Artigos de revistas sobre o tema "Seveso Upper Tier"

Abstract The purpose of this publication is to present the characteristics of upper-tier and lower-tier establishments of a major accident, which operate under the provisions of the Seveso III Directive. The article will also present information about the number of these establishments in the EU and Poland. Analysis of the data on the operation of upper-tier and lower-tier establishments of a major accident comparison with the number of major accidents which took place will allow for assessment of the effects of the implementation of the provisions of the Seveso III Directive by EU countries.

We present a case of a two-year-old boy with hemophilia A and high titer factor inhibitor, who developed forearm compartment syndrome two days after taking blood samples for a regular check-up of serum concentration of Factor VIII. Emergency fasciotomy was performed to prevent Volkmann contracture. The patient needed bypass therapies including recombitant activated factor VII (rFVIIa), activated prothrombin complexes (aPCC), factors VII・X (MC7-10), and transfusions. Eleven days after the surgical intervention, he was discharged without any functional loss in the affected upper extremity. Early surgical intervention prevented compartment syndrome of affected upper extreme.

The work is aimed at determining the age of ice wedges, as well as at characterizing winter temperature fluctuations during the formation of the Yedoma based on the isotopic composition of ice wedges in the unique outcrop of the Batagay mega-slump. The researchers carried out a detailed sampling from the Upper Ice Wedge Complex of the Batagay Yedoma, determined the isotopic composition in three ice wedges at different altitudes. The results of radiocarbon dating of organic matter from ice wedge confirm the time of syngenetic formation of the upper-tier ice wedges in the range from 27.2 to 30.8 thousand cal. years. Ice wedges of the lower tier, according to the results of radiocarbon dating of ice accumulated 44.7—47.9 thousand years ago simultaneously at different levels: 274—268 m and 224—227 respectively. The study of yedoma deposits and ice-wedge ice made it possible to obtain data on climatic fluctuations in a region with the most severe continental climate. Direct radiocarbon dating of syngenetic ice wedges provided dating of ice growth in the Batagay yedoma, data on the content of stable isotopes in the ice demonstrated stable and very harsh conditions of the winter season. The air paleotemperature in Batagay in January 47—42 and 30—25 thousand cal. years ago was consistently low about –51°C.

Heavy monsoon rainfall ravaged a large swath of East Asia in summer 2020. Severe flooding of the Yangtze River displaced millions of residents in the midst of a historic public health crisis. This extreme rainy season was not anticipated from El Niño conditions. Using observations and model experiments, we show that the record strong Indian Ocean Dipole event in 2019 is an important contributor to the extreme Yangtze flooding of 2020. This Indian Ocean mode and a weak El Niño in the Pacific excite downwelling oceanic Rossby waves that propagate slowly westward south of the equator. At a mooring in the Southwest Indian Ocean, the thermocline deepens by a record 70 m in late 2019. The deepened thermocline helps sustain the Indian Ocean warming through the 2020 summer. The Indian Ocean warming forces an anomalous anticyclone in the lower troposphere over the Indo-Northwest Pacific region and intensifies the upper-level westerly jet over East Asia, leading to heavy summer rainfall in the Yangtze Basin. These coupled ocean-atmosphere processes beyond the equatorial Pacific provide predictability. Indeed, dynamic models initialized with observed ocean state predicted the heavy summer rainfall in the Yangtze Basin as early as April 2020.

Abstract. This study was designed to investigate the dynamics of current and future surface water availability for different water users in the upper Pangani River Basin under changing climate. A multi-tier modeling technique was used in the study, by coupling the Soil and Water Assessment Tool (SWAT) and Water Evaluation And Planning (WEAP) models, to simulate streamflows under climate change and assess scenarios of future water availability to different socio-economic activities by year 2060. Six common Global Circulation Models (GCMs) from WCRP-CMIP3 with emissions Scenario A2 were selected. These are HadCM3, HadGEM1, ECHAM5, MIROC3.2MED, GFDLCM2.1 and CSIROMK3. They were downscaled by using LARS-WG to station scale. The SWAT model was calibrated with observed data and utilized the LARS-WG outputs to generate future streamflows before being used as input to WEAP model to assess future water availability to different socio-economic activities. GCMs results show future rainfall increase in upper Pangani River Basin between 16–18 % in 2050s relative to 1980–1999 periods. Temperature is projected to increase by an average of 2 ∘C in 2050s, relative to baseline period. Long-term mean streamflows is expected to increase by approximately 10 %. However, future peak flows are estimated to be lower than the prevailing average peak flows. Nevertheless, the overall annual water demand in Pangani basin will increase from 1879.73 Mm3 at present (2011) to 3249.69 Mm3 in the future (2060s), resulting to unmet demand of 1673.8 Mm3 (51.5 %). The impact of future shortage will be more severe in irrigation where 71.12 % of its future demand will be unmet. Future water demands of Hydropower and Livestock will be unmet by 27.47 and 1.41 % respectively. However, future domestic water use will have no shortage. This calls for planning of current and future surface water use in the upper Pangani River Basin.

Facing more and more severe global warming problems, renewable energy, as an alternative to traditional fossil fuels, is attracting more and more attentions due to its capability of reducing carbon emission. This paper considers two-tier HetNets with orthogonal frequency division multiple access (OFDMA), where the macro base station (MBS) is powered by power grid and small base stations (SBSs) have hybrid energy supplies. Through smart grid, SBSs can share their renewable energy with each other. We consider the problem of cross-layer interference caused by spectrum reuse, the burst of user data, and the randomness of renewable energy arrivals. Through energy cooperation, this paper investigates maximizing the time-average energy efficiency of SBSs. Based on user data queue and SBS energy queue, the optimal problem is decoupled into two subproblems by Lyapunov optimization: resource allocation subproblem and energy scheduling and energy cooperation subproblem. By solving two subproblems, the online solution to the optimization problem is obtained. Through theoretical analysis and simulations, both user data queues and energy queues have an upper bound, the network is stable, and the proposed algorithm performs better than the basic algorithm without energy cooperation.

Abstract. Here we for the first time present a nationwide characterization of flood hazards across China. Our analysis is based on an exceptional dataset of 1120 stream gauging stations with continuous records of annual flood peaks for at least 50 years across the entire country. Our results are organized by centering on various aspects of flood peak distributions, including temporal changes in flood series and their spatial variations, the statistical distribution of extreme values, and the properties of storms that lead to annual flood peaks. These aspects altogether contribute to an improved understanding of flood hydrology under a changing environment over China and promote advances in flood science at the global scale. Historical changes in annual flood peaks demonstrate frequent abrupt changes rather than slowly varying trends. The dominance of decreasing annual flood peak magnitudes indicates a weakening tendency of flood hazards over China in recent decades. We model the upper tails of flood peaks based on the generalized extreme value (GEV) distributions. The GEV shape parameter is weakly dependent on drainage area, but it shows spatial splits tied to rainfall climatology between northern and southern China. Landfalling tropical cyclones play an important role in characterizing the upper-tail properties of flood peak distributions especially in northern China and southeastern coast, while the upper tails of flood peaks are dominated by extreme monsoon rainfall in southern China. Severe flood hazards associated with landfalling tropical cyclones are characterized by complex interactions of storm circulations with synoptic environments (i.e., mid-latitude baroclinic disturbances) and regional topography.

Abstract The sensitivity of tropical cyclone intensity to ventilation of cooler, drier air into the inner core is examined using an axisymmetric tropical cyclone model with parameterized ventilation. Sufficiently strong ventilation induces cooling of the upper-level warm core, a shift in the secondary circulation radially outward, and a decrease in the simulated intensity. Increasing the strength of the ventilation and placing the ventilation at middle to lower levels results in a greater decrease in the quasi-steady intensity, whereas upper-level ventilation has little effect on the intensity. For strong ventilation, an oscillatory intensity regime materializes and is tied to transient convective bursts and strong downdrafts into the boundary layer. The sensitivity of tropical cyclone intensity to ventilation can be viewed in the context of the mechanical efficiency of the inner core or a modified thermal wind relation. In the former, ventilation decreases the mechanical efficiency, as the generation of available potential energy is wasted by entropy mixing above the boundary layer. In the latter, ventilation weakens the eyewall entropy front, resulting in a decrease in the intensity by thermal wind arguments. The experiments also support the existence of a threshold ventilation beyond which a tropical cyclone cannot be maintained. Downdrafts overwhelm surface fluxes, leading to a precipitous drop in intensity and a severe degradation of structure in such a scenario. For a given amount of ventilation below the threshold, there exists a minimum initial intensity necessary for intensification to the quasi-steady intensity.

Intensive groundwater abstraction has augmented socio-economic development worldwide but threatens the sustainability of groundwater resources. Spatiotemporal analysis of groundwater storage changes is a prerequisite to sustainable water resource management over river basins. To estimate the groundwater storage changes/anomalies (GWCs) in the Indus River Basin (IRB), where observation wells are sparse, Gravity Recovery and Climate Experiment, the Global Land Data Assimilation System, and the WaterGAP Hydrological Model data were employed. The groundwater storage changes and controlling factors were investigated at three tier levels (TTLs), i.e., the basin, river reach, and region, to explore their implications on regional water resource management and provide management options at each level. Overall, the IRB groundwater declined from January 2003 to December 2016, with a relatively higher rate during 2003–2009 than during 2010–2016. Spatially, according to a reach-specific analysis, 24%, 14%, and 2% of the upper, middle, and lower reaches of the IRB, respectively, were indicated by a ‘severe groundwater decline’ over the entire period (i.e., 2003–2016). The GRACE-based GWCs were validated with in situ data of two heterogeneous regions, i.e., Kabul River Basin (KRB) and Lower Bari Doab Canal (LBDC). The analysis showed a correlation (R2) of 0.77 for LBDC and 0.29 for KRB. This study’s results reveal that climatic variations (increase in evapotranspiration); anthropogenic activities, i.e., pumping for irrigation; and water allocations in these regions mainly drive the groundwater storage changes across the Indus Basin.

Background Expression of angiotensin-converting enzyme (ACE)-2 and co-factors like furin, play key-roles in entry of SARS-CoV-2 into host cells. Furin is also involved in oral carcinogenesis. We investigated their expression in oral pre-malignant/malignant epithelial pathologies to evaluate whether ACE2 and furin expression might increase susceptibility of patients with these lesions for SARS-CoV-2 infection. Methods Study included normal oral mucosa (N = 14), epithelial hyperplasia-mild dysplasia (N = 27), moderate-to-severe dysplasia (N = 24), squamous cell carcinoma (SCC, N = 34) and oral lichen planus (N = 51). Evaluation of ACE2/furin membranous/membranous-cytoplasmic immunohistochemical expression was divided by epithelial thirds (basal/middle/upper), on a 5-tier scale (0, 1—weak, 1.5 –weak-to-moderate, 2—moderate, 3—strong). Total score per case was the sum of all epithelial thirds, and the mean staining score per group was calculated. Real time-polymerase chain reaction was performed for ACE2-RNA. Statistical differences were analyzed by One-way ANOVA, significance at p<0.05. Results All oral mucosa samples were negative for ACE2 immuno-expression and its transcripts. Overall, furin expression was weakly present with total mean expression being higher in moderate-to-severe dysplasia and hyperplasia-mild dysplasia than in normal epithelium (p = 0.01, each) and SCC (p = 0.008, p = 0.009, respectively). Conclusions Oral mucosa, normal or with epithelial pathologies lacked ACE2 expression. Furin was weak and mainly expressed in dysplastic lesions. Thus, patients with epithelial pathologies do not seem to be at higher risk for SARS-CoV-2 infection. Overall, results show that oral mucosae do not seem to be a major site of SARS-CoV-2 entry and these were discussed vis-à-vis a comprehensive analysis of the literature.

The 2015 fire season and related smoke pollution in Indonesia was more severe than the major 2006 episode, making it the most severe season observed by the NASA Earth Observing System satellites that go back to the early 2000s, namely active fire detections from the Terra and Aqua Moderate Resolution Imaging Spectroradiometers (MODIS), MODIS aerosol optical depth, Terra Measurement of Pollution in the Troposphere (MOPITT) carbon monoxide (CO), Aqua Atmospheric Infrared Sounder (AIRS) CO, Aura Ozone Monitoring Instrument (OMI) aerosol index, and Aura Microwave Limb Sounder (MLS) CO. The MLS CO in the upper troposphere showed a plume of pollution stretching from East Africa to the western Pacific Ocean that persisted for 2 mo. Longer-term records of airport visibility in Sumatra and Kalimantan show that 2015 ranked after 1997 and alongside 1991 and 1994 as among the worst episodes on record. Analysis of yearly dry season rainfall from the Tropical Rainfall Measurement Mission (TRMM) and rain gauges shows that, due to the continued use of fire to clear and prepare land on degraded peat, the Indonesian fire environment continues to have nonlinear sensitivity to dry conditions during prolonged periods with less than 4 mm/d of precipitation, and this sensitivity appears to have increased over Kalimantan. Without significant reforms in land use and the adoption of early warning triggers tied to precipitation forecasts, these intense fire episodes will reoccur during future droughts, usually associated with El Niño events.

This article presents the results of the analysis of modern water levels of the upper reaches of the largest river named Prut in the mountain landscape of Chornohora for the period from 2010 to 2019, based on data from own long-term hydro-meteorological observations on the basis of Landscape Monitoring Laboratory of Ivan Franko National University. The studied river is characterized by a dense river network, a peculiar hydrological regime and periodic formation of heavy floods, as well as the presence in its basin of valuable landscape complexes and environmental facilities, high landscape diversity and recreational and tourist potential, which determines the relevance of this study. As a result of the study, the peculiarities of the formation and modern features of the hydro network of the Prut river basin were established, its heterogeneity in the mid-mountain and high-mountain landscape tiers was characterized. It is established that during the period 2010-2019 in the upper reaches of the Prut River there was an increase in river water levels, as well as identified the main factors and their impact on current changes in the hydrological regime of the river. The annual changes in the water level in the upper reaches of the Prut River for the period 2010-2019 were also analyzed and it was found that its mountainous nature causes high dynamics of river water levels at different times of the year and in certain months. It was important to identify the relationships between their indicators and the characteristics of the annual distribution of precipitation and snowmelt during studying the annual cycles of water level fluctuations. Particular attention is paid to the study of the formation and spread of floods as the most dangerous hydrological phenomenon of the upper reaches of the Prut River, characterized by a sharp rise in water levels, high erosion capacity, etc. The study found that more than 75 % of floods occur during the spring snowmelt in April and May where the average daily river water levels usually do not exceed 60-70 cm. The analysis of flood rises in terms of years and months shows that the most severe catastrophic floods are formed in November-December due to heavy rains, which cause the formation of powerful destructive water flows and catastrophic growth of river water levels over 90-100 cm. The total annual number of flood rises in the Prut River was also analyzed according to certain categories of indicators (over 60 cm, 70 cm, etc.) and it was found that the total number of floods in the upper reaches of the river is increasing.

Abstract While statistical analyses and observations show that severe bora with maximum gusts exceeding 40 m s−1 can occur in all parts of the Adriatic, the bora research to date has been mainly focused on the dynamics and structure of severe bora in the northern Adriatic. Examined to a significantly lesser degree is a less predictable counterpart in the southern Adriatic, where the Dinaric Alps are higher, broader, and steeper, and where the upwind bora layer is generally less well defined. Identification of the main differences in the sequence of mesoscale and macroscale events leading to the onset of bora in the northern and southern parts of the eastern Adriatic is of fundamental importance for its forecasting. To this end, presented here is a comparative analysis of the evolution and structure of two typical severe cyclonic bora events—one “northern” (7–8 November 1999) and one “southern” (6–7 May 2005) event. The analysis utilizes airborne, radiosonde, and ground-based observations, as well as the hydrostatic Aire Limitée Adaptation Dynamique Developement International (ALADIN/HR) mesoscale model simulations. It is shown that the development of a severe bora in both the northern and southern Adriatic is critically dependent on the synoptic setting to create an optimal set of environmental conditions. For severe bora in the northern Adriatic, these conditions include a strong forcing of the northeasterly low-level jet and pronounced discontinuities in the upstreamflow structure that promote layering, such as lower- to midtropospheric inversions and environmental critical levels. The development of severe bora in the southern Adriatic is crucially dependent on the establishment of a considerably deeper upstream layer that is able to overcome the strong blocking potential of the southern Dinaric Alps. While the upstream layering is less pronounced, it is closely tied to the presence of a cyclone in the southern Adriatic or over the southern Balkan peninsula. The upstream atmospheric layering is shown to strongly modulate bora behavior, and different phases of severe bora, related to the presence or absence of upstream layering, are shown to occur within a single bora episode. Furthermore, the presence of a mountain-parallel upper-level jet aloft appears to impede severe bora development in both the northern and southern Adriatic.

The article analyses the history of the amnesty granted by the Bolsheviks in 1921–1923 to nine Kolchak ministers led by P. I. Preobrazhensky, G. A. Krasnov, A. A. Gratsianov and N. Ya. Novombergsky, prominent figures of the anti-Bolshevik governments, convicted by the Extraordinary Siberian Revolutionary Tribunal at the open trial in Omsk on 20–30 May, 1920. Based on a wide range of archival sources, the authors have reconstructed the entire pardon process, from the improvements in conditions of detention to the official decision of the VTsIK. Amnesty is considered as a political tool of the Soviet power, which allowed the communist leadership of the country to effectively correct the cruel punitive policy, play the card of restoration of social justice, and win the victims over to its side. It is concluded that the pardon of the Kolchak ministers was an individual but significant component of the process of restoring civil peace in Russia at the end of the internal military-political confrontation. What made this amnesty unusual among the many similar acts announced by the Bolsheviks in 1922–1923 was that not the rank-and-file members of the anti-Soviet struggle were pardoned, but its immediate leaders. The main reason for the rehumanization of former enemies were their personal ties and contacts in the upper echelon of the Soviet leadership in Siberia, which were formed primarily in the course of joint activities. The main criterion for applying the amnesty was the high quality work of the Kolchak ministers in the economic departments of the Siberian Revolutionary Committee under the conditions of severe labor shortage.

Background: Superior mesenteric artery syndrome (SMAS) is a rare disease in adult. SMAS is characterized by acute, or, more commonly, chronic nonspecific symptoms due to duodenal obstruction and severe malnutrition with reduced arterio-mesenteric angle and distance. Surgical treatment may be necessary in most cases with chronic symptoms or when conservative treatment fails in SMAS. Methods: A retrospective chart review was performed on patients who underwent operation for SMAS from January 2008 to August 2020 in Cardinal Tien Hospital. Patients’ clinical presentations, surgical intervention, and outcomes. Results: Data from a total of 14 patients diagnosed with SMAS were analyzed, of which seven were diagnosed with SMAS by abdominal computed tomography and upper gastrointestinal series with water-soluble barium contrast. Six of the confirmed cases underwent surgery, namely, gastric decompression using a nasogastric tube, and correction of electrolyte imbalance. The nasoduodenal tube was placed through the obstructed duodenum to provide a high-nutrient fluid supplement. After conservative treatment failure, the patients underwent surgery. Of the six patients, four underwent duodenojejunostomy, one underwent a mini-laparotomy duodenojejunostomy bypass, and the last one underwent Roux-en-Y duodenojejunal bypass with duodenal feeding tube insertion. Conclusion: Patients with SMAS should initially be treated conservative. Surgical intervention should be considered in patients in whom conservative treatments were not effective. Complete resolution of all symptoms may not always be guaranteed after surgical intervention. Laparoscopy is currently widely used. In well-selected patients, minimally invasive or mini-laparotomy duodenojejunostomy is a safe and effective treatment for SMAS. The main advantages of mini-laparotomy duodenojejunostomy over other surgical approaches include half-length surgical incision and a shorter operative time. Duodenojejunostomy is rapidly becoming the standard procedure of this condition, and it has excellent outcomes comparable with those of open surgery.

Background: Impacted maxillary anterior teeth are a problem that has a significant impact on the aesthetics of the smile, dental arches, and occlusion. Teeth that have higher tendencies to get impacted are third molars, maxillary central incisors, maxillary canines, and mandibular premolars. Impacted teeth with severe root dilacerations are usually extracted surgically, then the space will be closed by orthodontic treatment or using a prosthesis. Purpose: This study aims to report the successful orthodontic traction of mesially 90° dilacerated root of impacted maxillary canine. Case: A 15-year-old female patient with the chief complaint of an unerupted left maxillary canine. Intraoral examination showed a class I molar relationship on both sides, a unilateral crossbite on the right side, 8 mm spacing between the maxillary left lateral incisor and the premolar. Also, mild crowding was found on both upper and lower anterior segments. CBCT results showed a left maxillary canine was palatally semi-vertical impacted and had a mesially 90° dilacerated root. A significant stress concentration occurred at the middle and apical of the dilacerated root apex when exposed to orthodontic force; this tends to be a higher potential for resorption. Case Management: The impacted dilacerated canine was successfully moved to the proper position by combining crown exposure surgery, orthodontic traction using continuous light force, and gingivectomy. Furthermore, traction was held using a gold chain combined with an elastic thread tied initially to a modified stainless-steel main archwire; this was followed by piggyback tandem wire and a vertical 3/16” light elastic traction. Conclusion: The patient showed successful traction of the canine in less than six months. In addition, the unilateral posterior crossbite was corrected and functional occlusion was achieved. That canine showed good orthodontic and periodontal stability at one-year follow-up, without any evidence of root resorption.

The production–living–ecological functions of rural settlements are closely tied to water resources, which are the primary influencing factors of the spatial characteristics of rural settlements. However, the specific relationship between water resources and the spatial characteristics of rural settlements remains unclear. Understanding the interrelationship between the two can better safeguard the ecological pattern of the basin and optimize the living environment of settlements. This study utilized multi-source data to calculate the water yield, water demand, and ecological surplus or deficit of water resources in the Yanhe watershed. We quantified the spatial characteristics of rural settlements and employed bivariate spatial autocorrelation methods to analyze the spatial correlation between water resources and the spatial distribution, scale, and boundary form of rural settlements in the Yanhe watershed. The results show the following: ➀ Seven sub-basins in the upper reaches exhibit a severe ecological deficit in water resources, with insufficient water resources to support the demands of regional socio-economic development. The middle and lower reaches have achieved a balance between water supply and demand. ➁ Rural settlements are most densely distributed in the middle reaches, with the smallest area scale, exhibiting a transitional spatial characteristic towards the upstream and downstream ends. ➂ The Moran’s I values of spatial aggregation and morphological index of rural settlements with respect to the ecological surplus or deficit of water resources are 0.36 and 0.50, respectively, indicating a strong positive correlation. The Moran’s I value of the area scale with respect to the ecological surplus or deficit of water resources is −0.60, indicating a significant negative correlation. This research has important practical significance for guiding the spatial layout of rural settlements in the Yanhe watershed and promoting their sustainable development.

Kęstutis Adamonis, Saulius Bradulskis, Juozas JuočasKauno medicinos universiteto Bendrosios chirurgijos klinika,Gastroenterologijos klinika,Eivenių g. 2, LT-50009 KaunasEl paštas: SBR@one.lt; k-adamonis@delfi.lt Įvadas / tikslas Kraujavimas iš skrandžio ir dvylikapirštės žarnos opų sudaro apie 60–70% visų viršutinės virškinamojo trakto dalies kraujavimo atvejų. Bendras mirštamumas nuo opinės kilmės kraujavimų siekia 2–15%. Jei kraujavimas sustoja ir nesikartoja (70–80%), mirštamumas neviršija 2%, jei pasikartoja (15–25%), mirštamumas padidėja iki 10%, o jei aktyvus kraujavimas tęsiasi (5%), miršta iki 30% pacientų. Įvairios endoskopinės technologijos, efektyvios medikamentinio gydymo metodikos labai sumažino chirurginio kraujavimų gydymo vaidmenį, tačiau chirurginė intervencija išlieka veiksmingiausia ir galutinė viršutinės virškinamojo trakto dalies kraujavimų gydymo priemonė 3–15% atvejų. Vyresnio amžiaus pacientų gydymo rezultatai dėl sisteminių gretutinių ligų, dažnų kraujavimo recidyvų, nepakankamo medikamentinio gydymo poveikio išlieka nepatenkinami. Šios amžiaus grupės ligonių mirštamumas tebėra didelis – 12–47%. Siekiant pagerinti chirurginio gydymo rezultatus, dažniausiai kreipiamas dėmesys į chirurgo operacinę techniką, infekcinių komplikacijų profilaktiką, tačiau dažnai užmirštama ligonių mitybos sutrikimų korekcija. Todėl mūsų darbo tikslas – atlikus retrospektyvų tyrimą (I etapas, 1992–1998 m.), įvertinti ankstyvo enterinio maitinimo (EM) reikalingumą ligoniams, operuotiems nuo kraujuojančių gastroduodeninių opų. Ligoniai ir metodai Atliktas 128 ligonių, operuotų nuo kraujuojančių gastroduodeninių opų 1992–1998 metais KMU Bendrosios chirurgijos klinikoje (III KKL), retrospektyvus tyrimas. Į jį įtraukti tik tie pacientai, kuriuos operavo aukščiausią kvalifikacinę kategoriją turintys chirurgai. Ligoniai suskirstyti į dvi grupes: pirmąją sudarė ligoniai, kuriems nuo operacijos dienos gydymui skyrėme EM, o antrąją, – kuriems pooperaciniu laikotarpiu EM netaikytas. EM grupė pavadinta tiriamąja, T grupe, antroji grupė – kontroline, K grupe. Iš viso T grupėje buvo 88 ligoniai, o K grupėje – 40. Grupių ligonius pagal amžių skirstėme į iki 60 metų ir 60-ies metų bei vyresnius. Esminio grupių skirtumo pagal amžių, opų lokalizaciją, gretutines ligas, diagnozuotas iki operacijos, nebuvo. Gretutinėmis ligomis (GL), diagnozuotomis iki operacijos, sirgo 43,2% T grupės ir 45% K grupės ligonių. Fiksavome šias pooperacines komplikacijas: vietinė ir bendrinė infekcija (žaizdos seroma, žaizdos supūliavimas, siūlių išsiskyrimas, peritonitas, intraabdominaliniai abscesai, sepsis), plaučių uždegimas, kraujagyslių trombozė ir embolija, galvos smegenų kraujotakos sutrikimai, ūminis širdies ir kraujagyslių sistemos bei inkstų funkcijos nepakankamumas. Rezultatai Iš T grupės 88 operuotų ligonių pooperacinių komplikacijų buvo 21 (23,86 ± 9,53%), o iš 40 K grupės – 12 ligonių (30 ± 13,81%). Skirtumas statistiškai reikšmingas (p = 0,00001). Operuotiems skubos tvarka T grupės ligoniams komplikacijų taip pat buvo rečiau (18,43 ± 6,37) negu K grupės (33,34 ± 10,54%), nors rezultatų skirtumo statistinio reikšmingumo negavome. T grupės ligoniams, kuriems prieš operaciją GL nediagnozuotos, pooperacinių komplikacijų buvo tik 10 ± 4,24%, o K grupės – 22,72 ± 9,14% ligonių. Palyginę rezultatus ligonių, kuriems prieš operaciją buvo nustatytos GL, gavome priešingą rezultatą: pooperacinių komplikacijų pareiškė 42,10 ± 8% T grupės ligonių ir 38,88 ± 11,82% K grupės, t. y. komplikacijų skaičius naudojant EM nepadidėjo ir nesumažėjo. Tokia pati tendencija būdinga tiek jaunesnių nei 60 metų, tiek vyresnių ligonių grupėms. Dėl ypač sunkios būklės 10 ligonių buvo atliktos tik gyvybę gelbstinčios minimalios operacijos: opos apsiuvimas ar ekscizija. T grupėje tokių ligonių buvo penki ir jų pooperacinis laikotarpis buvo sklandus, o K grupės penkiems operuotiems ligoniams šis laikotarpis komplikavosi (3 komplikacijos). Išvados Ankstyvas EM po kraujuojančių gastroduodeninių opų chirurginio gydymo turi teigiamos įtakos pooperacinių komplikacijų profilaktikai. Ligoniams, kurie serga gretutinėmis ligomis, EM iš esmės nesumažina pooperacinių komplikacijų galimybės. Ligoniai, kurie dėl besitęsiančio kraujavimo ar jo pasikartojimo operuojami kritinės būklės, pooperaciniu laikotarpiu turi būti gydomi EM, nes tai padeda sumažinti pooperacinių komplikacijų riziką. Reikšminiai žodžiai: pooperacinis laikotarpis, pooperacinės komplikacijos, ankstyvas enterinis maitinimas, opinis kraujavimas The role of enteral feeding in prevention of postoperative complications after surgery for gastroduodenal bleeding ulcers in elderly patients Kęstutis Adamonis, Saulius Bradulskis, Juozas JuočasKaunas University of Medicine, Clinics of General Surgery and Gastroenterology,Eivenių str. 29, LT-50009 Kaunas, LithuaniaE-mail: SBR@one.lt; k-adamonis@delfi.lt Background / objective Although hospitalization and surgery for uncomplicated ulcers have decreased in the United States and Europe over the past 20 to 30 years, the number of hospital admissions for hemorrhage associated with ulcers has remained relatively unchanged. Peptic gastroduodenal ulcer is the most common cause of severe upper gastrointestinal bleeding and accounts for at least 60–70 percent of all episodes. Overall mortality from a bleeding from the upper gastrointestinal tract reaches 2–15%. If a bleeding has stopped and does not recur (70–80%), mortality does not exceed 2%; in recurrent bleeding after initial endoscopic control of bleeding (15–25%), mortality rises up to 10%, and if an active bleeding continues (5%) – mortality can rise up to 30%. Endoscopic retreatment in patients with peptic ulcers reduces the need for surgery without increasing the risk of death and is associated with fewer complications than surgery. The wider use of endoscopic hemostasis, effective medicines and angiographic techniques (for severe, persistent bleeding if surgery poses an extremely high risk or endoscopic therapy has been unsuccessful) have reduced the need of surgery for treatment of bleeding gastroduodenal ulcers significantly. Nevertheless, surgery still plays a pivotal role in 3–15% of cases, and only surgical intervention is the most effective and final method of treatment for bleeding peptic ulcer. The overall mortality from bleeding ulcer is higher in elderly patients, ranging from 12 to 47% in patients older than 60 years. Factors responsible for increased morbidity and mortality in the elderly may include associated or underlying comorbid conditions such as malignancy; multiple organ system diseases, in particular atherosclerosis and its consequences, including cardiovascular and cerebrovascular diseases; increased frailty of elderly; and use of multiple medications, particularly nonsteroidal antiinflammatory drugs. The postoperative mortality rate also remains high (2–22%). The efficiency of surgery for bleeding ulcers depends not only on the surgeon’s skills, the time and type of operation, preoperative volume replacement and measures for infection prevention. Gastrointestinal surgery patients are at risk of nutritional depletion from inadequate nutritional intake, surgical stress and the subsequent increase in metabolic rate. The goal of this retrospective study was to evaluate the effectiveness of early postoperative enteral nutrition in patients that underwent surgery for bleeding gastroduodenal ulcers in Surgical Clinic of the 3rd Kaunas Clinical Hospital between 1992 and 1998. Patients and methods 128 patients that undervent surgery for gastroduodenal ulcer haemorrhage at the Surgical Clinic of the 3rd Kaunas Clinical Hospital from 1992 to 1998 were retrospectively analyzed. Only patients operated on by skilled and qualified surgeons were included in the study. The patients were separated into two groups: 88 patients of the first group (study group T) received early postoperative enteral nutrition and 40 patients from the second (control group K) received the same postoperative treatment, except enteral feeding. According to age, both groups of patients were divided into subgroups: >60 years and 60 years or older. Two groups were similar with respect to age, ratio of men to women, the site and size of ulcers, concomitant diseases before operation. In the study group, concomitant diseases were diagnosed in 43.2% of cases, and in the control group in 45% of patients co-morbidity was present. All local and general postoperative complications were fixed. Results In the study group, 88 patients undervent surgery for bleeding gastroduodenal ulcer. The postoperative period was complicated in 21 cases (23.86 ± 9.53%), and in the control group 40 patients were operated on and postoperative complications developed in 12 cases (30 ± 13.81%) (P = 0.00001). Among the patients from the study group that underwent emergency operation, complications were observed also less often (18.43 ± 6.37%) in comparison with the control group (33.34 ± 10.54%). The postoperative period in the study group patients without concomitant diseases was less complicated (only in 10 ± 4.24% of cases) than in the control group (22.72± 9.14%). Opposite results were received when we compared the data in both groups of patients with concomitant diseases. In the study group, the postoperative period was complicated in 42.10 ± 8% and in the control group in 38.88 ± 11.82%. This means that enteral nutrition did not increase or decrease the rate of postoperative complications in patients with other illnesses. A similar tendency was observed in both age groups. Ten extremely high risk patients with massive ulcer bleeding or rebleeding after endoscopic retreatment undervent life-threatening minimal emergency surgical procedures for hemostasis (ulcer suture or excision). The postoperative period in five study group patients was smooth, and in the control group (five patients were operated on) three patients developed postoperative complications. Conclusions Early postoperative enteral nutrition has a positive influence on reducing the incidence of postoperative complications in patients after surgery for bleeding gastroduodenal ulcer. Enteral nutrition is an effective option for critically ill high risk elderly surgical patients undergoing emergency surgical procedures for massive ulcer bleeding or rebleeding. Postoperative enteral feeding helps to decrease the risk of postoperative complications and is necessary. Keywords: postoperative period, postoperative complications, early enteral nutrition, peptic ulcer bleeding

The Important Bird Area (IBA) “Donyz-Tau cliff faces” (KZ019), with an area of 387,110 hectares, has been allocated by I.V. Karyakin (2008) based on survey results in 2003–2006. Survey showed several globally threatened and biome-specific species nesting here, including Steppe Eagle (Aquila nipalensis) and Eastern Imperial Eagle (Aquila heliaca), 26 breeding pairs of each species (Karyakin, 2008). Condition of large raptor nesting groups in the IBA was then checked (territories were always checked partially) in 2012, 2017, and 2018. IBA “Donyz-Tau cliff faces” is located in the Aktobe, Atyrau, and Mangistau regions of Kazakhstan, with 70% of an area belonging to Aktobe region. “Donyz-Tau cliff faces” is part of escarpments that form the northern border of the Ustyurt mesa plateau. In Aktobe region IBA is extended along the “Donyz-Tau cliff faces” in the latitudinal direction. It includes cliff faces itself with a variety of characteristic relief forms, along with adjacent strips of a watershed mesa plateau and a salt marsh depression along the cliff faces foot. Cliff faces scrap within the IBA ranges in width from 5 to 10 km (about 1100 km2), plateau and depression strips do not exceed 10 km as well. Pelitophytic and hemipsammophytic deserts lead among vegetation at plateau, characteristic petrophytic and gypsophytic desert communities predominate here along with steppe and shrub communities in logs and other shady habitats; in the sub cliff faces depression, halophytic succulent and annual saltwort deserts predominate. IBA survey within the Aktobe region was carried mainly between June 15 and June 25, 2022. Survey route ran along the cliff faces from east to west, from the Aschebulak rise to the border of the Atyrau region (east of the Tamdy massif). Within the IBA, the automobile route was 250 km (+30 km outside of IBA), the length of the inspected cliff faces strip was 150 km, survey went for 10 days (11 overnight stays). Additionally, we used data on bird sightings obtained by a camera trap in August 2022. For Golden Eagle (Aquila chrysaetos) and Eastern Imperial Eagle, nesting density was assessed not by area, but by the linear extent of favorable nesting biotopes: cliff faces and slopes of erosional ridges, as in previous surveys in the region (Karyakin et al., 2005a; 2005b; 2008; 2009; 2010; 2011). Steppe Eagle nesting density was estimated for the inspected area, which was calculated based on the entire survey route and the effective width of the registration strip, amounting to about 1100 km2 as well. A total of 34 Steppe Eagle nests were found, of which only one was active (occupied). Nine permanent perches were noted. Adult birds were encountered six times (six individuals), including one on the only occupied breeding territory (Fig. 1). Traces of recent (this year) Steppe Eagle visits were noted on seven nests and seven perches. Based on these findings, considering nests locations on the ground, 13 Steppe Eagle breeding territories were found in the examined area, 11 of which had birds or traces of their recent presence (occupied breeding territories), and only one territory had successful breeding. Two breeding territories (five nests) were located outside of IBA, although close to its border. The average frequency of adult Steppe Eagle encounters was around 2.1 birds per 100 km of the route, encounter density in the study area was about 0.5 birds per 100 km2. Nesting density was 1.2 breeding territories per 100 km2, including 0.09 successful territories per 100 km2. Three previously known Steppe Eagle breeding territories were inspected. Two of them were first identified in 2012 and then checked in 2017 and 2018. One was first identified in 2017 and has not been inspected until now. All territories were first identified by an occupied nest. No breeding was detected in all three territories so far, two were occupied (traces of recent bird visits were noticed), one was possibly empty. Nests that were found in 2012 have not been preserved, and no new nests were built instead (first disappeared by 2017 already, the second – between June 2018 and June 2022). The nest that was first described in 2017 continues to exist. The only active nest was located on plateau (about 3.5 km to the edge of the cliff faces slope). When examined on June 15, it contained three nestlings aged from 26–30 to 36–40 days. After 20 days, only one nestling remained in the nest upon the second visit, most likely the eldest (the nest was visited on May 7, 2022, by A.E. Bragin and T. Katzner). Two other nestlings have possibly become prey to Eagle Owl (Bubo bubo) or four-legged predators. Among Steppe Eagle pellets and food remains in nests and near perches, Great Gerbil (Rhombomys opimus) and Yellow Gound Squirrel were repeatedly identified, Steppe Agama (Trapelus sanguinolentus) and unidentified snake were found once. Saiga Antelope (Saiga tatarica) bones were used to build one nest. Nests inspected in 2022 were built on the ground, on the heap or collapse of stones, on the collapse of stone blocks of armored sandstone slabs on ledges, on burial structures, on low bushes (often leaning on a bush with one side on a slope). All nests were in the open and had enough space around them for grown nestlings to leave. Nests on the metal structures of Trigo points were previously known here, but now they have disappeared, and new ones were not built. Nests are built at relatively gentle cliff faces slopes, low gentle elevations on the plateau (behind the upper tier of the cliff faces), slopes, ridges, and remnant mountaintops of the erosion ridges of the lower cliff faces tier and in subcliff faces depression. A total of 23 Eastern Imperial Eagle nests were found, nine of which had broods at the time of the survey, in one nest the brood was possibly destroyed by Eagle Owl (traces of a gored nestling were found near an empty nest on a turanga), and a dead clutch was found in another. Thus, inhabited nests accounted for almost half of all examined nests (48%). Eleven adult birds and at least thirteen nestlings were observed in nests. The average sightings frequency of adult eagles was 3.9 birds/100 km of route, or 7.3 birds/100 km of route; the sightings density in the examined area (1100 km2) was 0.98 birds/100 km2. Virtually all observations of adult Eastern Imperial Eagles were in occupied breeding territories. Bird encounter without a connection to an occupied nest was recorded in a single case (nest most likely remained undetected). Based on the nest findings and bird sightings, 15 breeding territories were localized with certainty, with out counting previously disappeared known territories (three of them), including 12 active ones, out of which nine were successful at the time of the check. Nesting density for the entire surveyed area is 1.34 breeding territories/100 km2, including 0.98 active and 0.80 successful breeding territories/100 km2. For the length of 150 km of the surveyed cliff faces, nesting density per length of the cliff faces strip was 10 breeding territories/100 km of cliff faces, including eight active territories and of them six successful at the time of the survey/100 km. Eight previously known Eastern Imperial Eagle breeding territories (first identified in 2017 and earlier) were surveyed. Two of them turned out to be occupied with successful breeding, one is visited by birds, but no active nests were located. There is still a nest in one territory, but the area is most likely empty. In other four areas, nests have not survived (in two cases nesting trees disappeared as well), and no traces of bird presence were found. In all cases (n=6), when it was possible to examine nest contents in detail, there were two nestlings in the brood. In other cases (n=4), the number of nestlings in the brood remained unspecified (no less than one nestling). Nestlings age varied from 36 (possibly from 31) to 50 days. All found nests were located on low trees or large turanga bushes, willow, saxaul, or tamarisk. Usually, the nests were located in the upper fork of the branches or on the largest branch in the tree crown, with an open approach from above and from either side. However, from other sides the nest is often hidden by the tree crown. Nests were located at the bottom of large valleys on cliff faces or on slopes and bottoms of side logs cut into the sides of such valleys, often at the very top of the log, near the foot of the slope. Five adult Golden Eagles were encountered in the surveyed area (including two pairs) and five breeding areas were localized. Three of these territories were discovered for the first time – all of them occupied by birds, and an active nest found in one. It is possible that the remaining two occupied territories contained successful nests that remained undetected. Two breeding territories that were known since 2017 were checked as well. This year they were not occupied and, judging by nests condition and the absence of visiting signs, they have probably been empty for several years. The only found inhabited nest contained one fully feathered nestling. Other nestlings from this brood probably left the nest already, but it is more likely that at the time of examination the brood consisted of one nestling (Golden Eagle fledglings in Northern Ustyurt stay close to the nest for the first days after departure, but we did not meet any fledglings despite spending a long time at the breeding territory). The nesting density per 100 km of cliff faces was 3.3 breeding territories, including two occupied territories and between 0.7 and 2 territories with successful breeding. In total, 6–8 Golden Eagle nests were identified (some of them were attributed with uncertainty), of which one if residential, the rest are empty. All nests were located on ledges covered with canopies or in niches of high steep slopes of large valleys on cliff faces, on the cliffs of remnant erosion ridges or turtkuls. Typical nest location – at the top part of the slope, on the shelf ledge formed by a cut of the armor plate of the mesa plateau. In 2022, the share of active nests and breeding success of Steppe Eagle in IBA are the lowest for the entire observation period. The state of the nesting group can be confidently characterized as unfavorable. It has worsened significantly when compared to the situation in 2017–2018. In contrast, the state of Eastern Imperial Eagle nesting group is quite good and has undoubtedly not deteriorated in comparison with observations in 2017–2018. Golden Eagle nesting group appears to be prosperous, but its condition is worse than in 2017 and 2018, when occupied nests with successful breeding were found in all identified breeding territories. In addition to true eagles, Short-Toed Eagle (Circaetus gallicus, possibly one occupied breeding territory with an active nest), Cinereous Vulture (Aegypius monachus, encounters with adult birds), and Long-Legged Buzzard (Buteo rufinus) were noted. The latter species is the most numerous: a total of 70 nests of Long-Legged Buzzard were found, of which eight or nine were active: nestlings were found in six of them, one was already abandoned, and in one or two there was unsuccessful breeding (dead clutch, shell remains). 15 adult birds and 11 nestlings and fledglings were accounted. Based on these findings, at least 34 Long-Legged Buzzard breeding territories were located, 14 of which were occupied this year (41%), including 7 (20%) where successful breeding took place at the time of survey. In 2022, geophysical exploration was actively carried out at the IBA in search for hydrocarbons. The production base of the geological party was located right at the eastern border of the IBA. The work benefits Tethys Petroleum Limited (TPL, Tethys Petroleum Ltd), the subsoil user id “Kul-Bas” LLP, a subsidiary of TPL. The western half of the IBA in the Aktobe region (and its entire territory in the Atyrau region) is located in the contract area where exploration and development of the Kosbulak gas field was carried out, territory belongs to KazAzot LLP since March 2016. In 2022 (as well as in 2017–2019), we did not observe any noticeable activity of the company at the IBA. From the time when IBA was identified and until 2020, there were no places for keeping livestock or long-term human settlements in its Aktobe part (they were located in its territory located in the Atyrau region). But later, in 2019, a wintering area and a zhailau appeared here, where horses and camels graze. The number of these animals are small and do not have a negative impact on the ecosystems in the area. In 2020–2021, a large number of livestock was located in IBA (including sheep) – they were temporarily transferred from the Mangistau region, where severe drought happened at the time. Traces of grazing and livestock camps are visible. No other agricultural activity was noted. However, the anthropogenic load on ecosystems has increased significantly compared to the situation before 2020, when there was no agricultural activity. Over the medium term, a great danger is posed by the rapid gas fields development, which is accompanied by the development of linear infrastructure (happening outside of IBA at the time), the emergence and expansion of permanent human presence (people and transport) in the territory.

ObjectivesDuring their lifetimes, a majority of musicians experience playing-related musculoskeletal disorders (PRMD). PRMD prevalence is tied to instrument choice, yet most studies examine heterogeneous groups of musicians, leaving some high-risk groups such as oboists understudied. This paper aims to (1) ascertain the prevalence and nature of PRMDs in oboists, (2) determine relevant risk factors, and (3) evaluate the efficacy of treatment methods in preventing and remedying injuries in oboe players.MethodsA 10-question online questionnaire on PRMDs and their treatments was completed by 223 oboists. PRMDs were compared across gender, weekly playing hours, career level, age, and years of playing experience.ResultsOf all respondents, 74.9% (167/223) reported having had at least one PRMD in their lifetime. A majority of these injuries (61.9% of all respondents) were of moderate to extreme severity (5 or higher on a scale of 1 to 10). Females (mean = 5.88) reported significantly more severe injuries than males. No significant effects of career level (i.e., professional vs. student vs. amateur), age, or years of playing experience were observed. We found significant non-linear relationships between weekly playing hours and PRMD prevalence and severity. Injuries were most commonly on the right side of the body, with the right thumb, wrist, hand, and forearm being most affected in frequency and severity. Of those injuries for which recovery information was provided, only 26.1% of injuries were “completely recovered.” The perceived effectiveness of a few treatments (physical therapy, rest, stretching, occupational therapy, massage) tended to be ranked more highly than others.ConclusionThe oboists in this study experienced high rates of PRMD, particularly in the right upper extremities. Females and those playing 7-9 and 16-18 h per week reported a significantly higher severity of injuries than other groups.

Introduction Mentors play a role in real life, just as they do in fiction. They also feature in reality television, which sits somewhere between the two. In fiction, mentors contribute to the narrative arc by providing guidance and assistance (Vogler 12) to a mentee in his or her life or professional pursuits. These exchanges are usually characterized by reciprocity, the need for mutual recognition (Gadamer 353) and involve some kind of moral question. They dramatise the possibilities of mentoring in reality, to provide us with a greater understanding of the world, and our human interaction within it. Reality television offers a different perspective. Like drama it uses the plot device of a mentor character to heighten the story arc, but instead of focusing on knowledge-based portrayals (Gadamer 112) of the mentor and mentee, the emphasis is instead on the mentee’s quest for ascension. In attempting to transcend their unknownness (Boorstin) contestants aim to penetrate an exclusive creative class (Florida). Populated by celebrity chefs, businessmen, entertainers, fashionistas, models, socialites and talent judges (to name a few), this class seemingly adds authenticity to ‘competitions’ and other formats. While the mentor’s role, on the surface, is to provide divine knowledge and facilitate the journey, a different agenda is evident in the ways carefully scripted (Booth) dialogue heightens the drama through effusive praise (New York Daily News) and “tactless” (Woodward), humiliating (Hirschorn; Winant 69; Woodward) and cruel sentiments. From a screen narrative point of view, this takes reality television as ‘storytelling’ (Aggarwal; Day; Hirschorn; “Reality Writer”; Rupel; Stradal) into very different territory. The contrived and later edited (Crouch; Papacharissi and Mendelson 367) communication between mentor and mentee not only renders the relationship disingenuous, it compounds the primary ethical concerns of associated Schadenfreude (Balasubramanian, Forstie and van den Scott 434; Cartwright), and the severe financial inequality (Andrejevic) underpinning a multi-billion dollar industry (Hamilton). As upward mobility and instability continue to be ubiquitously portrayed in 21st century reality entertainment under neoliberalism (Sender 4; Winant 67), it is with increasing frequency that we are seeing the systematic reinvention of the once significant cultural and historical role of the mentor. Mentor as Fictional Archetype and Communicator of ThemesDepictions of mentors can be found across the Western art canon. From the mythological characters of Telemachus’ Athena and Achilles’ Chiron, to King Arthur’s Merlin, Cinderella’s Fairy Godmother, Jim Hawkins’ Long John Silver, Frodo’s Gandalf, Batman’s Alfred and Marty McFly’s Doc Emmett Brown (among many more), the dramatic energy of the teacher, expert or supernatural aid (Vogler 39) has been timelessly powerful. Heroes, typically, engage with a mentor as part of their journey. Mentor types range extensively, from those who provide motivation, inspiration, training or gifts (Vogler), to those who may be dark or malevolent, or have fallen from grace (such as Michael Douglas’ Gordon Gekko in Wall Street 1987, or the ex-tribute Haymitch in The Hunger Games, 2012). A good drama usually complicates the relationship in some way, exploring initial reluctance from either party, or instances of tragedy (Vogler 11, 44) which may prevent the relationship achieving its potential. The intriguing twist of a fallen or malevolent mentor additionally invites the audience to morally analyze the ways the hero responds to what the mentor provides, and to question what our teachers or superiors tell us. In television particularly, long running series such as Mad Men have shown how a mentoring relationship can change over time, where “non-rational” characters (Buzzanell and D’Enbeau 707) do not necessarily maintain reciprocity or equality (703) but become subject to intimate, ambivalent and erotic aspects.As the mentor in fiction has deep cultural roots for audiences today, it is no wonder they are used, in a variety of archetypal capacities, in reality television. The dark Simon Cowell (of Pop Idol, American Idol, Britain’s Got Talent, America’s Got Talent and The X-Factor series) and the ‘villainous’ (Byrnes) Michelin-starred Marco Pierre White (Hell’s Kitchen, The Chopping Block, Marco Pierre White’s Kitchen Wars, MasterChef Australia, New Zealand, South Africa) provide reality writers with much needed antagonism (Rupel, Stradal). Those who have fallen from grace, or allowed their personal lives to play out in tabloid sagas such as Britney Spears (Marikar), or Caitlyn Jenner (Bissinger) provide different sources of conflict and intrigue. They are then counterbalanced with or repackaged as the good mentor. Examples of the nurturer who shows "compassion and empathy" include American Idol’s Paula Abdul (Marche), or the supportive Jennifer Hawkins in Next Top Model (Thompson). These distinctive characters help audiences to understand the ‘reality’ as a story (Crouch; Rupel; Stradal). But when we consider the great mentors of screen fiction, it becomes clear how reality television has changed the nature of story. The Karate Kid I (1984) and Good Will Hunting (1998) are two examples where mentoring is almost the exclusive focus, and where the experience of the characters differs greatly. In both films an initially reluctant mentor becomes deeply involved in the mentee’s project. They act as a special companion to the hero in the face of isolation, and, significantly, reveal a tragedy of their own, providing a nexus through which the mentee can access a deeper kind of truth. Not only are they flawed and ordinary people (they are not celebrities within the imagined worlds of the stories) who the mentee must challenge and learn to truly respect, they are “effecting and important” (Maslin) in reminding audiences of those hidden idiosyncrasies that open the barriers to friendship. Mentors in these stories, and many others, communicate themes of class, culture, talent, jealousy, love and loss which inform ideas about the ethical treatment of the ‘other’ (Gadamer). They ultimately prove pivotal to self worth, human confidence and growth. Very little of this thematic substance survives in reality television (see comparison of plots and contrasting modes of human engagement in the example of The Office and Dirty Jobs, Winant 70). Archetypally identifiable as they may be, mean judges and empathetic supermodels as characters are concerned mostly with the embodiment of perfection. They are flawless, untouchable and indeed most powerful when human welfare is at stake, and when the mentee before them faces isolation (see promise to a future ‘Rihanna’, X-Factor USA, Season 2, Episode 1 and Tyra Banks’ Next Top Model tirade at a contestant who had not lived up to her potential, West). If connecting with a mentor in fiction has long signified the importance of understanding of the past, of handing down tradition (Gadamer 354), and of our fascination with the elder, wiser other, then we can see a fundamental shift in narrative representation of mentors in reality television stories. In the past, as we have opened our hearts to such characters, as a facilitator to or companion of the hero, we have rehearsed a sacred respect for the knowledge and fulfillment mentors can provide. In reality television the ‘drama’ may evoke a fleeting rush of excitement at the hero’s success or failure, but the reality belies a pronounced distancing between mentor and mentee. The Creative Class: An Aspirational ParadigmThemes of ascension and potential fulfillment are also central to modern creativity discourse (Runco; Runco 672; United Nations). Seen as the driving force of the 21st century, creativity is now understood as much more than art, capable of bringing economic prosperity (United Nations) and social cohesion to its acme (United Nations xxiii). At the upper end of creative practice, is what Florida called “the creative class: a fast growing, highly educated, and well-paid segment of the workforce” (on whose expertise corporate profits depend), in industries ranging “from technology to entertainment, journalism to finance, high-end manufacturing to the arts” (Florida). Their common ethos is centered on individuality, diversity, and merit; eclipsing previous systems focused on ‘shopping’ and theme park consumerism and social conservatism (Eisinger). While doubts have since been raised about the size (Eisinger) and financial practices (Krätke 838) of the creative class (particularly in America), from an entertainment perspective at least, the class can be seen in full action. Extending to rich housewives, celebrity teen mothers and even eccentric duck hunters and swamp people, the creative class has caught up to the more traditional ‘star’ actor or music artist, and is increasingly marketable within world’s most sought after and expensive media spaces. Often reality celebrities make their mark for being the most outrageous, the cruelest (Peyser), or the weirdest (Gallagher; Peyser) personalities in the spotlight. Aspiring to the creative class thus, is a very public affair in television. Willing participants scamper for positions on shows, particularly those with long running, heavyweight titles such as Big Brother, The Bachelor, Survivor and the Idol series (Hill 35). The better known formats provide high visibility, with the opportunity to perform in front of millions around the globe (Frere-Jones, Day). Tapping into the deeply ingrained upward-mobility rhetoric of America, and of Western society, shows are aided in large part by 24-hour news, social media, the proliferation of celebrity gossip and the successful correlation between pop culture and an entertainment-style democratic ideal. As some have noted, dramatized reality is closely tied to the rise of individualization, and trans-national capitalism (Darling-Wolf 127). Its creative dynamism indeed delivers multi-lateral benefits: audiences believe the road to fame and fortune is always just within reach, consumerism thrives, and, politically, themes of liberty, egalitarianism and freedom ‘provide a cushioning comfort’ (Peyser; Pinter) from the domestic and international ills that would otherwise dispel such optimism. As the trials and tests within the reality genre heighten the seriousness of, and excitement about ascending toward the creative elite, show creators reproduce the same upward-mobility themed narrative across formats all over the world. The artifice is further supported by the festival-like (Grodin 46) symbology of the live audience, mass viewership and the online voting community, which in economic terms, speaks to the creative power of the material. Whether through careful manipulation of extra media space, ‘game strategy’, or other devices, those who break through are even more idolized for the achievement of metamorphosing into a creative hero. For the creative elite however, who wins ‘doesn’t matter much’. Vertical integration is the priority, where the process of making contestants famous is as lucrative as the profits they will earn thereafter; it’s a form of “one-stop shopping” as the makers of Idol put it according to Frere-Jones. Furthermore, as Florida’s measures and indicators suggested, the geographically mobile new creative class is driven by lifestyle values, recreation, participatory culture and diversity. Reality shows are the embodiment this idea of creativity, taking us beyond stale police procedural dramas (Hirschorn) and racially typecast family sitcoms, into a world of possibility. From a social equality perspective, while there has been a notable rise in gay and transgender visibility (Gamson) and stories about lower socio-economic groups – fast food workers and machinists for example – are told in a way they never were before, the extent to which shows actually unhinge traditional power structures is, as scholars have noted (Andrejevic and Colby 197; Schroeder) open to question. As boundaries are nonetheless crossed in the age of neoliberal creativity, the aspirational paradigm of joining a new elite in real life is as potent as ever. Reality Television’s Mentors: How to Understand Their ‘Role’Reality television narratives rely heavily on the juxtaposition between celebrity glamour and comfort, and financial instability. As mentees put it ‘all on the line’, storylines about personal suffering are hyped and molded for maximum emotional impact. In the best case scenarios mentors such as Caitlyn Jenner will help a trans mentee discover their true self by directing them in a celebrity-style photo shoot (see episode featuring Caitlyn and Zeam, Logo TV 2015). In more extreme cases the focus will be on an adopted contestant’s hopes that his birth mother will hear him sing (The X Factor USA, Season 2, Episode 11 Part 1), or on a postal clerk’s fear that elimination will mean she has to go back “to selling stamps” (The X Factor US - Season 2 Episode 11 Part 2). In the entrepreneurship format, as Woodward pointed out, it is not ‘help’ that mentees are given, but condescension. “I have to tell you, my friend, that this is the worst idea I’ve ever heard. You don’t have a clue about how to set up a business or market a product,” Woodward noted as the feedback given by one elite businessman on The Shark Tank (Woodward). “This is a five million dollar contract and I have to know that you can go the distance” (The X Factor US – Season 2 Episode 11, Part 1) Britney Spears warned to a thirteen-year-old contestant before accepting her as part of her team. In each instance the fictitious premise of being either an ‘enabler’ or destroyer of dreams is replayed and slightly adapted for ongoing consumer interest. This lack of shared experience and mutual recognition in reality television also highlights the overt, yet rarely analyzed focus on the wealth of mentors as contrasted with their unstable mentees. In the respective cases of The X Factor and I Am Cait, one of the wealthiest moguls in entertainment, Cowell, reportedly contracts mentors for up to $15 million per season (Nair); Jenner’s performance in I Am Cait was also set to significantly boost the Kardashian empire (reportedly already worth $300 million, Pavia). In both series, significant screen time has been dedicated to showing the mentors in luxurious beachside houses, where mentees may visit. Despite the important social messages embedded in Caitlyn’s story (which no doubt nourishes the Kardashian family’s generally more ersatz material), the question, from a moral point of view becomes: would these mentors still interact with that particular mentee without the money? Regardless, reality participants insist they are fulfilling their dreams when they appear. Despite the preplanning, possibility of distress (Australia Network News; Bleasby) and even suicide (Schuster), as well as the ferocity of opinion surrounding shows (Marche) the parade of a type of ‘road of trials’ (Vogler 189) is enough to keep a huge fan base interested, and hungry for their turn to experience the fortune of being touched by the creative elite; or in narrative terms, a supernatural aid. ConclusionThe key differences between reality television and artistic narrative portrayals of mentors can be found in the use of archetypes for narrative conflict and resolution, in the ways themes are explored and the ways dialogue is put to use, and in the focus on and visibility of material wealth (Frere-Jones; Peyser). These differences highlight the political, cultural and social implications of exchanging stories about potential fulfillment, for stories about ascension to the creative class. Rather than being based on genuine reciprocity, and understanding of human issues, reality shows create drama around the desperation to penetrate the inner sanctum of celebrity fame and fortune. In fiction we see themes based on becoming famous, on gender transformation, and wealth acquisition, such as in the films and series Almost Famous (2000), The Bill Silvers Show (1955-1959), Filthy Rich (1982-1983), and Tootsie (1982), but these stories at least attempt to address a moral question. Critically, in an artistic - rather than commercial context – the actors (who may play mentees) are not at risk of exploitation (Australia Network News; Bleasby; Crouch). Where actors are paid and recognized creatively for their contribution to an artistic work (Rupel), the mentee in reality television has no involvement in the ways action may be set up for maximum voyeuristic enjoyment, or manipulated to enhance scandalous and salacious content which will return show and media profits (“Reality Show Fights”; Skeggs and Wood 64). The emphasis, ironically, from a reality production point of view, is wholly on making the audience believe (Papacharissi and Mendelson 367) that the content is realistic. This perhaps gives some insight as to why themes of personal suffering and instability are increasingly evident across formats.On an ethical level, unlike the knowledge transferred through complex television plots, or in coming of age films (as cited above) about the ways tradition is handed down, and the ways true mentors provide altruistic help in human experience; in reality television we take away the knowledge that life, under neoliberalism, is most remarkable when one is handpicked to undertake a televised journey featuring their desire for upward mobility. The value of the mentoring in these cases is directly proportionate to the financial objectives of the creative elite.ReferencesAggarwal, Sirpa. “WWE, A&E Networks, and Simplynew Share Benefits of White-Label Social TV Solutions at the Social TV Summit.” Arktan 25 July 2012. 1 August 2014 <http://arktan.com/wwe-ae-networks-and-simplynew-share-benefits-of-white-label-social-tv-solutions-at-the-social-tv-summit/>. 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