclear. We investigated the relationship between early use of TLV and the length of hospital stay. 369 consecutive ADHF patients who received TLV during hospitalization between February 2011 and June 2016 were initially enrolled. Patients who died in hospital, transferred hospital or clinical scenario 4 or 5 were excluded. We analyzed 247 ADHF patients. We evaluated the relationship between the length of hospital stay and the following findings: blood pressures, heart rate, New York Heart Association classification, and blood tests on admission. Moreover, we also evaluated treated agents and TLV initiated days from admission. TLV initiated days was statistically associated with the length of hospital stay (r = 0.625, P < 0.001). We compared the early use (within 4 days) vs delayed use of TLV (5 days or later), because the median of time until commencement of TLV from hospitalization was 4 days. The length of hospital stay in the delayed use group was significantly longer than early use group (31.9 ± 20.4 and 21.0 ± 12.9 days, P < 0.001). However, there was no difference in the length of hospital stay after initiation of TLV in both groups. Moreover, we investigated the factors related to the long-term hospitalization (hospital stay of median length or more). Multivariate analysis showed that TLV initiated days was independently related to the long-term hospitalization (odds ratio 1.32, 95% confidence interval 1.13–1.53, P < 0.001). Early use of TLV was related to the length of hospital stay for ADHF patients.

The human herpes virus, Epstein-Barr virus (EBV), is a known oncogenic virus and plays important roles in life-threatening T/NK-cell lymphoproliferative disorders (T/NK-cell LPD) such as hypersensitivity to mosquito bite (HMB), chronic active EBV infection (CAEBV), and NK/T-cell lymphoma/leukemia. During the clinical courses of HMB and CAEBV, patients frequently develop malignant lymphomas and the diseases passively progress sequentially. In the present study, gene expression of CD16(-)CD56(+)-, EBV(+) HMB, CAEBV, NK-lymphoma, and NK-leukemia cell lines, which were established from patients, was analyzed using oligonucleotide microarrays and compared to that of CD56brightCD16dim/- NK cells from healthy donors. Principal components analysis showed that CAEBV and NK-lymphoma cells were relatively closely located, indicating that they had similar expression profiles. Unsupervised hierarchal clustering analyses of microarray data and gene ontology analysis revealed specific gene clusters and identified several candidate genes responsible for disease that can be used to discriminate each category of NK-LPD and NK-cell lymphoma/leukemia.

BACKGROUND No studies have compared treatment efficacy between subcutaneous (SC) fondaparinux and oral edoxaban, which are categorized as factor Xa inhibitors, for venous thromboembolism (VTE) in the acute phase, and only a limited number of imaging-based quantitative studies have evaluated treatment.Methods and Results:In this open-label, randomized study, 50 patients with acute non-massive pulmonary embolism (PE) and/or deep-vein thrombosis (DVT) were assigned to fondaparinux or edoxaban groups. Lower-limb venous ultrasonography (US), and chest computed tomography (CT) were compared before and 7 days after treatment. Thrombus volume in DVT was calculated using quantitative ultrasound thrombosis (QUT) score on US. For evaluation of PE thrombus volume, lung perfused blood volume (PBV) on CT was calculated. The measurements before and after treatment, respectively, were as follows: QUT score: fondaparinux, 8.1±7.3 to 4.1±4.5; edoxaban, 7.7±6.3 to 4.4±4.3, both significant decreases (P=0.001, P

Background: The most common cause of heart failure (HF) is ischemic heart disease (IHD). Evaluation of IHD with non-invasive examinations is useful for the treatment of HF, and cardio-ankle vascular index (CAVI) is a good parameter for detecting systemic arteriosclerosis. However, the relationship between IHD and CAVI in acute HF (AHF) patients is still unclear. Therefore, we investigated the effect of non-invasive examinations, including CAVI to detect IHD. Methods: We studied 53 consecutive patients (average age of 66.5 ± 10.9 years old, 36 males) with AHF from January 2009 to December 2012. These patients were classified into the IHD group (n = 19) and non-IHD group (n = 34) according to the coronary artery angiography results. We evaluated the vital signs, laboratory findings and CAVI. Results: According to the laboratory findings, the C-reactive protein (CRP) in IHD group was significantly higher than non-IHD group (1.5 ± 2.1 mg/dL vs. 0.4 ± 0.4 mg/dL, P = 0.002). CAVI in IHD group was significantly higher than non-IHD group (9.58 ± 1.73 vs. 7.83 ± 1.86, P < 0.001). In the receiver operating characteristic (ROC) curve for discriminating the probability of IHD, the cut-off point of the CRP plus CAVI was 9.00. At that cut-off point, the sensitivity and the specificity were 69.7% and 89.5%, respectively. The mean area under the ROC curve (AUC) defined by the CRP plus CAVI was the greatest at all parameters. Conclusion: The CRP and CAVI were useful parameters for the identification of IHD in patients with AHF. J Clin Med Res. 2017;9(5):439-445 doi: https://doi.org/10.14740/jocmr2994w

Land use change could affect not only local species richness but also community assemblies. Essentially, the possible patterns of plant community assemblies are nonrandom species loss (nestedness) and species turnover. Plant community assemblies in human-mediated land use have a combination of both nestedness and turnover. This is because of historical effects that cause nonrandom species loss due to previous and/or original habitat quality and because of direct effects of human activities that cause species turnover. We investigated the complexity of the process of plant community assemblage in a paddy field, which is a typical agricultural land use in the monsoon season in central Japan. Using multi-temporal plant monitoring records, we tested the relationship between the ratio of species nestedness/turnover through multi-temporal and both the original habitat conditions and the extent of human modification. The findings revealed that paddy fields that originated from wetland habitat had a high nestedness ratio, whereas paddy fields that were largely consolidated had a high turnover ratio. Thus, we could divide the community assembly processes in human-mediated land use based on original habitat conditions and human activities. This concept could help land managers establish conservation and/or restoration plans that take into account community assembly.

Objective: Elucidation of the role of angiotensin-converting enzyme (ACE) 2 (ACE2)/angiotensin (Ang)-(1-7)/Mas receptor axis in heart failure is necessary. No previous study has reported serial changes in ACE2 and Ang-(1-7) concentrations after optimal therapy (OT) in acute heart failure (AHF) patients. We aimed to investigate serial changes in serum ACE2 and Ang-(1-7) concentrations after OT in AHF patients with reduced ejection fraction (EF). Methods: ACE2 and Ang-(1-7) concentrations were measured in 68 AHF patients with reduced EF immediately after admission and 1 and 3 months after OT. These parameters were compared with the healthy individuals at three time points. Results: In the acute phase, Ang-(1-7) and ACE2 concentrations was statistically significantly lower and higher in AHF patients than the healthy individuals (2.40 ± 1.11 vs. 3.1 ± 1.1 ng/ml, P Conclusion: ACE2 concentration was equivalent between AHF patients and the healthy individuals at 1 and 3 months after OT, and Ang-(1-7) concentration was equivalent at 3 months after OT.

Nonlinear susceptibilities are key to ultrafast lightwave driven optoelectronics, allowing petahertz scaling manipulation of the signal. Recent experiments retrieved a 3rd order nonlinear susceptibility by comparing the nonlinear response induced by a strong laser field to a linear response induced by the otherwise identical weak field. The highly nonlinear nature of high harmonic generation (HHG) has the potential to extract even higher order nonlinear susceptibility terms. However, up till now, such characterization has been elusive due to a lack of direct correspondence between high harmonics and nonlinear susceptibilities. Here, we demonstrate a regime where such correspondence can be clearly made, extracting nonlinear susceptibilities (7th, 9th, and 11th) from sapphire of the same order as the measured high harmonics. The extracted high order susceptibilities show angular-resolved periodicities arising from variation in the band structure with crystal orientation. Our results open a door to multi-channel signal processing, controlled by laser polarization., Characterizing higher order nonlinearities and responses to optical excitations in materials is challenging. Here, the authors use high harmonic generation in sapphire crystals to extract higher order susceptibilities and characterize the nonlinear electronic response directly from experimental measurements.

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Phosphodiesterase-3 (PDE3) inhibitors are widely used among patients with congestive heart failure (CHF). However, no studies have compared the cardiovascular outcomes between different PDE3 inhibitors in CHF management. In this report, we retrospectively compared the clinical benefits of two PDE3 inhibitors, milrinone and olprinone, to determine which better controls the progression of CHF. A total of 288 hospitalized patients who received PDE3 inhibitors [(milrinone; n = 77 and olprinone; n = 211, respectively)] for CHF were retrospectively enrolled. The primary endpoint was defined as having a major adverse cardiovascular and cerebrovascular event (MACCE) or cardiac death by day 60. Kaplan–Meier curves and multivariate Cox proportional models were used to compare the outcomes for patients treated with milrinone and olprinone. We found no significant differences in the baseline characteristics between the two groups. In patients treated with milrinone, a greater incidence of a MACCE or cardiac death was observed (log rank; P = 0.005 and P = 0.01, respectively). Milrinone-treated patients with ischemic heart disease and chronic kidney disease (CKD) at stage ≥ 4 presented with greater incidence of MACCE (log rank; P