A video book of ophthalmic skills for medical students

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A framework to support a simulation-based understanding of digitalisation in remanufacturing operations

This is the author accepted manuscript.Modelling and simulations are important in predicting the response and behavior of manufacturing shop-floor operations such as predictive maintenance in relation to the real-life operations. Thus, remanufacturing operations, an end-of-life operation focused on returning a “disassemble-able” product to a condition which is at least as new as the original specification, can be influenced by modelling and simulation. While simulations have a limitation in their ability to enable real-time business decisions in environments of complexity due to costs and time required to build these models, remanufacturing operations in particular will benefit from the application of simulations. As remanufacturing is characterized by an uncertain nature of product returns, simulation modelling can be used to support the understanding of different methods from a real-time scenario context. With manufacturing digitalization, complexity in remanufacturing is further increased with more data produced as sensor-enabled products enter the remanufacturing shop-floor. This paper investigates how modelling and simulation could be used to provide clarity to the digitalization of remanufacturing operations and proposes a framework to support simulation modelling for remanufacturing sensor-enabled products. Findings from the synthesis of a systematic literature review and five remanufacturing case studies reveal that system dynamics modelling has greater application to remanufacturing over other modelling techniques. Additionally, the importance of digitalisation across the six stages ofremanufacturing is expected to be similar and, as such, reduces medium term cost implications for remanufacturers looking to digitalise

Sustainability of Guinea Fowl (Numidia meleagris) layers fed varying levels of Centrosema pubescent leaf meal.

An experiment was conducted to determine the effect of egg size on hatchability of Guinea fowl keets. Three different egg size groups (treatments): small (<39 g); medium (39 - 42 g) and large (>42 g)] were used in the experiment. Each treatment had three replicates of 10 eggs each. A complete randomized design was used for the experiment. Eggs were incubated with their sharp ends pointing downwards at 37.5 - 37.8oC and 60% relative humidity for 28 days. Thereafter, incubation parameters including hatchability (number of eggs that successfully hatched), dead in shells (DIS), clears, pips and keets with deformities evaluated. Data were analyzed using General Linear Model (GLM) of SAS. Medium sized eggs had significantly (P<0.05) higher hatchability than small eggs. Also, medium sized eggs had lower pips. Egg size did not have effect on DIS, clears and deformities. The results of the present study showed that medium sized eggs (39 - 42 g) hatched best in comparison to both small and large categories. Keywords: Dead in shells, deformities, egg size, guinea fowl, hatchability, incubatio

Study of the Structural and Mechanical Properties of Recycled High Density Polyethylene/Palm Kernel Shell Ash Bio-Composite

This study examined the structure and mechanical properties of recycled high density polyethylene(RHDPE)/palm kernel shell ash (PKSA) bio-composite. The reinforcement was added to the polymer matrix in concentrations of 5, 10, 15, 20 and 25wt% and particle sizes of 100, 150, 200, 250, 300µm. The composite samples were produced using injection moulding technique and subjected to mechanical and tribological property tests for percentage elongation, ultimate tensile strength, and hardness. The structure of the composite samples was analyzed using an optical metallurgical microscope. Results of the structural analysis revealed that the reinforcement of small particle size (100µm) formed a better interfacial bond with the polymer matrix compared with that of other particles sizes. The structural analysis also revealed uniform distribution of hard and brittle particles of the reinforcement in the polymer matrix. Mechanical test results showed that addition of palm kernel shell ash to the polymer matrix decreased its percentage elongation and impact strength by 24.5% and 22% respectively but significantly increased the tensile strength and hardness by 107.9% and 72% respectively. The ultimate tensile strength, and hardness of the developed composite increased with decrease in reinforcement particle size. Maximum ultimate tensile strength of 131MPa was obtained by the RHDP containing 10wt% PKSA of 100µm particle size while maximum hardness value of 86BHN was obtained at 25wt% palm kernel shell ash of 100µm particle size addition. Palm kernel shell ash reinforced recycled high density polyethylene bio-composite of improved mechanical properties that can be applied in production of engineering components. Keywords: Palm kernel shell ash, RHDPE, Percentage elongation, Ultimate tensile strength, Hardness. DOI: 10.7176/CPER/62-05 Publication date: January 31st 202

Safe and Effective Prescribing with Dyslexia: A Collaborative Autoethnography

Prescribing medicines is the most common patient-level intervention made by doctors in the United Kingdom. However, this is associated with a potential for harm. Whilst dyslexia can bring many strengths, it also impacts reading and writing abilities and therefore has the potential to contribute to errors in the prescribing process if dyslexic doctors are unsupported. This paper explores the experiences of Seb – regarding prescribing and prescribing education – as a dyslexic medical student and doctor. We hope that this might spark more research on this overlooked issue. This is a collaborative, analytic, autoethnographic study within an interpretivist paradigm. Firstly, Seb wrote an autobiographical account; he was then interviewed by Mike. The interview audio-recording was transcribed verbatim and both data sources were thematically analysed. Emerging themes included: learning to prescribe, coping, struggling and support, errors, near misses and handwritten charts, and moving forward. Specific issues included a deficiency in active learning/assessment at an undergraduate level, a lack of support, and potential safety concerns regarding handwritten charts. Electronic prescribing was felt to be a positive step forwards for both safety and accessibility. Our findings suggest that further consideration of specific supports is needed to assist dyslexic trainee doctors in the prescribing of medicines, so as to prevent the clinical environment acting to disadvantage them. They also suggest that we may need to review the ways in which we teach and assess this vital skill at an undergraduate level

Towards a simulation-based understanding of smart remanufacturing operations : a comparative analysis

While the majority of literature on remanufacturing operations examines an end-of-life (EOL) strategy which is both manual and mechanised, authors generally agree that digitalisation of remanufacturing is expected to increase in the next decade. Subsequently, a new research area described as digitally-enabled remanufacturing, remanufacturing 4.0 or smart remanufacturing is emerging. This is an automated, data-driven system of remanufacturing by means of Industry 4.0 (I4.0) paradigms. Insights into smart remanufacturing can be provided through simulation modelling of the remanufacturing process. While the use of simulation modelling in order to predict responses and behaviour is prevalent in remanufacturing, the use of these tools in smart remanufacturing is still limited in literature. The goal of this research is to present, as a first of its kind, a comparative understanding of simulation modelling in remanufacturing in order to suggest the ideal modelling tool for smart remanufacturing. The proposed comparison includes system dynamics, discrete event simulation and agent based modelling techniques. We apply these modelling techniques on a smart remanufacturing space of a sensor-enabled product and use assumptions derived from industry experts. We then proceed to model the remanufacturing operation from sorting and inspection of cores to final inspection of the remanufactured product. Through our analysis of the assumptions utilised and simulation modelling results we conclude that, while individual modelling techniques present important strategic and operational insights, their individual use may not be sufficient to offer comprehensive knowledge to remanufacturers due to the challenge of data complexity that smart remanufacturing offers

The Impacts of E-Learning in Facilitating Academic Performance Among Private Secondary Schools and Tertiary Institutions in Ota, Ogun State, Nigeria

The introduction of multimedia technologies and the internet in learning has been observed as a means of improving accessibility and quality of delivery and learning among the students and teachers in private Secondary Schools and tertiary institutions in Nigeria. Thus, e-learning is a new paradigm shift in educational sector for the purpose of advancing the knowledge base. The beginning of 21st Century has heralded the educational technology that has facilitated e-learning among secondary and tertiary institutions in the developing countries. The empirical study will focus on some selected private Secondary Schools and Higher Institutions in Ota. Both primary and secondary data shall be utilized in the study. Structured and unstructured interviews with some staff and students of the selected Secondary and tertiary institutions will be conducted. This is necessary so as to obtain qualitative data on their e-learning experiences as well as the understanding of the usage. The Secondary Schools and Tertiary institutions websites will be assessed so as to elicit information on their learning management system which is crucial for this study. Questionnaires will be administered to the students in order to elicit information on their experiences on e-learning. This study in its purpose employs descriptive design in its procedural approach. The method of data collection entails a survey study conducted by the researchers using the questionnaire as the research instrument. This provides opportunity of the researchers having a direct contact with the target population in a bid to obtain vital information necessary for a thorough study of this kind. The survey method also provides the researchers with the privilege of obtain “first hand’ information and having a personal interview with the key players in the field or area of focus by the researcher. The descriptive design is utilized to analyze the characteristic of the respondents and the number of participants that responded to a particular issue of concerned being addressed the current study. The impacts of e-learning in facilitating academic performance were examined using regression analysis based on the testable hypothesis based on the study objectives. Analysis of the result from the study provides evidence of significant impact of e-learning in facilitating academic studies and self-development resulting to improved learning process and high academic performance. The therefore recommends that more effort should be made by the management of secondary schools and tertiary institutions in providing a e-learning facilities in their institutions and students should be encouraged to make a proper use of these facilities by given them e-learning related assignment and projects

Safe and effective prescribing with dyslexia

Background: The term ‘dyslexia’ refers to a condition that impacts upon reading and writing abilities whilst not altering intelligence. Individuals with dyslexia may have difficulties with the speed and accuracy and their reading and writing, amongst other issues. Dyslexia is not automatically considered a disability but is a protected characteristic under the UK Equality Act (2010), and therefore employers and educational institutions are required to provide ‘reasonable adjustments’ in order to allow individuals to reach their full potential. There is a lack of research on this issue, but what little there is suggests that doctors feel as though any support they received ended when they graduated from medical school. Main body: A core distinction between medical school and medical practice is the requirement to prescribe medicines as registered medical practitioners. Junior doctors have to master this complex and potentially hazardous skill “on the job”, with a perceived lack of support. Here, we open up a debate about the potential impact of dyslexia on prescribing, and the need to find supports that may be effective in enabling doctors with dyslexia prescribe medicines safely and effectively – and thus reach their full potential as medical practitioners and promote patient safety. Conclusion: We argue that medical schools and hospitals could immediately provide dyslexia awareness training in both undergraduate and postgraduate settings. We discuss electronic prescribing systems, and conclude that research is required to identify effective supports for junior doctors with dyslexia

Digitisation and the Circular Economy: A Review of Current Research and Future Trends

This is the final verson. Available on open access from MDPI via the DOI in this recordSince it first appeared in literature in the early nineties, the Circular Economy (CE) has grown in significance amongst academic, policymaking, and industry groups. The latest developments in the CE field have included the interrogation of CE as a paradigm, and its relationship with sustainability and other concepts, including iterative definitions. Research has also identified a significant opportunity to apply circular approaches to our rapidly changing industrial system, including manufacturing processes and Industry 4.0 (I4.0) which, with data, is enabling the latest advances in digital technologies (DT). Research which fuses these two areas has not been extensively explored. This is the first paper to provide a synergistic and integrative CE-DT framework which offers directions for policymakers and guidance for future research through a review of the integrated fields of CE and I4.0. To achieve this, a Systematic Literature Review (SLR; n = 174) of the empirical literature related to digital technologies, I4.0, and circular approaches is conducted. The SLR is based on peer-reviewed articles published between 2000 and early 2018. This paper also summarizes the current trends in CE research related to manufacturing. The findings confirm that while CE research has been on the increase, research on digital technologies to enable a CE is still relatively untouched. While the “interdisciplinarity” of CE research is well-known, the findings reveal that a substantial percentage is engineering-focused. The paper concludes by proposing a synergistic and integrative CE-DT framework for future research developed from the gaps in the current research landscapeEngineering and Physical Sciences Research Council (EPSRC

Use of fibroscan in assessment of hepatic fibrosis in patients with chronic hepatitis B infection

Introduction: Assessment of the stage of liver fibrosis plays a prominent role in the decision process of treatment in chronic viral hepatitis.Objective: To determine the stage of fibrosis in patients with chronic HBV infection using fibroscan.Method: This is a cross sectional descriptive study involving patients with CHB with a valid transient elastography (TE) measurement. Liver function test and platelet count was determined. APRI and FIB-4 were calculated and Spermans rank coefficient was applied for correlation of transient elastography (TE) with either serum biomarkers.Results: 190 patients were enrolled, mean age 36.3years, 64.2% males and 89.9% were asymptomatic. TE correlated significantly with APRI and FIB-4 (r = 0.58; P < 0.001 and r = 0.42; P < 0.001, respectively). Most of the patients 131(68.9%) had no significant fibrosis (F0,F1) while those with significant fibrosis and cirrhosis were 59 (31.1%) and 23(12.1%) respectively.Conclusion: The prevalence of significant fibrosis and cirrhosis is high in this population.Keywords: Fibroscan, Hepatic fibrosis, APRI, FIB-