关键词： Augmentative and alternative communication (AAC)   survey   demographics   service delivery   Saudi Arabia  

摘要： Purpose: To develop and distribute a survey to obtain information on the awareness, accessibility and funding for augmentative and alternative communication (AAC) services and devices within the Kingdom of Saudi Arabia (KSA). Method: The survey targeted three groups of people which included individuals with disabilities and their families, healthcare providers such as medical doctors and nurses and the third group included community members. Survey preparation and administration were performed online via a survey website in order to access a wide range of participants across KSA. Results: Results revealed different awareness levels for AAC among the three groups (chi(2) = 45.053, p < .001) with healthcare providers showing a higher degree of awareness compared to the remaining two groups. Moreover, AAC services and devices were found to be accessible within KSA, with no differences in obtaining AAC services and devices among different regions (chi(2) = 14.204, p = .164). Conclusion: Although numerous AAC users were able to obtain AAC devices, they identified barriers including a lack of sufficient awareness of the importance, associated expenses, funding constraints and a lack of Arabization of AAC devices. IMPLICATIONS FOR REHABILITATION Augmentative and alternative communication (AAC) methods allow individuals with communication difficulties to interact and socialize with those around them. The general authority of statistics in Saudi Arabia has shown that Saudi Arabia has an increased number of individuals suffering from severe to extreme communication disorders compared to other countries around the world. Consequently, the need for AAC in Saudi Arabia cannot be underestimated. This study demonstrates the importance of the awareness of AAC among different stakeholders in Saudi Arabia including AAC users, healthcare providers and community members so that individuals with communication problems can receive maximum benefit from AAC. Given that most healthcare prov

关键词： Blow tank   energy efficiency   pneumatic conveying   pressure vessel   solids feeder  

摘要： This work presents the experimental characterization of a novel industrial bulk solids feeder, named Batchpump, and aims to validate the performance in terms of transport capacity and compressed gas consumption of an unconventional compact pressure vessel, used as a feeding device for dense phase pneumatic conveying. Experimental test data was collected for limestone as the conveyed material. The developed device was shown to have similar performance parameters (transport rate and gas consumption) when compared to conventional versions of blow tanks operating at 4 bar pressure and conveying powder material at about 9 t/h rate, albeit the smaller dimensions and simplification in operation, resulting in significative advantages in retrofits and in the implement a new conveyor line.

关键词： Clay   EnergyPlus   hemp   lime   sustainability   thermal simulation  

摘要： This research aims to estimate the operational energy (OE) savings of a full-scale building, made of lime hemp concrete (LHC) with alternative binders partly replacing lime, compared to buildings made of conventional materials, e.g. Autoclaved Aerated Concrete (AAC), Hollow Concrete Blocks (HCB), and Expanded Polystyrene (ESP). The thermal performance of small size (1 m x 1 m) different materials test cells was experimentally studied. Experimental results were compared to simulated values obtained by EnergyPlus. Monitored and simulated indoor temperatures were found to be in good agreement. Subsequently, the thermal performance and energy consumption of full-scale buildings (10 m x 10 m x 2.9 m) were simulated by EnergyPlus with a great degree of confidence. In up-scaled building simulations, LHC presented the best thermal performance and consequently the lowest energy consumption, reaching similar to 7 kWh/m(2)/year, nearly Zero Energy Building standards, 90% lower as compared to HCB which obtained the highest energy consumption. Dynamic external window shading was shown to have a significant impact on cooling energy savings. This research clearly shows the high potential of using LHC with alternative binders as a partial replacement for lime, as it has advantages in terms of energy savings, and their equivalent CO2 emissions.

关键词： Estimand   Information-anchoring   Missing data   Multiple imputation   Pattern-mixture model   Sensitivity analysis  

摘要： Reference-based controlled imputations have become a popular tool to assess the sensitivity of primary analysis inference to different post-dropout assumptions and to yield an alternative effectiveness estimand of treatment effect. As the imputation and analysis models are uncongenial in this setting, Rubin's variance estimator overestimates the repeated sampling variability of the multiple imputation estimator of treatment effect. On the other hand, since reference-based methods borrow information across arms, the sampling variance of treatment effect estimator decreases as the proportion of missing data increases, rendering it inappropriate for use in sensitivity analysis. We propose to decouple the variance estimation from information borrowing by using a delta-adjusted pattern mixture model with delta-adjustments fixed at the maximum likelihood estimate. Reference-based pattern-mixture models can thus be embedded in the sensitivity analysis using delta-adjusted pattern-mixture models by identifying a scalar sensitivity parameter value to match the treatment effect estimate. We provide both theoretical and empirical justifications of the proposed approach and illustrate its use in the analysis of a clinical trial of major depressive disorder.

关键词： Rheumatology   alternative care providers   queueing theory   mean value analysis   simulation  

摘要： Patients diagnosed with rheumatoid arthritis require lifelong monitoring by a rheumatologist. Initiation of the disease-modifying anti-rheumatic drug therapy within twelve weeks of the onset of symptoms is crucial to prevent joint damage and functional disability. We examine the impact of the engagement of alternate care providers (ACP) in alleviating delay due to limited rheumatologist capacity. Using queueing theory and discrete-event simulation, we model rheumatologist-only and rheumatologist-with-ACP system configurations as closed, multiclass queueing networks with class *** summary data from an actual rheumatology clinic for illustration, we analyze various parameter conditions to aid clinic managers and policymakers in decisions concerning capacity allocations and feasible patient panel size that impact timeliness of care and resource *** not only confirm that a substantial increase in RA patient panel size with an ACP involved in the care of follow-up patients but also demonstrates the boundaries for feasible panel sizes and workload allocation

关键词： Arginase   glycemic status   nitric oxide synthase   sexual dimorphism   type 1 diabetes mellitus  

摘要： Background: Sexual dimorphism in specific biochemical pathways and immune response, underlies the heterogeneity of type 1 diabetes mellitus (T1DM) and affects the outcome of immunotherapy. Arginase and nitric oxide (NO) synthase (NOS) metabolize L-arginine and play opposite roles in the immune response and autoimmune processes. Objective: We hypothesized that the above mentioned enzymes can be involved in sex and age differences in T1DM and its treatment. Based on this, the enzymes have been studied in peripheral blood leukocytes (PBL) and plasma of young people with T1DM. Methods: Patients were recruited from Muratsan University Hospital (Yerevan, Armenia) and were divided into groups: girls and boys by age, from children to adolescents and adolescents/young adults with recent-onset T1DM (RO-T1DM) (0.1-1 years) and long-term T1DM (LT-T1DM) (1.6-9.9 years). Arginase activity was assessed by L-arginine-dependent production of L-ornithine, and the NOS activity was assessed by NO/nitrite production. Glycemic control was assessed using hemoglobin A1c test. Plasma HbA1c concentration below 7.5% (median (range) 6.7 [6.2-7.5]) was taken as good glycemic control (+) and above 7.5% (median (range) 10.5 [7.6-13]) as poor glycemic control (-). Healthy volunteers with corresponding sex and age were used as the control group. Results: All the patients with RO-T1DM, with poor glycemic control, had increased arginase activity in the cytoplasm (cARG) and mitochondria (mARG) in PBL. In girls with RO-T1DM, with good glycemic control, the subcellular arginase activity decreased, and normalized in LT-T1DM, regardless of age. In contrast, boys from both age groups showed high arginase activity, regardless of glycemic control and duration of T1DM along with insulin therapy. At the same time, a significant decrease in the subcellular production of bioavailable NO was observed in children/preadolescents, regardless of glycemic control and duration of diabetes. In adolescents/young adult bo

关键词： 造船行业   产品数据管理   PDM集成   大规模数据   队列  

摘要： 文章从PDM系统与其他系统的集成内容、集成方式、集成难点和技术选型等方面全面地阐述了SPDM系统在数据集成方面的应用模式。旨在总结SPDM系统与其他系统集成技术的选择和实现,分析其中的得失优劣,供后续开发系统参考。

关键词： 多元智能   小学音乐教育   学科联动教学  

摘要： 在全球化大背景下,“以人为本,因材施教”的教育理念深入人心。美国哈佛大学教育研究院的心理发展学家霍华德·加德纳(Howard Gardner)提出的多元智能理论强调,要关注学生在不同智能领域的发展。目前,该理论已被运用到各学科的教学之中。当然,音乐学科的教育教学也深受这一理论的启发。本文将在多元智能理论的基础上,对我国小学音乐教育与其他学科联动教学展开探索。

关键词： 新金融工具准则   新财务报表格式   其他综合收益   会计政策  

摘要： 各类具体会计准则在实际运用环节,需要考虑本准则与其他具体准则、其他会计规范甚至其他法规的协调问题。本文以“其他权益工具投资”为例,紧扣金融工具准则和财务报表列报准则,探讨不能重分类进损益的其他综合收益涉及的有关资产或交易在终止确认时转入留存收益的会计处理规范;结合金融工具准则、财务报表列报准则的演变历史,分析容易发生不当处理的原因,并对常见指导性案例的会计处理提出完善建议。

关键词： 文言文教学   文言实词   一遍遍   文言文学习   初中语文教师   生活体验   特殊句式   通假字  

摘要： 文言文难教。初中语文教师大多有过此感叹。究其因有二。刚接触文言文的初中生,没有文言文学习的经验,只能在教师的要求下一遍遍机械地诵读。在文言文教学中,教师大多注重对文言实词意义、虚词用法、通假字、古今异义词、一词多义现象、特殊句式等古汉语知识的讲解。一篇篇文优质美的名作被肢解成一个个分散的知识点。学生文本之间缺乏对话。学生的生活体验及自我的认知得不到尊重。久而久之,学生对文言文学习失去了兴趣。