You talkin' to me? Communicative talker gaze activates left-lateralized superior temporal cortex during perception of degraded speech.

Neuroimaging studies of speech perception have consistently indicated a left-hemisphere dominance in the temporal lobes' responses to intelligible auditory speech signals (McGettigan and Scott, 2012). However, there are important communicative cues that cannot be extracted from auditory signals alone, including the direction of the talker's gaze. Previous work has implicated the superior temporal cortices in processing gaze direction, with evidence for predominantly right-lateralized responses (Carlin & Calder, 2013). The aim of the current study was to investigate whether the lateralization of responses to talker gaze differs in an auditory communicative context. Participants in a functional MRI experiment watched and listened to videos of spoken sentences in which the auditory intelligibility and talker gaze direction were manipulated factorially. We observed a left-dominant temporal lobe sensitivity to the talker's gaze direction, in which the left anterior superior temporal sulcus/gyrus and temporal pole showed an enhanced response to direct gaze - further investigation revealed that this pattern of lateralization was modulated by auditory intelligibility. Our results suggest flexibility in the distribution of neural responses to social cues in the face within the context of a challenging speech perception task

Using a staircase procedure for the objective measurement of auditory stream integration and segregation thresholds

Auditory scene analysis describes the ability to segregate relevant sounds out from the environment and to integrate them into a single sound stream using the characteristics of the sounds to determine whether or not they are related. This study aims to contrast task performances in objective threshold measurements of segregation and integration using identical stimuli, manipulating two variables known to influence streaming, inter-stimulus-interval (ISI) and frequency difference (Δf). For each measurement, one parameter (either ISI or Δf) was held constant while the other was altered in a staircase procedure. By using this paradigm, it is possible to test within-subject across multiple conditions, covering a wide Δf and ISI range in one testing session. The objective tasks were based on across-stream temporal judgments (facilitated by integration) and within-stream deviance detection (facilitated by segregation). Results show the objective integration task is well suited for combination with the staircase procedure, as it yields consistent threshold measurements for separate variations of ISI and Δf, as well as being significantly related to the subjective thresholds. The objective segregation task appears less suited to the staircase procedure. With the integration-based staircase paradigm, a comprehensive assessment of streaming thresholds can be obtained in a relatively short space of time. This permits efficient threshold measurements particularly in groups for which there is little prior knowledge on the relevant parameter space for streaming perception

Attention effects on auditory scene analysis: Insights from event-related brain potentials

Sounds emitted by different sources arrive at our ears as a mixture that must be disentangled before meaningful information can be retrieved. It is still a matter of debate whether this decomposition happens automatically or requires the listener’s attention. These opposite positions partly stem from different methodological approaches to the problem. We propose an integrative approach that combines the logic of previous measurements targeting either auditory stream segregation (interpreting a mixture as coming from two separate sources) or integration (interpreting a mixture as originating from only one source). By means of combined behavioral and event-related potential (ERP) measures, our paradigm has the potential to measure stream segregation and integration at the same time, providing the opportunity to obtain positive evidence of either one. This reduces the reliance on zero findings (i.e., the occurrence of stream integration in a given condition can be demonstrated directly, rather than indirectly based on the absence of empirical evidence for stream segregation, and vice versa). With this two-way approach, we systematically manipulate attention devoted to the auditory stimuli (by varying their task relevance) and to their underlying structure (by delivering perceptual tasks that require segregated or integrated percepts). ERP results based on the mismatch negativity (MMN) show no evidence for a modulation of stream integration by attention, while stream segregation results were less clear due to overlapping attention-related components in the MMN latency range. We suggest future studies combining the proposed two-way approach with some improvements in the ERP measurement of sequential stream segregation

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications