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Self-hybridizing structures based on transition metal dichalcogenides (TMDCs) are becoming promising candidates for the study of an intrinsic strong light-matter coupling because of the efficient mode overlap with much simplified geometries. However, realizing flexible tuning of intrinsic strong coupling in such TMDC-based structures is still challenging. Here, we propose a strategy for flexible tuning of the intrinsic strong light-matter coupling based on a bulk TMDC material. We report the first demonstration of the strong coupling of intrinsic excitons to whispering gallery modes (WGMs) supported by an all-TMDC nanocavity. Importantly, by simply controlling angles of incidence, a selective excitation of WGMs and an anapole can be realized, which enables a direct modulation of self-hybridized interactions from a bright WGM-exciton coupling to a dark anapole-exciton coupling. Our work is expected to provide unique opportunities for engineering a strong light-matter coupling and to open exciting avenues for highly integrated novel nanophotonic devices.
RESUMEN
OBJECTIVES: The primary focus of this research is the proposition of a methodological framework for the clinical application of the long COVID symptoms and severity score (LC-SSS). This tool is not just a self-reported assessment instrument developed and validated but serves as a standardized, quantifiable means to monitor the diverse and persistent symptoms frequently observed in individuals with long COVID. METHODS: A 3-stage process was used to develop, validate, and establish scoring standards for the LC-SSS. Validation measures included correlations with other patient-reported measures, confirmatory factor analysis, Cronbach's α for internal consistency, and test-retest reliability. Scoring standards were determined using K-means clustering, with comparative assessments made against hierarchical clustering and the Gaussian Mixture Model. RESULTS: The LC-SSS showed correlations with EuroQol 5-Dimension 5-Level (rs = -0.55), EuroQol visual analog scale (rs = -0.368), Patient Health Questionnaire-9 (rs = 0.538), Beck Anxiety Inventory (rs = 0.689), and Insomnia Severity Index (rs = 0.516), confirming its construct validity. Structural validity was good with a comparative fit index of 0.969, with Cronbach's α of 0.93 indicating excellent internal consistency. Test-retest reliability was also satisfactory (intraclass correlation coefficient 0.732). K-means clustering identified 3 distinct severity categories in individuals living with long COVID, providing a basis for personalized treatment strategies. CONCLUSIONS: The LC-SSS provides a robust and valid tool for assessing long COVID. The severity categories established via K-means clustering demonstrate significant variation in symptom severity, informing personalized treatment and improving care quality for patients with long COVID.
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COVID-19 , Índice de Severidad de la Enfermedad , Humanos , COVID-19/diagnóstico , Reproducibilidad de los Resultados , Femenino , Psicometría , Masculino , Persona de Mediana Edad , Síndrome Post Agudo de COVID-19 , Encuestas y Cuestionarios , SARS-CoV-2 , Adulto , Calidad de Vida , Autoinforme , Anciano , Análisis FactorialRESUMEN
OBJECTIVES: To investigate the perivascular fat attenuation index (FAI) in association with epicardial adipose tissue (EAT) parameters and its distribution over the entire coronary vasculature in patients with known or suspected coronary artery disease (CAD). METHODS: Patients with known or suspected CAD who underwent coronary computed tomography angiography from January 1, 2019, to June 1, 2019, were retrospectively included. The perivascular FAI was quantified on four main epicardial coronary arteries and seven coronary segments. Moreover, EAT density and volume were measured. RESULTS: We included 192 consecutive patients (55 without coronary plaque [mean age 46.4 ± 13.2 years, 69.1% male] and 137 with coronary plaque [mean age 57.9 ± 13.0 years, 84.7% male]). EAT density was lower than perivascular FAI in both groups, but they exhibited substantial correlation (- 83.33 ± 4.54 vs. - 78.22 ± 6.52 HU, p < 0.001; r = 0.667 in plaque- patients and - 83.11 ± 4.48 vs. - 77.81 ± 5.63 HU, p < 0.001; r = 0.778 in plaque+ patients). The left main coronary artery had the highest perivascular FAI, followed by the left circumflex artery. The perivascular FAI in proximal segments was significantly higher compared to that in distal segments (all p < 0.05). Furthermore, the presence of plaque did not alter perivascular FAI on the patient or segmental level. CONCLUSION: The perivascular FAI was significantly higher than EAT density and correlated substantially with EAT density. The perivascular FAI distribution over the entire coronary tree varied and prompted for vessel-specific or segment-specific thresholds to determine abnormal perivascular FAI in practice. KEY POINTS: ⢠The perivascular FAI correlated well with EAT density and had higher values than EAT density. ⢠The distributions of perivascular FAI differ between coronary vessels or segments; considering segment and vessel confounding factors while conducting a perivascular FAI study is necessary. ⢠No significant difference of perivascular FAI was observed between patients without and with coronary plaque, nor between coronary segments without plaque and those with plaque.
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Enfermedad de la Arteria Coronaria , Placa Aterosclerótica , Tejido Adiposo/diagnóstico por imagen , Adulto , Anciano , Angiografía por Tomografía Computarizada/métodos , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Vasos Coronarios/diagnóstico por imagen , Humanos , Persona de Mediana Edad , Pericardio/diagnóstico por imagen , Placa Aterosclerótica/complicaciones , Estudios RetrospectivosRESUMEN
OBJECTIVES: This study aimed to evaluate coronary inflammation by measuring the perivascular fat attenuation index (FAI) and quantify the atherosclerosis burden in patients with psoriasis and control individuals without psoriasis based on coronary computed tomography angiography (CCTA) images. METHODS: A total of 98 consecutive patients with psoriasis (76 male [77.6%], aged 56.5 years, range 45.5-65.0) were recruited, and 196 patients (157 male [80.1%]; aged 54.6 ± 14.1 years) without established cardiovascular disease (CVD) who underwent CCTA within the same period were enrolled in the control group. Coronary plaque burden was quantified using the computed tomography-adapted Leaman score (CT-LeSc), and the FAI surrounding the proximal of three main epicardial vessels was measured to represent coronary inflammation. RESULTS: Patients with psoriasis and the control subjects were well matched in CVD risk factors (all p > 0.05). Psoriasis patients had a greater overall CT-LeSc (5.86 vs. 4.69, p = 0.030) and lower perivascular FAI (-80.19 ± 7.48 vs. -78.14 ± 7.81 HU, p < 0.001). A similar result was found upon comparing psoriasis patients without biological or statin therapy with non-psoriasis individuals without statin treatments. Furthermore, the psoriasis group had a higher prevalence of non-calcified plaques (30.3% in the psoriasis group vs. 20.1% in the control subjects, p = 0.001). No difference in perivascular FAI on either calcified and mixed plaques or non-calcified plaques between the two groups was found. CONCLUSION: Patients with psoriasis have a higher atherosclerotic burden as quantified by CT-LeSc and less coronary inflammation as detected by perivascular FAI around the most proximal of the three major epicardial vessels. The usefulness of perivascular FAI for evaluating coronary inflammation in patients with chronic low-grade inflammatory disease such as psoriasis should be verified.
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Enfermedad de la Arteria Coronaria , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Placa Aterosclerótica , Psoriasis , Tejido Adiposo/diagnóstico por imagen , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Femenino , Humanos , Inflamación/diagnóstico por imagen , Masculino , Valor Predictivo de las Pruebas , Puntaje de Propensión , Psoriasis/complicaciones , Psoriasis/diagnóstico por imagenRESUMEN
To assess the association between epicardial adipose tissue (EAT) index derived from cardiac computed tomography and atrial fibrillation (AF) recurrence after ablation by comparing with a propensity score matched non-recurrence AF patients. A total of 506 patients with AF recurrence and 174 patients without AF recurrence were enrolled in this retrospective study. Density and volume of total EAT surrounding the heart (Total-EAT) and EAT surrounding the left atrium (LA-EAT) were measured, propensity score matching(PSM) analyses were used to compare the outcomes of the two groups while controlling for confounders. Total-EAT density (HU) value (-81.27 ± 4.67 vs -84.05 ± 3.84, P < 0.001) and LA-EAT density (HU) value (-76.16 ± 4.11 vs -78.83 ± 3.81, P < 0.001) were significantly higher in the patients with AF recurrence than in those without recurrence. LA-EAT density (HU) value was significantly higher than Total-EAT (- 77.50 ± 4.18 vs -82.66 ± 4.49, P = 0.000). In a multiple logistic regression analysis, a higher LA-EAT density (odds ratio: 1.12; 95% CI: 1.02-1.22, p = 0.015) was significantly associated with the AF recurrence after adjusting for other risk factors. The LA-EAT density plays an important role in the AF recurrence after ablation. Assessment of LA-EAT density can improve ablation outcomes by refining patient selection.