bluuebunny/crossref_metadata_2025 huggingface dataset:
Building Intelligent Systems by Combining Machine Learning and Automated Commonsense Reasoning
Authors: Gupta Gopal , Zeng Yankai , Rajasekaran Abhiraman , Padalkar Parth , Kimbrell Keegan , Basu Kinjal , Shakerin Farahad , Salazar Elmer , Arias Joaquín
Published: January 2024

We present an approach to building systems that emulate human-like intelligence. Our approach uses machine learning technology (including generative AI systems) to extract knowledge from pictures, text, etc., and represents it as (pre-defined) predicates. Next, we use the s(CASP) automated commonsense reasoning system to check the consistency of this extracted knowledge and reason over it in a manner very similar to how a human would do it. We have used our approach for building systems for visual question answering, task-specific chatbots that can ``understand" human dialogs and interactively talk to them, and autonomous driving systems that rely on commonsense reasoning. Essentially, our approach emulates how humans process knowledge where they use sensing and pattern recognition to gain knowledge (Kahneman's System 1 thinking, akin to using a machine learning model), and then use reasoning to draw conclusions, generate response, or take actions (Kahneman's System 2 thinking, akin to automated reasoning).
Exploring the Path from Instructions to Rewards with Large Language Models in Instance-Based Learning
Authors: McDonald Chase , Malloy Tyler , Nguyen Thuy Ngoc , Gonzalez Cleotilde
Published: January 2024

A prominent method to model human learning is through experiential learning, where decisions are influenced by the outcomes observed in previous actions. The decisions-from-experience approach often excludes other forms of learning in humans, such as learning from descriptive information. In humans, descriptive information can enhance learning by providing a denser signal, achieved through understanding the relationship between intermediate decisions and their future outcomes, instead of relying solely on observed outcomes. To account for experiential and descriptive information, we propose the use of large language models (LLMs) to convert descriptive information into dense signals that can be used by computational models that learn from experience. Building on past work in cognitive modeling, we utilize task instructions and prompt an LLM to define and quantify the critical actions an agent must take to succeed in the task. In an initial experiment, we test this approach using an Instance-Based Learning cognitive model of experiential decisions in a gridworld task. We demonstrate how the LLM can be prompted to provide a series of actions and relative values given the task instructions, then show how these values can be used in place of sparse outcome signals to improve the model’s learning of the task significantly.
Psychologically-Valid Generative Agents: A Novel Approach to Agent-Based Modeling in Social Sciences
Authors: Mitsopoulos Konstantinos , Bose Ritwik , Mather Brodie , Bhatia Archna , Gluck Kevin , Dorr Bonnie , Lebiere Christian , Pirolli Peter
Published: January 2024

Incorporating dynamic realistic human behaviors in population-scale computational models has been challenging. While some efforts have leveraged behavioral theories from social science, validated theories specifically applicable to Agent-based modeling remain limited. Existing approaches lack a comprehensive framework to model the situated, adaptive nature of human cognition and choice. To address these challenges, this paper proposes a novel framework, Psychologically-Valid Generative Agents. These agents consist of a Cognitive Architecture that provides data-driven and cognitively-constrained decision-making functionality, and a Large Language Model that generates human-like linguistic data. In addition, our framework benefits from Stance Detection, a Natural Language Processing technique, that allows highly personalize initialization of the agents, based on real-world data, within Agent-based modeling simulations. This combination provides a flexible yet structured approach to endogenously represent how people perceive, deliberate, and respond to social or other types of complex decision-making dynamics. Previous work has demonstrated promising results by using a subset of the components of our proposed architecture. Our approach has the potential to exhibit highly-realistic human behavior and can be used across a variety of domains (e.g., public health, group dynamics, social and psychological sciences, and financial markets).
Using Large Language Models in the Companion Cognitive Architecture: A Case Study and Future Prospects
Authors: Nakos Constantine , Forbus Kenneth D.
Published: January 2024

The goal of the Companion cognitive architecture is to understand how to create human-like software social organisms. Thus natural language capabilities, both for reading and conversation, are essential. Recently we have begun experimenting with large language models as a component in the Companion architecture. This paper summarizes a case study indicating why we are currently using BERT with our symbolic natural language understanding system. It also describes some additional ways we are contemplating using large language models with Companions.
Proposed Uses of Generative AI in a Cybersecurity-Focused Soar Agent
Authors: Prieto Indelisio , Blakely Benjamin
Published: January 2024

With the rapidly increasing use of AI and machine learning in recent years and the current generative AI revolution, it is no surprise that the malicious use of AI has begun to establish it- self in the realm of cybersecurity. At risk of being left behind in this “arms race”, it’s imperative that autonomous intelli- gent cybersecurity agent (AICAs) are developed to counter this emerging threat. Currently, a project at Argonne National Laboratory is using Soar as a starting point for developing a cognitive-architecture based AICA, but the utilization of Soar in this project has shortcomings, in particular the lack of modern AI principles to generate novel analysis in the face of novel situations. Generative AI has the potential to allow a Soar cognitive agent to consider a much broader range of con- textual information, and learn from past episodic knowledge in novel ways by using transformer architectures. This paper focuses on the theoretical integration of Generative AI into the Soar cognitive architecture from a cybersecurity stand- point, and discuss the advantages to doing so.
Integrating Cognitive Architectures with Foundation Models: Cognitively-Guided Few-Shot Learning to Support Trusted Artificial Intelligence
Authors: Thomson Robert H. , Bastian Nathaniel D.
Published: January 2024

We present an updated position integrating cognitive architectures into workflow by utilizing the architecture for what it does most effectively: human-like few-shot learning integrating the vast amount of data stored by foundation models. By supplementing the language-generation capabilities with the constraints of cognitive-architectures guiding prompts, it should be possible to generate more relevant output and possibly even predict when the foundation model is hallucinating. Recent advances in few-shot learning capabilities of cognitive architectures in applied domains will be discussed with some parallel capabilities described by foundation models. Just as we use research from social psychology to 'nudge' people into making informed decisions, we should be able to use cognitive architectures to 'nudge' foundation models into developing more human-relevant content.
Comparing LLMs for Prompt-Enhanced ACT-R and Soar Model Development: A Case Study in Cognitive Simulation
Authors: Wu Siyu , Souza Rodrigo F. , Ritter Frank E. , Lima Jr Walter T.
Published: January 2024

This paper presents experiments on using ChatGPT4 and Google Bard to create ACT-R and Soar models. The study involves two simulated cognitive tasks, where ChatGPT4 and Google Bard (Large Language Models, LLMs) serve as conversational interfaces within the ACT-R and Soar framework development environments. The first task involves creating an intelligent driving model using ACT-R with motor and perceptual behavior and can further interact with an unmodified interface. The second task evaluates the development of educational skills using Soar. Prompts were designed to represent cognitive operations and actions, including providing context, asking perception-related questions, decision-making scenarios, and evaluating the system's responses, and they were iteratively refined based on model behavior evaluation. Results demonstrate the potential of using LLMs to serve as interactive interfaces to develop ACT-R and Soar models within a human-in-the-loop model development process. We documented the mistakes LLMs made during this integration and provided corresponding resolutions when adopting this modeling approach. Furthermore, we presented a framework of prompt patterns that maximizes LLMs interaction for artificial cognitive architectures.
Risk Modeling of Time-Varying Covariates Using an Ensemble of Survival Trees: Predicting Future Cancer Events
Authors: Coster Dan , Fisher Eyal , Shenhar-Tsarfaty Shani , Menes Tehillah , Berliner Shlomo , Rogowski Ori , Zeltser David , Shapira Itzhak , Halperin Eran , Rosset Saharon , Gorfine Malka , Shamir Ron
Published: January 2024

The challenge of survival prediction is ubiquitous in medicine, but only a handful of methods are available for survival prediction based on time-varying data. Here we propose a novel method for this problem, using a random forest of survival trees for left-truncated and right-censored data. We demonstrate the advantage of our method on prediction of breast cancer and prostate gland cancer risk among healthy individuals by analyzing routine laboratory measurements, vital signs and age. We analyze electronic medical records of 20,317 healthy individuals who underwent routine checkups and identified those who later developed cancer. In cross-validation, our method predicted future prostate and breast cancers six months before diagnosis with an area under the ROC curve of 0.62±0.05 and 0.6±0.03 respectively, outperforming standard random forest, random survival forest, cox-regression model, dynamic deep-hit and a single survival tree. Our work proposes a new framework for survival risk prediction in time-varying data and our results suggest that computational analysis of data on healthy individuals can improve the detection of those at risk of future cancer development.
On the Effects of Type II Left Censoring in Stable and Chaotic Compartmental Models for Infectious Diseases: Do Small Sample Estimates Survive Censoring?
Authors: Selvitella Alessandro Maria , Foster Kathleen Lois
Published: January 2024

In this paper, we discuss a selection of tools from dynamical systems and order statistics, which are most often utilized separately, and combine them into an algorithm to estimate the parameters of mathematical models for infectious diseases in the case of small sample sizes and left censoring, which is relevant in the case of rapidly evolving infectious diseases and remote populations. The proposed method relies on the analogy between survival functions and the dynamics of the susceptible compartment in SIR-type models, which are both monotone decreasing in time and are both determined by a dual variable: the hazard function in survival prediction and the number of infected people in SIR-type models. We illustrate the methodology in the case of a continuous model in the presence of noisy measurements with different distributions (Normal, Poisson, Negative Binomial) and in a discrete model, reminiscent of the Ricker map, which admits chaotic dynamics. This estimation procedure shows stable results in experiments based on a popular benchmark dataset for SIR-type models and small samples. This manuscript illustrates how classical theoretical statistical methods and dynamical systems can be merged in interesting ways to study problems ranging from more fundamental small sample situations to more complex infectious disease and survival models, with the potential that this tools can be applied in the presence of a large number of covariates and different types of censored data.
A Categorical Representation Language and Computational System for Knowledge-Based Robotic Task Planning
Authors: Aguinaldo Angeline , Patterson Evan , Fairbanks James , Regli William , Ruiz Jaime
Published: January 2024

Classical planning representation languages based on first-order logic have preliminarily been used to model and solve robotic task planning problems. Wider adoption of these representation languages, however, is hindered by the limitations present when managing implicit world changes with concise action models. To address this problem, we propose an alternative approach to representing and managing updates to world states during planning. Based on the category-theoretic concepts of C-sets and double-pushout rewriting (DPO), our proposed representation can effectively handle structured knowledge about world states that support domain abstractions at all levels. It formalizes the semantics of predicates according to a user-provided ontology and preserves the semantics when transitioning between world states. This method provides a formal semantics for using knowledge graphs and relational databases to model world states and updates in planning. In this paper, we conceptually compare our category-theoretic representation with the classical planning representation. We show that our proposed representation has advantages over the classical representation in terms of handling implicit preconditions and effects, and provides a more structured framework in which to model and solve planning problems.
When Robots Self-Disclosure Personal Information, Do Users Reciprocate?
Authors: Barfield Jessica K.
Published: January 2024

Human-robot interaction consists of a rich set of behaviors between humans and robots often requiring the exchange of personal and sensitive information between them. From a conceptual framework, this paper discusses whether a robot who self-discloses personal information when conversing with a user will prompt the user to reciprocate and self-dis- close personal and sensitive information to the robot. Additionally, the paper discusses various factors which may influence whether self-disclosure of personal information between human and robot occurs and briefly discusses aspects of a conceptual representational system necessary for HRI enabling the robot to self-disclose to a user.
Embracing the Lag: Real-Time Challenges in Multi-Agent Systems
Authors: Dumnich Sarah , Birmingham William , Wolfe Britton
Published: January 2024

In this paper, we discuss the interplay between distributed multi-agent systems and the concept of "lag." We introduce a new representation of these systems to more clearly include time and the effects of latency. We also present real-world situations where communication delays can mean the difference between success and failure, between order and chaotic disarray.
HomeRobot: An Open Source Software Stack for Mobile Manipulation Research
Authors: Paxton Chris , Wang Austin , Shah Binit , Matulevich Blaine , Shah Dhruv , Yadav Karmesh , Ramakrishnan Santhosh , Yenamandra Sriram , Bisk Yonatan
Published: January 2024

Reproducibility in robotics research requires capable, shared hardware platforms which can be used for a wide variety of research. We’ve seen the power of these sorts of shared platforms in more general machine learning research, where there is constant iteration on shared AI platforms like PyTorch. To be able to make rapid progress in robotics in the same way, we propose that we need: (1) shared real-world platforms which allow different teams to test and compare methods at low cost; (2) challenging simulations that reflect real-world environments and especially can drive perception and planning research; and (3) low-cost platforms with enough software to get started addressing all of these problems. To this end, we propose HomeRobot, a mobile manipulator software stack with associated benchmark in simulation, which is initially based on the low-cost, human-safe Hello Robot Stretch.
Petri Nets for the Iterative Development of Interactive Robotic Systems
Authors: Praveena Pragathi , Schoen Andrew , Gleicher Michael , Porfirio David , Mutlu Bilge
Published: January 2024

We argue for the use of Petri nets as a modeling language for the iterative development process of interactive robotic systems. Petri nets, particularly Timed Colored Petri nets (TCPNs), have the potential to unify various phases of the development process-design, specification, simulation, validation, implementation, and deployment. We additionally discuss future directions for creating a domain-specific variant of TCPNs tailored specifically for HRI systems development.
Supporting AI Planning and Collaboration for Robotic Applications Using TAEMS
Authors: Zhang Shelley , Moulton Alexander , Bedi Abhijot , Chabot Eugene
Published: January 2024

This paper describes a general approach to integrating higher-level reasoning mechanisms including planning and scheduling methods with lower-level robotic control processes. We adopt a domain-independent task representation language TAEMS to describe the knowledge of tasks, resources, and their interrelationships. This TAEMS representation language serves as the input of the reasoning functions, which generate a schedule of executable methods to be executed by the robot in the physical world. In the execution process of this goal-directed plan, the robot also needs to attend to basic functions. The potential interactions between the plan and these basic functions would lead to interesting challenges that will be discussed. An integrated development platform with a simulator that supports real-world physics is also presented.
Enhancing strength of cement using aluminium sulfate accelerator with aluminium formate
Authors: Zhang Wan , Wu Zhihong , Huang Wang , Wang Jiawei , Pan Yuexin , Li Zhishun , Ren Shufang , Xu Hongjin
Published: January 2024

An alkali-free liquid accelerator was prepared with aluminium sulfate and aluminium formate as the main components. The effects of the accelerator on the setting of paste and the mechanical strength of mortar were studied, and the impact of the accelerator on the early hydration behaviour and hydration products of the paste were investigated by isothermal calorimeter analysis, X-ray diffraction analysis, scanning electron microscopy and thermogravimetric analysis. The results show that the accelerator is excellent for the rapid setting and hardening of the cement. When the content of the accelerator was 8 wt%, the initial setting time and final setting time of the paste were 85 s and 180 s, respectively, and the strengths of the mortar at 1 day and 28 days were 9.52 MPa and 44.42 MPa, respectively. The proposed accelerator can accelerate the dissolution and hydration of tricalcium aluminate and tricalcium silicate and promote the formation of ettringite, formate and portlandite.
Functional brain connectivity in electrical status epilepticus in sleep
Authors: Mott Steven H. , Morse Richard P. , Burroughs Scott A. , Buckley Ashura W. , Farmer Cristan A. , Thurm Audrey E. , Swedo Susan E. , Krag Amara L. , Holmes Gregory L.
Published: January 2024

Aims. Electrical status epilepticus in sleep (ESES) is an age‐related, self‐limited epileptic encephalopathy. The syndrome is characterized by cognitive and behavioral abnormalities and a specific EEG pattern of continuous spikes and waves during slow‐wave sleep. While spikes and sharp waves are known to result in transient cognitive impairment during learning and memory tasks performed during the waking state, the effect of epileptiform discharges during sleep on cognition and behavior is unclear. There is increasing evidence that abnormalities of coherence, a measure of the consistency of the phase difference between two EEG signals when compared over time, is an important feature of brain oscillations and plays a role in cognition and behavior. The objective of this study was to determine whether coherence of EEG activity is altered during slow‐wave sleep in children with ESES when compared to typically developing children.

Methods. We examined coherence during epochs of ESES versus epochs when ESES was not present. In addition, we compared coherence during slow‐wave sleep between typically developing children and children with ESES.

Results. ESES was associated with remarkably high coherences at all bandwidths and most electrode pairs. While the high coherence was largely attributed to the spikes and spike‐and‐wave discharge, activity between spikes and spike‐and‐wave discharge also demonstrated high coherence.

Conclusions. This study indicates that EEG coherence during ESES is relatively high. Whether these increases in coherence correlate with the cognitive and behavioral abnormalities seen in children with this EEG pattern remains to be determined.
Neuropsychological correlates of obstructive sleep apnea severity in patients with epilepsy
Authors: Latreille Véronique , Willment Kim C. , Sarkis Rani A. , Pavlova Milena
Published: January 2024

Aims. Obstructive sleep apnea affects up to 30% of patients with epilepsy. As obstructive sleep apnea represents a clinical risk factor for cognitive deficits, its occurrence in epilepsy patients may exacerbate cognitive deficits associated with this condition. However, the cognitive burden of obstructive sleep apnea in epilepsy remains poorly understood. We conducted a retrospective record review of adults with epilepsy who underwent a polysomnography and a neuropsychological assessment at Brigham and Women's Hospital.

Methods. We examined the relationship between obstructive sleep apnea severity and cognitive functioning, particularly attention/executive functions, memory, and processing speed in untreated obstructive sleep apnea patients with epilepsy. Twenty patients with epilepsy and mild‐to‐severe obstructive sleep apnea were included in the analyses.

Results. We found significant positive correlations between the oxygen saturation levels during rapid‐eye‐movement sleep and attention/executive tests (p<0.05), as well as time spent with saturation levels ≤90% and executive functioning (p=0.008). Similarly, worse verbal memory performances were associated with lower oxygen levels (p=0.003). In addition, more severe respiratory events during rapid‐eye‐movement sleep were associated with worse performances on attention tests (p=0.03).

Conclusions. Our findings indicate that more severe obstructive sleep apnea‐related hypoxemia during sleep is associated with poorer cognitive performances on tests that assess attention/executive functions and verbal memory in patients with epilepsy. Overall, these results are consistent with the sleep apnea literature, and suggest that patients with epilepsy are also vulnerable to the effects of obstructive sleep apnea. Future prospective studies will help in determining whether treatment of obstructive sleep apnea may help improve cognitive functioning in patients with epilepsy.
A novel mutation in KCNQ3‐related benign familial neonatal epilepsy: electroclinical features and neurodevelopmental outcome
Authors: Piro Ettore , Nardello Rosaria , Gennaro Elena , Fontana Antonina , Taglialatela Maurizio , Mangano Giuseppe Donato , Corsello Giovanni , Mangano Salvatore
Published: January 2024

Benign familial neonatal epilepsy (BFNE) is caused, in about 5% of families, by mutations in the KCNQ3 gene encoding voltage‐gated potassium channel subunits. Usually, newborns with BFNE show a normal neurological outcome, but recently, refractory seizures and/or developmental disability have been reported suggesting phenotype variability associated with KCNQ3‐related BFNE. Here, we describe a proband from a BFNE family carrying a novel variant in the KCNQ3 gene. Regarding the paucity of data in the literature, we describe the presented case with a view to further establishing: (1) a genotype/phenotype correlation in order to define a BFNE phenotype associated with favourable outcome; (2) an electroclinical pattern associated with BFNE based on video‐EEG recording; (3) appropriate first‐line AEDs; and (4) the duration of AED treatment. The presented case from Day 3 exhibited a cluster of ictal events, identified as epileptic seizures on Day 10 based on continuous video‐EEG polygraphy. The seizures were characterized by asymmetric tonic posturing, associated with a generalized decrease in EEG amplitude, and followed by bilateral asynchronous clonic movements associated with bicentral sharp‐wave discharges. The seizures were refractory to intravenous pyridoxine, whereas levetiracetam resulted in rapid total seizure control which has remained to date. This study demonstrates that the novel heterozygous KCNQ3 (c. 914A>T; p.Asp305Val) variant, affecting residues in the pore region, is associated with a specific electroclinical pattern and favourable neurodevelopmental outcome. [Published with video sequence on www.epilepticdisorders.com]
Epilepsy surgery in the first months of life: a large type IIb focal cortical dysplasia causing neonatal drug‐resistant epilepsy
Authors: Borggraefe Ingo , Tacke Moritz , Gerstl Lucia , Leiz Steffen , Coras Roland , Blümcke Ingmar , Giese Armin , Ertl‐Wagner Birgit , Thiel Christian T. , Noachtar Soheyl , Peraud Aurelia
Published: January 2024

Focal cortical dysplasia is a common cause of medically refractory epilepsy in infancy and childhood. We report a neonate with seizures occurring within the first day of life. Continuous video‐EEG monitoring led to detection of left motor seizures and a right frontal EEG seizure pattern. Brain MRI revealed a lesion within the right frontal lobe without contrast enhancement. The patient was referred for epilepsy surgery due to drug resistance to vitamin B6 and four antiepileptic drugs. Lesionectomy was performed at the age of two and a half months, and histopathological evaluation confirmed the diagnosis of focal cortical dysplasia type IIb (FCD IIb). The patient is free of unprovoked seizures without medication (Engel Class I) and is normally developed at 36 months after surgery. The case study demonstrates that FCD IIb may cause seizures within the first day of life and that epilepsy surgery can be successfully performed in medically intractable patients with a clearly identifiable seizure onset zone within the first three months of life. Although radical surgery such as hemispherectomy and multi‐lobar resections are over‐represented in early infancy, this case also illustrates a favourable outcome with a more limited resection in this age group.
Childhood epilepsy with a small number of seizures may be left untreated: an international prospective study
Authors: Arts Willem F. , Geerts Ada T. , Brouwer Oebele F. , van Donselaar Cees A. , Stroink Hans , Peters Boudewijn AC. , Peeters Els AJ. , Camfield Peter , Camfield Carol
Published: January 2024

Aims. It is unknown whether treatment with antiepileptic drugs in children with epilepsy with a presumed good prognosis is always necessary. We aimed to study the course of newly diagnosed epilepsy in children with a presumed good prognosis who are managed without AED treatment.

Methods. A total of 151 children (one month to 12 years of age) with two to five lifetime unprovoked seizures (excluding febrile convulsions), were followed for three years. Treatment was initially withheld. Children with symptomatic epilepsy, or absence or myoclonic epilepsy, were excluded. AED treatment was started after >10 lifetime seizures or an episode of status epilepticus during follow‐up, or if the parents or treating physician deemed it otherwise necessary.

Results. During follow‐up, 113 children continued to meet our criteria for refraining from treatment with antiepileptic drugs, yet 30 started treatment at the request of the parents. Thirty‐eight children at some time met the criteria to start treatment, but the parents of 16 declined treatment. In all, 99 (66%) children maintained the no‐treatment regime. Ninety‐eight children (65% of 151) reached terminal remission for at least one year, including 83 who did not receive antiepileptic drug treatment (84% of the untreated 99). Mean terminal remission was significantly longer in the group with a total of <10 seizures compared to those with >10 seizures. Treatment did not increase the length of terminal remission. Adverse events, including traumatic injury, occurred equally in the treated and untreated children. Measures of quality of life suggested a better outcome in those without treatment.

Conclusions. Children with newly diagnosed epilepsy with a presumed good prognosis may not need immediate AED treatment. Postponing treatment does not alter the chance of remission or the risk of accidents and adverse events and appears to be associated with a good quality of life.
Loss of responsiveness in psychogenic non‐epileptic seizures
Authors: Asadi‐Pooya Ali A. , Bahrami Zahra
Published: January 2024

Aims: The aim of this study was to investigate the frequency of loss of responsiveness (LOR) in patients with psychogenic non‐epileptic seizures (PNES) and to characterize the patients' clinical variables that may be associated with such a manifestation.

Methods: In this retrospective study, all patients with documented PNES, who were investigated at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 to 2018, were investigated.

Results: During the study period, data was available for 324/325 patients with PNES. In total, 275 patients (85%) reported LOR during their seizures, but this was not the case for 49 patients (15%). The model, generated by regression analysis, was shown to be significant (p=0.0001) and LOR could be predicted in 84% of the patients. Closed eyes during seizures (OR: 4.4; 95% CI: 2.101–9.235; p=0.0001) and seizure‐associated injury (OR: 3.5; 95% CI: 1.402–8.686; p=0.007) were significantly associated with LOR based on the model.

Conclusion: Patients with PNES may frequently report LOR, which is significantly associated with seizure‐related injuries. Therefore, it is important to apply appropriate management strategies for patients with PNES and LOR in order to prevent or decrease the possibility of any associated consequences, including ictal injury.
Multinodular and vacuolating neuronal tumour of the cerebrum: a rare neuroimaging incidentaloma or a potentially treatable cause of focal epilepsy?
Authors: Baščarević Vladimir , Pejović Aleksa T. , Ristić Aleksandar J. , Vojvodić Nikola , Raičević Savo , Đukić Tijana , Brajković Leposava , Sokić Dragoslav
Published: January 2024

Multinodular and vacuolating neuronal tumour (MVNT) of the cerebrum is a relatively new, well defined histopathological and neuroradiological entity, in many cases associated with an early adult‐onset epilepsy. These lesions have an indolent course and resemble both malformative and neoplastic processes, combining a focal developmental anomaly and a low‐grade tumour. Herein, we report a case of a 48‐year‐old female patient with left temporal lobe epilepsy associated with MVNT. In addition, a comprehensive review of all the previously published cases is provided with a focus on seizure‐related cases, surgical treatment, and postoperative outcome.
Quantitative EEG analysis in Encephalopathy related to Status Epilepticus during slow Sleep
Authors: Cantalupo Gaetano , Pavlidis Elena , Beniczky Sandor , Avanzini Pietro , Gardella Elena , Larsson Pål G.
Published: January 2024

Since its first description, quantifying the burden of epileptiform abnormalities in sleep EEG has played a fundamental role in the diagnosis of Encephalopathy related to Status Epilepticus during slow Sleep (ESES). In fact, in the 1971 seminal paper by Tassinari's group and in the following studies on this syndrome, the amount of epileptiform discharges (EDs) was calculated as the percentage of slow sleep occupied by spike‐and‐waves and referred to as “spike and wave index” (SWI). However, nowadays it is becoming increasingly clear that the SWI alone does not explain the whole clinical course of patients affected by ESES. In this paper, we aim to provide a state‐of‐the‐art summary of the quantitative EEG methods currently used in the ESES/CSWS literature, highlighting the possible pitfalls and discrepancies explaining the unsatisfactory correlation between SWI and clinical course. Furthermore; we illustrate a number of methodological refinements ‐ taking into account inter‐individual, intra‐individual, and temporal variability of EDs ‐ alongside “new” quantitative variables ‐including ED‐related and sleep‐related features ‐ potentially useful to reach a reliable electro‐clinical correlation in patients with ESES.
Clinical evolution and epilepsy outcome in three patients with CDKL5‐related developmental encephalopathy
Authors: Bernardo Pia , Ferretti Alessandro , Terrone Gaetano , Santoro Claudia , Bravaccio Carmela , Striano Salvatore , Coppola Antonietta , Striano Pasquale
Published: January 2024

Aims. To further characterise CDKL5‐related disorder, previously classified as an early‐onset seizure variant of Rett syndrome, which is currently considered a specific and independent early‐infantile epileptic encephalopathy.

Methods. We describe the epileptic phenotype and neurocognitive development in three girls with CDKL5 mutations showing severe neurodevelopmental impairment, with different epileptic phenotypes and severity.

Results. The patients differed regarding age at epilepsy onset, seizure frequency, duration of “honeymoon periods”, as well as EEG features. The “honeymoon period”, defined as a seizure‐free period longer than two months, represented, in our case series, a good indicator of the epilepsy outcome, but not of the severity of developmental impairment. However, even during the “honeymoon period”, the interictal EEG showed epileptiform abnormalities, slowing, or a disappearance of physiological pattern. The natural history of CDKL5 disorder was compared between the three girls, focusing on the relationship between electroclinical features and neurological development.

Conclusion. Our findings suggest that CDKL5 mutations likely play a direct role in psychomotor development, whereas epilepsy is one of the clinical features associated with this complex disorder.
Temporal encephalocele: a novel indication for magnetic resonance‐guided laser interstitial thermal therapy for medically intractable epilepsy
Authors: Ranjan Manish , Wilfong Angus W. , Borewinkle Varina , Jarrar Randa , Adelson P. David
Published: January 2024

Temporal encephalocele (TE) is a rare but surgically treatable/curable cause of temporal lobe epilepsy (TLE). The surgical intervention varies from local disconnection to extensive anterior temporal lobectomy and amygdalohippocampectomy (ATL/AH). Magnetic resonance‐guided laser interstitial thermal therapy (MRgLITT) has evolved as a minimally invasive alternative for intractable epilepsy with good results, however, application of MRgLITT for intractable pediatric epilepsy secondary to TE has not been reported. We present a detailed technical report and clinical experience of MRgLITT in two adolescent children with medically intractable TLE secondary to TE. Pre‐surgical evaluation revealed anterior inferior TE with concordant clinico‐electrophysiological data. Both the patients underwent MRgLITT after review with the institutional multidisciplinary epilepsy team and discussion with the patient and the family. Both the patients were discharged on post‐operative day one and have been seizure‐free since the procedure at the last follow‐up visit at 18 months and 6 months, respectively. The present series demonstrates first‐ever clinical and technical experience of MRgLITT for TE with intractable pediatric epilepsy. The excellent post‐operative seizure outcome and favorable postoperative course support MRgLITT as the first line of surgical intervention for TE with intractable TLE and broadens the application of MRgLITT.
Comparison of clinical and electrophysiological characteristics between ictal and cardiac asystole encountered during video‐EEG monitoring
Authors: Sankaranarayanan Muthukani , Makhija Prashant , Gopinath Siby , Mathew Navin , Radhakrishnan Kurupath
Published: January 2024

Aims
. Differentiation between syncope secondary to epileptic seizures and cardiac disease in patients displaying transient loss of consciousness associated with convulsive movements is a diagnostic challenge both for neurologists and cardiologists. In such patients, prolonged video‐EEG monitoring not only helps in identifying asystole as the cause of syncope, but also in categorizing asystole as primarily cardiac in origin (cardiac asystole) and secondary to epileptic seizures (ictal asystole). We carried out this study to ascertain the prevalence of asystole in an epilepsy monitoring unit, and to contrast the clinical and electrophysiological characteristics between ictal asystole and cardiac asystole.

Methods
. Through a retrospective search, we identified patients who were shown to have had asystole using a database of patients who underwent prolonged video‐EEG monitoring during a 68‐month period. We compared the data of 18 consecutive patients; five with ictal asystole and 13 with cardiac asystole, with 121 and 64 events recorded from them, respectively.

Results
. Of the 10,096 patients who underwent prolonged video‐EEG monitoring during the study period, we identified 18 (0.17%) patients with asystole. Cardiac asystole was 2.6 times more frequent than ictal asystole. Older age at onset, heralding symptoms of presyncope, occurrence during wakefulness, and brief duration of the events supported the diagnosis of cardiac asystole. Ictal asystole events were more protracted, and prolonged asystole more frequently occurred in patients with extratemporal seizures compared to temporal lobe seizures. Asystole occurred in only half of the recorded seizures.

Conclusions
. The accurate categorization of asystole as seizure‐related or heart disease‐related has huge implications for management strategy and outcome. The necessity of permanent pacemaker implantation is more frequent and urgent in patients with cardiac asystole because of the greater risk of sudden death. Hence, in patients with an ominous diagnosis of cardiac asystole, a thorough cardiac evaluation should surpass neurological evaluation.
Multimodal assessment of language and memory reorganization: a proof of concept in two patients with drug‐resistant temporal lobe epilepsy
Authors: Roger Elise , Pichat Cédric , Renard Félix , Cousin Emilie , Perrone‐Bertolotti Marcela , Hot Pascal , Minotti Lorella , Job Anne‐Sophie , Kahane Philippe , Trebuchon Agnes , Krainik Alexandre , Baciu Monica
Published: January 2024

Aims. We report two patients suffering from drug‐resistant temporal lobe epilepsy to show how their neuroplasticity can be apprehended using a multimodal, integrative and clinically relevant approach.

Methods. This is a proof of concept based on using multimodal data including: (1) white matter structural connectivity (DTI) of the main tracts involved in language and memory; (2) neurophysiological biomarkers (fMRI‐BOLD signal and LI lateralization indices); and (3) cognitive scores as measured during the neuropsychological assessment. We characterized tri‐modal data for each patient using a descriptive integrative approach, in terms of reorganization and by comparing with a group of healthy participants.

Conclusions. This proof of concept suggests that the inclusion of multimodal data in clinical studies is currently a major challenge. Since the various datasets obtained from MRI neuroimaging and cognitive scores are probably interrelated, it is important to go beyond the mono‐modal approach and move towards greater integration of several multimodal data. Multimodal integration of anatomical, functional, and cognitive data facilitates the identification of comprehensive neurocognitive patterns in epileptic patients, thus enabling clinicians to differentiate between reorganization profiles and help to predict post‐surgical outcomes for curative neurosurgery.
Stimulus‐induced rhythmic, periodic ictal discharges during funduscopic examination in a patient with status epilepticus
Authors: Hong Wei‐Pin , Chen Tsang‐Shan , Huang Chin‐Wei
Published: January 2024

Stimulus‐induced rhythmic, periodic, or ictal discharges (SIRPIDs), an unusual pattern in electroencephalography, have been described in critically‐ill encephalopathic patients in response to alerting stimuli. The phenomenon may be seen in patients with a broad range of aetiologies, including cerebral infarct, haemorrhage, anoxia, and degenerative diseases. Here, we report a unique case of status epilepticus presenting with SIRPIDs during funduscopic examination‐induced focal to bilateral tonic‐clonic seizures.
The localizing value of epileptic auras: pitfalls in semiology and involved networks
Authors: Russo Angelo , Arbune Anca Adriana , Bansal Lalit , Mindruta Ioanna , Gobbi Giuseppe , Duchowny Michael
Published: January 2024

A more complete understanding of the epileptic aura represents an important challenge for localizing the epileptogenic zone and understanding brain networks. This review re‐visits the localizing value of the epileptic aura, focusing on clinical pitfalls in epileptogenic zone detection and the importance of defining functional connectivity. We review the role of network node activation or alteration and its relationship to hub activation.
Prolonged EEGs in adult patients with a first unprovoked seizure: a prospective pilot study
Authors: Shapiro Michelle , Foster Gary
Published: January 2024

Aims
. Definitions of epilepsy have changed to include a first unprovoked seizure with a high (>60%) risk of recurrence in the next 10 years. A single seizure and an epileptiform discharge on an EEG would suffice for this diagnosis. We hypothesized that an extended six‐hour EEG in adult patients presenting with a first unprovoked seizure would demonstrate an increased yield of epileptiform discharges in comparison to a standard 30‐minute EEG, and therefore higher rates of epilepsy diagnosis.

Methods
. Thirty‐eight patients were recruited at Hamilton Health Sciences over six years and 36 underwent extended six‐hour EEGs.

Results
. Two of seven patients demonstrated epileptiform discharges on their EEG after only the first 30 minutes of recording, observed during sleep for both patients. This correlated to an overall increase of 5.56%, or a yield of 29%.

Conclusion
. A third more patients could benefit from early diagnosis with extended EEGs. The rate of epilepsy diagnosis based on EEG overall was superior to that of brain imaging (19%
versus
6%). Given the limitations due to sample size in this study, a larger trial would be beneficial to confirm these findings.
Dignidad humana e inclusión laboral
Authors:   Universidad Cooperativa de Colombia, Montoya Agudelo Cesar Alveiro , Taborda Morales Yarmin Lorena ,   Fundación Universitaria CEIPA, Arango Benjumea Jhon Jaime ,   Universidad Cooperativa de Colombia, Ortega Barro Ana Cristina ,   Universidad Nacional Autónoma de México, Pérez Villa Pastor Emilio ,   Universidad Cooperativa de Colombia
Published: January 2024

This book is the result of the INV3081 research project titled "Labor Discrimination as a Risk Factor for the Sustainability of Decent Work," which has been funded by the Universidad Cooperativa de Colombia and led by the research group in Management and Organizational Development (GDO) of the Medellín branch. For the development of this research, we had the participation of co-investigators from professors at the CEIPA University Foundation and the Faculty of Accounting and Administration at the Autonomous University of Mexico. The main objective of this work is to present readers with an analysis of the various types of workplace discrimination as a risk factor for the sustainability of decent work. Therefore, throughout this text, readers will be able to identify each of the elements that are part of discrimination in the organizational context. This is a study that was conducted using a mixed methodology that involved searching for information in a specialized database on discrimination topics, specifically in the work environment. Likewise, a questionnaire with closed-ended questions was designed and administered, focusing on understanding the participants' perception of fundamental aspects related to labor discrimination and how it hinders the creation of decent work. It is concluded that no one has been or will be free, directly or indirectly, from experiencing some form of exclusion in the workplace, despite the progress made in non-discrimination in the field of employment.
Effect of Circuit Training on Calcium Level and Physical Fitness in Pregnant Women with Hypocalcemia: A randomized controlled trial
Authors: Wahb Shorouk , ElDeeb Abeer , Kamel Hossam , El-Shafei Manal
Published: January 2024

Background: Hypocalcemia is a common problem during pregnancy that affects maternal and fetal outcomes. So, preventive and treatment measures are warranted to prevent complications and promote health and well-being in pregnant women with calcium deficiency. Purpose: This study aimed to investigate the effect of circuit training (CT) on calcium levels and physical fitness in pregnant women with hypocalcemia. Methods: Forty-four pregnant women in their 2nd trimester having hypocalcemia participated in the study; their ages ranged from 20 to 35 years old, and their body mass index (BMI) was 35.00 to 39.99kg/m2. They were randomly divided into two equal groups. The control group received daily calcium supplements (1.5 – 2 g), while the CT group received the same tablets and performed the CT program for 60 minutes, three sessions per week for 12 weeks. Serum-free and ionized calcium levels were measured, and sit and reach flexibility test, wall squat test, chair stand test, and modified push-up test assessed the physical fitness before and after treatment. Results: The control and CT groups showed statistically significant increases (p<0.0001) in free and ionized calcium levels and a non-significant difference (p>0.05) between groups after treatment. Compared to the control group, the CT group showed statistically significant increases (p<0.0001) in the scores of sit and reach flexibility test, wall squat test, chair stand test, and modified push-up test after treatment. However, the control group showed a non-significant difference (p>0.05) in all test scores. Conclusion: Adding CT to calcium supplements is a safe and effective method that maintains calcium and improves physical fitness in pregnant women with hypocalcemia, which should be a part of the antenatal exercises program for gravid women.