PaFESD: Patterns augmented by Features Epileptic Seizure Detection.

The detection of epileptic seizures can have a significant impact on the patients' quality of life and on their caregivers. In this paper we propose a method for detecting such seizures from electroencephalogram (EEG) data named Patterns augmented by Features Epileptic Seizure Detection (PaFESD). The main novelty of our proposal consists in a detection model that combines EEG signal features with pattern matching. After cleaning the signal and removing artifacts (as eye blinking or muscle movement noise), time-domain and frequency-domain features are extracted to filter out non-seizure regions of the EEG. Jointly, pattern matching based on Dynamic Time Warping (DTW) distance is also leveraged to identify the most discriminative patterns of the seizures, even under scarce training data. The proposed model is evaluated on all patients in the CHB-MIT database, and the results show that it is able to detect seizures with an average F1 score of 98.9%. Furthermore, our approach achieves a F1 score of 100% (no false alarms or missed true seizures) for 20 of the patients (out of 24). Additionally, we automatically detect the most seizure/non-seizure discriminative EEG channel so that a wearable with only two electrodes would suffice to warn patients of seizures.

Clinical outcomes of switching to adalimumab biosimilar (MSB11022) in patients with rheumatoid arthritis: RESTART Spanish Registry.

OBJECTIVE: MSB11022 is a biosimilar of adalimumab that has been shown comparable bioequivalence, safety, tolerability, and immunogenicity profiles to the reference adalimumab in healthy volunteers or in patients with psoriasis or rheumatoid arthritis (RA). This is the first study conducted under clinical practice conditions evaluating the switch from reference adalimumab to MSB11022 in patients with RA. METHODS: Retrospective and multicenter study with data from the medical records of patients with RA who switched from reference adalimumab or another biosimilar to MSB11022 and maintained this treatment for at least 6 months. Information registered comes from baseline visit, the moment of the switch, and the follow-up visits. RESULTS: Data from 86 patients were evaluated (median age 63.5 years, 75.6% female, 44.2% had erosive RA). Only 3.5% of the patients received biologic therapy prior to adalimumab. At baseline, median DAS28-CRP was 1.77 (80.2% in remission and 96.5% with low disease activity) and median CDAI was 4.00 (44.2% in remission and 90.7% with low disease activity). After a median follow-up of 8 months, median DAS28-CRP was 1.87 (86.0% in remission and 94.2% with low disease activity) and median CDAI was 4.00 (38.5% in remission and 95.3% with low disease activity). Only three patients experienced pain, swelling, and stinging at the injection site or a locally extensive hematoma in the area of administration. CONCLUSIONS: Adalimumab biosimilar MSB11022 maintained the efficacy benefits provided by previous adalimumab treatments with a safety profile in line with that already described for other biosimilars.

Influence of the EULAR recommendations for the use of imaging in large vessel vasculitis in the diagnosis of giant cell arteritis: results of the ARTESER register.

OBJECTIVE: The main study objective was to determine how giant cell arteritis (GCA) is diagnosed in our clinical practice and whether the EULAR recommendations have influenced the diagnostic procedures used. METHODS: ARTEritis of the Rheumatology Spanish Society -Sociedad Española de Reumatología (ARTESER) is a multicentre observational retrospective study conducted in 26 hospitals with support from the Spanish Society of Rheumatology. All patients diagnosed with GCA between 1 June 2013 and 29 March 2019 were included. The gold standard for the diagnosis of GCA was the judgement of the physician in charge, according to clinical criteria, supported by data available from laboratory tests, imaging studies (ultrasound, positron emission tomography (PET) and MRI/CT angiography) and temporal artery biopsy (TAB) when available. RESULTS: We included 1675 patients with GCA (mean age±SD (76.9±8.1) years, 1178 women (70.3%)). Of these, 776 patients had a positive TAB (46.3%), 503 (30.0%) positive ultrasound, 245 positive PET (14.6%) and 64 positive MRI/CT angiography (3.8%). These percentages changed substantially over the study. From 2013 to 2019, the use of ultrasound in diagnosis grew from 25.8% to 52.9% and PET from 12.3% to 19.6%, while use of TAB decreased from 50.3% to 33.3%. CONCLUSIONS: Biopsy was the most widely used diagnostic test for confirming GCA, but use of imaging as a diagnostic tool has grown in recent years. Following publication of the 2018 EULAR recommendations, ultrasound has displaced biopsy as the first-line diagnostic test; TAB was performed in a third and PET in a fifth of cases.

Characterization, Statistical Analysis and Method Selection in the Two-Clocks Synchronization Problem for Pairwise Interconnected Sensors.

Time synchronization among sensor devices connected through non-deterministic media is a fundamental requirement for sensor fusion and other distributed tasks that need a common time reference. In many of the time synchronization methods existing in literature, the estimation of the relation between pairs of clocks is a core concept; moreover, in applications that do not have general connectivity among its devices but a simple pairwise topology, such as embedded systems, mobile robots or home automation, two-clock synchronization is actually the basic form of the time estimation problem. In these kinds of applications, especially for critical ones, not only the quality of the estimation of the relation between two clocks is important, but also the bounds the methods provide for the estimated values, and their computational effort (since many are small systems). In this paper, we characterize, with a thorough parameterization, the possible scenarios where two-clock synchronization is to be solved, and then conduct a rigorous statistical study of both scenarios and methods. The study is based on exhaustive simulations run in a super-computer. Our aim is to provide a sound basis to select the best clock synchronization algorithm depending on the application requirements and characteristics, and also to deduce which ones of these characteristics are most relevant, in general, when solving the problem. For our comparisons we have considered several representative methods for clock synchronization according to a novel taxonomy that we also propose in the paper, and in particular, a few geometrical ones that have special desirable characteristics for the two-clock problem. We illustrate the method selection procedure with practical use-cases of sensory systems where two-clock synchronization is essential.

Ecografía Doppler de arterias temporales superficiales en la arteritis de células gigantes en una cohorte con alta sospecha clínica / Doppler ultrasonography of superficial temporal artery in a cohort of patients with strong clinical suspicion of giant cell arteritis

Fundamento y objetivo: La arteritis de células gigantes (ACG) es la vasculitis sistémica más frecuente en adultos. En los últimos años, existe un interés creciente en evaluar la utilidad de la ecografía de arterias temporales superficiales (EATS), que permite valorar la inflamación de la pared vascular. Material y métodos: Estudio de cohorte observacional y descriptivo de 120 EATS a 60 pacientes con sospecha clínica de ACG según criterios clásicos de ACR (American College of Rheumatology). Resultados: De todos los pacientes a quienes se les realizó la EATS, el 42,3% presentó diagnóstico de ACG según los criterios de clasificación ACR. La sensibilidad y la especificidad de la ecografía en nuestra cohorte de pacientes con alta sospecha clínica fueron de 81,8 y 93,3%, respectivamente, con un VPP de 90,1% y un VPN de 87,5%. Conclusión: Los resultados avalan la ecografía de arteria temporal bilateral como una técnica útil, indolora, rápida, accesible, de alta especificidad y amplia validez diagnóstica

Background and objective: Giant cell arteritis (GCA) is the most frequent systemic vasculitis in adults. In recent years, the usefulness of temporal artery ultrasound (TAUS) as a diagnostic tool to assess the underlying inflammation of the vascular wall during the inflammatory process has been under clinical investigation. Material and methods: Observational and descriptive cohort study of 120 TAUS in 60 patients with clinical suspicions of GCA, according to the ACR (American College of Rheumatology) classification criteria. Results: Among all patients who underwent ultrasound, 42.3% met clinical criteria for GCA according to ACR. Sensitivity and specificity of TAUS in our cohort with clinical suspicion was 81.8% and 93.3%, respectively. A PPV of 90.1% and a VPN of 87.5% were observed. Conclusion: Our results showed that TAUS as a useful, indolent, fast, and accessible tool with high diagnostic specificity and diagnostic value

Doppler ultrasonography of superficial temporal artery in a cohort of patients with strong clinical suspicion of giant cell arteritis. / Ecografía Doppler de arterias temporales superficiales en la arteritis de células gigantes en una cohorte con alta sospecha clínica.

BACKGROUND AND OBJECTIVE: Giant cell arteritis (GCA) is the most frequent systemic vasculitis in adults. In recent years, the usefulness of temporal artery ultrasound (TAUS) as a diagnostic tool to assess the underlying inflammation of the vascular wall during the inflammatory process has been under clinical investigation. MATERIAL AND METHODS: Observational and descriptive cohort study of 120 TAUS in 60 patients with clinical suspicions of GCA, according to the ACR (American College of Rheumatology) classification criteria. RESULTS: Among all patients who underwent ultrasound, 42.3% met clinical criteria for GCA according to ACR. Sensitivity and specificity of TAUS in our cohort with clinical suspicion was 81.8% and 93.3%, respectively. A PPV of 90.1% and a VPN of 87.5% were observed. CONCLUSION: Our results showed that TAUS as a useful, indolent, fast, and accessible tool with high diagnostic specificity and diagnostic value.