Neuropsychological investigations of art production and perception have the potential to offer critical insight into the biology of visual aesthetics. Thus far, however, investigations of art production in patients have been limited to anecdotal observations and investigations of art perception are non-existent. Progress in the field is hampered by the lack of an adequate instrument to provide basic quantification of artwork attributes. Motivated by the need to move neuropsychology of art beyond the fascinating anecdote, we present the Assessment of Art Attributes (AAA). The AAA is an instrument designed to assess six formal-perceptual and six conceptual-representational attributes using 24 paintings from the Western canon. Both artistically naïve and experienced participants were given the AAA. We found high degrees of agreement in the assessment of these attributes in both groups and few differences between the groups. We expect that the AAA's componential and quantitative approach will be useful in advancing neuropsychological studies as well as any investigations in which style and content of art works need to be quantified and compared.Since the time of Broca and Wernicke, the study of individuals with brain damage has provided unique insights into the biological basis of behavior. Thus, by the 207 Ó 2010, Baywood Publishing Co., Inc.

We know little about the neurologic bases of art production. The idea that the right brain hemisphere is the "artistic brain" is widely held, despite the lack of evidence for this claim. Artists with brain damage can offer insight into these laterality questions. The authors used an instrument called the Assessment of Art Attributes to examine the work of two individuals with left-brain damage and one with right-hemisphere damage. In each case, their art became more abstract and distorted and less realistic. They also painted with looser strokes, less depth and more vibrant colors. No unique pattern was observed following right-brain damage. However, art produced after left-brain damage also became more symbolic. These results show that the neural basis of art production is distributed across both hemispheres in the human brain. Rebecca Sternschein University of Pennsylvania Page Widick University of PennsylvaniaThis paper is posted at ScholarlyCommons. http://repository.upenn.edu/neuroethics_pubs/1 For more information, please contact repository@pobox.upenn.edu. Artistic Production Following Brain Damage: A Study of Three Artists AbstractWe know little about the neurologic bases of art production. The idea that the right brain hemisphere is the "artistic brain" is widely held, despite the lack of evidence for this claim. Artists with brain damage can offer insight into these laterality questions. The authors used an instrument called the Assessment of Art Attributes to examine the work of two individuals with left-brain damage and one with right-hemisphere damage. In each case, their art became more abstract and distorted and less realistic. They also painted with looser strokes, less depth and more vibrant colors. No unique pattern was observed following right-brain damage. However, art produced after left-brain damage also became more symbolic. These results show that the neural basis of art production is distributed across both hemispheres in the human brain.

Little about the neuropsychology of art perception and evaluation is known. Most neuropsychological approaches to art have focused on art production and have been anecdotal and qualitative. The field is in desperate need of quantitative methods if it is to advance. Here, we combine a quantitative approach to the assessment of art with modern voxel-lesion-symptom-mapping methods to determine brain–behavior relationships in art perception. We hypothesized that perception of different attributes of art are likely to be disrupted by damage to different regions of the brain. Twenty participants with right hemisphere damage were given the Assessment of Art Attributes, which is designed to quantify judgments of descriptive attributes of visual art. Each participant rated 24 paintings on 6 conceptual attributes (depictive accuracy, abstractness, emotion, symbolism, realism, and animacy) and 6 perceptual attributes (depth, color temperature, color saturation, balance, stroke, and simplicity) and their interest in and preference for these paintings. Deviation scores were obtained for each brain-damaged participant for each attribute based on correlations with group average ratings from 30 age-matched healthy participants. Right hemisphere damage affected participants’ judgments of abstractness, accuracy, and stroke quality. Damage to areas within different parts of the frontal parietal and lateral temporal cortices produced deviation in judgments in four of six conceptual attributes (abstractness, symbolism, realism, and animacy). Of the formal attributes, only depth was affected by inferior prefrontal damage. No areas of brain damage were associated with deviations in interestingness or preference judgments. The perception of conceptual and formal attributes in artwork may in part dissociate from each other and from evaluative judgments. More generally, this approach demonstrates the feasibility of quantitative approaches to the neuropsychology of art.

Background: Interpersonal and communication skills are essential for physicians practicing in critical care settings. Accordingly, demonstration of these skills has been a core competency of the Accreditation Council for Graduate Medical Education since 2014. However, current practices regarding communication skills training in adult and pediatric critical care fellowships are not well described. Objective: To describe the current state of communication curricula and training methods in adult and pediatric critical care training programs as demonstrated by the published literature. Methods: We performed a systematic review of the published literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Three authors reviewed a comprehensive set of databases and independently selected articles on the basis of a predefined set of inclusion and exclusion criteria. Data were independently extracted from the selected articles. Results: The 23 publications meeting inclusion criteria fell into the following study classifications: intervention ( n = 15), cross-sectional survey ( n = 5), and instrument validation ( n = 3). Most interventional studies assessed short-term and self-reported outcomes (e.g., learner attitudes and perspectives) only. Fifteen of 22 publications represented pediatric subspecialty programs. Conclusion: Opportunities exist to evaluate the influence of communication training programs on important outcomes, including measured learner behavior and patient and family outcomes, and the durability of skill retention.

hree-dimensional (3D) sonography, an extremely important development in ultrasound imaging, 1,2 has proven useful in many clinical applications, especially in obstetrics, gynecology and musculoskeletal imaging, but it is not yet routinely performed in the evaluation of patients with hyperparathyroidism. Three-dimensional sonography enables postprocessing reconstruction of the images in all planes, including the coronal view, which is most similar to that of the surgical field. 3 With volumerendered views, important information regarding the feeding arterial vessel, the regional vascularity, and the configuration of the vascularity of parathyroid nodules may be obtained. This information can be used to better evaluate an enlarged parathyroid, to facilitate the recognition of a parathyroid adenoma, and to display pathologic conditions in a more useful format for the surgeon. Materials and MethodsFor this pictorial essay, we performed 3D sonography on 61 patients who were referred to our department for hyperparathyroidism or hypercalcemia. We received Institutional Review Board approval for this project and obtained informed consent from each patient. All images for this publication were obtained with a LOGIQ 9 3D ultrasound system (GE Healthcare, Milwaukee, WI), and an RSP6-16-D small-parts/pediatric linear transducer (frequency, 6-15 MHZ) was used for the 3D imaging. The 2-dimensional (2D) images were obtained with an ML6-15-D small-parts/pediatric linear transducer (frequency, 6-15 MHZ). Of the original 61 patients, 15 patients had primary hyperparathyroidism due to pathologically proven parathyroid adenomas or hyperplasia. They ranged in age from 31 to 83 years and were predominantly female (2 male and 13 female). Three-dimensional sonography is useful in the preoperative evaluation of patients with primary hyperparathyroidism. In this pictorial essay, we review the characteristic spectrum of grayscale and Doppler appearances of parathyroid glands on 2-dimensional sonography and demonstrate the additional benefits of 3-dimensional scanning.