Precision comparison of intensity ratios and area ratios in spectral analysis.

The long-debated question in analytical chemistry of which of the area ratio or the intensity ratio is the more precise has yielded no definitive analytical conclusion. To address this issue theoretically, we derived analytical solutions for the lower limits of estimation precision for spectral parameters, including the intensity ratio and area ratio, based on the Cramér-Rao lower bound (CRLB) framework for a Gaussian spectrum. The precisions of spectral parameter estimations from the analytical solutions were consistent with results obtained from Monte Carlo simulations. Our theoretical and simulation results revealed that the precision of estimating the area ratio surpassed that of the intensity ratio by a factor of 2 . Additionally, our experimental results aligned well with both theoretical predictions and simulation outcomes, further validating our approach. This increased precision of the area ratio is due to negative covariance between intensity and bandwidth, rather than the area containing more intensity information, as often misinterpreted. Consequently, and quite counter intuitively, prior bandwidth and intensity related information does not improve the area ratio precision: it worsens it. The analytical solution we derived represents the fundamental limits of spectral parameter measurement precision. Thus, it can be used as an alternative method for estimating the minimum error when experimental measurement uncertainty cannot be determined.

An Improved Unfolded Coprime Linear Array Design for DOA Estimation with No Phase Ambiguity.

In this paper, the direction of arrival (DOA) estimation problem for the unfolded coprime linear array (UCLA) is researched. Existing common stacking subarray-based methods for the coprime array are invalid in the case of its subarrays, which have the same steering vectors of source angles. To solve the phase ambiguity problem, we reconstruct an improved unfolded coprime linear array (IUCLA) by rearranging the reference element of the prototype UCLA. Specifically, we design the multiple coprime inter pairs by introducing the third coprime integer, which can be pairwise with the other two integers. Then, the phase ambiguity problem can be solved via the multiple coprime property. Furthermore, we employ a spectral peak searching method that can exploit the whole aperture and full DOFs of the IUCLA to detect targets and achieve angle estimation. Meanwhile, the proposed method avoids extra processing in eliminating ambiguous angles, and reduces the computational complexity. Finally, the Cramer-Rao bound (CRB) and numerical simulations are provided to demonstrate the effectiveness and superiority of the proposed method.

Aspergillus fumigatus antigen-reactive Th17 cells are enriched in bronchoalveolar lavage fluid in severe equine asthma.

Introduction: Equine asthma (EA) is a common disease of adult horses with chronic respiratory pathology and common neutrophilic airway inflammation. It presents with hyperreactivity to hay dust components such as molds, and underlying dysregulated T cell responses have been suggested. Thus far, T cells have been analysed in EA with conflicting results and the antigen reactivity of T cells has not been demonstrated. Serological and epidemiological data point to the relevance of Aspergillus fumigatus as an antigen source in EA. Here, we aimed to identify and characterise Aspergillus antigen-reactive T cells in EA. Methods: Cryopreserved bronchoalveolar lavage cells (BALC) and peripheral blood mononuclear cells (PBMC) from healthy horses (HE, n=9) and those with mild-moderate (MEA, n=3) or severe asthma (SEA, n=8) were stimulated in vitro with the recombinant A. fumigatus antigens Asp f 1, or Asp f 7 combined with Asp f 8, to assess antigen reactivity, and with phorbol-12-myristat-13-acetate and ionomycin (P/i) to assess overall T cell reactivity. Stimulated cells were analysed by flow cytometry for CD4, CD8, IL-17, IL-4, and IFN-γ. Cytokine expression in all lymphocytes, and in CD4+ or CD8+ T cells, was quantified and compared between the groups. In BAL fluid (BALF), soluble cytokines and chemokines were quantified by bead-based assays. Results: Antigen restimulation of BALC with Asp f 1 or Asp f 7/8 provoked higher frequencies of IL-17+ lymphocytes, CD4+IL-17+ Th17 cells, and CD4+IL-4+ Th2 cells in SEA than in HE, whereas MEA and HE were similar. Antigen stimulation of PBMC did not result in group differences. P/i stimulation of BALC resulted in increased IL-17+ lymphocyte and CD4+IL-17+ Th17 cell frequencies in MEA compared with HE but the limited number of horses with MEA must be considered. P/i-stimulated PBMC from MEA or SEA contained more IL-17+ lymphocytes compared with HE. Cytokines were hardly detected in BALF and similar between the groups but CCL2 and CCL5 concentrations were increased in BALF from SEA or MEA, respectively, compared with HE. Conclusion: Horses with SEA have increased Aspergillus antigen-reactive Th17 cells in their airways, emphasising local T cell responses to this mold, which were quantified in EA for the first time here.

The Potential of Phase Constraints for Non-Fourier Radiofrequency-Encoded MRI.

In modern magnetic resonance imaging, it is common to use phase constraints to reduce sampling requirements along Fourier-encoded spatial dimensions. In this work, we investigate whether phase constraints might also be beneficial to reduce sampling requirements along spatial dimensions that are measured using non-Fourier encoding techniques, with direct relevance to approaches that use tailored spatially-selective radiofrequency (RF) pulses to perform spatial encoding along the slice dimension in a 3D imaging experiment. In the first part of the paper, we use the Cramér-Rao lower bound to examine the potential estimation theoretic benefits of using phase constraints. The results suggest that phase constraints can be used to improve experimental efficiency and enable acceleration, but only if the RF encoding matrix is complex-valued and appropriately designed. In the second part of the paper, we use simulations of RF-encoded data to test the benefits of phase constraints combined with optimized RF-encodings, and find that the theoretical benefits are indeed borne out empirically. These results provide new insights into the potential benefits of phase constraints for RF-encoded data, and provide a solid theoretical foundation for future practical explorations.

Imaging Hypoxia to Predict Primary Neuronal Cell Damage in Branch Retinal Artery Occlusion.

PURPOSE: To develop a reliable method to generate a mouse model of branch retinal artery occlusion (BRAO) using laser-induced thrombosis of a major artery in the mouse retina. Also, to develop a reliable method to detect retinal hypoxia as predictive biomarker for the risk of neuronal cell damage in BRAO. METHODS: A reliable and reproducible model of laser-induced BRAO was developed in mouse retina using Rose Bengal. To characterize retinal hypoxia in BRAO, pimonidazole immunostaining and HYPOX-4 molecular imaging methods were used. Terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) was used to characterize neuronal cell damage in the BRAO retina. Expression of mRNA in retinal tissues from BRAO and age-matched control retinas were analyzed using qRT-PCR. RESULTS: Occlusion of a branch retinal artery near the optic nerve head (ONH) caused a pattern of retinal tissue hypoxia covering about 12.5% of the entire retina. TUNEL-positive cells were localized in all layers in BRAO retinal tissue cross sections. In addition, qRT-PCR data analysis suggests that BRAO is associated with both inflammation and hypoxia. CONCLUSIONS: This study provides a reliable method for BRAO in mouse retina and demonstrates the utility of molecular imaging method to detect retinal hypoxia as predictive biomarker for the risk of neuronal cell damage in BRAO. In addition, our data suggest that BRAO retinas are associated with inflammation and also associated with hypoxia-related neuronal cell damage. PERSPECTIVES: Imaging areas of retinal hypoxia may provide accurate diagnosis, evaluating retinal tissue injury from BRAO.

Sine π -power odd-G family of distributions with applications.

This paper investigates a novel category of probability distributions and a specific member within this category. We have formulated a new family of trigonometric distributions by utilizing the odds ratio derived from the distribution function of a base distribution. This newly devised distribution family termed the "Sine pie-power odd-G family" of distributions, is constructed through a transformation involving the sine function. The paper presents an overview of the fundamental characteristics inherent to this proposed distribution family. Using the Weibull distribution as a base reference, we have introduced a member belonging to the proposed distribution family. This member demonstrates various hazard functions such as j, reverse-j, increasing, decreasing, or bathtub shapes. The paper examines essential statistical attributes of this newly introduced distribution. The estimation of the distribution's parameters is carried out via the maximum likelihood estimation method. The accuracy of the parameter estimation procedure is validated through Monte Carlo simulations. The outcomes of these simulations reveal a reduction in biases and mean square errors as sample sizes increase, even for small samples. Two sets of real-engineering data are considered to demonstrate the proposed distribution's applicability. The performance of the suggested distribution is evaluated using some model selection criteria and goodness-of-fit test statistics. Empirical evidence from these evaluations substantiates that the proposed model outperforms six existing models.

Steep right anterior oblique view of self-expandable transcatheter aortic valve to timely detect stent under-expansion or non-uniform expansion before final release: a case series.

Background: Severely calcified aortic valves are a major limitation of transcatheter aortic valve replacement, because eccentric and heavy calcification of the aortic valve occasionally inhibits self-expansion of the valve frame, resulting in stent under-expansion, including non-uniform expansion or infolding. Nevertheless, the two-dimensional nature of fluoroscopic projection imaging can limit detection of stent under-expansion prior to the final release. Case summary: We present two cases demonstrating the importance of the steep right anterior oblique (RAO) view (>50°) in detecting significant stent under-expansion of a self-expanding valve prior to the final release. In Case 1, despite enough pre-dilatation, the partially deployed transcatheter heart valve (THV) appeared to be a substantial under-expansion, which was detected only in steep RAO view. Immediately after the final release, the THV was spontaneously embolized into the ascending aorta (the so-called 'pop-up' phenomenon). Emergent implantation of balloon-expandable valve proved to be successful as a bailout. In Case 2, significant stent distortion and infolding, especially on the non-coronary cusp side, was successfully diagnosed only in a steep RAO view prior to the final release. This finding allowed THV recapture and replacement with a new THV. Discussion: Notably, the steep RAO view can visualize the THV from its short axis while eliminating parallax, allowing for accurate diagnosis of THV under-expansion particularly in patients with severe calcification in the non- or right-coronary cusp. Therefore, the steep RAO view allows timely detection of THV under-expansion before the final release, enabling THV recapture and the adoption of several management strategies.

Aspergillus fumigatus binding IgA and IgG1 are increased in bronchoalveolar lavage fluid of horses with neutrophilic asthma.

Introduction: Equine asthma (EA) is a common lower airway disease in horses, but whether its pathogenesis is allergic is ambiguous. Extrinsic stimuli like hay dust induce acute exacerbation of clinical signs and sustained local neutrophilic inflammation in susceptible horses. Aspergillus fumigatus is an EA stimulus, but it is unclear if it merely acts as an IgE-provoking allergen. We aimed to comprehensively analyze immunoglobulin (Ig) isotypes in EA, elucidating their binding to different A. fumigatus antigens, and their quantities systemically in serum and locally in bronchoalveolar lavage fluid (BALF). Methods: Serum and BALF from healthy horses (HE, n = 18) and horses with mild-moderate asthma (MEA, n = 20) or severe asthma (SEA, n = 24) were compared. Ig isotype (IgG1, IgG3/5, IgG4/7, IgG6, IgA, and IgE) binding to nine antigens (A. fumigatus lysate, and recombinant Asp f 1, Asp f 7, Asp f 8, dipeptidyl-peptidase 5, class II aldolase/adducin domain protein, glucoamylase, beta-hexosaminidase, and peptide hydrolase) was compared by enzyme-linked immunosorbent assays. Total Ig isotype contents were determined by bead-based assays. Results: MEA and SEA differed from HE but hardly from each other. Compared to HE, asthmatic horses showed increased anti-A. fumigatus binding of IgG (BALF and serum) and IgA (BALF). Serum and BALF IgE binding and total IgE contents were similar between HE and EA. Single antigens, as well as A. fumigatus lysate, yielded similar Ig binding patterns. Serum and BALF IgG1 binding to all antigens was increased in SEA and to several antigens in MEA. Serum IgG4/7 binding to two antigens was increased in SEA. BALF IgA binding to all antigens was increased in SEA and MEA. Total BALF IgG1 and IgG4/7 contents were increased in SEA, and serum IgG4/7 content was increased in MEA compared to HE. Yet, total isotype contents differentiated EA and HE less clearly than antigen-binding Ig. Discussion: A. fumigatus immunogenicity was confirmed without identification of single dominant antigens here. A. fumigatus provoked elevated BALF IgG1 and IgA binding, and these isotypes appear relevant for neutrophilic EA, which does not support allergy. BALF Ig isotype differentiation beyond IgE is crucial for a comprehensive analysis of immune responses to fungi in EA pathogenesis.

UAV-UGV Collaborative Localisation with Minimum Sensing.

This paper presents a novel methodology to localise Unmanned Ground Vehicles (UGVs) using Unmanned Aerial Vehicles (UAVs). The UGVs are assumed to be operating in a Global Navigation Satellite System (GNSS)-denied environment. The localisation of the ground vehicles is achieved using UAVs that have full access to the GNSS. The UAVs use range sensors to localise the UGV. One of the major requirements is to use the minimum number of UAVs, which is two UAVs in this paper. Using only two UAVs leads to a significant complication that results an estimation unobservability under certain circumstances. As a solution to the unobservability problem, the main contribution of this paper is to present a methodology to treat the unobservability problem. A Constrained Extended Kalman Filter (CEKF)-based solution, which uses novel kinematics and heuristics-based constraints, is presented. The proposed methodology has been assessed based on the stochastic observability using the Posterior Cramér-Rao Bound (PCRB), and the results demonstrate the successful operation of the proposed localisation method.

Adaptive RAO ensembled dichotomy technique for the accurate parameters extraction of solar PV system.

The parameter extraction process for PV models poses a complex nonlinear and multi-model optimization challenge. Accurately estimating these parameters is crucial for optimizing the efficiency of PV systems. To address this, the paper introduces the Adaptive Rao Dichotomy Method (ARDM) which leverages the adaptive characteristics of the Rao algorithm and the Dichotomy Technique. ARDM is compared with the several recent optimization techniques, including the tuna swarm optimizer, African vulture's optimizer, and teaching-learning-based optimizer. Statistical analyses and experimental results demonstrate the ARDM's superior performance in the parameter extraction for the various PV models, such as RTC France and PWP 201 polycrystalline, utilizing manufacturer-provided datasheets. Comparisons with competing techniques further underscore ARDM dominance. Simulation results highlight ARDM quick processing time, steady convergence, and consistently high accuracy in delivering optimal solutions.

Incidence and Prognostic Factors of Radial Artery Occlusion in Transradial Coronary Catheterization.

Background/Objectives: Radial artery occlusion (RAO) is the most common complication of transradial coronary catheterization. In this study, we aimed to evaluate the incidence of RAO and identify the risk factors that predispose patients to it. Methods: We conducted an investigator-initiated, prospective, multicenter, open-label study involving 1357 patients who underwent cardiac catheterization via the transradial route for angiography and/or a percutaneous coronary intervention (PCI). Univariate and multivariate logistic regression analyses were performed to identify potential predictors of RAO occurrence. Additionally, a subgroup analysis only for patients undergoing PCIs was performed. Results: The incidence of RAO was 9.5% overall, 10.6% in the angiography-only group and 6.2% in the PCI group. Independent predictors of RAO were as follows: (i) the female gender (aOR = 1.72 (1.05-2.83)), (ii) access site cross-over (aOR = 4.33 (1.02-18.39)), (iii) increased total time of the sheath in the artery (aOR = 1.01 (1.00-1.02)), (iv) radial artery spasms (aOR = 2.47 (1.40-4.36)), (v) the presence of a hematoma (aOR = 2.28 (1.28-4.06)), (vi) post-catheterization dabigatran use (aOR = 5.15 (1.29-20.55)), (vii) manual hemostasis (aOR = 1.94 (1.01-3.72)) and (viii) numbness at radial artery ultrasound (aOR = 8.25 (1.70-40)). Contrariwise, two variables were independently associated with increased odds for radial artery patency (RAP): (i) PCI performance (aOR = 0.19 (0.06-0.63)), and (ii) a higher dosage of intravenous heparin per patient weight (aOR = 0.98 (0.96-0.99)), particularly, a dosage of >50 IU/kg (aOR = 0.56 (0.31-1.00)). In the PCI subgroup, independent predictors of RAO were as follows: (i) radial artery spasms (aOR = 4.48 (1.42-14.16)), (ii) the use of intra-arterial nitroglycerin as a vasodilator (aOR = 7.40 (1.67-32.79)) and (iii) the presence of symptoms at echo (aOR = 3.80 (1.46-9.87)), either pain (aOR = 2.93 (1.05-8.15)) or numbness (aOR = 4.66 (1.17-18.57)). On the other hand, the use of intra-arterial verapamil as a vasodilator (aOR = 0.17 (0.04-0.76)) was independently associated with a greater frequency of RAP. Conclusions: The incidence of RAO in an unselected, all-comers European population after transradial coronary catheterization for angiography and/or PCIs is similar to that reported in the international literature. Several RAO prognostic factors have been confirmed, and new ones are described. The female gender, radial artery trauma and manual hemostasis are the strongest predictors of RAO. Our results could help in the future identification of patients at higher risk of RAO, for whom less invasive diagnostic procedures maybe preferred, if possible.

A novel optimal identification of various solar PV cell parameters by using MRDT controller.

At present, Renewable Energy Sources (RES) utilization keeps on increasing because of their merits are more availability in the atmosphere, easy energy harvesting, less maintenance expenses, plus more reliability. Here, the solar power generation systems are utilized for supplying the energy to the local consumers. The accurate, and efficient solar power supply to the customers is a very important factor to meet the peak load demand. The accurate power generation of the sunlight system completely depends on its accurate parameters extraction. In this work, a Modified Rao-based Dichotomy Technique (MRAODT) is introduced to identify the actual parameters of the different PV cells which are PWP 201 polycrystalline, plus RTC France. The proposed MRAODT method is compared with the other existing algorithms which are the teaching and learning algorithm, African vultures, plus tuna intelligence algorithm. Finally, from the simulation results, the MRAODT gives superior performance when associated with the other controllers in terms of parameters extraction time, accuracy in the PV cells parameters identification, plus convergence time of the algorithm.

Radial Artery Reconstruction After Iatrogenic Cannulation-Related Occlusion: A Case Report.

A 59-year-old male, with a history of angiogram via the left radial artery during the workup for multi-trauma, presented to the hand clinic with a 14-day history of progressive critical ischemia in the left thumb and index finger, along with dry gangrene of the distal index fingertip. Radial artery occlusion was confirmed on imaging. The patient underwent radial artery thrombectomy, arterial reconstruction with vein graft, and amputation of the index fingertip. Postoperatively, perfusion to the thumb and index finger was restored, resulting in the resolution of associated pain and hypersensitivity. This case demonstrates the delayed presentation of ischemia following radial artery cannulation, which was successfully managed with radial artery thrombectomy and a saphenous vein graft.

Towards non-invasive tissue hydration measurements with optical coherence tomography.

The attenuation coefficient ( µ OCT ) measured by optical coherence tomography (OCT) has been used to determine tissue hydration. Previous dual-wavelength OCT systems could not attain the needed precision, which we attribute to the absence of wavelength-dependent scattering of tissue in the underlying model. Assuming that scattering can be described using two parameters, we propose a triple/quadrupole-OCT system to achieve clinically relevant precision in water volume fraction. In this study, we conduct a quantitative analysis to determine the necessary precision of µ OCT measurements and compare it with numerical simulation. Our findings emphasize that achieving a clinically relevant assessment of a 2% water fraction requires determining the attenuation coefficient with a remarkable precision of 0.01 m m - 1 . This precision threshold is influenced by the chosen wavelength for attenuation measurement and can be enhanced through the inclusion of a fourth wavelength range.

Bias-reduced neural networks for parameter estimation in quantitative MRI.

PURPOSE: To develop neural network (NN)-based quantitative MRI parameter estimators with minimal bias and a variance close to the Cramér-Rao bound. THEORY AND METHODS: We generalize the mean squared error loss to control the bias and variance of the NN's estimates, which involves averaging over multiple noise realizations of the same measurements during training. Bias and variance properties of the resulting NNs are studied for two neuroimaging applications. RESULTS: In simulations, the proposed strategy reduces the estimates' bias throughout parameter space and achieves a variance close to the Cramér-Rao bound. In vivo, we observe good concordance between parameter maps estimated with the proposed NNs and traditional estimators, such as nonlinear least-squares fitting, while state-of-the-art NNs show larger deviations. CONCLUSION: The proposed NNs have greatly reduced bias compared to those trained using the mean squared error and offer significantly improved computational efficiency over traditional estimators with comparable or better accuracy.

Photon Phase Delay Sensing with Sub-Attosecond Uncertainty.

The application of statistical estimation theory to Hong-Ou-Mandel interferometry led to enticing results in terms of the detection limit for photon reciprocal delay and polarisation measurement. In the following paper, a fully fibre-coupled setup operating in the telecom wavelength region proves to achieve, for the first time, in common-path Hong-Ou-Mandel-based interferometry, a detection limit for photon phase delay at the zeptosecond scale. The experimental results are then framed in a theoretical model by calculating the Cramer-Rao bound (CRB) and, after comparison with the obtained experimental results, it is shown that our setup attains the optimal measurement, nearly saturating CRB.

Cramér-Rao Lower Bound for Magnetic Field Localization around Elementary Structures.

The determination of a mobile terminal's position with high accuracy and ubiquitous coverage is still challenging. Global satellite navigation systems (GNSSs) provide sufficient accuracy in areas with a clear view to the sky. For GNSS-denied environments like indoors, complementary positioning technologies are required. A promising approach is to use the Earth's magnetic field for positioning. In open areas, the Earth's magnetic field is almost homogeneous, which makes it possible to determine the orientation of a mobile device using a compass. In more complex environments like indoors, ferromagnetic materials cause distortions of the Earth's magnetic field. A compass usually fails in such areas. However, these magnetic distortions are location dependent and therefore can be used for positioning. In this paper, we investigate the influence of elementary structures, in particular a sphere and a cylinder, on the achievable accuracy of magnetic positioning methods. In a first step, we analytically calculate the magnetic field around a sphere and a cylinder in an outer homogeneous magnetic field. Assuming a noisy magnetic field sensor, we investigate the achievable positioning accuracy when observing these resulting fields. For our analysis, we calculate the Cramér-Rao lower bound, which is a fundamental lower bound on the variance of an unbiased estimator. The results of our investigations show the dependency of the positioning error variance on the magnetic sensor properties, in particular the sensor noise variance and the material properties, i.e., the relative permeability of the sphere with respect to the cylinder and the location of the sensor relative to the sphere with respect to the cylinder. The insights provided in this work make it possible to evaluate experimental results from a theoretical perspective.

Immunoproteomics enable broad identification of new Aspergillus fumigatus antigens in severe equine asthma.

Introduction: Severe equine asthma (SEA) is a common chronic disease of adult horses with characteristic recurrent airway obstruction and similarities to neutrophilic asthma in humans. As an extrinsic stimulus, hay dust exposure is a major risk factor and induces acute exacerbation in susceptible horses. However, single inducing agents of SEA have hardly been identified on a molecular basis. Aspergillus fumigatus (A. fumigatus) is a common mold species in hay and has been described as a major provoking agent of SEA. Methods: Aiming to identify disease-relevant antigens, we analyzed A. fumigatus using an immunoproteomics approach on two-dimensional immunoblots of A. fumigatus protein probed with serum from environmentally matched asthmatic and healthy horses (n=5 pairs). A. fumigatus binding serum immunoglobulins (Pan-Ig), and the isotypes IgG4/7 and IgG3/5 were quantified for each protein spot and then compared between asthmatic and healthy horses. Results and discussion: For 21 out of 289 spots serum immunoglobulin (Ig) binding was different between the two groups for Pan-Ig or the isotypes. If differences were detected, Pan-Ig and IgG4/7 binding to the proteins were lower, while IgG3/5 binding was higher in asthmatic than healthy horse sera. Proteins were extracted from the 21 spots of interest and analyzed by liquid chromatography mass spectrometry. Eight prioritized proteins (candidate antigens) were expressed as recombinant proteins. Some of these have been previously described as major or minor A. fumigatus allergens, alongside other proteins, most with hydrolase activity. Recombinant candidate antigens were tested on 1D immunoblots to confirm their relevance as antigens by serum antibody binding. Four proteins (beta-hexosaminidase, class II aldolase/adducin domain protein, glucoamylase, peptide hydrolase B0XX53) showed different antibody binding characteristics between asthmatic and healthy horses and are likely relevant antigens in SEA. Their identification can provide the basis for innovative diagnostics, prevention, or therapeutic approaches. Additionally, a more profound understanding of SEA and its potential underlying mechanisms can be established. Elevated serum IgG3/5 antibodies correlate with T helper cell 2 responses in other equine pathologies, and the recombinant SEA antigens developed here can become instrumental in analyzing the involvement of SEA-specific T cell responses and Ig responses in future studies.

Bias-Reduced Neural Networks for Parameter Estimation in Quantitative MRI.

Purpose: To develop neural network (NN)-based quantitative MRI parameter estimators with minimal bias and a variance close to the Cramér-Rao bound. Theory and Methods: We generalize the mean squared error loss to control the bias and variance of the NN's estimates, which involves averaging over multiple noise realizations of the same measurements during training. Bias and variance properties of the resulting NNs are studied for two neuroimaging applications. Results: In simulations, the proposed strategy reduces the estimates' bias throughout parameter space and achieves a variance close to the Cramér-Rao bound. In vivo, we observe good concordance between parameter maps estimated with the proposed NNs and traditional estimators, such as non-linear least-squares fitting, while state-of-the-art NNs show larger deviations. Conclusion: The proposed NNs have greatly reduced bias compared to those trained using the mean squared error and offer significantly improved computational efficiency over traditional estimators with comparable or better accuracy.

Effectiveness and Safety of Left Distal Transradial Access in Coronary Procedures in the Caribbean.

INTRODUCTION: This retrospective study investigated the effectiveness and safety of left distal transradial access (LDTRA) in patients with cardiovascular disease in Trinidad undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). METHOD: Procedural parameters, including technical success and safety outcomes such as vascular complications and radial artery occlusion (RAO), were assessed in 111 consecutive patients undergoing CAG or PCI from January 2023 to June 2023 at the Eric Williams Medical Sciences Complex, Trinidad and Tobago. Eighty-eight patients underwent LDTRA, while 23 received left transradial access (LTRA). RESULTS: There was no difference in procedural success with LDTRA compared to LTRA, 90.9% vs. 100%, p-value 0.202, non-significant (ns). LDTRA was associated with shorter fluoroscopy times (8.4 ± 6.8 minutes vs. 12.4 ± 7.7 minutes, p-value = 0.02), procedural duration (26.7 ± 18 minutes vs. 35.8 ± 20 minutes, p-value = 0.04), and hemostasis time (142 ± 41 minutes vs. 186 ± 44 minutes, p-value < 0.05). There were no significant differences in procedural-related complications (8% for LDTRA vs. 4.3% for LTRA, p-value = 0.476, ns). There were no reported cases of RAO. In the subgroup of patients with prior coronary artery bypass grafting (CABG), the fluoroscopy and procedure times were similar for both access sites; however, LDTRA was associated with a shorter hemostasis time (128 ± 30 minutes vs. 194 ± 39 minutes, p-value = 0.01). CONCLUSIONS: LDTRA is effective and safe for coronary procedures and is associated with a shorter hemostasis time. This study may prove clinically pertinent in a limited-resource Caribbean setting.