A Supervised Machine Learning Approach to Classify Brain Morphology of Professional Visual Artists versus Non-Artists.

This study aimed to investigate whether there are structural differences in the brains of professional artists who received formal training in the visual arts and non-artists who did not have any formal training or professional experience in the visual arts, and whether these differences can be used to accurately classify individuals as being an artist or not. Previous research using functional MRI has suggested that general creativity involves a balance between the default mode network and the executive control network. However, it is not known whether there are structural differences between the brains of artists and non-artists. In this study, a machine learning method called Multi-Kernel Learning (MKL) was applied to gray matter images of 12 artists and 12 non-artists matched for age and gender. The results showed that the predictive model was able to correctly classify artists from non-artists with an accuracy of 79.17% (AUC 88%), and had the ability to predict new cases with an accuracy of 81.82%. The brain regions most important for this classification were the Heschl area, amygdala, cingulate, thalamus, and parts of the parietal and occipital lobes as well as the temporal pole. These regions may be related to the enhanced emotional and visuospatial abilities that professional artists possess compared to non-artists. Additionally, the reliability of this circuit was assessed using two different classifiers, which confirmed the findings. There was also a trend towards significance between the circuit and a measure of vividness of imagery, further supporting the idea that these brain regions may be related to the imagery abilities involved in the artistic process.

Acute heart failure in the elderly: setting related differences in clinical features and management.

BACKGROUND: Administrative data show that acute heart failure (HF) patients are older than those enrolled in clinical registries and frequently admitted to non-cardiological settings of care. The purpose of this study was to describe clinical characteristics of old patients hospitalised for acute HF in Cardiology, Internal Medicine or Geriatrics wards. METHODS: Data came from ATHENA (AcuTe Heart failurE in advaNced Age) registry which included elderly patients (≥ 65 years) admitted to the above mentioned settings of care from December 1, 2014 to December 1, 2015. RESULTS: We enrolled 396 patients, 15.4% assigned to Cardiology, 69.7% to Internal Medicine, and 14.9% to a Geriatrics ward. Mean age was 83.5 ± 7.6 years (51.8% of patients ≥ 85 years) and was higher in patients admitted to Geriatrics (P < 0.001); more than half were females. Medical treatments did not differ significantly among settings of care (in a context of a low prescription rate of renin-angiotensin-aldosterone system inhibitors) whereas significant differences were observed in comorbidity patterns and management guidelines recommendation adherence for decongestion evaluation with comparison of weight and N-terminal pro-B-type natriuretic peptide levels on admission and at discharge (both P = 0.035 and P < 0.001), echocardiographic evaluation ( P < 0.001) and follow-up visits planning ( P < 0.001), all higher in Cardiology. Mean in-hospital length of stay was 9 ± 5.9 days, significantly higher in Geriatrics (13.7 ± 6.5 days) and Cardiology (9.9 ± 6.7 days) compared to Internal Medicine (8 ± 5.2 days), P < 0.001. In-hospital mortality was 9.3%, resulting higher in Geriatrics (18.6%) and Cardiology (16.4%) than Internal Medicine (5.8%), P = 0.001. CONCLUSIONS: In elderly patients hospitalised for acute HF, clinical characteristics and management differ significantly according to the setting of admission.

Risk factors and outcomes of new-onset atrial fibrillation in patients hospitalized in an internal medicine ward: a case-control study.

Atrial fibrillation (AF) is a frequent pathology in Internal Medicine departments. The aim of our study was to identify the risk factors associated with the development of new-onset AF during hospitalization and to evaluate its outcome as in-hospital mortality. We conducted a retrospective case-control study on a cohort of 14,179 patients admitted to an internal medicine department. We included in the study the patients who did not have an anamnestic history of AF, who presented a sinus rhythm at the time of admission and who developed a new-onset AF during hospitalization. For each of these cases, two controls were enrolled who were not affected by AF. The patients included in the study were 588, including 196 cases and 392 controls. Patients who developed AF during hospitalization had significantly more comorbidity than controls. The most frequent causes for hospitalization were sepsis, significantly higher in the case group. From the results of the multivariate analysis, the factors related independently to the development of AF were the presence of a number of comorbidities ≥ 3 (OR = 1.52; p = 0.017), sepsis as a reason of hospitalization (OR = 2, 16; p = 0.001) and glycemic value at the admission ≥ 130 mg/dL (OR = 1.44; p = 0.047). Both the length of hospital stay and in-hospital mortality were higher in the group of patients who developed AF, with a statistically significant difference compared to controls (p < 0.001).

Performance status and in-hospital mortality of elderly patients with community acquired pneumonia.

To evaluate the role of performance status evaluated by the Eastern Cooperative Oncology Group (ECOG) score in predicting 30-day mortality in subjects hospitalized for community acquired pneumonia (CAP), this was a prospective study of patients consecutively hospitalized for CAP at a large University Hospital in Italy. Performance status was evaluated using the ECOG score that in a 0-5 point scale indicates progressive functional deterioration. The end-point of the study is the 30-day mortality. Two-hundred-sixteen patients were enrolled, 75.9% were aged > 70 years, 31.5% had severe pneumonia at CURB-65 score (3-4), and 27.5% of patients had severe disability (ECOG 3-4). Thirty-day mortality is 15.3%. Progression in ECOG score independently increases the probability of 30-day mortality at multivariable logistic regression analysis (HR 2.19, 95% CI 1.60-3.01, p < 0.0001). ECOG 3 or 4 determines a four-fold increase in 30-day mortality (HR 4.07, 95% CI 1.84-9.02, p < 0.001). ECOG score 3 or 4 is highly predictive of death in patients classified at low risk of mortality by CURB-65 (0-2 points) score. Functional status is directly related to outcome in elderly patients hospitalized for CAP. The use of a very simple and fast tool, such as the ECOG score, might help to better stratify the risk of short-term mortality, especially in patients otherwise classified at low risk of death by CURB-65 score.

Brain networks for visual creativity: a functional connectivity study of planning a visual artwork.

Throughout recorded history, and across cultures, humans have made visual art. In recent years, the neural bases of creativity, including artistic creativity, have become a topic of interest. In this study we investigated the neural bases of the visual creative process with both professional artists and a group of control participants. We tested the idea that creativity (planning an artwork) would influence the functional connectivity between regions involved in the default mode network (DMN), implicated in divergent thinking and generating novel ideas, and the executive control network (EN), implicated in evaluating and selecting ideas. We measured functional connectivity with functional Magnetic Resonance Imaging (fMRI) during three different conditions: rest, visual imagery of the alphabet and planning an artwork to be executed immediately after the scanning session. Consistent with our hypothesis, we found stronger connectivity between areas of the DMN and EN during the creative task, and this difference was enhanced in professional artists. These findings suggest that creativity involves an expert balance of two brain networks typically viewed as being in opposition.

The Tactile Dimensions of Abstract Paintings: A Cross-Modal Study.

In our research, we tested for the existence of cross-modal visual and tactile associations in the experience of abstract art. Specifically, we measured the association of 60 abstract paintings with four couples of antonyms related to texture, such as warm or cold, smooth or rough, lightweight or heavy, soft or hard, investigating if the different modality of presentation on a computer screen (color versions: natural colors, inverted colors, black and white) gave rise to different associations relative to the four couples of opponent qualities. Second, we tested whether there might be differences between the ratings of the paintings when they were presented as images on a computer screen versus in real life at the museum. The results confirmed that associations between visual and tactile experience with such complex stimuli exist. In the case of the couple warm or cold, a significant inversion of associated qualities occurs when the images are presented in inverted colors as opposed to natural colors; furthermore, when presented in black and white, warm evaluations are "cooled down," but cold evaluations remain the same. The degree of smoothness could be considered not associated with the color versions. When seen in black and white, both the mean softness and the mean lightweight-ness of the paintings were reduced; however, in the last case, this effect was more evident for the most lightweight pictures. There is only a slight difference between the two presentations of the paintings as images presented on a computer screen and seen in real life, relative to the warm or cold and soft or hard dimensions. Of the four opponent qualities, the three pairs warm or cold, lightweight or heavy, and soft or hard showed the most interesting results in relation to the cross-modal associations.

The Influence of Art Expertise and Training on Emotion and Preference Ratings for Representational and Abstract Artworks.

Across cultures and throughout recorded history, humans have produced visual art. This raises the question of why people report such an emotional response to artworks and find some works more beautiful or compelling than others. In the current study we investigated the interplay between art expertise, and emotional and preference judgments. Sixty participants (40 novices, 20 art experts) rated a set of 150 abstract artworks and portraits during two occasions: in a laboratory setting and in a museum. Before commencing their second session, half of the art novices received a brief training on stylistic and art historical aspects of abstract art and portraiture. Results showed that art experts rated the artworks higher than novices on aesthetic facets (beauty and wanting), but no group differences were observed on affective evaluations (valence and arousal). The training session made a small effect on ratings of preference compared to the non-trained group of novices. Overall, these findings are consistent with the idea that affective components of art appreciation are less driven by expertise and largely consistent across observers, while more cognitive aspects of aesthetic viewing depend on viewer characteristics such as art expertise.

Procalcitonin Kinetics in the First 72 Hours Predicts 30-Day Mortality in Severely Ill Septic Patients Admitted to an Intermediate Care Unit.

BACKGROUND: Severe sepsis and septic shock are leading causes of morbidity and mortality among critically ill patients, thus the identification of prognostic factors is crucial to determine their outcome. In this study, we explored the value of procalcitonin (PCT) variation in predicting 30-day mortality in patients with sepsis admitted to an intermediate care unit. METHODS: This prospective observational study enrolled 789 consecutive patients with severe sepsis and septic shock admitted to a medical intermediate care unit between November 2012 and February 2014. Kinetics of PCT expressed as percentage were defined by the variation between admission and 72 hours, and 24 and 72 hours; they were defined as Δ-PCT0-72h and Δ-PCT24-72h, respectively. RESULTS: The final study group of 144 patients featured a mean age of 73 ± 14 years, with a high prevalence of comorbidities (Charlson index greater than 6 in 39%). Overall, 30-day mortality was 28.5% (41/144 patients). A receiver-operating-characteristic (ROC) analysis identified a decrease of Δ-PCT0-72h less than 15% (area under the curve: 0.75; 95% confidence interval (CI): 0.67 - 0.82) and a decrease of Δ-PCT24-72h less than 20% (area under the curve: 0.83; 95% CI: 0.74 - 0.92) as the most accurate cut-offs in predicting mortality. Decreases of Δ-PCT0-72h less than 15% (HR: 3.9, 95% CI: 1.6 - 9.5; P < 0.0001) and Δ-PCT24-72h less than 20% (HR: 3.1, 95% CI: 1.2 - 7.9; P < 0.001) were independent predictors of 30-day mortality. CONCLUSIONS: Evaluation of PCT kinetics over the first 72 hours is a useful tool for predicting 30-day mortality in patients with severe sepsis and septic shock admitted to an intermediate care unit.

Perception of emotion in abstract artworks: a multidisciplinary approach.

There is a long-standing and fundamental debate regarding how emotion can be expressed by fine art. Some artists and theorists have claimed that certain features of paintings, such as color, line, form, and composition, can consistently express an "objective" emotion, while others have argued that emotion perception is subjective and depends more on expertise of the observer. Here, we discuss two studies in which we have found evidence for consistency in observer ratings of emotion for abstract artworks. We have developed a stimulus set of abstract art images to test emotional priming, both between different painting images and between paintings and faces. The ratings were also used in a computational vision analysis of the visual features underlying emotion expression. Overall, these findings suggest that there is a strong bottom-up and objective aspect to perception of emotion in abstract artworks that may tap into basic visual mechanisms.

NT-ProBNP reduction percentage during hospital stay predicts long-term mortality and readmission in heart failure patients.

We prospectively evaluated whether the N-terminal brain natriuretic peptide (NT-ProBNP) reduction percentage, during hospitalization for acutely decompensated heart failure (HF), has a prognostic significance in 6-month follow-up. In 120 patients consecutively admitted for acute HF to an internal medicine unit, plasma NT-ProBNP was measured on admission and at discharge. During a 6-month follow-up 52 (43.3%) patients had events: 9 (7.5%) died from cardiovascular causes, and 43 (35.8%) were readmitted for HF. In patients without events, the mean reduction percentage of NT-ProBNP was greater than in patients with events (39.5 +/- 7.4 versus 26.3 +/- 5.9%; P = 0.04). In receiver operating characteristic curve analysis, the mean area under the curve for NT-ProBNP reduction percentage was 0.63 (95% CI, 0.51-0.75; P = 0.04) for the composite end point (death or readmission), and 0.81 (95% CI, 0.65-0.97, P = 0.01) for cardiovascular mortality. NT-ProBNP reduction percentage less than 30% was the best cut-off for the identification of patients at risk of events. We suggest that in clinical practice the evaluation of change of NT-ProBNP levels during admission is probably more helpful than predischarge NT-ProBNP absolute value.

The visual system as a constraint on the survival and success of specific artworks.

Why should vision science turn its gaze towards artworks? One possibility is that understanding visual processing might yield some fundamental insight into the nature of art. However, there are many examples of phenomena that can be seen - such as automobiles, clouds or leaves - but which are not explained in any deep sense by the properties of human visual perception. We examine one art historical question that might benefit from knowledge about the visual system: why do some artworks 'survive' historically while others fade into the dustbin of time? One possible reason, suggested by studies of rapid visual categorization, is that some objects are recognized more quickly and easily than others and thus are less culturally specific in terms of pictorial representation. A second, related, explanation is that many artistic techniques use the eyes as a channel to evoke other senses, cognition, emotions and the motor system. 'Art' is a social and historical construct - after all, the concept of 'fine art' was invented in the 18th century - and thus many aspects of artistic appreciation are specific to particular cultural and historical contexts. Some great works, however, may be adopted by successive generations because of an ability to appeal to a shared perceptual system.

Pre-discharge B-type natriuretic peptide predicts early recurrence of decompensated heart failure in patients admitted to a general medical unit.

BACKGROUND: B-type natriuretic peptide (BNP) represents a promising predictor of early (30 days) re-admission in patients with heart failure (HF) admitted to cardiology units. Whether BNP retains its predictive value in unselected patients admitted to general medical wards is unknown. METHODS: We determined BNP levels on admission and pre-discharge in 100 consecutive patients (71 male, mean age 78+/-10 years) admitted to a general medical unit due to decompensated HF. Follow-up after discharge was 30 days. RESULTS: Of the 100 patients, 86 had >/=1 comorbid conditions. Median BNP was 739 pg/ml on admission (25th-75th percentile 355-1333 pg/ml, respectively), and 414 pg/ml pre-discharge (25th-75th percentile 220-696 pg/ml). Seventeen patients were re-admitted or died within 30 days. Patients with pre-discharge BNP values >75th percentile (696 pg/ml) had greater risk of re-hospitalisation, as compared to values 75th percentile were associated with a 15.0 independent relative hazard (RH) of early re-admission or death (95% CI 4.2-53.8; p<0.0001). The other independent predictor was a NYHA class >/=III at discharge (RH 2.9; 95% CI 1.1-9.3; p<0.05). CONCLUSION: In a general medical unit, pre-discharge BNP levels were a strong independent predictor of early re-admission or death due to HF, irrespective of substantial comorbidity and advanced age.

"A moment's monument": the central vision of Italian sculptor Medardo Rosso (1858-1928).

One of the basic limitations on visual perception is that it is impossible, in any given moment, to see the world sharply and full of colors beyond the central area of the visual field. This fact was popularized and brought to the attention of artists in the nineteenth century. To accurately represent the 'impression', or vision of a single glance, an artistic work should contain only a central area in focus surrounded by a progressively greater blur. The work of the Italian sculptor Medardo Rosso (1858-1928) may be the first artistic representation of differences in central and peripheral acuity. Despite using the medium of sculpture, typically three-dimensional, Rosso conceived of his art as two-dimensional because in a given moment it is possible to view a scene from only one viewpoint. The analysis of Rosso's photographs of his own sculptures emphasizes the areas of detail and relative blur, allowing a reconstruction of his point de vue unique--where the observer should stand when viewing that specific sculpture. We argue that the role of central and peripheral vision in subjective perception is critical to understanding the work of Rosso, aptly defined by critics as monument d'un instant.