Additional Reasons Research Articles

Misperceptions about the effectiveness of cutting down and low-rate daily smoking for reducing the risk of tobacco-caused harm.

Reducing the amount smoked per day, or smoking at a low rate, confers limited protection from smoking harms. We aimed to quantify the prevalence of misperceptions about cutting down and low-rate smoking among Australian adults who smoke. Cross-sectional online survey in April/May 2022 (N=2,740). Participants were asked whether they agreed (misperception) or disagreed that "Reducing the number of cigarettes smoked per day is an effective way to reduce the risk of experiencing the health harms of smoking". They were also asked whether the statement "Smoking 1 cigarette per day is about 1/20th as dangerous as smoking a pack of 20 cigarettes per day" sounded about right (misperception) or if it was less dangerous (misperception) or more dangerous than that. The misperception that reducing the number of cigarettes smoked is an effective way to reduce risk was held by 72.0% of people who smoke overall, but was more common among those who smoked <5 cigarettes daily (76.3%; Adj PR=1.11 [95% CI 1.01-1.21]) or only occasionally (79.7%; Adj PR=1.14 [1.06-1.23]) compared with those who smoked 5+ cigarettes daily (66.7%). Over two-thirds (67.9%) underestimated the dangers of smoking 1 cigarette per day, and this misperception was also more common among low-rate smokers (77.6%, Adj PR=1.14 [95% CI 1.04-1.26]) compared to those who smoked 5+ cigarettes daily (63.1%). Misperceptions about the value of cutting down and low-rate smoking for reducing the risk of tobacco-caused harm are pervasive, especially among those who currently smoke at a low-rate or only occasionally. Recent epidemiological evidence confirms that the risks of harm associated with low-rate smoking and cutting down are much higher than would be expected if the relationship between consumption and harm was linear. Findings from this study indicate that misperceptions about the benefits conferred by these smoking patterns are pervasive among people who smoke, particularly among those who currently smoke at a low rate. Corrective education that explains the mechanisms for the increased risk posed by these behaviours could be delivered via package health warnings and/or public health campaigns and may provide low-rate and occasional smokers with additional reasons to quit.

7752 Navigating Hypercalcemia in Pregnancy: A Case Report

Abstract Disclosure: J. Gabbay: None. S. Steinmetz-Wood: None. Introduction: Primary hyperparathyroidism (PHPT) in pregnancy is rare but presents many diagnostic and therapeutic challenges. Prompt diagnosis and treatment are important due to associated maternal and fetal risks, however evaluation of urine calcium to differentiate from Familial Hypocalciuric Hypercalcemia (FHH) becomes less reliable due to physiologic changes in pregnancy, sestamibi scans. CT scans require radiation, parathyroidectomy introduces surgical risk, and medical alternatives like bisphosphonates can interfere with fetal skeletal development. Clinical Case: A 24-year-old woman who presented to the emergency room for progressive nausea and abdominal pain was found to be pregnant with elevated serum calculated calcium to 11.4 mg/dL (2.84 mmol/L). She had a history of renal stones, longstanding hypercalcemia of unknown etiology and a remote family history of parathyroid “issues”. Follow up laboratory work showed a PTH of 75.8 pg/ml (8.04 pmol/L) with an elevated 24-hour urine calcium and a low 25OH vitamin D. Given her history of kidney stones and overt symptoms it was our clinical judgement that this was not a case of FHH. She was started on IV fluids twice weekly. After an unrevealing neck ultrasound, an MRI neck showed a 7 mm lesion along the posterior aspect of the left thyroid suggestive of a parathyroid adenoma. Sestamibi scan was avoided due to the risks of radiation to the developing fetus. Given the presumptive diagnosis of parathyroid adenoma, the lack of response to aggressive hydration, and the maternal and fetal risks of hypercalcemia during pregnancy, parathyroidectomy was pursued in her second trimester. Intra-operative inspection and biopsy showed the lesion to be only a lymph node. She underwent 4-gland exploration and the left inferior parathyroid gland, which appeared abnormal and enlarged, was removed. The intra-operative PTH dropped only from 98 to 80 (10.4 to 8.5 pmol/L). She otherwise had an unremarkable hospital course and at discharge her calcium was normal with an undetectable PTH, which can be an expected finding in pregnancy. On follow up she was feeling well with sustained normocalcemia and low PTH levels. Given the age at which her hyperparathyroidism started, she was referred to genetics for further evaluation. Clinical Lessons/Conclusion: There were significant biochemical and radiological limitations in the management of this case. Normally an inappropriately normal PTH with elevated serum calcium and normal urine calcium/creatinine clearance ratio confirms the diagnosis of PHPT, however in pregnancy it should be noted that FHH could also present with normal or elevated urine calcium due to absorptive hypercalciuria in pregnancy. Additional clinical history and reasoning was needed for management as well as a skilled surgeon, where preoperative localization was limited and was not ultimately helpful. Presentation: 6/2/2024

Slovenian policies and initiatives addressing noise and acoustics issues in kindergartens and schools

The focus of this paper is on Slovenian policies and initiatives addressing acoustics and noise issues in kindergartens and schools. Despite crucial legislation for noise protection in buildings, technical guidelines are inconsistently followed, resulting in reverberation issues in various educational premises. Surveys gathered teachers' opinions on noise disturbance in three categories: kindergartens, primary schools, and a broader survey on dietary guidelines, which included questions on noise in dining areas. Preliminary findings reveal that primary schools, more than kindergartens, view noise as a significant concern, particularly acoustics over external sources. A National Institute of Public Health study, covering 653 education institutions, found that 107 primary schools considered noise disturbing. Poor acoustics was identified as the primary cause of disturbance in 171 of all institutions. Additional reasons included loud children, overcrowded places, and insufficient caregiver supervision. Information from a specialized noise and acoustics company highlighted nearly 180 interventions in Slovenian educational institutions over 15 years, primarily in primary schools (104), followed by kindergartens (11), and music schools (26). The widespread need for improvements underscores the importance of awareness and recommendations for schools, kindergartens, and municipalities to enhance the educational sound environment. This work was partly supported by the EU H2020 Equal-Life project.

Experiences of patients with hard-to-heal wounds: insights from a pilot survey.

To learn about the experiences of people who seek treatment for hard-to-heal wounds, we distributed a nationwide pilot survey, asking questions about the nature of their wound, how it shaped their daily lives, pathways to receiving care and experiences with treatment. The long-term objective is to quantify the journey of patients with hard-to-heal wounds to identify ideal intervention points that will lead to the best outcomes. This article summarises the findings, implications, limitations and suggestions for future research. Qualitative data were self-reported from patients with hard-to-heal wounds (open for ≥4 weeks) in a pilot chatbot survey, (Wound Expert Survey (WES)) provided online in the US on Meta platforms (Facebook and Instagram) between 2021 and 2022. The US national pilot survey attracted responses from 780 patients, 27 of whom provided a video testimonial. Some 57% of patients delayed treatment because they believed their wound would heal on its own, and only 4% saw a wound care specialist. Respondents reported the cost of care as the most frequent reason for not following all of a doctor's treatment recommendations. Queries regarding quality of life (QoL) revealed that more than half (65%) said they have negative thoughts associated with their wound at least every few days. Some 19% of respondents said their wound had an odour and, of them, 34% said odour had a major or severe negative impact on their self-confidence. Economically, nearly one-quarter of respondents said having a wound led to a drop in their total household income and 17% said their wound led to a change in their employment status. A national pilot survey of patients with hard-to-heal wounds revealed that many delay seeking professional assistance and only a small minority see a wound care specialist. Experiencing an ulcer, even for a few months, can have significant negative effects on a patient's QoL. Patients frequently had negative thoughts associated with their wound, and odour compounded these negative effects, leading to major or severe negative impacts on self-confidence. Households experienced a decline in income, due to both the direct reduction or loss of patient employment and the additional time spent by family members assisting in patient recovery. Thus, a variety of factors contribute to poor outcomes for patients with hard-to-heal wounds. To validate and extend these preliminary results, future surveys of patients with hard-to-heal wounds should focus on additional reasons patients do not seek professional help sooner. To improve health outcomes and QoL, assessment of patient socioeconomic variables should occur whenever wound closure stalls.

Is superintelligence necessarily moral?

Abstract Numerous authors have expressed concern that advanced artificial intelligence (AI) poses an existential risk to humanity. These authors argue that we might build AI which is vastly intellectually superior to humans (a ‘superintelligence’), and which optimizes for goals that strike us as morally bad, or even irrational. Thus this argument assumes that a superintelligence might have morally bad goals. However, according to some views, a superintelligence necessarily has morally adequate goals. This might be the case either because abilities for moral reasoning and intelligence mutually depend on each other, or because moral realism and moral internalism are true. I argue that the former argument misconstrues the view that intelligence and goals are independent, and that the latter argument misunderstands the implications of moral internalism. Moreover, the current state of AI research provides additional reasons to think that a superintelligence could have bad goals.

Own goals in football: do they occur randomly or exhibit systematic patterns?

ABSTRACT Due to the low-scoring nature of soccer every single goal can drastically change the outcome of a match. Therefore, most large-scale performance studies aim at defining systematic processes and factors involved in goal scoring, while the scoring of the seemingly unintentional goals (like own goals) appears to be overlooked so far. In this study, factors for scoring own goals are investigated and compared to the factors connected to other (normal) goals. Therefore, a large dataset consisting of all goals from seven full seasons of the English Premier League (seasons 12/13 to 18/19) was analysed. Factors investigated include a priori factors like matchday, playing minute and team strength, but also specific situational variables like the zone from where the goal was scored, the body parts used, scoreline, defensive order and the preceding action. Favourites (p < .001) and home teams (p <0.05) profit more often from own goals than outsiders and away teams, suggesting systematic influences on own goal scoring. However, own goals significantly differ from all goals in the zone of goal scoring where more than 50% of the own goals are scored from the zone closest to goal (Zone 1). Additional aspects and potential reasons for the observed patterns are discussed.

Evaluation of Causes of Visual Impairment Among Bespectacled Between the Age 18-23: A Study from Tamil Nadu, India

Visual impairment is internationally related to severe public health, social, and economic challenges. Uncorrected refractive error is one of the main targets of the global movement to end preventable visual disability, as it is a treatable source of vision impairment. With precise information about the prevalence and underlying causes of vision impairment in the general population, health organizations may find it simpler to develop infrastructure and human resource strategies, as well as to distribute resources properly. The design of screening programs to identify individuals who are more vulnerable to eye issues may also be facilitated by having this knowledge. Wearing spectacles, also called glasses, is the practice of wearing frames with lenses in front of the eyes, usually with the intention of improving vision. There are additional reasons to wear glasses, including fashion, eye protection, and concealing visual defects. Even with the rising popularity of contact lenses and refractive surgery, wearing glasses is still the most prevalent technique to correct refractive difficulties. Despite its many built-in advantages, namely the capacity to control usage, spectacles do have some significant disadvantages. Many people who require glasses are unable to afford them, and if they are prescribed incorrectly, they may cause irritation to the eyes. Refractive errors are a major cause of visual impairment worldwide. People who lack professional skills in eye care or dispensing have abused the system due to irregularities in the distribution of spectacles.

Origen’s ‘Celsus’: Questions of Identity

This article will investigate a certain similarity between Origen’s response to Celsus’ True Logos and the criticisms against Longinus’ interpretation of the early pages of Plato’s Timaeus made in Proclus’ Commentary by a certain Origenes, usually held to be a pagan though without compelling evidence. Origen begins by assuming that ‘Celsus’ was an Epicurean of that name, even though it has long been obvious that ‘Celsus’ has adopted a Platonist point of view and that Origen’s answers often rely on Plato’s authority; in Proclus, Origenes regularly regards Longinus’ explanations as turning Plato into a hedonist by having him aim at the reader’s pleasure, and at one point Longinus even made reference to Epicurus. The paper uses recent work on the presence in Porphyry and Lucian of alternative names, whether inside philosophic schools or as a nom de plume, to argue that Origen could not be sure of his opponent’s identity, but that as he wrote he came to suspect that ‘Celsus’ was in fact his younger contemporary Longinus, the initial teacher of Porphyry himself. Hence the allusions to his ‘philological’ tendencies. If this is correct, then there is additional reason to identify Origen with Origenes.

Optimizing User Retention for a Digital Recruitment App with CLM and the Hooked Model

As the digital recruitment market in Indonesia becomes increasingly competitive, it is crucial for Chatterhire, a job portal tech startup, to retain a strong user base for sustainability and growth. Retention is vital for demonstrating product-market fit, monetization potential, and attracting future investments. To achieve this, Chatterhire aims to shift its focus from aggressive user acquisition to retention, by optimizing its platform for regular use. This research combined quantitative data on user in-app activities with qualitative feedback from in-depth interviews. The quantitative analysis utilized Customer Lifecycle Management (CLM) techniques, including cohort analysis, behavioral cohort analysis, and funnel analysis, to identify critical experiences that encourage users to return, reasons for user churn, and features that need enhancement for better retention. The study found that retaining users is challenging for an episodic-use app like a job portal, where engagement is sporadic and infrequent. Once users secure a job, their need for the app diminishes, leading to significant drops in engagement and even app uninstalls. Therefore, the company needs to expand the platform’s features to provide additional reasons for users to return. Additionally, ensuring users perceive the app’s value through repeated interactions is essential. The research revealed that users who apply for at least four jobs within the first seven days are likely to have higher retention. This research highlights the importance of integrating intrinsic value into the product to foster a sustained user journey. The Hooked Model’s core elements—Trigger, Action, Variable Reward, and Investment—can encourage habitual use and sustained engagement, crucial for maintaining a competitive edge in the digital recruitment industry.

Evaluation of natural radioactivity and radiological hazards in water sample of Tounsa Sharif, South Punjab, Pakistan

Radioactive material, especially Uranium, is very dangerous for human beings, creatures, and plants. It has been documented that the groundwater of the Dera Ghazi Khan Division in Punjab is contaminated with 238U. In this communication, the groundwater of the Tehsil Taunsa located at Indus River has been investigated. 144 samples of drinking water were collected from 48 villages/towns located in the area of about 500 km2 of the city. The samples were collected in the month of June, August and November, to concentrate on the temperature impact over the Uranium concentration. All samples were analyzed for 238U concentration using a fluorometric technique. The fluorometric technique was applied after pre-treatment of the sample. The analysis of the result revealed that groundwater obtained from this region contains a high value of 238U contents. Among the 48 trials, 26 samples were found below the permissible limit, while the remaining samples contained 238U contents above the permissible level. The sample collected from areas like, Qarim Wala, Jhoke Jamki, Basti peer, Tibi Qaisrani, Pehar Adda & Malana contained even up to the alarming level (30 μg l−1 to 54 μg l−1). In addition, it was observed that the sampling period had a significant effect on the contents, which were most prominent in June. This area being almost annually flooded by water from Rodh Kohi, who originated from Koh-e-Suleiman, may lead to such a high concentration of 238U. The additional reason could be the topographical and geological structure of the earth from which the samples were collected.

Macedonian ballet (1949 – 2024), decoding of diverse choreographic “letters”

This article attempts to determine the relevant processes related to ballet, positioned in a concrete geographic space&amp;ndash;the Republic of Macedonia. The time frame starts with the year of the founding of the professional ballet ensemble within the Macedonian National Theatre (MNT) 1949 and ends with the year 2024. An additional reason for such a theoretical review is the celebration of the 75th anniversary of the Macedonian ballet. Due to the volume of material, the author decided to detect general styles, that is, general &amp;ldquo;chapters&amp;rdquo; or &amp;ldquo;letters&amp;rdquo; (as will be defined in the article), with their specific tendencies. From an analysis of the entire repertoire, performances can be classified into three general groups. The first is classical ballet with a fixed choreography (in Macedonia&amp;rsquo;s case, versions currently performed in Russia, that is, countries of the former Soviet Union). The second group is performances classified as contemporary regarding theme and music, but most importantly dance style. The third group is the works where there is a symbiosis between classical ballet and folk dance, which are referred to as national ballets. This group carries the most important and most distinctive national features. Each of the aforementioned groups is in close interaction with cultural politics, that is, current societal trends, which will be further elaborated.

Legal Protection for Victims of Illegal Investment Fraud Using the Ponzi Scheme in Indonesia

This study was conducted through the investigation and analysis of additional criminal reasons for rulgi can be applied as an ulpaya perlindungan victim of investment with a ponzi scheme. Also, reviewing and analyzing Hukum Perlindungan for Victims of Investigative Pellnipulan with Ponzi Skema. This research uses a Normative Juridical approach. While the penelitian that is carried out by pelnelliti is the case study (Casel Approach). The results of this study show two things, namely: 1) At present there are only a few regulations that more or less allude to the discussion of ponzi, including: Law No. 7 of 2014 concerning Trade, Law No. 21 of 2008 concerning Sharia Banking, Law No. 19 of 2016 Jo. Law No. 11 of 2008 concerning Electronic Information and Transactions Government Regulation No. 82 of 2012 concerning the Implementation of Electronic Systems and Transactions. Criminal provisions against investment activities with ponzi / fraudulent schemes are regulated in Article 378 of the Criminal Code and are very closely related to crime and the scope of criminal liability, 2) Compensation as one type of criminal sanction adopted in the new Criminal Code does not provide further explanation about the amount.

Superselection-resolved entanglement in lattice gauge theories: a tensor network approach

Lattice gauge theories (LGT) play a central role in modern physics, providing insights into high-energy physics, condensed matter physics, and quantum computation. Due to the nontrivial structure of the Hilbert space of LGT systems, entanglement in such systems is tricky to define. However, when one limits themselves to superselection-resolved entanglement, that is, entanglement corresponding to specific gauge symmetry sectors (commonly denoted as superselection sectors), this problem disappears, and the entanglement becomes well-defined. The study of superselection-resolved entanglement is interesting in LGT for an additional reason: when the gauge symmetry is strictly obeyed, superselection-resolved entanglement becomes the only distillable contribution to the entanglement. In our work, we study the behavior of superselection-resolved entanglement in LGT systems. We employ a tensor network construction for gauge-invariant systems as defined by Zohar and Burrello [1] and find that, in a vast range of cases, the leading term in superselection-resolved entanglement depends on the number of corners in the partition — corner-law entanglement. To our knowledge, this is the first case of such a corner-law being observed in any lattice system.

MECHANICAL PROPERTIES OF LAMINATED BAMBOO LUMBER MADE OF TROPICAL SPECIES

Bamboo has been the trend for a sustainable material, due to its renewability. Bamboo can grow abundantly throughout the tropical area of the world, such as Latin America, East Asia and Southeast Asia. It is seen that Southeast Asia has variety of bamboo to utilize and many of them are suitable for structural applications. One additional reason is that they are clumping type, so fibers are built stronger. Bamboo is hollow and irregular in sizes and shapes, so it cannot maximize the use out of the materials. Bamboo Laminated Lumber (LBL) is the product to solve bamboo issues on the irregularity be transforming into solid lumber. It can be called the engineered bamboo, which have been transformed conventional form of bamboo using engineering process. This is the same technology as laminated timber. It has more potential to substitute the use of timber. This research is to experiment of making LBL using structural bamboo species that are widely used in Southeast Asia. They are Dendrocalamus Asper, Dendrocalamus Sericeus, Bambusa Multiplex, and Bambusa Blumena. They are tested for mechanical properties; Tension, compression parallel to grain, compression perpendicular to grain, and bending. Those properties are compared to other tropical hardwood and engineered wood. The result shows that LBL of all species are qualified for medium-hardwood quality, while B.Multiplex lumber performs best overall. The rest still have great mechanical properties and can be qualified some structural lumber in order to reduce the use of timber.

Investigation of Veterinary Student and Faculty Perspectives of Factors Affecting In-Person Lecture Attendance.

A proposal was submitted to our institution's curriculum committee to discontinue lecture livestreaming to increase attendance, and we performed a study to investigate factors affecting lecture attendance. In January 2022, the faculty and students were surveyed to explore their perspectives on the impact that student attendance has on both the student and faculty lecture experience. We included a subset of common questions to allow for comparison. For students, in-person lecture attendance was not largely influenced by content or delivery. Instead, most students indicated flexibility, preserving emotional well-being, optimizing efficiency, exams, and COVID-19 as important. Students also indicated that part-time jobs, caring for family or pets, and commuting were additional reasons to elect a remote lecture experience. Faculty also recognized the impact of these factors on lecture attendance, but they were concerned about student learning and preparedness for clinics, and their own effectiveness and wellbeing as educators. Sixty-one percent of faculty agreed that low lecture attendance negatively impacted their overall professional satisfaction and 67% indicated that it decreased their enjoyment of teaching. Faculty mentioned missing real-time feedback from students and they expressed sadness at the loss of personal interactions. After reviewing results of the study, the curriculum committee voted to discontinue livestreaming of lectures. Although students provided strong feedback on the importance of flexibility, the committee agreed with faculty concerns. It remains to be determined if lecture attendance increases because of this decision and preparedness for clinics should be objectively measured in the future.

Clinical Correlates of In-Hospital Mortality in Patients Undergoing Inferior Vena Cava Filter Placement for Acute Deep Vein Thrombosis.

Background: It is reasonable to place an Inferior Vena Cava Filter (IVCF) when an acute deep vein thrombosis (DVT) of the lower limbs occurs in a patient with absolute contraindication to therapeutic anticoagulation. An additional potential reason for placing an IVCF is the need to stop therapeutic anticoagulation in a patient with acute DVT who must undergo urgent non-deferrable surgery. However, IVCFs are often used outside of such established indications and many authors argue about their actual utility, especially in terms of survival. In this retrospective study, we looked for clinical correlates of in-hospital mortality among patients who underwent IVCF placement, limiting our analysis to the cases for which a correct indication to IVCF placement existed. Methods: We retrospectively analyzed the electronic database of our University Hospital, searching for consecutive hospitalized patients who had acute DVT and underwent IVCF placement because of an established contraindication to therapeutic anticoagulation and/or because it was necessary to stop anticoagulation due to urgent surgery. The search covered the period between 1 January 2010 and 31 December 2020. Results: The search resulted in the identification of 168 individuals. An established contraindication to therapeutic anticoagulation was present in 116 patients (69.0%), while urgent non-deferrable surgery was the reason for IVCF placement in 52 patients (31.0%). A total of 24 patients (14.3%) died during the same hospital stay in which the IVCF was placed. Mortality rate was significantly higher in patients with a contraindication to anticoagulation than in patients who underwent IVCF placement because of urgent surgery (19.0% vs. 3.8%, OD 5.85 vs. 0.17). In-hospital mortality was also significantly higher among patients with chronic kidney disease and those who needed blood cell transfusion during hospitalization. Conclusions: This study provides novel information on clinical correlates of in-hospital mortality among patients with acute DVT who undergo IVCF. Prospective observational studies are needed to substantiate these findings.

Diagrams with composition fields of the pelitic fraction of bottom sediments in the estuarine parts of different modern river’s categories: another approach to verification

According to analytical data given in publications [Savenko, 2006; Bayon et al., 2015], compared the position of data points of pelitic fraction of bottom sediments in the estuarine parts of a number of large rivers (rivers of category 1 according to [Bayon et al., 2015]: Amazon, Congo, Mississippi, Niger, Yangtze, Mackenzie, Volga, Danube, Mekong, Amu Darya, Northern Dvina and Loire) and their suspended material on the (La/Yb)N – Eu/Eu* and (La/Yb)N – Th diagrams. The first samples were subjected to special processing. The samples of the latter were not processed before the study. It has been established that the data points of both sample’s groups in the above diagrams are localized in the field of fine-grained (pelitic) suspension of large rivers, demonstrating some scatter for specific rivers, but generally not going beyond its limits. This gives additional reason to believe that for decoding the categories of rivers that formed certain sedimentary sequences, not only specially prepared samples can be used, but also data obtained from bulk/unprocessed samples. At the example of a fine-grained suspension of Zambezi river (South Africa) some features of the use of (La/Yb)N – Eu/Eu* and (La/Yb)N – Th diagrams were considered.

Predominantly unilateral laryngomalacia in infants with unilateral vocal fold paralysis

BackgroundNeonatal unilateral vocal fold paralysis may arise iatrogenically, idiopathically, or in the context of an underlying neurologic disorder. Management is often supportive, focusing on diet modification to allow for safe oral feeding. We describe the clinical course of six infants with unilateral vocal fold paralysis who developed predominantly unilateral laryngomalacia ipsilateral to the affected vocal fold with associated severe respiratory symptoms and feeding difficulty. MethodsRetrospective review of six infants with unilateral vocal fold paralysis and predominantly unilateral laryngomalacia. Charts were reviewed for etiology of vocal fold paralysis, presenting symptoms, operative details, postoperative course, and outcomes for breathing and swallowing. ResultsEtiology of vocal fold paralysis included cardiac surgery in four patients, intubation-related in one, and idiopathic in one. Presenting symptoms included increased work of breathing, stridor, feeding difficulty, respiratory failure requiring noninvasive respiratory support, and weak cry. All infants were on nasogastric tube feedings. Direct microlaryngoscopy with unilateral or predominantly unilateral (conservative contralateral aryepiglottic fold division) supraglottoplasty was performed. Stridor and work of breathing improved in all six patients within 1 week postoperatively. Oral feeding improved in three patients within 2 weeks. Three patients had persistent feeding impairment with improvement within one year. ConclusionsPredominantly unilateral laryngomalacia may arise in the context of unilateral vocal fold paralysis. Addressing the ipsilateral cuneiform collapse can improve breathing and feeding. This may be an under-described phenomenon and represents an additional reason to include the otolaryngologist early in the care of infants with suspected possible new unilateral vocal fold paralysis. Breathing and swallow can improve post-operatively, but feeding may remain limited by the vocal fold paralysis and any medical comorbidities. Ongoing follow-up and collaboration with speech-language pathology to optimize feeding are important.

The history of the soviet innovation of purchase foreign vessels and the prospect of using bareboat charter as way for replenishing the fleet in current circumstances

The anniversary date, 50 years since the beginning of the grandiose project on chartering foreign vessels with the right to buy them, which became the history of the formation of the shipping company «Sovcomflot», gives an additional reason to consider its details. The analysis of the successful experience of off-budget replenishment of the merchant fleet implemented in the Soviet period is given. It will allow us to come to the conclusion that the financial schemes developed and applied at that time to attract foreign capital through shipping companies specially created in a foreign jurisdiction, acquiring a fleet using tax and other benefits provided for by national legislation for subsequent bareboat charter and compensating for all the expenses by income from transportation of Russian foreign trade cargoes, are fully relevant today to replenish the fleet of domestic shipping companies. Also, the advantages of acquiring a merchant fleet using leasing in combination with bareboat charter already considered in the article in modern conditions have shown that this is the optimal mechanism for both preferential leasing and commercial financing schemes. The disadvantage of bareboat charter, which limits its use in modern conditions, is associated with its narrow specialization, both legal and commercial. As appropriate as possible to the traditions and peculiarities of world commercial shipping, it meets the interests of shipping companies, but is little understood by financial institutions. In this regard, it is of particular importance to develop or adapt the available methodological support for assessing the key indicators of the financial scheme for chartering a vessel without a crew (bareboat charter) on the terms of a financial lease (leasing).

Prevention and counteraction of mobbing in labor relations: regulatory and legal support in Ukraine

The article examines the legislative regulation of the concept and forms of mobbing, responsibility for committing such acts. Attention is drawn to the fact that the problem of mobbing is relevant not only for our country, where it is increasingly possible to observe cases of this phenomenon at work (harassment of an employee by both colleagues, subordinates, and management), but also for European countries, where they know what is mobbing and have long since legally regulated the issue of preventing and countering this phenomenon. It is noted that Ukraine has also joined European countries in this matter by adopting the Law "On Amendments to Certain Legislative Acts of Ukraine on Prevention and Counteraction to Mobbing (bullying)” dated 11.16.2022 No. 2759-IX, which brought the norms of Ukrainian legislation in accordance with European and provided protection against discrimination and psychological pressure in the workforce. It is noted that the legislative regulation of the concept and forms of mobbing, responsibility for committing such acts will contribute to the protection and protection of the rights of employees, as well as overcoming mobbing as a negative phenomenon in labor relations. At the same time, it was concluded that despite the fact that the concept of "mobbing” is legally defined, the responsibility for it, many issues still remain today, which need to be resolved. Since the amendments to the legislation gave birth to many aspects that were not familiar either to the practice or to the science of domestic labor law. Yes, now the psychological and economic pressure of employees has become an additional reason for terminating the employment contract; the regulation of mobbing established new areas of employer responsibility, and also gave rise to many unanswered questions - how to distinguish bullying from a joke; whether to consider the use of obscene language as mobbing; is it considered mobbing when an employee compares his work with the work of another employee and complains about being overworked compared to a colleague; where the line will be drawn between the employer's legal requirement for the employee to perform the job well and mobbing the employee and many others. There is also an objective need to develop a legal mechanism to protect employees from mobbing, which would provide legal certainty regarding this phenomenon in labor relations.