Bone-anchored Hearing Aids: correlation between pure-tone thresholds and outcome in three user groups

OBJECTIVE: To investigate correlations between preoperative hearing thresholds and postoperative aided thresholds and speech understanding of users of Bone-anchored Hearing Aids (BAHA). Such correlations may be useful to estimate the postoperative outcome with BAHA from preoperative data. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS:: Ninety-two adult unilaterally implanted BAHA users in 3 groups: (A) 24 subjects with a unilateral conductive hearing loss, (B) 38 subjects with a bilateral conductive hearing loss, and (C) 30 subjects with single-sided deafness. INTERVENTIONS: Preoperative air-conduction and bone-conduction thresholds and 3-month postoperative aided and unaided sound-field thresholds as well as speech understanding using German 2-digit numbers and monosyllabic words were measured and analyzed. MAIN OUTCOME MEASURES: Correlation between preoperative air-conduction and bone-conduction thresholds of the better and of the poorer ear and postoperative aided thresholds as well as correlations between gain in sound-field threshold and gain in speech understanding. RESULTS: Aided postoperative sound-field thresholds correlate best with BC threshold of the better ear (correlation coefficients, r2 = 0.237 to 0.419, p = 0.0006 to 0.0064, depending on the group of subjects). Improvements in sound-field threshold correspond to improvements in speech understanding. CONCLUSION: When estimating expected postoperative aided sound-field thresholds of BAHA users from preoperative hearing thresholds, the BC threshold of the better ear should be used. For the patient groups considered, speech understanding in quiet can be estimated from the improvement in sound-field thresholds.

Changes in species composition in alpine snowbeds with climate change inferred from small-scale spatial patterns

Alpine snowbeds are characterised by a very short growing season. However, the length of the snow-free period is increasingly prolonged due to climate change, so that snowbeds become susceptible to invasions from neighbouring alpine meadow communities. We hypothesised that spatial distribution of species generated by plant interactions may indicate whether snowbed species will coexist with or will be out-competed by invading alpine species – spatial aggregation or segregation will point to coexistence or competitive exclusion, respectively. We tested this hypothesis in snowbeds of the Swiss Alps using the variance ratio statistics. We focused on the relationships between dominant snowbed species, subordinate snowbed species, and potentially invading alpine grassland species. Subordinate snowbed species were generally spatially aggregated with each other, but were segregated from alpine grassland species. Competition between alpine grassland and subordinate snowbed species may have caused this segregation. Segregation between these species groups increased with earlier snowmelt, suggesting an increasing importance of competition with climate change. Further, a dominant snowbed species (Alchemilla pentaphyllea) was spatially aggregated with subordinate snowbed species, while two other dominants (Gnaphalium supinum and Salix herbacea) showed aggregated patterns with alpine grassland species. These dominant species are known to show distinct microhabitat preferences suggesting the existence of hidden microhabitats with different susceptibility to invaders. These results allow us to suggest that alpine snowbed areas are likely to be reduced as a consequence of climate change and that invading species from nearby alpine grasslands could outcompete subordinate snowbed species. On the other hand, microhabitats dominated by Gnaphalium or Salix seem to be particularly prone to invasions by non-snowbed species.