Adjustable breathing resistance for laryngectomized patients: Proof of principle in a novel heat and moisture exchanger cassette

Background: Due to the heat and moisture exchanger's (HME) breathing resistance, laryngectomized patients cannot always use an (optimal) HME during physical exercise. We propose a novel HME cassette concept with adjustable “bypass,” to provide adjustment between different breathing resistances within one device. Methods: Under standardized conditions, the resistance and humidification performance of a high resistance/high humidification HME (XM) foam in a cassette with and without bypass were compared to a lower resistance/lesser humidification HME (XF) foam in a closed cassette. Results: With a bypass in the cassette, the resistance and humidification performance of XM foam were similar to those of XF foam in the closed cassette. Compared to XM foam in the closed cassette, introducing the bypass resulted in a 40% resistance decrease, whereas humidification performance was maintained at 80% of the original value. Conclusions: This HME cassette prototype allows adjustment between substantially different resistances while maintaining appropriate humidification performances

Adjustable breathing resistance for laryngectomized patients: Proof of principle in a novel heat and moisture exchanger cassette

Background: Due to the heat and moisture exchanger's (HME) breathing resistance, laryngectomized patients cannot always use an (optimal) HME during physical exercise. We propose a novel HME cassette concept with adjustable “bypass,” to provide adjustment between different breathing resistances within one device. Methods: Under standardized conditions, the resistance and humidification performance of a high resistance/high humidification HME (XM) foam in a cassette with and without bypass were compared to a lower resistance/lesser humidification HME (XF) foam in a closed cassette. Results: With a bypass in the cassette, the resistance and humidification performance of XM foam were similar to those of XF foam in the closed cassette. Compared to XM foam in the closed cassette, introducing the bypass resulted in a 40% resistance decrease, whereas humidification performance was maintained at 80% of the original value. Conclusions: This HME cassette prototype allows adjustment between substantially different resistances while maintaining appropriate humidification performances

Halmyris: Geoarchaeology of a fluvial harbour on the Danube Delta (Dobrogea, Romania)

In Northern Dobrogea, north of the Dunavăţ promontory, the Roman fortress of Halmyris was founded in the late 1st century AD on a Getic settlement dating to the middle of the 1st millennium BC, probably associated with a Greek emporium of the Classical and Hellenistic periods. At the time of the foundation of Halmyris, the Danube delta had already prograded several kilometres to the east leading to the progressive retreat of the sea and the formation of a deltaic plain characterised by numerous lakes and river channels. Here, we present the results of a multiproxy study combining sedimentology and palaeoecology to (1) understand the evolution of fluvial landscapes around Halmyris since ca. 8000 years BP and (2) identify the fluvial palaeoenvironments close to the city in Getic/Greek and Roman times, in order to locate and characterise the waterfront and the harbour. Our overriding objective was to improve understanding of human–environment relations in river delta settings. We demonstrate that Halmyris, protected by the Danubian floods due to its location on a palaeo-cliff top, had direct access to the river. A secondary channel of the Saint George, flowing north of the site, has been elucidated between the 7th century BC and the 7th century AD and could have been used as a natural harbour