Objective. After laryngectomy, the breathing resistance of heat and moisture exchangers may limit exercise capacity. Breathing gas analysis during cardiopulmonary exercise testing is not possible using regular masks. This study tested the feasibility of cardiopulmonary exercise testing with a heat and moisture exchanger in situ, using an in-house designed connector. Additionally, we explored the effect of different heat and moisture exchanger resistances on exercise capacity in this group. Methods. Ten participants underwent two cardiopulmonary exercise tests using their daily life heat and moisture exchanger (0.3 hPa or 0.6 hPa) and one specifically developed for activity (0.15 hPa). Heat and moisture exchanger order was randomised and blinded.Results. All participants completed both tests. No (serious) adverse events occurred. Only four subjects reached a respiratory exchange ratio of more than 1.1 in at least one test. Maximum exercise levels using heat and moisture exchangers with different resistances did not differ. Conclusion. Cardiopulmonary exercise testing in laryngectomees with a heat and moisture exchanger is feasible; however, the protocol does not seem appropriate to reach this group's maximal exercise capacity. Lowering heat and moisture exchanger resistance does not increase exercise capacity in this sample.
For children it is important to consume enough vegetables to establish healthy dietary patterns. Taste acceptance is an important factor contributing to food choice and consumption. Sweetness and sourness enhancement can increase acceptance of specific foods in children. The aim of this study was to determine the effect of sweetness and sourness enhancement on acceptance of cucumber and green capsicum purees in 5-6-year-old children. Three concentrations of sucrose (2, 5 and 10%) and citric acid (0.05, 0.08 and 0.15%) were added to cucumber and green capsicum purees. Children (n = 70, 5.7 ± 0.5 yrs) assessed acceptance of the vegetable purees using a 5-point hedonic facial scale. Sweetness enhancement significantly increased acceptance of cucumber purees (5 and 10% sucrose) and green capsicum purees (2 and 10% sucrose) compared to unmodified purees. Sourness enhancement (0.05, 0.08 and 0.15% citric acid) did not significantly influence acceptance of cucumber and green capsicum purees compared to unmodified purees. Children differed in acceptance of vegetable purees with added sucrose and citric acid. Sweetness likers (cucumber 77.1%, green capsicum 58.6%) accepted sucrose concentrations better than sweetness non-likers in both vegetables. Sourness likers (cucumber 50.0%, green capsicum 44.3%) accepted medium and high concentrations of citric acid better than sourness non-likers in cucumber and all citric acid concentrations in green capsicum. We conclude that enhancement of sweetness increases acceptance of cucumber and green capsicum purees in most children whereas enhancement of sourness is better accepted by only a few children. This study highlights the challenge to get children to better accept vegetables, since only sweetness enhancement improved acceptance while addition of sucrose is undesirable. For a small subset of children enhancing sourness might be an alternative strategy to increase acceptance of vegetables
Echinoderm mass mortality events shape marine ecosystems by altering the dynamics among major benthic groups. The sea urchin Diadema antillarum, virtually extirpated in the Caribbean in the early 1980s by an unknown cause, recently experienced another mass mortality beginning in January 2022. We investigated the cause of this mass mortality event through combined molecular biological and veterinary pathologic approaches comparing grossly normal and abnormal animals collected from 23 sites, representing locations that were either affected or unaffected at the time of sampling. Here, we report that a scuticociliate most similar to Philaster apodigitiformis was consistently associated with abnormal urchins at affected sites but was absent from unaffected sites. Experimentally challenging naïve urchins with a Philaster culture isolated from an abnormal, field-collected specimen resulted in gross signs consistent with those of the mortality event. The same ciliate was recovered from treated specimens postmortem, thus fulfilling Koch’s postulates for this microorganism. We term this condition D. antillarum scuticociliatosis.
MULTIFILE
