Lentzea sokolovensis sp. nov., Lentzea kristufekii sp. nov. and Lentzea miocenica sp. nov., rare actinobacteria from Miocene lacustrine sediment of the Sokolov Coal Basin, Czech Republic.

The taxonomic position of three actinobacterial strains, BCCO 10_0061T, BCCO 10_0798T, and BCCO 10_0856T, recovered from bare soil in the Sokolov Coal Basin, Czech Republic, was established using a polyphasic approach. The multilocus sequence analysis based on 100 single-copy genes positioned BCCO 10_0061T in the same cluster as Lentzea waywayandensis, strain BCCO 10_0798T in the same cluster as Lentzea flaviverrucosa, Lentzea californiensis, Lentzea violacea, and Lentzea albidocapillata, and strain BCCO 10_0856T clustered together with Lentzea kentuckyensis and Lentzea alba. Morphological and chemotaxonomic characteristics of these strains support their assignment to the genus Lentzea. In all three strains, MK-9(H4) accounted for more than 80 % of the isoprenoid quinone. The diagnostic diamino acid in the cell-wall peptidoglycan was meso-diaminopimelic acid. The whole-cell sugars were rhamnose, ribose, mannose, glucose, and galactose. The major fatty acids (>10 %) were iso-C15 : 0, anteiso-C15 : 0, iso-C16 : 0, and C16 : 0. The polar lipids were diphosphatidylglycerol, methyl-phosphatidylethanolamine, phosphatidylethanolamine, hydroxy-phosphatidylethanolamine, phosphatidylglycerol, and phosphatidylinositol. The genomic DNA G+C content of strains (mol%) was 68.8 for BCCO 10_0061T, 69.2 for BCCO 10_0798T, and 68.5 for BCCO 10_0856T. The combination of digital DNA-DNA hybridization results, average nucleotide identity values and phenotypic characteristics of BCCO 10_0061T, BCCO 10_0798T, and BCCO 10_0856T distinguishes them from their closely related strains. Bioinformatic analysis of the genome sequences of the strains revealed several biosynthetic gene clusters (BGCs) with identities >50 % to already known clusters, including BGCs for geosmin, coelichelin, ε-poly-l-lysine, and erythromycin-like BGCs. Most of the identified BGCs showed low similarity to known BGCs (<50 %) suggesting their genetic potential for the biosynthesis of novel secondary metabolites. Based on the above results, each strain represents a novel species of the genus Lentzea, for which we propose the name Lentzea sokolovensis sp. nov. for BCCO 10_0061T (=DSM 116175T), Lentzea kristufekii sp. nov. for BCCO 10_0798T (=DSM 116176T), and Lentzea miocenica sp. nov. for BCCO 10_0856T (=DSM 116177T).

Mesenchymal Stromal Cells from Perinatal Tissues as an Alternative for Ex Vivo Expansion of Hematopoietic Progenitor and Stem Cells from Umbilical Cord Blood.

Umbilical cord blood (UCB) serves as a source of hematopoietic stem and progenitor cells (HSPCs) utilized in the regeneration of hematopoietic and immune systems, forming a crucial part of the treatment for various benign and malignant hematological diseases. UCB has been utilized as an alternative HSPC source to bone marrow (BM). Although the use of UCB has extended transplantation access to many individuals, it still encounters significant challenges in selecting a histocompatible UCB unit with an adequate cell dose for a substantial proportion of adults with malignant hematological diseases. Consequently, recent research has focused on developing ex vivo expansion strategies for UCB HSPCs. Our results demonstrate that co-cultures with the investigated mesenchymal stromal cells (MSCs) enable a 10- to 15-fold increase in the cellular dose of UCB HSPCs while partially regulating the proliferation capacity when compared to HSPCs expanded with early acting cytokines. Furthermore, the secretory profile of UCB-derived MSCs closely resembles that of BM-derived MSCs. Moreover, both co-cultures exhibit alterations in cytokine secretion, which could potentially impact HSPC proliferation during the expansion process. This study underscores the fact that UCB-derived MSCs possess a remarkably similar supportive capacity to BM-derived MSCs, implying their potential use as feeder layers in the ex vivo expansion process of HSPCs.

Effects of motivations in marine protected areas: The case of Galápagos Islands.

This research proposes: (i) analyze push and pull motivations in insular marine protected areas, and (ii) determine their effects on tourists' satisfaction, positive recommendations and loyalty in terms of returning. The study was conducted in the Galápagos Islands in Ecuador; a renowned marine protected area with a National Park being a Natural Heritage Site of Humanity by UNESCO. An exploratory (EFA) and confirmatory factor analysis (CFA), followed by a stepwise multiple regression analysis applied on a sample of 407 tourists in the Galápagos Islands showed four push and pull motivational factors in this destination: "passive marine," "active marine," "novelty and escape," and "social relations". "Passive marine" and "social relations" were the most prominent factors influencing tourist satisfaction and return intentions. Moreover, "passive marine" and "novelty and escape " highly influenced visitors' intention to recommend and give positive feedback about this place. These findings constitute action guides for the adequate management of marine protected areas.

Does compartmental resection really impact retroperitoneal soft tissue sarcomas? A retrospective analysis from a Single Referral Center.

BACKGROUND: The treatment of choice for retroperitoneal soft tissue sarcomas (RPS) is surgical resection; the outcomes with more radical surgeries, notably compartmental resection, remains a subject of debate. Arguments against it, include the complexity of the technique and high morbidity. MATERIALS AND METHODS: A retrospective analysis of cases treated in a single center from January 2010 to December 2019 is presented. Two time periods were evaluated: 2010-2015 and 2016-2019, corresponding to before and after the implementation of routine compartmentectomy. We evaluated the short- and long-term outcomes of compartmental resection compared to limited surgeries through a multivariate analysis of prognostic factors. RESULTS: A total of 176 cases were included, of which 102 met the inclusion criteria. The sex distribution was similar. The average age was 52.9 years, and the average tumor size was 24.5 cm. The most frequent histology was liposarcoma (65.7%), followed by leiomyosarcoma (12.7%), and malignant peripheral nerve sheath tumor (8.8%). The median follow-up period was 40 months. We found a lower local recurrence in the group treated in the recent period (compartmentectomy) 42.3% vs 20% p = 0.007. The median overall survival (OS) was 38.7 months, and there was no difference in distant recurrence between the two time periods. Postoperative morbidity was higher in the recent period (25% vs 10% p 0.041), with no difference in 30-day mortality. CONCLUSIONS: The implementation of extensive surgery, specifically compartmentectomy, for retroperitoneal sarcomas has been linked to reduced local recurrence. We recommend considering this surgical approach for RPS in alignment with current expert consensus guidelines, as highlighted by the updated TARPSWG consensus.

Improving startups through excellence initiatives: addressing circular economy and innovation.

This study analyses how startups implement circular business models supported by innovation and Industry 4.0, in which strategic stakeholders for value creation are to be found in this specific business ecosystem. The theoretical framework of circular business models supported by innovation was used for analysing the startups based on some assumptions of stakeholder theory. Fifty-one startups were selected, which correspond to the unit of analysis for this study on the improvement of supply chains through circular business models supported by innovation aimed at sustainability in organizations. We conducted a multiple case study whose results suggest that: (i) circularity is strategic for the business to assume its commitment to a sustainable development agenda, especially regarding pollution prevention and proactive action; (ii) visionary entrepreneurs are actively engaged with circular economy practices and technological innovation to promote a circular flow for their business ecosystem; (iii) Industry 4.0 is still incipient, but it is synergistic and beneficial for a successful circular economy in startups; and (iv) primary stakeholders are the activators of circular cycles in the startups surveyed. The present study contributes to the literature in four ways by: (i) presenting a framework which brings together exploratory theoretical propositions on strategic stakeholders for startups, innovative capabilities and assumptions of circular business models; (ii) validating exploratory theoretical propositions with 51 startups; (iii) providing lessons learned so far by the startups which are in line with the assumptions of circular business models for triggering their innovation capabilities and promoting Industry 4.0; (iv) providing an original typology of circular economy assumptions and technological innovations adopted by startups. The originality of this study lies in presenting useful insights for motivating managers to: (i) invest in circular business to become one of the first entrants and earn extra profits; (ii) make investments in circular business and technological innovations to obtain efficiency, practicality and process optimization; (iii) internalize Industry 4.0 technologies concomitantly with technological innovations and circular economy to generate systemic effects; (iv) integrate relevant stakeholders of the business ecosystem to generate a synergistic and effective effect for sustainable development.

Utilização da telenfermagem por enfermeiras durante a pandemia da covid-19 / Use of telenursing by nurses during the covid-19 pandemic / Uso de la teleenfermería por parte de las enfermeras durante la pandemia de covid-19

Objetivo: conhecer as perspectivas de enfermeiras sobre a utilização da telenfermagem durante a pandemia da COVID-19. Métodos: estudo exploratório e qualitativo, realizado entre os meses de janeiro e fevereiro de 2021, em um município de Mato Grosso, Brasil. Para a coleta de dados, utilizou-se entrevistas individuais, analisadas por meio da técnica de análise de conteúdo sob a luz da teoria das transições de Afaf Ibrahim Meleis. Resultados: as participantes mostraram-se receptivas à telenfermagem, porém a baixa acessibilidade e o desconhecimento acerca deste recurso pela população podem influenciar na aplicabilidade e no alcance. Em contrapartida, houveram participantes que destacaram a importância do cuidado presencial associado à telenfermagem. Na condição de pacientes, as enfermeiras não foram unânimes em relação à sua aceitação. Conclusão: as participantes reconhecem a otimização que a tecnologia pode oferecer, porém, dada a incipiência da inserção da telenfermagem no contexto brasileiro e a modos particularidades de compreender a necessidade de avanço e aprimoramento de práticas, há uma parcela que apresenta ainda dificuldades nesse processo de transição quer seja para a concretização dessa forma de assistência como na utilização para seus cuidados pessoais. (AU)

Objective: to know the perspectives of nurses on the use of telenursing during the COVID-19 pandemic. Methods: exploratory and qualitative approach, carried out between January and February 2021, in a municipality of Mato Grosso, Brazil. For data collection, individual interviews were used, analyzed using the content analysis technique under the light of Afaf Ibrahim Meleis' theory of transitions. Results: the participants were receptive to telenursing, but the low accessibility and lack of knowledge about this resource by the population can influence its applicability and reach. On the other hand, there were participants who highlighted the importance of face-to-face care associated with telenursing. As patients, nurses were not unanimous about their acceptance. Conclusion:: the participants recognize the optimization that technology can offer, however, given the incipience of the insertion of telenursing in the Brazilian context and the particular ways of understanding the need to advance and improve practices, there is a portion that still presents difficulties in this process transition, whether for the realization of this form of assistance or in the use for their personal care. (AU)

Objetivo: conocer las perspectivas de los enfermeros sobre el uso de la teleenfermería durante la pandemia de Covid 19. Métodos: estudio exploratorio y cualitativo, realizado entre enero y febrero de 2021, en un municipio de Mato Grosso, Brasil. Para la recolección de datos se utilizaron entrevistas individuales, analizadas mediante la técnica de análisis de contenido a la luz de la teoría de las transiciones de Afaf Ibrahim Meleis. Resultados: los participantes se mostraron receptivos a la teleenfermería, pero la baja accesibilidad y el desconocimiento de este recurso por parte de la población pueden influir en su aplicabilidad y alcance. Por otro lado, hubo participantes que destacaron la importancia de la atención presencial asociada a la teleenfermería. Como pacientes, las enfermeras no fueron unánimes en su aceptación. Conclusion: los participantes reconocen la optimización que la tecnología puede ofrecer, sin embargo, dado el inicio de la inserción de la teleenfermería en el contexto brasileño y las formas particulares de entender la necesidad de avanzar y mejorar las prácticas, hay una parte que todavía presenta dificultades en este proceso de transición, ya sea para la realización de esta forma de asistencia o en el uso para su cuidado personal. (AU)

Classificação de pacientes e dimensionamento de pessoal de enfermagem em unidade de internação pediátrica / Patient classification and nursing staff dimensioning in a pediatric inpatient unit / Clasificación de pacientes y dimensionamiento del personal de enfermería en una unidad de hospitalización pediátrica

RESUMO Objetivo: descrever a implantação do Sistema de Classificação de Pacientes e o dimensionamento do pessoal de enfermagem em unidade de internação pediátrica. Método: estudo descritivo, transversal e retrospectivo, realizado em um hospital universitário do Centro-Oeste do Brasil. Depois da implantação do Sistema de Classificação de Pacientes pediátricos, compilaram-se dados das classificações do nível de complexidade assistencial (N=4.639) entre pacientes (n=608) internados de janeiro a dezembro de 2019. Empregou-se análise estatística descritiva, incluindo metodologia própria para dimensionamento de pessoal. Resultados: houve prevalência de pacientes de cuidados intermediários. Pelo dimensionamento do pessoal, constatou-se superávit (+10) de trabalhadores de nível médio, e o quantitativo de enfermeiros projetado (seis) era compatível com o disponível. Conclusão: a implantação/emprego estratégico do Sistema de Classificação de Pacientes foi indispensável para a previsão de pessoal de enfermagem pediátrica, considerando que o superávit de pessoal constatado deve ser apreciado com cautela.

ABSTRACT Objective: to describe the implementation of the Patient Classification System and the dimensioning of the nursing staff in a pediatric inpatient unit. Method: a descriptive, cross-sectional, and retrospective study, carried out at a university hospital in the Midwest of Brazil. After the implementation of the Pediatric Patient Classification System, we compiled data from the classifications of the level of care complexity (N=4,639) among patients (n=608) admitted from January to December 2019. Descriptive statistical analysis was employed, including proprietary methodology for staff sizing. Results: there was a prevalence of intermediate care patients. According to the staff dimensioning, there was a surplus (+10) of mid-level workers, and the projected number of nurses (six) was compatible with the available number. Conclusion: the strategic implementation/employment of the Patient Classification System was indispensable for the pediatric nursing staffing forecast, considering that the staffing surplus found should be appreciated with caution.

RESUMEN Objetivo: describir la implantación del Sistema de Clasificación de Pacientes y el dimensionamiento del personal de enfermería en una unidad de hospitalización pediátrica. Método: estudio descriptivo, transversal, retrospectivo, realizado en un hospital universitario del Centro-Oeste de Brasil. Tras la implantación del Sistema de Clasificación de Pacientes Pediátricos, se recopilaron los datos de las clasificaciones del nivel de complejidad asistencial (N=4.639) entre los pacientes (n=608) ingresados de enero a diciembre de 2019. Se utilizó el análisis estadístico descriptivo, incluida nuestra propia metodología de dimensionamiento del personal. Resultados: prevalencia de pacientes de cuidados intermedios. En cuanto a la dimensión del personal, se constató un superávit (+10) de trabajadores de nivel medio, y el número de enfermeros proyectado (seis) era compatible con el disponible. Conclusión: la implementación/empleo estratégico del Sistema de Clasificación de Pacientes fue indispensable para la previsión del personal de enfermería pediátrica, considerando que el excedente de personal encontrado debe ser apreciado con cautela.

Polyenic Antibiotics and Other Antifungal Compounds Produced by Hemolytic Streptomyces Species.

Streptomyces are of great interest in the pharmaceutical industry as they produce a plethora of secondary metabolites that act as antibacterial and antifungal agents. They may thrive on their own in the soil, or associate with other organisms, such as plants or invertebrates. Some soil-derived strains exhibit hemolytic properties when cultivated on blood agar, raising the question of whether hemolysis could be a virulence factor of the bacteria. In this work we examined hemolytic compound production in 23 ß-hemolytic Streptomyces isolates; of these 12 were soil-derived, 10 were arthropod-associated, and 1 was plant-associated. An additional human-associated S. sp. TR1341 served as a control. Mass spectrometry analysis suggested synthesis of polyene molecules responsible for the hemolysis: candicidins, filipins, strevertene A, tetrafungin, and tetrin A, as well as four novel polyene compounds (denoted here as polyene A, B, C, and D) in individual liquid cultures or paired co-cultures. The non-polyene antifungal compounds actiphenol and surugamide A were also identified. The findings indicate that the ability of Streptomyces to produce cytolytic compounds (here manifested by hemolysis on blood agar) is an intrinsic feature of the bacteria in the soil environment and could even serve as a virulence factor when colonizing available host organisms. Additionally, a literature review of polyenes and non-polyene hemolytic metabolites produced by Streptomyces is presented.

COVID-19 staycations and the implications for leisure travel.

The COVID-19 pandemic has prompted the re-emergence of staycations to the fore, as many people were forced to spend their vacations at or close to home due to travel restrictions. This phenomenon first went mainstream during the 2008 financial crisis, and has now been further accelerated by the COVID-19 pandemic. This study investigated the growth and practice of staycations during the first two years of the pandemic by analyzing social media and internet search data using Latent Dirichlet Allocation (LDA) topic modeling and Google Trends analytics. Key findings suggest that, while spatially close to home, people tried to achieve a psychological distance away from home. This was demonstrated by a strong global search interest in spending staycations at hotels close to home. The optimal LDA topic model produced 38 topics which were classified under four aggregate dimensions of antecedents, attributes, activities, and consequences of staycations. The findings provide useful insights to managers and policymakers on boosting revenue through this practice, and the role of staycations in promoting leisure activities close to home and sustainable tourism.

Evaluation and comparison of antibiotic susceptibility profiles of Streptomyces spp. from clinical specimens revealed common and region-dependent resistance patterns.

Notwithstanding the fact that streptomycetes are overlooked in clinical laboratories, studies describing their occurrence in disease and potential pathogenicity are emerging. Information on their species diversity in clinical specimens, aetiology and appropriate therapeutic treatment is scarce. We identified and evaluated the antibiotic susceptibility profile of 84 Streptomyces clinical isolates from the Czech Republic. In the absence of appropriate disk diffusion (DD) breakpoints for antibiotic susceptibility testing (AST) of Streptomyces spp., we determined DD breakpoints by correlation with the broth microdilution method and by the distribution of zone diameters among isolates. Correlation accuracy was high for 9 antibiotics, leading to the establishment of the most valid DD breakpoints for Streptomyces antibiotic susceptibility evaluation so far. Clinical strains belonged to 17 different phylotypes dominated by a cluster of strains sharing the same percentage of 16S rRNA gene sequence identity with more than one species (S. albidoflavus group, S. hydrogenans, S. resistomycificus, S. griseochromogenes; 70% of isolates). AST results showed that Streptomyces exhibited intrinsic resistance to penicillin, general susceptibility to amikacin, gentamycin, vancomycin and linezolid, and high percentage of susceptibility to tetracyclines and clarithromycin. For the remaining antibiotics, AST showed inter- and intra-species variations when compared to available literature (erythromycin, trimethoprim-sulfamethoxazole), indicating a region-dependent rather than species-specific patterns.

An example of adaptation: experience of virtual clinical skills circuits of internal medicine students at the Faculty of Medicine, University of Granada (Spain) during the COVID-19 pandemic.

BACKGROUND: The state of alarm declared in Spain in response to the Coronavirus pandemic (COVID-19) has had far-reaching consequences in all areas of life. At the University of Granada's (UGR) Faculty of Medicine, online teaching was implemented immediately without any preexisting plan. Second-year undergraduates in medicine, particularly those enrolled in the subject 'Bases of Internal Medicine,' would normally undergo clinical skills circuits in face-to-face group settings. OBJECTIVE: To facilitate undergraduates' acquisition of specific transversal skills by means of an integrated online working system. DESIGN: Before the pandemic, teaching/learning methods consisted of 1) face-to-face group work; 2) teletutoring; 3) written work uploaded to the PRADO online platform for marking by the teletutor; and 4) presentation of written work to the group. As a result of the lockdown, presentations in class were suspended and replaced by online presentations. The means adopted by students in online presentations were freely chosen using various communication techniques: linear projection systems (6); acting/simulation (4); dramatization (1); and role-playing (1). RESULTS: The number of online clinical skills circuits developed was 12, one for each of the clinical skills circuits established for imparting this subject. A total of 12 presentations were made by the 10 groups, each lasting 15 minutes followed by a 5-minute discussion to settle any questions raised. The presentations were marked jointly by the teaching staff, coordinator, and students. CONCLUSIONS: The transference of classroom learning to the online environment proved an essential resource for teaching/learning clinical/practical skills during the lockdown, which have never before been imparted at distance.

High expression of both desmoplastic stroma and epithelial to mesenchymal transition markers associate with shorter survival in pancreatic ductal adenocarcinoma.

Desmoplastic stroma (DS) and the epithelial-to-mesenchymal transition (EMT) play a key role in pancreatic ductal adenocarcinoma (PDAC) progression. To date, however, the combined expression of DS and EMT markers, and their association with variations in survival within each clinical stage and degree of tumor differentiation is unknown. The purpose of this study was to investigate the association between expression of DS and EMT markers and survival variability in patients diagnosed with PDAC. We examined the expression levels of DS markers alpha smooth muscle actin (α-SMA), fibronectin, and vimentin, and the EMT markers epithelial cell adhesion molecule (EPCAM), pan-cytokeratin, and vimentin, by immunohistochemistry using a tissue microarray of a retrospective cohort of 25 patients with PDAC. The results were examined for association with survival by clinical stage and by degree of tumor differentiation. High DS markers expression -α-SMA, fibronectin, and vimentin- was associated with decreased survival at intermediate and advanced clinical stages (p=0.006-0.03), as well as with both poorly and moderately differentiated tumor grades (p=0.01-0.02). Interestingly, the same pattern was observed for EMT markers, i.e., EPCAM, pan-cytokeratin, and vimentin (p=0.00008-0.03). High expression of DS and EMT markers within each clinical stage and degree of tumor differentiation was associated with lower PDAC survival. Evaluation of these markers may have a prognostic impact on survival time variation in patients with PDAC.

#CoronavirusCruise: Impact and implications of the COVID-19 outbreaks on the perception of cruise tourism.

Early in the COVID-19 pandemic, the Diamond Princess became the center of the largest outbreak outside the original epicenter in China. This outbreak which left 712 passengers infected and 14 dead, followed by subsequent outbreaks affecting over one-third of the active ships in the cruise industry's global fleet, quickly became a crisis that captured public attention and dominated mainstream news and social media. This study investigates the perception of cruising during these outbreaks by analyzing the tweets on cruising using Natural Language Processing (NLP). The findings show a prevalent negative sentiment in most of the analyzed tweets, while the criticisms directed at the cruise industry were based on perceptions and stereotypes of the industry before the pandemic. The study provides insight into the concerns raised in these conversations and highlights the need for new business models outside the pre-pandemic mass-market model and to genuinely make cruising more environmentally friendly.

Six Sigma for workplace safety improvement: improving hazards and unsafe conditions in a metallic packaging manufacturing company.

Six Sigma has been applied as a business process improvement strategy in many companies worldwide with great results. On the other hand, workplace safety constitutes a key issue for company managers due to their responsibility. The aim of this article is to demonstrate how using Six Sigma can reduce accidents. A case study is conducted on a large European metallic packaging manufacturing company. As a result, the company presented a reduction of lost time accidents from 97 to 30 that saved a lot of time and cost. The σ value achieved was 4.24. This project shows the effectiveness of Six Sigma as an improvement tool in the human resources area, despite most of the previous Six Sigma research being focused on manufacturing aspects. The case studied can be useful either for large companies or small and medium-sized companies interested in improving safety.

Relação entre empregabilidade e habilidades sociais na Rede Federal de Educação Tecnológica / Relationship between employability and social skills in the federal network of technological education

O mercado de trabalho conectado, integrado e tecnológico impulsiona a busca pelo desenvolvimento de habilidades sociais para o trabalho e o potencial de empregabilidade. Nesse contexto, o objetivo é avaliar a existência de correlação entre Habilidades Sociais e Empregabilidade. A abordagem utilizada na pesquisa foi quantitativa com a análise de correlação entre as variáveis. Participaram da amostra, 260 estudantes de uma Instituição de Educação Básica, Técnica e Tecnológica. Os resultados evidenciam que existe uma correlação positiva entre o repertório Habilidades Sociais e as subescalas de Empregabilidade para a amostra geral e amostra estratificada em sexo masculino, curso superior e estudantes não trabalhadores. Destaca-se que em todas as correlações a subescala ‘otimismo’ está associada ao reportório de Habilidades Sociais. Outras correlações foram verificadas como ‘eficácia de busca’, ‘enfrentamento de dificuldades’, ‘responsabilidade’ e ‘decisão com o repertório de habilidades sociais’. Esses resultados possibilitam que diferentes instituições de ensino proponham ações voltadas para desenvolvimento de Habilidades Sociais e Empregabilidades de seus estudantes. Por fim, são apresentadas as limitações da pesquisa e sugestões para futuros trabalhos.(AU)

The connected, integrated, and technological labor market drives the search for the development of social skills for work and the potential for employability. In this context, the objective of this article is to assess the existence of a correlation between Social Skills and Employability. The approach used in the research was quantitative with the analysis of the correlation between the variables. Two hundred sixty students from a Basic, Technical, and Technological Education Institution participated in the sample. The results show a positive correlation between the Social Skills repertoire and the Employability subscales for the general sample and stratified sample in male, college, and non-working students. It is noteworthy that in all correlations, the subscale ‘optimism’ is associated with the Social Skills repertoire. Other correlations were verified, such as 'search effectiveness,’ ‘facing difficulties,’ ‘responsibility,’ and ‘decision with the social skills repertoire.’ These results make it possible for different educational institutions to propose actions aimed at developing Social Skills and Employability of their students. Finally, the limitations of the research and suggestions for future work are presented.(AU)

Is Time-Driven Activity-Based Costing Coming out on Top? A Comparison with Activity-Based Costing in the Health Field.

The cost of health is a recurrent topic that has generated much research, as it affects all of society. Both public and private agents need to know the real cost of treatments, services, and products for decision-making. This article aims to compare the use and research impact of two cost systems widely used in health: ABC and TDABC, which is an evolution of ABC. For doing so, a bibliometric review in Scopus and Medline was carried out encompassing the years 2009-2019. The results show a great increase in publications using TDABC, while publications on ABC stabilized. On the other hand, the TDABC articles presented higher research impacts in traditional and alternative metrics. Articles on TDABC are more frequently cited, published in better journals, and more visible in academic social networks. The findings suggest that scholars and practitioners should focus on TDABC rather than ABC for addressing cost in health for its simplicity, projection, and research opportunities.

Improving healthcare performance through Activity-Based Costing and Time-Driven Activity-Based Costing.

Improving healthcare performance has become a need for resource optimisation in a field where they are scarce. Activity-Based Costing (ABC) has been applied for more than 30 years to allocate costs and provide information for decision-making. This paper seeks to review previous literature in the health field that analysed this cost system and its new version, TDABC (Time-Driven Activity-Based Costing). Five hundred ninety articles published from 1989 to 2019 were retrieved from Scopus and Medline. The review includes descriptive, relational and content analyses. Results show that the interest in applying these cost systems is growing, especially in journals focusing on the financial aspects of health, policy and planning, and radiology. However, there is a difference in the application of ABC and TDABC. ABC is more related to efficiency and more used in laboratories. In contrast, TDABC is primarily used in hospitals and addressing the value of health rather than cost-effectiveness. On the other hand, the findings suggest that TDABC present greater opportunities for publication compared with ABC. Its progression is higher and gets more citations. The current article contributes to broadening the field's vision and encourages authors for further research.

Six Sigma in Health Literature, What Matters?

Six Sigma has been widely used in the health field for process or quality improvement, constituting a quite profusely investigated topic. This paper aims at exploring why some studies have more academic and societal impact, attracting more attention from academics and health professionals. Academic and societal impact was addressed using traditional academic metrics and alternative metrics, often known as altmetrics. We conducted a systematic search following the PRISMA statement through three well-known databases, and identified 212 papers published during 1998-2019. We conducted zero-inflated negative binomial regressions to explore the influence of bibliometric and content determinants on traditional academic and alternative metrics. We observe that the factors influencing alternative metrics are more varied and difficult to apprehend than those explaining traditional impact metrics. We also conclude that, independently of how the impact is measured, the paper's content, rather than bibliometric characteristics, better explains its impact. In the specific case of research on Six Sigma applied to health, the papers with more impact address process improvement focusing on time and waste reduction. This study sheds light on the aspects that better explain publications' impact in the field of Six Sigma application in health, either from an academic or a societal point of view.