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Purpose: The purpose of this study is to systematically dissect strategies against the challenges stalling digital transformation (DT) in the UK higher education (HE) sector. It addresses the challenges impeding DT's incorporation and offers a blueprint for fostering innovation and efficiency within academic institutions. Design/methodology/approach: Using a systematic literature review, the research integrates a nuanced literature review with interpretive structural modelling (ISM). Through meticulous ISM analysis, including sensitivity analysis and level partitioning, a robust framework is developed to pinpoint and interrelate DT challenges. Findings: This investigation delineates a spectrum of impediments to DT in HE, most notably the need for more digital understanding among educators, intensified by inadequate support and resources. The findings reveal that the effective integration of DT is hindered by factors such as insufficient educator digital skills, resistance to technology and the continuous evolution of digital infrastructure. Practical implications: The study's findings and the developed level partitioning diagram offer invaluable insight into how DT must be integrated into the curriculum to enhance HE. Additionally, it could further lead to research within digital infrastructure and how learning needs to be facilitated for students in HE. Originality/value: This study breaks new ground by systematically illuminating the centrality of the educator skill gap. By contributing insights into the educator skill gap, it proposes a unique analytical model that underscores actionable pathways for advancing DT initiatives in HE institutions.

While strict vertical transmission insures the durability of intracellular symbioses, phylogenetic incongruences between hosts and endosymbionts suggest horizontal transmission must also occur. These horizontal acquisitions can have important implications for the biology of the host. Wolbachia is one of the most ecologically successful prokaryotes in arthropods, infecting an estimated 50-70% of all insect species. Much of this success is likely due to the fact that, in arthropods, Wolbachia is notorious for manipulating host reproduction to favor transmission through the female germline. However, its natural potential for horizontal transmission remains poorly understood. Here we evaluate the fundamental prerequisites for successful horizontal transfer, including necessary environmental conditions, genetic potential of bacterial strains, and means of mediating transfers. Furthermore, we revisit the relatedness of Wolbachia strains infecting the Panamanian leaf-cutting ant, Acromyrmex echinatior, and its inquiline social parasite, Acromyrmex insinuator, and compare our results to a study published more than 15 years ago by Van Borm et al. (2003). The results of this pilot study prompt us to reevaluate previous notions that obligate social parasitism reliably facilitates horizontal transfer and suggest that not all Wolbachia strains associated with ants have the same genetic potential for horizontal transmission.

Sexuality education is one of the most disputable health education programs as far as its inclusion in Early Childhood Education is concerned. This study was conducted in order to investigate early childhood future educators' attitudes and considerations about introducing sexuality education to their future pupils. We used a qualitative research method: semi-structured interviews for two groups of students in the Department of Educational Studies in Early Childhood, University of Northern Greece. The results revealed that the students who had chosen and successfully completed a course about early childhood sexuality education were the ones who indicated the subject as one of the basic ones to be taught in the kindergarten. Furthermore, they expressed their considerations about Greek bibliography's lag in this field. Finally, they exhibited more readiness to introduce sexuality education to their future pupils than the rest of the students did. Students who had not attended a relative course referred to developmentally inappropriate subject areas, showing their inability or even riskiness to introduce sexuality to their pupils. The results suggested the students' need for relevant theoretical as well as practical education.

It is often argued that the rise of psychological sciences has offered a new way of constructing subjectivity. Although this framework was used by institutions for regulatory and administrative purposes, soon it became part of common sense and psychological language and notions began to constitute an interpretative resource for social actors. Researchers argue that often discourses of psychologization have been used both by theorists and lay people to account for intergroup conflict, relegating intergroup processes to interpersonal or intrapersonal issues. In this paper, we examine how parents mobilize psychological notions to account for the behavior of children of immigrants within Greek schools. It is argued that psychological discourse was often used to frame "problematic" behavior as the result of interpersonal or intrapersonal processes. These constructions allowed participants to account for the children of immigrants' behaviour avoiding accusations of prejudice, while at the same time the role of the Greek dominant group (both as a school institution and as the majority of the school population) in shaping intergroup relations within schools was omitted.

The etiology of anterior knee pain after total knee arthroplasty (TKA) remains unclear. Few studies have examined patellar fixation quality. The purpose of the present study was to evaluate the patellar cement-bone interface after TKA on magnetic resonance imaging (MRI) and to correlate the patella fixation grade with the incidence of anterior knee pain. We retrospectively reviewed 279 knees undergoing metal artifact reduction MRI for either anterior or generalized knee pain at least 6 months after cemented, posterior-stabilized TKA with patellar resurfacing with one implant manufacturer. MRI cement-bone interfaces and percent-integration of the patella, femur, and tibia were assessed by a fellowship-trained senior musculoskeletal radiologist. The grade and character of the patella interface were compared to the femur and tibia. Regression analyses were used to determine the association between patella integration with anterior knee pain. There were more patellar components with ≥75% zones of fibrous tissue (50%) compared to the femur (18%) or tibia (5%) (P <.001). There were a greater number of patellar implants with poor cement integration (18%) compared to the femur (1%) or tibia (1%) (P <.001). MRI findings showed more evidence of patellar component loosening (8%) compared to the femur (1%) or tibia (1%) (P <.001). Anterior knee pain was correlated with worse patella cement integration (P =.01), with women predicted to have better integration (P <.001). The quality of the patellar cement-bone interface after TKA is worse compared to the femoral or tibial component interface. Poor patellar cement-bone interface may be a source of anterior knee pain after TKA, but further investigation is required. [ABSTRACT FROM AUTHOR]

Knee instability is a leading cause of dissatisfaction following total knee arthroplasty (TKA). Instability can involve abnormal laxity in multiple directions including varus-valgus (VV) angulation, anterior-posterior (AP) translation, and internal-external rotation (IER). No existing arthrometer objectively quantifies knee laxity in all three of these directions. The study objectives were to verify the safety and assess reliability of a novel multiplanar arthrometer. The arthrometer utilized a five degree-of-freedom instrumented linkage. Two examiners each conducted two tests on the leg that had received a TKA of 20 patients (mean age 65 years (range, 53-75); 9 men, 11 women), with nine and eleven distinct patients tested at 3-month and 1-year postoperative time points, respectively. AP forces from −10 to 30 Newtons, VV moments of ±3 Newton-meters, and IER moments of ±2.5 Newton-meters were applied to each subject's replaced knee. Severity and location of knee pain during testing were assessed using a visual analog scale. Intraexaminer and interexaminer reliabilities were characterized using intraclass correlation coefficients. All subjects successfully completed testing. Pain during testing averaged 0.7 (out of possible 10; range, 0-2.5). Intraexaminer reliability was >0.77 for all loading directions and examiners. Interexaminer reliability and 95% confidence intervals were 0.85 (0.66-0.94), 0.67 (0.35-0.85), and 0.54 (0.16-0.79) in the VV, IER, and AP directions, respectively. The novel arthrometer was safe for evaluating AP, VV, and IER laxities in subjects who had received TKA. This device could be used to examine relationships between laxity and patient perceptions of knee instability. [ABSTRACT FROM AUTHOR]

Summary Background Although perforator-to-perforator anastomosis in supermicrosurgery may be used in transferring free flaps with small vessels, it is still difficult in certain situations that include potentially infected wounds. Moreover, it is limited to smaller flaps. Anastomosis of large vessels is still safer for transfer of a large flap for most surgeons. The harvesting of a patch of the parent artery together with the perforator supplying the flap allows the surgeon to perform an anastomosis between the vessel ends of larger caliber, and possibly with greater anastomotic success. Method When the vascular pedicle of a free flap is < 0.8 mm, an option is to take a cuff of the major artery for an end-to-patch anastomosis. From 1983 to 2013, this method was applied to the anteromedial thigh (AMT) flap (seven cases), the groin flap (81 cases), and the free Becker's flap (five cases). When a patch was taken from the femoral artery, direct anastomosis for the major artery was performed using 5/0 Prolene sutures, followed by coverage with local soft tissue. When a patch was taken from the ulnar artery, a patch of vein graft was used for repair of the ulnar artery. In one case, a segment of the femoral artery was harvested with an AMT flap and a segment of a sartorius muscle flap; the compound tissue was transferred to the neck with the femoral artery to replace the left carotid artery. In the donor site, the defect of the femoral artery was reconstructed with an artificial graft. Results The flaps had no failure or partial necrosis, but one patient developed bleeding from the femoral artery 2 days postoperatively. It was treated by adding one more suture for the femoral artery and coverage with the sartorius muscle. In the ulnar artery, the patients did not complain of cold intolerance and the postoperative angiogram showed good patency of the ulnar artery after an average follow-up of 1 year. Conclusion For the majority of plastic surgeons, this method provides a reliable and comfortable anastomosis when transferring a flap with small vessels. The only concern is to repair the donor artery carefully and ensure coverage of the repair site with local tissue. [ABSTRACT FROM AUTHOR]

Abstract: This study is an exploratory research effort to understand hotel future customers’ intentions to adopt and perform the three types of ethical tourism, namely positive, negative and discursive types. There has been scant research, so far, with regards to ethical behaviour in the tourism sector. In addition there are considerable voids with reference to the factors that are able to affect this type of behaviour. However, in Greece there is already a considerable number of hotels, which have obtained the Green Key certificate. Their managers do need and seek for the most optimum marketing channels to promote their competitive advantages. The present study aimed to offer a somewhat better understanding of future travellers’ intentions to adopt ethical consumption when travelling. Intentions of future travellers to search, plan and actually visit a green hotel was examined. The examination included also consumers’ willingness to participate in a boycotting against an unethical hotel and further spread their word against unethical hotel practices through discursive activities, such as petitions gathering, taking part in protest events etc. In addition, it was aimed to investigate the impact of attitudes and demographics on customers’ intentions to adopt and perform the above mentioned ethical behaviours. With reference to intentions to stay at a green hotel, it was found that potential travellers seem more agreeable to express their willingness to stay at a green hotel than to plan or make an actual effort to do so. The usual in consumer behaviour gap between intentions and actual behaviour was established here once more. It was also found that travellers are very much willing to participate in a hotel boycotting in cases that the hotel under boycotting has been demonstrably reported for safety and hygiene scandals, child labour, cruelty towards animals and particularly barbaric exploitation of their employees. On the con trary, consumers were not found equally willing to participate in discursive activities against unethical hotels. In fact, all they were found to do is to discuss with their friends the possibility of getting engaged in a hotel boycotting. The results also indicated t hat better educated consumers expressed higher level of intentions to stay at a green hotel, to boycott and discursively act against an unethical hotel, than their counterparts did. Women were found more likely to participate in a hotel's boycotting and consume rs of 35-44 years of age were found more likely to enhance discursive activities. Attitudes that concern green hotels seem to be able to influence moderately travellers’ intentions to stay at a green hotel. Intentions are mostly effected by those attitudes that concern consumers’ feelings that staying at a green hotel is favourable and desirable. Attitudes in overall were found to be more able to influence consumers’ willingness to stay at a green hotel than their actual plans or efforts to do so. Attitudes seem to be able, to a lesser extent, to influence consumers’ intentions to get involved in boycotting and discursive activities. These findings, if studied carefully, might very well be found useful to marketing management strategies in cas es of green hotels or hotels, which would decide to “go green” in the future. The Green Key certification should become one of criteria u sed in searching and locating hotels either through internet or the agencies. In addition, enthusiastic testimonials of past customers might very well be incorporated in the communication campaigns of the green hotels. [Copyright &y& Elsevier]

Background: Pain catastrophizing, anxiety, and depression are associated with poor outcomes after total hip (THA) and total knee (TKA) arthroplasty. The goal of this study is to determine the relationship between post-operative pain scores and opioid consumption; and the association among pre-operative measures of anxiety, depression, and pain catastrophizing and post-operative opioid consumption in patients undergoing THA and TKA.Methods: This is a single-institution prospective cohort study of 243 opioid-naïve patients undergoing elective, primary THA (n = 123) or TKA (n = 120) for osteoarthritis. Pre-operatively, patients completed the PROMIS-29 (Patient-Reported Outcomes Measures Information System; physical function/anxiety/depression/fatigue/sleep disturbance/social activities/pain interference/pain intensity) and Pain Catastrophizing Scale. Post-operatively, patients completed a weekly survey for 12 weeks determining morphine-milligram-equivalent (MME) opioid consumption, opioid cessation, and visual analog scale pain scores. Multivariable regression models determined the association between pre-operative scores and post-operative opioid consumption.Results: Mean (±standard deviation) total opioid consumption and duration was 75.1 ± 112.0 MME and 1.7 ± 1.7 weeks in THA and 384.7 ± 473.3 MME and 4.3 ± 3.5 weeks in TKA. Visual analog scale pain scores (0-100) after opioid cessation were 28.0 ± 22.9 in THA and 30.7 ± 25.8 in TKA. Multivariable regression showed that each unit increase in PROMIS-29 fatigue T-score was associated with 8.4 hours longer opioid usage in THA (P = .008) and 15.1 hours longer in TKA (P = .036), as well as 12.7 MME additional opioids in TKA (P = .027). There were no significant associations with other PROMIS-29 domains or the Pain Catastrophizing Scale.Conclusion: Opioid use duration is different for THA and TKA and may correlate with pain scores. Only pre-operative fatigue was associated with post-operative opioid consumption. These findings should inform THA and TKA post-operative pain management pathways. [ABSTRACT FROM AUTHOR]

This project deals with the application of the Gavrilović method simulating the erosion processes in small catchments. The study area is Skiathos, a Greek island, which is situated in the region of Thessaly and belongs to the "Northern Sporades" complex. Skiathos is characterized by intensive touristic activities and has historical and environmental interests. The purpose of this study is to apply the Gavrilović method so as to determine erosion in Skiathos, providing quantitative data. The Gavrilovic method takes into account several factors like geology, geomorphology, soil, climatic condition (temperature and rainfall), and land-uses according to Corine 2000. The method finally computes the erosion in terms of volume per year W [m3/y] and volume per year and area W/F [m3/y/km2] for each one of the studied catchments. It was found, for the 2nd , 3rd and 4th order sub-catchments, the mean values of W were equal to 66.76 m3/y, 226.99 m3/y, and 624.89 m3/y, respectively. More detailed information is the computation of the ratio W/F. For the 2nd , 3rd and 4th order sub-catchments, the values of 229.383 m3/y/km2 , 195.085 m3/y/km2 and 158.571 m3/y/km2 were found, respectively. Although the magnitude of W is greater in the high order sub-catchments, the ratio W/F is greater in the low order catchments, meaning that the erosion processes are more intense in the low order sub-catchments. These results are compared with other similar areas of the Aegean Sea. Further research could contain more detailed comparison with other areas of the Mediterranean, application of other similar erosion models and erosion monitoring programs. [ABSTRACT FROM AUTHOR]

Vanadium oxide microcrystallites are electrodeposited at room temperature. The effect of the deposition current density on the structural, morphological and electrochemical properties of the coatings is studied. The electrochemical activity of the material is found to improve with the deposition current density utilized during electrodeposition. At the highest deposition current values, marked amounts of lithium charge are observed to interchange with the material owing to the increased coverage of its structure. The highest specific capacitance of 145 F g-1 measured in 1 M LiCIO4 is comparable to previously reported values using different electrolytes such as NaCl, LiCl and KCl. [ABSTRACT FROM AUTHOR]