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Sexual assault survivors can experience a wide variety of psychological consequences—from none to Major Depression Disorder to Substance use and, most commonly, Acute Stress Disorder/Post Traumatic Stress Disorder. These clinical outcomes depend on the severity of the assault, as well as pre-assault psychological status, and post-assault social support, the effectiveness of therapy, and events that occur during therapy. This case study will focus on one particular event that can arise during the treatment of a survivor of sexual assault, namely the impact of a not guilty verdict on the survivor occurring during the course of therapy. The client in question experienced an immediate and significant increase in depressive symptoms and the course of therapy needed to be altered significantly to respond to the not guilty verdict rendered during the therapy process. This case study will explore how therapy was altered in response to this guilty verdict and the lessons that were learned from this experience in order to better prepare assault survivors who are involved in legal proceedings during their therapy. Overall, this case study demonstrated the vital need to prepare survivors who plan to testify in court against the perpetrator beforehand for all possible outcomes of the trial. Furthermore, the case study demonstrated the need to implement effective interventions in the aftermath of a trial to help buffer against the effects of a "not guilty" verdict. [ABSTRACT FROM AUTHOR]

The relevance of the research is related to the issues of increasing the operation efficiency of wells equipped with an electric submersible pump, based on the optimal choice of operating mode, frequency and parameters of power equipment according to the profit criterion delivered by a «pump – motor» pair during the full life cycle of its operation. The possible variability of operating conditions is taken into account by adjusting the planning horizon of the criterion. The main scope: formalization of the optimal choice of operation mode, input power frequency and parameters of electric submersible pump equipment, while taking into account direct energy costs and indirect factors of accelerated wear in stationary operating conditions with an adjustable planning horizon Methods: material and heat balances, hydrostatics, linearized kinetics of head losses in lift segments, numerical integration and analysis of nonlinear systems, typical formalization of optimization problems. Results and summary. Taking into account the main factors of accelerated wear in the profit criterion expands the range of definitions of optimal solutions, anticipating the overestimated choices of initial productivity by the fact of reducing the total profit on complete life cycle of the electric submersible pump operation. The problem of possible variability of operating conditions is partially taken into account in the scheme for estimating stationary optimal solutions by introducing the planning horizon indicator into the criterion. The decrease in the energy efficiency of the electric submersible pump operation at shifted frequencies indicates that the «visible freedoms» of frequency regulation have a price to use and chosen frequencies in the optimal solutions with long operation periods approaches synchronous value with the maximum electric submersible pump efficiency. The proposed thermobaric and energy description of the system equilibrium states, taking into account the factors of the dynamics of electric submersible pump resource consumption, allows using simplified model solutions as the primary basis for the subsequent construction of adaptive automated regulations for operational control and management under conditions of uncertainty.

The relevance of the research is associated with the problems of creating and maintaining dynamic models of electrical submerged pump-equipped well as a part of operational monitoring and control systems under conditions of the elevator and inflow parameters deviation. Assessment of the root causes of well desired operating mode violation and the forecast of the immediate negative consequences are important for balanced (optimal) decisions on operational modes correction and ensuring stable operating conditions. The main aim of the research is to develop the least-squares algorithm – estimating the drift parameters of the elevator including the electrical submerged pump and the inflow of a dynamic well model and methods for stabilizing these estimates in real-time operations based on noisy measurements data. Methods: numerical integration of nonlinear differential equations, regression least-squares analysis methods, statistical computational tests, test perturbations, methods of regularizing estimation algorithms. Results. The authors have developed the two-stage algorithm for estimating the drift parameters of the elevator (wear, impurities) and inflow (productivity and reservoir parameters) to simplify the presentation of a complex dynamic model «inflow–elevator–electrical submerged pump–wellhead» according to two speed scales for monitoring the operating conditions of the system with inflow dynamics observer under conditions of test frequency disturbances. Summary. The proposed rules for stabilizing the model parameters estimates based on the generation of test perturbations, reducing dimension by decomposing the complex model into composite blocks, filtering noisy measurement signals by approximation, implementing a dynamic inflow observer form the basis for identification algorithm design with reliable estimation of the main group of deformation parameters of pump pressure-head characteristics and inflow. Despite the low accuracy of the elevator hydraulic resistance identification, the error in reproducing the dynamics of the variable states of the system in disturbed operating modes from the observer outputs does not exceed 2 %, which indicates the low sensitivity of the standard operating modes of the elevator to the desired parameter setting within the framework of the model solutions used. The required accuracy of the pipe hydraulic resistance identification should be consistent with the conditions for the periodic cleaning of the lift from sorbents.

Relevance. A significant number of the largest oil fields in Russia are in the final stages of development, characterized by a decrease in production volumes, increase in the share of complicated wells. Sucker-rod pump units are one of the most common methods of operating wells short-term production fund. The operation of rod pump installations in complicated operating conditions in some cases is accompanied by decrease in the turnaround time of work, increase in the specific energy and economic costs during production. In these conditions, one of the most urgent task is ensuring the cost-effective development of wells due to the timely diagnosis of the technical condition and operating conditions of pumping equipment. Objects: pumping unit operating in various operating conditions, including in the presence of complicating factors, and a wellhead dynamometer card of operation of the rig, reflecting technical condition and operating conditions of the downhole equipment. The aim of the research is to develop a new approach to diagnosing the state of rod pumping units using a dynamometer card, based on solving inverse problems of the dynamics of a rod installation. Methods: methods for numerical solution of partial differential equations for direct problems, including modeling the theoretical dynamometer cards of the rod installation; methods for solving inverse problems aimed at quantifying the parameters of the model characterizing the operation of the rod installation. Results. The authors have developed two-tier method for diagnosing the state of pumping units using a dynamometer card. The proposed diagnostic method includes: at the first level, the processing of practical dynamometer cards by the pattern recognition system and, at the second level, a quantitative determination of the consequences of faults, based on the physical laws of formation of configuration of dynamometer cards, the solution of the problem of the dynamics of a rod installation. By analyzing the configuration of dynamometer cards under various operating conditions of pumping equipment (normal operation, high gas content at the pump intake, leakage in the pump discharge valve, low plunger fit in the cylinder), the examples of solving quantitative diagnostics problems based on the developed algorithm are shown.

The relevance of the research is related to the effectiveness of monitoring dynamic operating modes of wells equipped with a frequency-controlled electric submersible pump at development and computational implementation of well system models operating in real time. Complex functionality of the solution introduced in the article allows reproducing the systems real forms of behavior in transient and equilibrium operation modes under the impact of complicating factors, which is the basis of the correct parametric estimation using real-time control data of well operating states. The main aim of the research is to construct a complex hydrodynamic model of the «reservoir–well–electric pump–wellhead» type, oriented to the tasks of complicated operating modes control of real-time systems. Objects: material balance, linear filtration, hydrostatics, linearized kinetics of friction losses, numerical modeling of differential equations. Methods. The constructed and implemented hydrodynamic model of electric submersible pump-equipped well reproduces a holistic and logical «portrait» of actual behavior of the system in transient and equilibrium operation modes under the impact of complicating factors. The simplified nature of model components and connections descriptions allows the implementation and usage of functionally updated monitoring applications within the information resources of the enterprise. Results. Complexity and factor wholeness of the model description are the basis for designing algorithms and regulations for parametric identification and subsequent recognition of the types and levels of impacting complications on system using actual operation data. The implementation of the computational process in sync with the dynamics of state and disturbances control data update make it possible to use the model as a virtual measure of the extended vector of well states in transient and steady-state operating modes.

Relevance. In the Russian Federation rod screw pumps installations are widely used in the Ural-Volga region and first of all in the Republic of Tatarstan as they allow extracting reservoir liquid of the increased viscosity with the content of mechanical impurity and gas. The main aim of the research is to determine the effect of complicating factors, such as the presence of mechanical impurities, increased viscosity, water cut of formation fluid, on operational efficiency of rod screw pumps; determine the regularities in reducing the operating time of the rod column and the elastomer of the pump. Objects. The main number of rod screw pumps is in wells, which have opened the layers of the Bashkirian stage and the Verean horizon. They are distinguished by high viscosity of oil and presence of water-oil emulsion. The analysis of the chemical properties of oil samples from 188 wells in Sheshmaoyl, Kondurchaneft and Ideoloyl, operated by rod screw pumps, showed that the average viscosity of oil wells is 610 mPas. At the same time, a significant proportion falls on the wells producing reservoir fluid with a viscosity of more than 500 mPass. Methods. The accumulated volume of operational data on Bashkirian and Vereisk horizon wells equipped with rod screw pumps allows determining the operating time of the rod pumps reduction with an increase in viscosity of the fluid caused by a significant growth in hydraulic resistance to rotary motion of the rod string. The carried out statistical analysis of the rod screw pumps repair determined the regularity of wearout degree of the elastomer depending on a number of accumulated rotor speed, water content, content of mechanical impurities in the produced fluid, saturation pressure, fluid level in the well and with favorable conditions. Results. We defined the main complicating factors which influence the efficiency of rod pump operation. The analysis of the rod screw pumps repair causes shown that low quality of polished rods produced by the manufacturer, rod deviation from geometric parameters of different structures, hardness, chemical composition of rods (factory defect) are often the causes of breaks. Open threaded rod or polished rod was primarily due to insufficient torque screwing the threaded connection or a bend in the rod head. The breackage of polished rods mainly occur in the oil seal and due to fatigue voltage. The fatigue fracture occurs as a result of permanent deformation forces and temperature action. One of the main causes of the elastomer swelling is the maintenance with pressure at the reception of rod screw pumps below the saturation pressure. It leads to saturation of elastomer material with gases and rotor jamming in the stator which can turn into breakages of the rod string and polished rod.

Copyright of Philosophy & Cosmology is the property of International Society of Philosophy & Cosmology (ISPC) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mr. Wellington, a 61-year-old veteran, was referred for a neuropsychological assessment and mental health treatment by his attending physician and psychologist following a spinal cord injury (SCI) and alcohol withdrawal. According to the referral, Mr. Wellington had been experiencing anxiety and depressive symptoms, as well as diminished cognitive functioning. These symptoms were considered to be interfering with his participation in SCI rehabilitation. Prior to the assessment, Mr. Wellington had sustained a tetraplegic injury due to a syrinx and partial L5 injury caused by an uncontrolled chronic bone infection and was receiving treatment at a Veteran’s Administration medical center. Results of the assessment, the related challenges in identifying the etiology of the patient’s diminished neurocognitive functioning, and mental health treatment are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease, associated with impaired skin barrier function and an atopic background. Various complicating factors, such as irritants, aeroallergens, food, microbial organisms, contact allergens, sweat, and scratching can induce the development of AD symptoms. Irritants, including soap/shampoo and clothes, can cause itching and eczematous lesions. In addition, young children with AD tend to become sensitized to eggs, milk, or peanuts, while older children and adults more often become sensitized to environmental allergens, such as house dust mites (HDM), animal dander, or pollen. Serum-specific IgE levels and skin prick test reactions to food tend to show high negative predictive values and low specificity and positive predictive values for diagnosing food allergy. On the other hand, AD adult patients tend to have severe skin symptoms and exhibit high HDM-specific IgE levels. Microbial organisms, e.g., Staphylococcus aureus and Malassezia furfur, might contribute to the pathogenetic mechanisms of AD. While sweat plays a major role in maintaining skin homeostasis, it can become an aggravating factor in patients with AD. Furthermore, scratching often exacerbates eczematous lesions. Several patient-specific complicating factors are seen in most cases. The identification and management of complicating factors are important for controlling AD. [ABSTRACT FROM AUTHOR]

The management of 50 children with acute laryngotracheobronchitis (LTB) in a general I.C.U. in a developing country is presented. The overall mortality was 16%, with no patient demising from LTB. It is stressed that LTB in developing countries is a very different disorder to that seen in Western societies, due to complicating factors such as bronchopneumonia, malnutrition and measles. Guidelines for therapy are proposed. [ABSTRACT FROM AUTHOR]

Objective: Urinary tract infections (UTI) are the second most common infection in geriatric population. This study investigated clinical findings, diagnostic approaches, complicating factors, prognosis, causative microorganisms and antimicrobial susceptibility in geriatric patients diagnosed with UTI., Methods: A total of 140 hospitalised patients with UTIs were evaluated within three years between January 2011-January 2015 at the Eskisehir Yunus Emre State Hospital. UTI diagnosed when there were systemic and urinary signs and symptoms and a positive dipstick test and urine culture result, leukocyte and CRP like serum parameters., Results: Among the studied patients, 41.4% had urological diseases, 20.7% had diabetes mellitus and 19.2% had neurological diseases. The most common symptoms and signs were fever, dysuria nausea/vomiting, general condition impairment, pyuria, haematuria. The laboratory values for CRP, ESR and leukocyte count were 84 mg/dL, 56 mm/s and 11.9 (10^3μL), with mean values being determined. Among patients having a urinary catheter (17.1%), 27.9% had a history of UTI, while 29.3% had been hospitalised. Escherichia coli and Klebsiella pneumoniae were the most commonly identified microorganisms. The mean duration for hospitalisation was 7.6 days, while a 5% mortality rate was observed over the course of the disease., Conclusion: Because of the potential for serious complications and mortality, elderly patients with urinary tract infection, should receive immediate empirical treatment based on anamnesis, clinical evaluation and urinalysis and should be re-examined using results from cultures and antibiograms upon follow-up., Competing Interests: Conflicts of interest: No potential conflicts of interest were disclosed.