The current study aimed to identify latent profiles of positive solitude during the recurrent outbreak of COVID-19 among Chinese adults. A total of 902 adults from China completed the questionnaires. We found five different profiles of positive solitude: low positive solitude group, medium-low positive solitude group, quietness positive solitude group, medium-high positive solitude group, and high positive solitude group. Positive and negative affect were significantly different from the five profiles. In addition, gender had different effects on different positive solitude profiles. The results of the study provide a new perspective to understand the positive solitude of Chinese adults during the recurrent outbreak of COVID-19 by using the people-centered approach. Since 2020, the novel coronavirus disease COVID-19 has become a global epidemic. Due to the difficulties of epidemic prevention, COVID-19 has repeatedly broken out in countries around the world. In order to avoid the further spread of COVID-19, the Chinese government has taken many preventive measures, such as succeeding social isolation, limiting traffic and travel, controlling social distance, and studying or working online. And thus individuals' scope of activities narrowed and social activities decreased in this situation. Solitude became the norm for most Chinese people in the COVID-19 period. Some studies have shown that quarantine can affect individuals' physical and mental health , which vPositive solitude refers to individuals' ability to positively enjoy alone time without meaningful interaction with others . In the The concept of solitude was first introduced in 1959 by the sociologist Goffman, and Goffman argued that when individuals are in solitude, they feel the joy of being liberated . HoweverNonetheless, some researchers have proposed that solitude and loneliness are two different concepts , 22. ThePositive solitude was first proposed by Ost Mor in 2020 , and PalThere are qualitative differences among individuals in positive solitude, which can be divided into multiple categories. For example, a qualitative study conducted by Ost Mor et al. investigated 124 participants through interviews, and divided them into seven categories according to different characteristics of individuals' positive solitude . AlthougThe second goal of this study was to explore the effect of gender on positive solitude. In the previous variable-centered studies, there are some debates on the impact of gender on positive solitude. Some studies have found no difference between males and females in their preference for solitude –37, wherFinally, our third goal was to examine the association between positive solitude and affect. From the perspective of valence, affect can be divided into positive affect and negative affect . Modern The first purpose of this study was to explore the latent classes of positive solitude by using latent profile analysis. The second objective was to examine the differences in gender between different latent types of positive solitude. A final objective was to investigate differences in positive and negative affect among different latent classes of positive solitude.n = 306) were aged 18 to 24, 31.71% (n = 286) were aged 25 to 30, 27.16% (n = 245) were aged 31 to 40 and 7.21% (n = 65) were aged 41 to 60. In addition, among the 902 participants, 7.21% (n = 65) have high school degree or below, 22.51% (n = 203) have associate degree, 65.30% (n = 589) have bachelor degree, and 4.99% (n = 45) have master degree or above.A sample of 902 adults  from China completed the questionnaires. Among them, 33.92% (https://www.wenjuan.com/). Before completing the questionnaire, all participants read and signed the informed consent form. In this study, all responses were anonymous. There was no compensation for participating in this study, and the participants participated entirely voluntarily. The study was approved by the ethics committee of the First Author's University.Nine hundred and two participants from China completed the survey. Specifically, this research publishes recruitment information on the internet, and interested participants can participate in the research. Participants completed a survey anonymously to collect information on gender, age group, positive solitude, and positive or negative affect. The survey was hosted on questionnaire web  on a five-point scale ranging from 1 (never) to 5 . Higher total scores indicated higher positive solitude. This study used a forward and backward translation technique to translate the Positive Solitude Scale into Chinese  , and negatively correlated with negative affect . Therefore, the Chinese version of Positive Solitude Scale has good reliability and validity, and hence can be used as a tool to measure positive solitude of Chinese adults. The contents of the questionnaire for the nine items are shown in The nine-item and one-dimensional Positive Solitude Scale (PS) was used to measure the positive solitude ability . Individ Chinese . First,  = 0.07) , 48. Theinterested”) and 10 items are negative affect . Each item was rated on a five-point scale , with higher scores of positive/negative affect subscale representing higher positive/negative affect. In the present study, Cronbach's α were 0.91 and 0.94 for the positive affect subscale and negative affect subscale.The Chinese version  of Positk class model is better than the k-1 class model , but the difference was significant in subsequent latent profile analysis results. And positive solitude was significantly positively correlated with positive affect  and was negatively correlated with negative affect .The mean value, the standard deviation of each variable and the correlation matrix among variables are shown in The fit statistics of profile models are presented in n = 160) of adults who showed low positive solitude (labeled as the low positive solitude group). Class 2 included 23.61% (n = 213) of adults and was labeled as the medium-low positive solitude group because they showed medium-low levels of positive solitude. Class 3 consisted of 14.41% (n = 130) of adults who scored highest on item 9, which fell into the quietness category in the original initial pool (labeled as the quietness positive solitude group). Class 4 included 25.94% (n = 234) of adults who showed medium-low levels of positive solitude (labeled as the medium-low positive solitude group). Finally, Class 5 consisted of 18.29% (n = 165) of adults who showed high positive solitude in all items (labeled as the high positive solitude group).SE = 0.280, p < 0.05, OR = 1.749) and Profile 4  in reference to Profile 3 (Quietness).The results of the multinomial logistic regression model were shown in F = 60.147, p < 0.001]. Specifically, the high positive solitude group had higher positive affect than the other four groups (ps < 0.001). The medium-high positive solitude group had higher positive affect than the low and the medium-low positive solitude group (ps < 0.001). The quietness positive solitude group had higher positive affect than the low (p < 0.05) and the medium-low positive solitude group (p < 0.001). However, there was no significant difference between the low and the medium-low positive solitude groups, and also between the quietness and the medium-high positive solitude groups.The results are shown in F = 5.347, p < 0.001]. The low positive solitude group had higher negative affect than the quietness (p < 0.01), medium-high (p < 0.05) and high (p < 0.01) positive solitude groups. However, the medium-low positive solitude group did not differ from the other four groups. The quietness positive solitude group did not differ from the medium-high and the high positive solitude groups. And the differences between the medium-high and the high positive solitude groups were not statistically significant.The mean level of negative affect was significantly different among the five groups [This study aimed to identify distinct profiles of positive solitude. Additionally, the current study used multinomial logistic regression to examine how these profiles related to gender. We also examined the differences in positive and negative affect across different latent profiles. Results showed five latent classes: low, medium-low, quietness, medium-high, and high positive solitude groups. Specifically, adults in the high positive solitude group scored highest on all items, indicating that they had high positive solitude and were better able to adapt to self-isolation during the recurrent outbreak of COVID-19. In contrast, adults in the low positive solitude group displayed low scores across all items, indicating that adults in this group were at a relative disadvantage in positive solitude ability and were more likely to have difficulty in adapting to isolation during the recurrent outbreak of COVID-19. In addition, the quality of life of adults in the quietness positive solitude group improved through positive solitude. According to Ost Mor's definition of “quiet positive solitude,” sometimes people need solitude to obtain a quiet environment or condition in order to calm down from their daily burdens. Everyone has a need for quiet, and solitude can help individuals obtain the conditions for quiet . ThroughOur findings found that gender was not significantly associated with the total score of positive solitude, but there were significant differences in gender across profiles. This is precisely the characteristic of the latent profile analysis: the overall association between gender and the total score of positive solitude is not significant because the traditional variable-centered approach ignores intra-individual differences, but when we explore the different profiles separately, we can find more detailed differential results. The results of the latent profile analysis partially support our hypothesis. In previous studies, the effects of gender on solitude were controversial, and however, as previously mentioned, the reason for such controversy was probably that those studies used the variable-centered approach. Although this variable-centered method was simple and effective, some critical individual differences were relatively ignored, which may lead to different conclusions. Multinomial logistic regression results for different models of positive solitude showed that compared with males, females were more likely to be positive solitude than males in Profile 2 (Medium-low) and Profile 4 (Medium-high) in reference to Profile 3 (Quietness). The results of this study suggested that during the recurrent outbreak of COVID-19, attention should be paid to the positive solitude of individuals and whether they also suffered from the difficulty of positive solitude during the isolation period, especially for males. The study found that the positive solitude of males was not as good as that of females, which suggested that a heavier emphasis needs to be placed on males' positive solitude.Our hypothesis about the association between profiles and positive and negative affect is basically supported. We found that the positive affect of the high positive solitude group was higher than the other four groups, and the low positive solitude group had higher negative affect than the quietness, medium-high and high positive solitude groups. This suggested that positive solitude was accompanied by more positive affect and less negative affect. It demonstrated that positive solitude played a key role in mood regulation. Based on the results of positive and negative affect of Chinese adults during the recurrent outbreak of COVID-19, we can provide supportive care to individuals at risk of emotional distress. And in practical work, we should attach great importance to the positive solitude of individuals with high negative affect.There are some limitations to the current survey which we need to note. First of all, our research hypothesis assumed that gender differences would have an impact on positive solitude, and the results showed that gender causes differences in positive solitude in different profiles. However, the analysis in this study is not sufficient for the differential impact of gender, and more research should be conducted to examine the gender difference in future studies. Secondly, all variables were assessed by self-report measurement in our study, which may affect the validity of this study. Since response bias and social desirability effects may have influenced the results. In the future, measures with less social desirability effect can be taken into consideration. Thirdly, due to the large sample size, detailed information on the social background of the sample was not available for this study. In future studies, detailed background information of the subjects should be investigated. Finally, given the differences between individualistic and collectivistic cultures and the fact that COVID-19 is currently spreading in many countries worldwide, there may be a need for further investigation and validation of positive solitude affected by COVID-19 in some other diverse samples from different countries.This study found five latent profiles of positive solitude  among Chinese adults. The results of the multinomial logistic regression model showed that females were more likely to display positive solitude than males in Profile 2 and Profile 4 in reference to Profile 3 (Quietness). These profiles had a unique pattern of association with both positive and negative emotions. The high positive solitude group had higher positive affect than the other four groups; The low positive solitude group had higher negative affect than the quietness, medium-high and high positive solitude groups.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.ZY, BY, and YH designed the study, analyzed the data, and conceptualized the models. ZY collected the data. QY supervised the project. All authors have seen and approved the manuscript and wrote and revised the manuscript.This study was supported by the National Natural Science Foundation of China (72164018), National Social Science Fund Project (BFA200065), Jiangxi Social Science Foundation Project (21JY13), Jiangxi' Key Research Base Project of Humanities and Social Sciences (JD20068), and Science and Technology Research Project of Jiangxi' Department of Education (GJJ200306).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Sarcopenia in the elderly population is a public health challenge, and there are few data on its prevalence in Europe. In this study, we investigated the prevalence of sarcopenia in the elderly Polish population and its association with the level of obesity and co-existing diseases. We conducted a population-based cross-sectional study involving 823 men and 1177 women aged 65 years and older, randomly selected from the population living in the territory of the Republic of Poland between 2017 and 2020. We analyzed the results of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Risk of sarcopenia was assessed with the simple questionnaire to rapidly diagnose sarcopenia (SARC-F), and sarcopenic obesity risk was defined as the combination of anthropometry and SARC-F results. In addition, we collected disease data with an author questionnaire. The prevalence of risk of sarcopenia was 18.6% (22.3% in women and 13.2% in men), and its incidence significantly increased with age in both sexes. The risk of sarcopenic obesity was more common in women than in men, and it was higher in the older age group, except for sarcopenic obesity diagnosed by the WHR criteria. The group of elderly with concomitant diseases had a higher risk of developing sarcopenia, which emphasizes the need to monitor sarcopenia when concomitant diseases are diagnosed. In both groups, risk of sarcopenia was associated with motor and respiratory system diseases, type 2 diabetes, and neurological diseases. This study highlights that the risk of sarcopenia in the elderly population affects women to a greater extent than men. It is important to identify the elderly at risk of sarcopenia in routine clinical practice to develop long-term prevention strategies. Sarcopenia is considered a muscle disorder characterized by progressive loss of muscle strength and mass due to aging and/or chronic diseases . While mIt is known that there is a significant association between sarcopenia and malnutrition in hospitalized older adults . HoweverThis was a population-based cross-sectional study involving 823 men and 1177 women aged 65 years and older, randomly selected from the population living in the territory of the Republic of Poland. The research was carried out from 2017 to 2020. The design and methods of the study are presented in detail in a separate paper . The stuPrior to the pandemic triggered by COVID-19 (October 2017–March 2020), all data were collected using the computer-assisted personal interviews (CAPI) method; thereafter the computer-assisted telephone interviews (CATI) method was used (June 2020–December 2020). An author questionnaire was used to collect demographic and clinical data.Trained interviewers performed anthropometric measurements  according to the recommendations of the WHO . Body weFor waist circumference (WC) measurement, the respondents stood upright and relaxed. Measurements were taken after the subjects had taken several free breaths. The tape measure was placed parallel to the floor around the abdomen at the narrowest point (between the lowest rib and the top of the hip bone). The result was noted with an accuracy of 1 mm. Waist circumference categories were classified according to the IDF criteria .To measure hip circumference, the interviewer placed the tape measure around the hip at the widest part of the buttocks, below the hip plates (directly above the pubic bone in women and between the iliac crest and the pubic bone in men). The tape was positioned parallel to the ground. The result was measured with an accuracy of 1 mm.2 [Body mass index (BMI) was calculated by dividing weight (kg) by height (m) squared. BMI categories were classified according to the CDC criteria  and the 2 .Adipose tissue distribution was assessed using the waist-to-hip ratio (WHR), which is calculated by dividing waist circumference by hip circumference in centimeters. In women, values of 0.85 or greater indicate abdominal  obesity and less than 0.85 indicate gluteal  obesity. In men, the cutoff value is 0.9 . The waiPatients at risk of sarcopenia were identified using the simple questionnaire to rapidly diagnose sarcopenia (SARC-F) developed by Malmstrom TK and Morley JE . We used2 or abdominal obesity defined by one of the following criteria: WC ≥102 (M), ≥88 (F); WHR ≥ 0.9 (M), ≥0.85 (F); or WHtR > 0.5.Sarcopenic obesity risk was defined by the coexistence of sarcopenia risk  and obesity defined as BMI value ≥ 30 kg/mt-test and the Z-test (Tests About a Population Mean and About a Population Proportion). For all computations, a significance level of alpha equals 0.05  used. Calculations were performed using R packages.The collected data were presented using descriptive statistics. For qualitative variables, the chi-square test was used. Quantitative variables were compared using the Student’s p < 0.001), were more often obese according to the criteria set by the WHO , and were more often overweight according to the criteria set for the elderly population . Men had a higher mean waist circumference  but a lower percentage of the highest category of WC values  than women. In contrast, abdominal obesity, defined by the WHR value, was more common in men . The frequency of WHtR values above 0.5 was higher in women than men .The demographic characteristics of all 2000 subjects studied, divided into sex and age groups, are shown in p < 0.001). Sarcopenia risk, defined as SARC-F score ≥ 4, of the whole group was 18.6% and was more frequent in women . The frequency of sarcopenia significantly increased with age in both sexes.The mean SARC-F score was higher in women than in men , while a BMI ≥ 27 kg/m2 was a protective factor  [According to our analysis, the overall prevalence of those at risk of sarcopenia was 18.6%. Similar results were reported by Krzymińska-Siemaszko et al.; 10.4% to 33.0% of participants were identified as having an increased risk of sarcopenia, depending on the modified SARC-F questionnaire used. A trend toward more frequent occurrences of risk factors for sarcopenia in women than in men was noted; however, the group size of women did not allow comparative analysis . In our < 0.001) . Previou< 0.001) ,33,34. I< 0.001) , which i< 0.001) . It is w< 0.001) .Studies in smaller groups, mainly from clinical trials, suggest that sarcopenia is more common in malnourished people when more advanced diagnostic methods are used . SarcopeElderly people are at risk of developing age-related diseases, i.e., the coexistence of two or more diseases . It is eWe have shown that sarcopenia was more common in men and women who had musculoskeletal and respiratory diseases, type 2 diabetes, and neurological diseases as well as in women with allergies, urinary tract diseases, cardiovascular diseases, and type 1 diabetes. It is commonly known that sarcopenia shares risk factors with cardiovascular disease, diabetes mellitus, respiratory diseases, and dementia . Our resThe prevalence of sarcopenia in patients with type 2 diabetes mellitus has not been fully elucidated. However, there is a decrease in muscle mass associated with insulin resistance and a chronic inflammatory state. It is worth emphasizing the co-occurrence of obesity, type 2 diabetes mellitus, and sarcopenia. Independently, low muscle mass and excess adipose tissue have been associated with a higher incidence of metabolic disorders ,51. In ap < 0.01) [Our findings confirmed a higher prevalence of sarcopenia risk in both females and males who suffered from diseases associated with motor and respiratory systems, neurological disease, and type 2 diabetes. In neurological and motor system disease, many factors contribute to the risk of sarcopenia. These include decreased physical activity, chronic inflammation, and pain . Peterma < 0.01) .Interestingly, we found an increased risk of sarcopenia in women with allergies and urinary tract disease. Several mechanisms may affect muscle mass and function in chronic kidney disease, such as low protein intake, physical inactivity, inflammation, and low serum vitamin D concentration . MoreoveOur study has some limitations. First, the COVID-19 pandemic forced changes in the research methodology. Second, we used the SARC-F questionnaire, as a highly specific screening tool recommended by EWGSOP2 but which is highly criticized in recent publications for its low sensitivity ,61,62. HThirdly, the character of our study made it difficult to determine specific conditions for sarcopenia risk. Fourth, our exclusively Caucasian study population limits the generalizability of our results to other populations. To our knowledge, a strength of our analysis is that this is one of the first studies to examine the prevalence risk of sarcopenia in community-dwelling older adults.This study has shown that the risk of sarcopenia in the elderly population affects women to a greater extent than men. The group of elderly with concomitant diseases has a higher risk of developing sarcopenia, which emphasizes the need to monitor sarcopenia when concomitant diseases are diagnosed. Our results confirmed a higher prevalence of sarcopenia risk in both women and men who had motor and respiratory system diseases, type 2 diabetes, or neurologic diseases. In addition, women, but not men, who had urinary tract disease, allergies, cardiovascular disease, and type 1 diabetes had an increased risk of sarcopenia. It is important to identify the elderly at risk for sarcopenia and sarcopenic obesity in routine clinical practice to develop long-term prevention strategies. Further studies are needed to better understand population-level risk factors of sarcopenia.


Systemic inflammation seems to be involved in the pathogenetic pathways of colorectal cancer (CRC). Analytical markers that reflect the inflammatory status, such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) or systemic immune-inflammation index (SII), have been proposed as tools for the prognosis of CRC. Nevertheless, their use for diagnosis has been scarcely investigated.To analyze the ability of these markers and of a new marker combining SII and hemoglobin concentration, named NP/LHb = [neutrophils x platelets]/[lymphocytes x hemoglobin], as tools for CRC diagnosis. Furthermore, we studied their association with CRC-related variables.Case-control study including 214 CRC patients and 214 controls without CRC, matched by age (±5 years) and sex. We collected demographic, CRC-related and laboratory variables to calculate NLR, PLR, SII, and NP/LHb. In the case group, the laboratory variables were collected at two different period times, 6 months (IQR 4–8) before the CRC diagnosis and at the time of the diagnosis. ROC analysis was performed to evaluate the discriminatory accuracy of each index and we calculated Se, Sp, PPV, NPV, and OR to identify the diagnostic performance of each positive marker.p < 0.05). PLR, SII and NP/LHb (but not NLR) showed significant differences according to tumor location (p < 0.05). Right-sided colon cancers presented the highest values, in comparison with left-sided and rectal cancers.NP/LHb showed high Sp (92.06%) and PPV (87.50%) to diagnose patients with CRC. This index exhibited an OR of 14.52 (8.26–25.52) and the best area under the curve (AUC: 0.78) for a positive CRC diagnosis. We found significant differences in all indices according to the presence of CRC, observing the highest values in CRC patients at time of diagnosis, in comparison with the analysis performed in the previous months to diagnosis or with control patients. There were significant differences in all ratios according to TNM stages  change over time with the development of CRC, so they could be useful in its early diagnosis. We suggest that they could be routinely measured in patients with suspicion of CRC, to identify those ones with a higher risk of cancer, considering the high positive predictive value they have shown in our study. Colorectal cancer (CRC) is the most common cancer in western societies when men and women are considered together and its incidence is increasing , 2. StabThe pathogenesis of CRC seems to be driven by systemic inflammation –8, in adIt has been observed an association between higher levels of the inflammatory markers and the risk of CRC progression, which could traduce in a worse prognosis , 27. MorThe investigation of the sequential cell-ratios in people with a normal colonoscopy and people with CRC would help to establish their potential and usefulness as biomarkers for the diagnosis of CRC. Furthermore, it would be desirable to investigate the potential increase of their diagnostic yield by adding other analytical parameters related to the presence of a colorectal tumor, such as hemoglobin concentration (Hb). Hb would reflect the degree of anemia in these patients. Anemia due to a cancer status is usually multifactorial . Based on this hypothesis, we formulated a new index named NP/LHb, not previously used, including hemoglobin concentration.To summarize, we hypothesized that these blood-cell-based ratios could be not only a precise tool to assess the prognosis and the characterization of CRC, but also as an useful tool for the early diagnosis of CRC that could be used, alone or together with exiting tests, to increase the yield of current CRC prevention programs. Our main aim was to analyze the diagnostic value of these analytical markers and the new marker named NP/LHb, by exploring their ability to discriminate patients with and without CRC. Also, we evaluated whether there were differences between the marker's values at the time of cancer diagnosis and months before, in CRC patients. Furthermore, we explored the association between them and the different clinicopathological features of the tumor, such as the TNM stage and tumor location.In this retrospective case-control study, we included 214 patients with CRC (obtained from the registry of CRC diagnosed cases in our center), and 214 control patients without CRC diagnosis (obtained from the CRC screening program database of our center), between 2010 and 2018. Controls were chosen for each included case, adjusted by age (±5 years) and sex, and taking into consideration the inclusion and exclusion criteria showed below. This study was reviewed and approved by the Regional Ethical Committee of Aragón (CEICA). Written informed consent from the participants was not required since this study is retrospective and used data stored in databases, which were anonymized for data analysis.in situ colorectal carcinoma; (2) A diagnosis of a systemic inflammatory process, an hematological disease or being under a pharmacological treatment that could modify the blood cell count; and (3) Not having an available blood test at the time of the CRC diagnosis that follow the exposed criteria.The inclusion criteria for CRC patients were as follows: (1) The patient had a primary colorectal cancer confirmed by histopathology; (2) The patient had a blood test performed at the time of the CRC diagnosis; and (3) This blood test must have been performed before any type of therapeutic intervention  and in a baseline situation . The exclusion criteria were: (1) A diagnosis of The inclusion criteria for control patients were as follows: (1) They had to be included within the CRC screening population at our center and have a normal colonoscopy; (2) They should not have a personal or familiar history of CRC; and (3) Have a blood test within the previous year to the screening colonoscopy and performed in a baseline condition . The exclusion criteria for controls were: (1) Current or past diagnosis of another cancer; (2) Diagnosis of a systemic inflammatory process, an hematological disease or pharmacological treatment that could modify the blood cell count; and (3) Not having any available blood test within the previous year to the screening colonoscopy that follow the exposed criteria.The following inflammatory cell ratios were considered the main variables of the study:n = 214 patients), 131 were those who had a blood test previously to be diagnosed. The maximum and minimum period marked, in which this blood test was performed, was 12 and 3 months before the CRC diagnosis, respectively.In the CRC group, these laboratory variables were collected at two different period times. Due to this, the blood cell ratios were calculated twice. One determination was from the blood test performed at the time of CRC diagnosis. The other one was calculated from a blood test performed before the diagnosis . Having a blood test at the time of diagnosis was one of the requirements to be included in the case group. However, it was not mandatory to be included to have an analysis from a period prior to diagnosis. In our case group .Furthermore, we collect demographic variables (age and sex) for both groups and the following CRC-related variables in the case group: tumor-nodes-metastases (TNM) stage, tumor invasion (T), lymph nodes (N), metastases (M), tumor location, differentiation level and symptoms at diagnosis. The symptoms collected were: rectal bleeding, change in bowel habit, anemia, abdominal pain, constitutional syndrome and obstruction. Constitutional syndrome is the clinical entity that include fatigue, anorexia and involuntary weight loss.An initial descriptive exploratory analysis of all clinical variables was carried out. Qualitative variables were expressed as frequencies and percentages, whereas continuous variables were reported as mean with standard deviation (SD) or median with interquartile range (IQR). Normality was tested using the Shapiro-Wilk test.Differences between independent groups were evaluated with Chi-square (χ2) test for qualitative variables and with Mann-Whitney or Kruskal-Wallis test for continuous variables. Wilcoxon test was performed to evaluate the same analytical index at different times.The discriminatory accuracy of each analytical marker to diagnose CRC was evaluated using the area under the receiver operating characteristics (ROC) curve (AUC). DeLong test was used to test the statistical significance of the difference between the areas under two dependent ROC curves. The Youden index was used to identify the optimal cut-off value to discriminate CCR. In order to evaluate the diagnostic performance of each positive marker, sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and odds ratio (OR) with 95% confidence intervals (CI) were calculated.The level of significance in the study was established at 0.05. Data was analyzed using the Jamovi software for iOS, version 1.6.15.A total of 428 patients were finally included in the study. No statistical difference in age and sex were found between cases and controls. The mean age in the CRC group was 67.08 ± 11.08 and 65.60 ± 3.09 years in the control group. The proportion of males/females was the same in both groups (140/74). The baseline characteristics of CRC patients (reflected by tumor-related variables collected) are shown in (p< 0.05) and with the control group of patients without CRC (p< 0.05).As shown in p = 0.866).Levels of NLR, PLR, SII, and NP/LHb were significantly associated with TNM stage . The tump = 0.003, p = 0.047, p = 0.007 and p = 0.011, respectively. However, no statically significant differences were found for lymph nodes (N), metastases (M) and tumor differentiation variables (p = 0.023) and NP/LHb (p = 0.034), and also, a significant association was found between patients who presented intestinal obstruction and NLR (p < 0.001), PLR (p = 0.015), SII (p = 0.000) and NP/LHb (p < 0.001).In addition to TNM stage and tumor location, we analyzed other CRC-related variables. Significant differences were found between tumor invasion (T) and NLR, PLR, SII and NP/LHb, with ariables . Finallyariables . MoreoveThe NP/LHb ratio showed significantly the best diagnostic value, with an AUC (95% CI) of 0.78 (0.73–0.82), in comparison with the other three analyzed ratios, with an AUC of 0.72 (0.68–0.77) for NRL, 0.74 (0.69–0.78) for PLR and 0.74 (0.69–0.79) for SII. These data are represented in Furthermore, we found that the number of positive markers  calculated for each patient, significantly increases the risk of CRC, with an OR (95% CI): 1.60 (0.86–3.00), 2.73 (1.23–6.07), 7.37 (3.30–16.49) and 28.77 (12.63–65.54) for one, two, three or all positive markers respectively.The implication of the systemic inflammation in the CRC pathogenesis has been studied in detail , 6. WithIn the present study, CRC patients showed higher values of these inflammatory indices and their values significantly differ from the values of patients without CRC, which is in concordance with previously published data , 41, 42.In our study, we have observed an increasing trend in the values of all indices studied during the time period where patients go from being asymptomatic to develop symptoms who led to a diagnosis of CRC. This evolution could reflect their dynamic changes on their way to CRC progression. The definition of the role of these inflammatory indices and the precise cut-off values before the cancer is diagnosed with current tests would identify high-risk populations and improve our screening methods, based on these complementary biomarkers.Different studies have shown that high NLR, PLR, or SII values are associated with advanced TNM stage, more tumor invasion, poorer differentiation level and worse overall survival (OS) , 16–29. In relation to the association of the blood analytical markers according to the three variables that consists the TNM stage in a separated analysis , we obtained similar results according to those presented in other studies, especially related to T, in which articles they found significant association with T and the four blood studied markers, as we found too. However, and as it has been shown in other articles , it coulAccording to the tumor location, we found that PLR, SII and NP/LHb were significantly associated with this variable, but we did not find association for NLR. The higher values of the markers were found in patients with right-sided colon cancer (RCC), which is also in concordance with other studies, that found higher values of NLR and PLR in patients with RCC , 31, sugWe have found another interesting data related to symptoms at diagnosis and their association with the inflammatory markers. Patients with constitutional syndrome and intestinal obstruction at diagnosis presented the higher values of the inflammatory indices in comparison with patients that had anemia, abdominal pain or rectal bleeding at diagnosis. Nevertheless, only intestinal obstruction showed significant association with the four indices. These findings could be related to the fact that patients who present with an obstruction usually have advanced tumors.To evaluate the potential diagnostic use of these ratios in colorectal cancer, firstly we examined their optimal cut-off points, which were found after ROC analysis. Although NP/LHb ratio was the marker that obtained the best AUC, all of them had very similar AUC values. In some studies, it has already been published that the combination of different indices shows an increase in the accuracy to discriminate CRC , 41, 42.Currently, the most important and developed CRC screening method in most country is the fecal occult blood test (FOBT). This method has an acceptable sensitivity and a good negative predictive value. However, and for this reason, there are a high number of non-pathological colonoscopies in patients with positive FOBT (around 40%), producing a non-negligible rate of false positives, with the extra cost and possible risks that such examinations entail. Our studied indices have obtained diagnostic parameters contrary to FOBT, with limited sensitivity and negative predictive value. We understand that they would not be good screening tests when used in isolation and as single tests, however, since they have a high positive predictive value and specificity, they could be good tools to be used together with other tests  to ensure an accurate diagnosis and increase the probability for a positive diagnosis of CRC.Therefore, the hypothesis that can be deduced from this work is that in the CRC screening population a FOBT (test with high sensitivity), can be performed first and then a blood test to determine the indices here reported (more specific test). This should prioritize patients with a higher risk of CRC for colonoscopy or other tests. The priority could be given to those patients who presented higher scores in NLR, PLR, SII and, specially, in NP/LHb. Another aspect in favor of the use of these indices is their low cost, simplicity, accessibility and easy interpretation, since they can be obtained directly from the hemogram in a blood extraction.We are aware of the limitations of our study. It is a single-center and a retrospective study. In addition to, all analyzed markers may reflect a non-specific inflammatory response due to CRC or other tumors. For these reasons, further research in prospective and larger sample size studies are needed, in order to validate these results and to compare these markers with other diagnostic test to confirm their diagnostic usefulness.In conclusion, the blood-cell-based inflammation markers could be used as an additional tool to predict the CRC prognosis and also to improve the early diagnosis in combination with other screening strategies.The original contributions presented in the study are included in the article/The studies involving human participants were reviewed and approved by Regional Ethical Committee of Aragón (CEICA). Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.MH-A collected data, analyzed data, and drafted the manuscript. RV collected and analyzed data. AL analyzed data and revised the manuscript. PC-L analyzed data, performed all statistical analysis, and drafted the manuscript. EP designed the study, analyzed data, and drafted the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.This research was funded by Instituto de Salud Carlos III and co-funded by European Union : PI17/02171 (to EP), Diputación General de Aragón (Digestive Pathology Group B25_17R), and the Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


This study proposed and examined a conceptual framework on the influence of real estate brokers’ personalities, psychological empowerment, social capital, and knowledge sharing on their innovation performance, and used moral hazard as a moderating variable. We used structural equation modeling (SEM) for data analysis and estimation. The participants were real estate brokers in Kaohsiung City. A total of 1,000 questionnaires were administered to 100 branch offices of real estate companies, 571 of which were later recovered from 80 branch offices. After removing 52 for being invalid, we were left with 519 valid questionnaires, indicating a 51.9% recovery rate. The empirical results suggest that the real estate brokers’ personalities and psychological empowerment positively and significantly influence social capital; personality and psychological empowerment also positively and significantly influence their innovation performance; and social capital significantly influences knowledge sharing, which in turn positively and significantly influences the brokers’ innovation performance. In environments with higher levels of moral hazard, the influence of social capital on the brokers’ knowledge sharing is significantly diminished. A company’s innovation performance signifies its developmental capability and is also a key indicator in the service industry. Innovation is the process of acquiring original and valuable new products, processes, or services by means of displaying, combining, or integrating knowledge . PreviouReal estate falls within the service industry. The close interactions and relationships between industry players often involve knowledge sharing. Social capital is a means to study personal relations. In recent years, related studies have argued that social capital is based on the establishment of trust-based networks, and the status of the social networks within an organization affect the production of organizational knowledge . This isAdditionally, personality-related factors, such as personality and psychological empowerment, are important to real estate brokers’ interpersonal relations or innovation performance. Personality is a stable and crucial component in life . Franco The information above suggests that social capital influences knowledge sharing, which in turn impacts innovation performance. In economies reliant on capital markets, informational asymmetry is likely to occur between buyers and sellers, which leads to the risk of moral hazard . BecauseIn political science studies, Based on statistics from the A key characteristic of the real estate brokerage industry is that it is highly dependent on humans, from processes such as product development to the provision of professional front-and backend services. Relationships  are essential to the industry’s expansion. The global pandemic over the past 2°years has prolonged working hours at home, and fueled developments in the real estate industry including leveraging online technologies to boost sales . Knowledge sharing is another important tool for achieving innovation performance.Based on the characteristics of the industry, this study consolidates information on certain human psychological traits . It then explores how trust is established through strong interpersonal relationships as a form of social capital, which is then used to achieve knowledge sharing within the organization and promote innovation. We developed a conceptual model to validate the causal relationships between these latent variables. To summarize, the objectives of this study are: (1) To explore the influence of personality and psychological empowerment on social capital; (2) To explore the influence of personality and psychological empowerment on innovation performance; (3) To explore the influence of social capital on knowledge sharing and the influence of knowledge sharing on innovation performance; and (4) To explore how hazard as a confounding variable influences the effect of social capital on knowledge sharing.H1: Personality significantly and positively influences social capital.H2: Personality significantly and positively influences innovation performance.1 A wealth of research has demonstrated the positive association between interpersonal relations and psychological empowerment see H3: Psychological empowerment significantly and positively influences social capital.According to H4: Psychological empowerment significantly and positively influences innovation performance.H5: Social capital significantly and positively influences knowledge sharing.H6: Social capital significantly and positively influences innovation performance.H7: Moral hazard moderates the influence of social capital on knowledge sharing.The study framework shown in According to In both Our questionnaire consisted of two sections. The first included the participants’ basic information, such as their gender, age, tenure in the real estate industry, income, job position, education level, and business model. The second section covered items pertaining to the variables of personality, social capital, innovation performance, psychological empowerment, knowledge sharing, and moral hazard.We developed the ten items concerning personality on the basis of studies conducted by The nine items concerning innovation performance were developed following the definitions of We employed purposive sampling to survey real estate brokers from seven administrative districts in Kaohsiung City. A questionnaire was administered to the participants in person. The survey period ranged from May 1, 2020 to June 30, 2020. There were 1,000 questionnaires, 571 of which were recovered . After removing 52 invalid responses, we were left with a final count of 519, thus indicating an effective response rate of 51.9%.The results of the questionnaire survey are provided in The reliability of a sample is a measure of its accuracy in terms of the consistency and stability of the results. The most common method for testing a sample’s reliability is by using the coefficient developed by L. J. Cronbach, as represented by the following equation 1:K represents the total number of questionnaire items, S2 represents the total variance of the overall score of the questionnaire, and where  0 and 1 . Nunnall 0 and 1 .We performed a validity analysis in terms of content, convergent, and discriminant validity. In terms of discriminant validity, we followed First, we evaluated the theoretical model to confirm whether the overall model fit was acceptable. Once done, we performed linear structural equation modeling.R2 of the three structural equations were 0.741, 0.754, and 0.647, respectively. Accordingly, the preliminary fit criteria were generally acceptable.According to The fit of the internal structure of a model primarily assesses the level of significance of the model’s estimated parameters, as well as the reliability of each indicator and latent variable. 2), the normal chi-square statistic (χ2/df), the goodness of fit index (GFI), the root mean square residual (RMR), root mean square error of approximation (RMSEA), adjusted goodness of fit index (AGFI), normed fit index (NFI), comparative fit index (CFI), parsimonious goodness-of-fit index (PGFI), and parsimonious normed fit index (PNFI). The overall fit of a model is used to assess the fit of the observed data and the overall model. 2 value in this study was 770.961 (p = 0.001) and attained a 1% significance level. This suggests that the theoretical model is inconsistent with the distribution of the sample data. A further analysis of the other indicators showed that χ2/df = 5.976; GFI = 0.870; RMR = 0.090; RMSEA = 0.097, which were all in the proximity of an acceptable fit.Incremental fit measures compare the improvement in the fit of an independent model based on a preset model. As shown in Parsimonious fit measures refer to adjusted fit measures that determine the goodness of fit that can be obtained by each estimated parameter. As shown in This study employed AMOS-24 statistical software for path analysis. All of the predictors  were placed into the regression model to generate the estimated relation between each variable, as well as to determine whether the hypotheses are supported. The path analysis results are presented in Based on the empirical results, the estimated coefficient of personality on social capital was 0.588 and attained a 1% significance level. This shows that personality has a significant and positive influence on social capital, i.e., different personalities influence social capital differently. Therefore, H1 is supported. This result validates The estimated coefficient of psychological empowerment on social capital was 0.420 and attained a 1% significance level. This shows that psychological empowerment has a significant and positive influence on social capital, i.e., brokers with strong psychological empowerment exert a high influence on social capital. Therefore, H3 is supported. This result aligns with The estimated coefficient of social capital on knowledge sharing was 1.053 and attained a 1% significance level. The results showed that social capital has a significant and positive influence on knowledge sharing, thereby supporting H5. The estimated coefficient of knowledge sharing on innovation performance was 0.249 and attained a 1% significance level, thus demonstrating knowledge sharing’s significant and positive influence on innovation performance. Accordingly, H6 is supported. 2 of the original model  was 900.870 . The original model represents there being no invariance assumptions across samples, that is, the high and low moral hazard groups are a combination of structurally similar models that are independent of, and unassociated with, one another. The χ2 of the competing model was 905.635 . We obtained the competing model by adding constraints into the original model, which is to say by assuming that moral hazard was set as two (high and low) groups with the same path coefficient. The difference (Δχ2) between the chi-square statistic of the original and competing models was 4.765, and statistically significant. Since the difference between the two models lay in the addition of constraints, the significant differences in the chi-square statistics of both rejected the constraints. Therefore, the estimated paths of the high and low moral hazard groups in social capital and knowledge sharing differed  and psychological empowerment  are factors that are important to real estate brokers. Social capital (interaction intimacy and trust) reinforce the relationship between personality and psychological empowerment. With the rise of information technology, knowledge has become the greatest asset. Thus, establishing trust between the organization’s members, provoking their willingness to share knowledge, and achieving healthy competition is conducive to teamwork. Additionally, innovativeness is an indispensable trait for enhancing an individual’s professionalism. The information recipient and sharer can enhance their own competence and competitiveness based on the diverse experiences of their colleagues or through in-service education programs. Nevertheless, moral hazards are very likely to arise in industries that serve people. Real estate brokers often put their own interests first when they encounter competition from their colleagues or rival companies. This puts them at risk of a situation of moral hazard that terminates relationships and knowledge sharing. Our findings are consistent with what is seen in practice practical situations. Therefore, personality, psychological empowerment, and social capital generate knowledge spillover through mutual trust and cooperation, and are conducive to enhancing innovation performance, and industry sustainability.In this study, we identified a relationship between social responsibility and employee mobility. Future studies could undertake an in-depth exploration of these two variables, so as to enhance the level of innovation in real estate brokerage.lcc@mail.nptu.edu.tw).Publicly available datasets were analyzed in this study. This data can be found here: C-CL (Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent from the patients/participants or patients/participants legal guardian/next of kin was not required to participate in this study in accordance with the national legislation and the institutional requirements.H-CC: topic conception, research method, and revision. C-CL: research methods and writing and revision. W-CY: writing and revision. Y-LC: data collection and questionnaire survey. All authors contributed to the article and approved the submitted version.


Hepatitis delta virus (HDV) is a satellite RNA virus that relies on hepatitis B virus (HBV) for transmission. HIV/HBV/HDV coinfection or triple infection is common and has a worse prognosis than monoinfection.We aimed to reveal the epidemiological characteristics of HIV/HBV/HDV triple infection in the global population.A systematic literature search in PubMed, Embase, and the Cochrane Library was performed for studies of the prevalence of HIV/HBV/HDV triple infection published from January 1, 1990, to May 31, 2021. The Der Simonian-Laird random effects model was used to calculate the pooled prevalence.We included 14 studies with 11,852 participants. The pooled triple infection rate in the global population was 7.4% . The results of the subgroup analysis showed that the prevalence of triple infection was significantly higher in the Asian population , in men , and in men who have sex with men . In addition, compared with people living with HIV, the HIV/HBV/HDV triple infection rate was higher in people with hepatitis B.This meta-analysis suggests that the prevalence of HIV/HBV/HDV triple infection in the global population is underestimated, and we should focus more effort on the prevention and control of HIV/HBV/HDV triple infection.PROSPERO CRD42021273949; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273949 Hepatitis D virus (HDV) is a peculiar, small, defective virus that requires the assistance of hepatitis B virus (HBV) surface antigen (HBsAg) for replication and pathogenesis . Accordi+ and CD8+ T lymphocytes and natural killer cells, resulting in poor immune recovery after antiretroviral therapy, thus affecting AIDS disease progression [Given the shared transmission routes with HIV, HIV/HBV/HDV triple infection is relatively common . HIV/HBVgression . Additiogression . Meanwhigression ,12. SignThere have been several meta-analyses exploring the global HIV/HBV coinfection rate; however, the prevalence of HIV/HBV/HDV triple infection remains largely unknown. Chu et al  examinedThis meta-analysis was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and it was registered in PROSPERO (CRD42021273949).A systematic literature search in PubMed, Embase, and the Cochrane Library was performed for studies on the prevalence of HBV, HIV/AIDS, and HDV triple infection published from January 1, 1990, to May 31, 2021.Studies were selected based on the following inclusion criteria: (1) study participants were HIV or HBV monoinfected or HBV and HIV coinfected; (2) the diagnosis of infection with HIV or HBV met the international uniform standards; (3) studies related to the prevalence of triple infection were cross-sectional studies, and those related to incidence and risk factors associated with triple infection were case control studies or cohort studies; (4) in the original study, coinfection with HBV was defined as HBsAg-positive, coinfection with HDV was defined as anti-HDV positive, and coinfection with HIV was confirmed by Western blot.Studies were excluded if they (1) were case reports or review articles, (2) had a research sample size of less than 50 participants, (3) were duplicate studies, or (4) had incomplete or unclear study information. The study screening was carried out independently by 2 reviewers, who both read the full text and screened the studies that met the inclusion and exclusion criteria. Disagreements between reviewers about inclusion were resolved by consulting third-party experts.Two researchers independently extracted and coded data using an Excel spreadsheet. The data obtained included basic information of the included studies, including the first author, year of publication, study period, research type, study location, age or sex distribution, total number of participants, number of participants with HIV/HBV/HDV triple infection, and crude prevalence rate.The Newcastle-Ottawa Scale   was usedI2 measurement. The threshold for the heterogeneity test result was 0.05, and that of the level of goodness-of-fit test was 0.10. If heterogeneity was high (P<.10 or I2>50%), the random effects model was used to calculate pooled prevalence estimates with 95% CIs. Subgroup analysis was conducted according to the basic disease, research continent, research country, and HIV transmission route to explore the source of heterogeneity. The Egger linear regression method combined with the observation funnel plot was used to evaluate the publication bias. We evaluated the stability of the model through a sensitivity analysis.We used Stata software for the meta-analysis. Heterogeneity was assessed statistically using the The detailed flow of the literature search is shown in The detailed characteristics of the 14 included studies are listed in I2=98.995%, P<.01), and a random effects model was selected to combine the results of the included studies, which showed that the triple infection rate in the global population was 7.4% , and Europe had the lowest prevalence at 5.7% , the highest prevalence among the 8 countries included. Nigeria had the lowest prevalence at 0.7% . The prevalence rates in the other 6 countries are shown in We analyzed 14 studies by regional subgroup and found that Asia had the highest pooled prevalence of triple infection at 21.4%  in patients with chronic hepatitis B, 1.7%  in people living with HIV, and 11.9%  in people with HBV/HIV coinfection . MeanwhiSince the first discovery of the HDV in 1977 , it is eThe results of this meta-analysis showed that the prevalence of HIV/HBV/HDV triple infection was 7.4%. The results of the subgroup analysis showed significant regional differences in global triple infection rates. The prevalence of triple infection is significantly higher in Asia, especially in Taiwan and China, than in other countries or regions. These results may be caused by several reasons. First, the included studies included people with IDU; IDU is a high-risk factor that may promote triple infections . In addiThere were significant differences in the rate of triple infection for people living with HIV from different population sources, which was similar to rates for HIV/HBV coinfection ; howeverFurthermore, through the analysis of the results, we found a very interesting phenomenon. The rate of HIV/HBV/HDV triple infection was higher in people with HBV monoinfection than in people with HIV monoinfection or people with HBV/HIV coinfection. However, the credibility and reason for these findings are still unclear, and a large number of clinical studies is needed to better confirm the results.There were several limitations in this systematic review. Although strict inclusion and exclusion criteria were established and the quality of the included literature was evaluated using the NOS or AHRQ statement entries during the search and screening processes, there was still some subjectivity in the evaluation of the literature due to the lack of accepted quality evaluation criteria, which may lead to some selection bias in the included literature. The results of the sensitivity analysis in this systematic review showed that there was a certain selection bias. In addition, the wide inclusion criteria in this study produced significant heterogeneity that could not be explained. We used a random effects model with subgroup analyses whenever possible to reduce the effect of heterogeneity. Furthermore, the population included in this meta-analysis included people with HBV infection or HIV, lacking a comparable general population; some of these patients were drug users, which would increase the overall prevalence to some extent; and the evidence base had some shortcomings.In summary, the prevalence of HIV/HBV/HDV triple infection in the global population is underestimated. Therefore, during the management and antiviral treatment of patients with HBV/HIV single infection or coinfection, they should be screened for HIV/HBV/HDV triple infection in a timely manner. In addition, the prevention and treatment of coinfection should be combined with antiviral treatment to provide comprehensive prevention and treatment of triple infection and improve the quality of survival for this population. Additionally, the rates of triple infection in the two special groups of men who have sex with men and people with IDU are also worthy of attention. However, because there are few relevant studies, it is impossible to accurately evaluate the current status of rates of triple infection in the global populations of men who have sex with men and people with IDU ,44. More


Accordingly, upon increasing the humidity from 60% to 90% RH, the resistance and impedance decreased by up to 1.04 times, while upon increasing the temperature from 25 °C to 43 °C, the resistance and impedances also decreased by up to 1.05 times. Moreover, under the effect of vibration, a decrease in resistance and impedance, by up to 1.03 times, was observed. The investigated samples can potentially be used as prototypes for the development of shockproof jelly electronic-based devices in particular resistors. The technological achievement in the fabrication of these devices is the use of edible organic oil, which allows for the fabrication of uniform jelly films of organic materials that cannot be realized simply by mixing “dry” ingredients. Especially, we highlight that edible organic oil is environmentally friendly, unlike some other inorganic oils that are used in practice.Here, we present the design, fabrication and characterization of shockproof rubber–jelly (NiPc–CNT–oil) composite-based resistors. To fabricate the resistors, gels of CNT and NiPc with edible oil were prepared and deposited on a flexible rubber substrate using rubbing-in technique. The devices’ resistance and impedance were investigated under the effect of pressure, displacement, humidity, temperature and mechanical vibrations. The resistance and the impedance decreased, on average, by 1.08 times under the effect of pressure (up to 850 gf/cm During the last few years, organic materials-based electronic devices have been investigated very intensively, especially in the area of sensor fabrication and investigation. On the other hand, a number of organic materials-based devices, particularly those with resistive properties, were also recently fabricated ,6,7,8,9.Details of the fabrication, investigations and properties of various types of resistors were also provided in the refs. ,13,14,152O4 spinel were also investigated for impedimetric temperature and humidity sensing [In recent years, a number of papers related to resistive/impedimetric sensors were published by us ,26,27,28 sensing . In ref. sensing , a nickeIn a continuation of our efforts to study organic semiconductor and conductor devices, we present data on the fabrication, properties and investigation of shockproof jelly (NiPc–CNT–oil)–rubber composite-based resistors. The effect of pressure, displacement, humidity, temperature and vibrations on the performance of resistors has previously been studied. For the fabrication of organic-materials-based resistors, a unique combination of materials—edible oil, nickel phthalocyanine, carbon nanotubes and rubber (substrate)—was used. A technological achievement in the fabrication of these resistors is the use of edible organic oils, which allow the uniform jelly films of organic materials, which could not be realized simply by mixing “dry” ingredients, to be fabricated. These fabricated, flexible resistors provide an approximately constant resistance. The used organic materials and fabrication technology (rubbing-in technology) make the resistor ecologically clean. This device is ecologically clean not only from the point of fabrication, but also for practical utilization. Moreover, the fabricated resistors may potentially be used as a prototype for the development of shockproof-jelly-based electronic devices, particularly resistors.The XPS spectrum of the CNT-NiPc composite is shown in The samples’ resistance and impedance were investigated under the effect of displacement, pressure, humidity, temperature and mechanical vibrations. The resistance and the impedance of the surface type samples were equal to 2.2 kΩ, on average.2, the resistance and impedance decreased by 1.08 times on average. The results of resistance/impedance–pressure relationships are shown in 2) values for the resistance–humidity and impedance–humidity relationships were also calculated. The value of R2 for the resistance–humidity relationship was 0.865, while for the impedance–humidity relationship, these values were in the range of 0.967 to 0.991.Similarly, when increasing the humidity from 59% to 90% RH (relative humidity), the resistance and impedance of the samples decreased by up to 1.04 times. The resistance/impedance–humidity relationships are shown in +) and hydroxide ions (OH) that, ultimately, leads to the separation of (H+) and (OH−), according to Equation (1), and the increase in the concentration of charges:Concerning the effect of humidity on the electric properties of the materials, two mechanisms may be considered: firstly, the diffusion of water molecules into material and increase in dielectric permittivity; secondly, the self-ionization of the water molecules into protons  and T2 (instantaneous temperature). The ∆T is the difference between initial and instantaneous temperatures. The temperature coefficient of resistance (TCR) may be calculated as:Similarly, the temperature coefficient of impedance (TCI) can also be introduced:Through these calculations, it was found that TCR was equal to −0.0023/°C. Using the same calculations, it was found that the temperature coefficient of impedance (TCI) was equal to −0.0023/°C at all frequencies in the interval of 0.1 kHz–200 kHz.A comparison of the obtained values of TCR and the TCI with the TCRs of some metals that are used in electronics (such as silver (0.0038), copper (0.0039) and aluminum (0.0043)) shows that the resistance–temperature behavior of the NiPc–CNT–oil–rubber composite causes stress in metals. However, the resistance–temperature behavior of NiPc–CNT–oil–rubber composite is similar to semiconductors because, with the increasing temperature, the resistance/impedance decreases. In principle, this allows jelly-based and traditional metals-based composites to be fabricated with approximately zero temperature coefficients. The effect of vibration on the resistance and the impedance of the samples is shown in The results are summarized in The investigated samples can potentially be used as a prototype for the development of shockproof jelly electronic-based devices, particularly sensors. The impedance and resistance may also be changed if the ratio of the ingredients and type of ingredients are changed. A technological achievement regarding the fabrication of these devices is the use of edible organic oil, which could fabricate the uniform jelly type films of organic materials, which could not be realized simply by mixing “dry” ingredients. Especially, we would like to highlight that edible organic oil is environmentally friendly, unlike some other inorganic oils that are used in practice. This fact may be especially important in the implementation of the obtained results in practice.The analysis of data received from the literature showed that the obtained results were supplementary. These results are primarily useful for the fabrication of cheap and flexible devices, which are especially important as a teaching aid. Secondly, these results support the investigation and understanding of the physical and electro-chemical properties of the flexible composites for their potential applications in the electronic devices which may be used in vibration conditions. Moreover, the jelly-based electronic devices are very attractive to be used successfully in vibration conditions.The purpose of this research was the design, fabrication and investigation of the properties of shockproof, flexible, organic resistors. In this study, a rubber–jelly (NiPc–CNT-edible oil) composite-based flexible resistor was fabricated. The changes in the resistance and impedance of the resistor were measured under the effect of humidity, temperature, pressure, displacement and vibration. The results of this investigation showed that fabricated organic resistors are ecologically clean and environmentally friendly. This is due to the utilization of edible oil for the fabrication of the jelly that was used in the organic resistor: all organic components, including the organic semiconductor NiPc and carbon nanotubes were surrounded by edible oil. The presence of edible oil not only made the composite environmentally friendly but also provided an approximately constant resistance.For samples fabrication, we used edible oil (coconut oil and hempseed oil), organic semiconductor nickel phthalocyanine (NiPc), carbon nanotubes and rubber substrate. The CNTs (carbon nanotubes) and NiPc powder were purchased from Sun Nanotek Co., Ltd. and Sigma Aldrich, respectively. The diameter of the multi-walled carbon nanotubes was 10 to 30 nm, while their length ranged from 100 to 200 nm. The NiPc powder was used as it was received. The shockproof organic resistors, consisting of rubber–jelly (NiPc–CNT–oil) composites, were fabricated using rubbing-in technology. The effects of pressure, displacement, humidity, temperature and vibrations on the resistance and impedance of the resistors were studied. These jelly-based resistors were fabricated in the following way. The jelly of CNT and hempseed oil was prepared by mixing both 1:1 (50 wt.% and 50 wt.%). The jelly of NiPc and coconut oil was also prepared by mixing both of the ingredients in a ratio of 50 wt.% and 50 wt.%. The CNT–oil jelly was deposited on the rubber substrates by rubbing-in technology. The NiPc–oil jelly was deposited on the CNT–oil jelly layer. 3. Displacement and pressure were applied along the length of the samples. For the measurements of the impedance in the range of frequencies from 100 Hz to 200 kHz, the digital LCR meter MT-4090 was used. The temperature was measured using a Fluke-87 multimeter, while the humidity was measured using Fisher scientific humidity meter.


The purpose of this paper is to determine how employee trust in management regarding digitalization (TMD) is encouraged to successfully promote technological change linked to digitalization and implement digital technologies within organizations. TMD is considered a necessary precondition for employee cooperation regarding the successful implementation of digitalization within organizations. Derived from existing theoretical and empirical research on trust, a double-mediation model is developed. The proposed model investigates the direct relationships between strong digital vision (SDV), leader-member exchange (LMX), and perceptions of organizational politics (POP) on employee TMD. Further, the mediating roles of LMX and POP are investigated regarding the relationship between SDV and TMD. Based on data collected from 1,145 employees of an internationally operating energy supplier, significant positive relationships between SDV, LMX, POP, and employee TMD were found. Further, the results confirmed that LMX and POP sequentially double-mediated the relationship between SDV and TMD. Consequently, by developing a theoretical model for the specific context of digitalization, this study contributes to theory development concerning employee TMD. Furthermore, this study provides practical implications for management in terms of identifying institutional aspects within organizations that enhance TMD in the digital labor context. In the digital era, organizations increasingly rely on their employees to successfully promote technological change linked to digitalization , had an average organizational tenure of 20.85 years (SD = 12.55) and had worked with their current supervisor for an average of 3.53 years (SD = 0.92).Online survey data were collected from 1,305 employees of an internationally operating energy supplier in Germany (response rate = 61%). Through data cleansing, we eliminated datasets of employees whose work environment was not affected by digitalization. Further datasets of employees who revealed they did not have a supervisor and those who had been working with their supervisors for less than six months were excluded. Additionally, missing values in metric scales were replaced by the mean for datasets with fewer than 5% of missing values. In the remaining 1,145 data sets , 272 (23.8%) employees were female, 862 (75.3%) were male, nine (0.8%) were of non-binary gender, and two (0.2%) did not give this information. The average age of participants was 43 years old  and the stepwise procedure were ensured to addressing several weaknesses associated with the Sobel test  was addressed by using procedural and statistical remedies . Similarly, SDV was positively significantly related to LMX , supporting H2. Our results further provided support for H3, suggesting a positive and significant relationship between LMX and TMD . Moreover, the indirect effect of SDV on TMD through LMX (H4) was significant at 0.03 . Although LMX was entered into the regression, the direct effect of SDV on TMD remained highly significant, confirming the partial mediating effect of LMX regarding the positive relationship between SDV and TMD. Thus, H4 was supported.The results for the double-mediation model are presented in Table B = -0.20, p < 0.01). Moreover, H6 was supported by the negative significant relationship between POP and TMD . Regarding H7, the partial mediating effect of POP in the relationship between SDV and TMD was significant at 0.04 . Even though POP was entered into the regression, the direct effect of SDV on TMD remained highly significant, confirming the partially mediating effect of POP in the corresponding positive relationship. Hence, H7 was supported.The results for H5 confirmed that SDV was significantly negatively related to POP , the effect was weak in our model. Thus, LMX and POP had a weak significant sequential double-mediation effect on the relationship between SDV and TMD.Last, regarding the double-mediation model, 32% of the variance in employees’ TMD is accounted for in the independent variables in our model. The results supported that LMX and POP sequentially double-mediate the positive relationship between SDV and TMD, supporting H8. Although the double-mediation effect was significant at 0.02  to build high-quality relationships with their employees and be sensitized to POP (Colquitt et al. Management has to take a holistic approach regarding organizational digitalization by further considering the intercorrelation of managements’ characteristics in terms of SDV, LMX, and POP to develop TMD. Thereby, organizations should note that an SDV shapes a collective identity among employees that facilitates high-quality LMX Kauppila . ParticuThus, in the digital labor context, management increases employee TMD by specifying an SDV that addresses the importance and implementation of high-quality LMX and fair policies within the organization and limiting the degree to which decisions are politically driven (Crawford et al. This study has several limitations that should be considered in future research. First, this study was not based entirely on reliable and valid scales. For example, TMD was analyzed by adapting items of the scale developed by Stanley et al.  to the dSecond, all measures were focused on employees’ perceptions to emphasize their role in the corporate challenge of digitalization. This focus was based on the theoretical assumptions of Mayer et al.  as well Because we used self-reporting measures and single-source data, our study design partly accounted for CMV bias (Chang et al. Moreover, by applying a cross-sectional study design, the data were collected at one point in time. Due to this, we were not able to conclude causal relations based on the data (e.g., Antonakis In line with Podsakoff et al. , we recoNext, our data were collected from employees in one organization in Germany, an internationally operating energy supplier. Considering that digitalization and innovation highly affect the energy industry worldwide in terms of the energy revolution, climate change, and the related transition from conventional to renewable energies (Midttun and Piccini The problem of endogeneity was addressed by including several control variables in our model, even though it could not be avoided entirely in the present study. Nevertheless, further variables might be worth considering to identify conditional, indirect effects that explain TMD. Following prior research, future studies could investigate perceived risk, trust regarding coworkers or organizational factors, such as leadership, organizational support, the way organizations implement digitalization, and attitudes toward digitalization (Adler and Borys The present study advances the research on trust in the workplace by investigating the antecedents of TMD. In considering employee TMD as a necessary precondition for the successful implementation of digitalization and investigating institutional aspects as antecedents of TMD, our study addressed research gaps of particular importance. Based on prior research (Mayer et al. Consequently, to create and increase employee TMD and successfully implement digitalization within organizations, management should provide SDV, ensure high-quality LMX, and reduce POP.The results of the present study contribute to theory development concerning TMD by specifying, extending and applying the model of trust by Mayer et al.  in terms


The prevalence of mental health problems during childhood and adolescence is on the rise. There is a growing interest in the examination of personal variables that may function as risk factors and that may be targeted for effective intervention. This study explores the relationships amongst different aspects of psychological inflexibility , emotional intelligence, and mental health symptoms. A total of 129 school-going children (mean age: 11.16 years old) completed a battery of instruments comprising the Avoidance and Fusion Questionnaire-Youth (AFQ-Y17), the Experiential Approach Scale (EAS), the Emotional Intelligence Quotient Inventory (EQi-YV), and the Revised Child Anxiety and Depression Scale (RCADS-30). Results showed that both the AFQ-Y17 score and an EAS subscale score (Anxious Clinging) were significant independent predictors of mental health symptoms in general. Emotional intelligence was predictive only for depression, and both the AFQ-Y17 and the Anxious Clinging EAS subscale significantly incremented the predictive power of a hierarchical linear regression model including all three variables. These results underscore the relevance of psychological inflexibility for child/adolescent mental health, and the need to further explore a specific aspect of inflexibility regarding positive emotions and other appetitive private events. The prevalence of mental health problems in children and adolescents has been on the rise for the last few decades ,2. This An ample literature exists on research that examines risk and protection factors for the development of psychological disorders during childhood and adolescence. While social and family factors are credited with an essential role in the development of these problems ,7, thereSince the 1990s, emotional intelligence (EI) has gathered growing research interest, with particular attention paid to its relationship with mental health. Over the years, different definitions and models of EI have appeared. Most of them share in common that they describe some aspect of personality, and to some degree, understand EI as a trait, or as having trait-like qualities , which dA different approach to how individuals perceive and react to their emotions has developed from the functional-contextual perspective of Acceptance and Commitment Therapy (ACT) ,22. ACT ACT conceptualizes most psychological disorders as resulting from extended, generalized patterns of responding to one’s private events characterized by a lack of flexibility (or presence of inflexibility). Psychological inflexibility (PI) is characterized by cognitive fusion  and ensuing inflexible patterns of experiential avoidance  ,27. WhilThe vast majority of existing research on PF/PI has focused on responding to aversive private events . However, there is nothing in the PF model that necessarily leads to constraining the concept of psychological (in)flexibility to aversive experiences. Arguably, deliberate attempts at controlling positive cognitions and emotions  might as well be problematic if they become generalized, inflexible patterns of responding that end up interfering with valued living. Recently, Swails et al.  presenteSo far, thus, no study has explored the relative contributions of different aspects of PI regarding the types of private events that are experienced  with children and adolescents . This is an important issue both practically  and theoretically . The goal of the present study was to explore the extent to which PI and EA are associated with and predict relevant mental health symptoms (anxiety and depression), compared to a traditional trait-like measure of EI.A convenience sample of 129 primary and secondary school students with ages ranging between 9.33 and 14.83 years old  was recruited from a chartered school in a mid-sized town in Southern Spain. All of them showed typical development and normal reading abilities for their age range (as reported by their teachers). Participants did not receive any incentive for participation, financial or otherwise. Informed consent was obtained from participants and their legal guardians before conducting the study.This sample size allowed for a minimum statistical power (1-β) of 0.80 for medium effect sizes for all statistical tests performed in the data analyses, as calculated with G*Power software .Avoidance and Fusion Questionnaire–Youth . The RCThe study was conducted at the participants’ school. Study information and consent forms were distributed to all parents or legal guardians in compliance with standing regulations and ethical guidelines from the authors’ university Institutional Review Board (IRB), and the study was approved both by the IRB and by the school management team. All participants took part in a larger research project that involved responding to latency-based tests in different conditions (data not included in the present report). Questionnaire administration was conducted previously to participation in the experimental tasks in all cases. Participants completed the questionnaires in one session at their usual classroom during a regular class, supervised both by a research psychologist and the student’s usual teacher. Questionnaires were presented in the following order: AFQ-Y17, EAS, RCADS-30, EQ-iYV. Completion took around 30 min.This study attempted to examine the relationship amongst different aspects of psychological inflexibility (involved in responding either to unwanted or to desired affective states and cognitions), emotional intelligence, and mental health symptomatology in children and adolescents. Since we were exploring the use of the EAS (which so far has only been tested with young adults) , before Cronbach’s α for the different instruments was calculated with Hayes and Coutts’s OMEGA macro for SPSS  as a meaWe examined associations amongst PI, EA, EI, and mental health symptoms through Pearson product-to-moment correlations. In order to explore how different aspects of PI regarding aversive or appetitive private events could be used to make clinically relevant predictions regarding mental health symptoms, we conducted hierarchical regression analyses with general mental health symptomatology  and specific symptoms  as the criterion variables. For each analysis, we compared a model in which the criterion variable was predicted by PI regarding aversive private events (AFQ-Y17 scores) with a model that also included as a predictor an aspect of PI regarding appetitive private events , in order to see whether and how these different aspects increased the predictive power of the model. EI was included as a predictor in the model, in case it correlated significantly with the criterion variable.2(153) = 890.6; p ≤ 0.001] were indicative of the sample adequacy for factor analysis. Two factors were retained , which points to two independent EAS subscales with the same pattern of items’ factor loadings as in the Spanish adaptation with adults. The different indicators revealed a very good fit for the model: RMSEA = 0.0028; NNFI = 0.988; CFI = 0.991; GFI = 0.954.Factor loadings for the different EAS items . Internal consistency was good for all the scales, with αs ranging from 0.80 (EASAnxious Clinging) to 0.91 (EQi-YV). It was acceptable/good for the RCADS-30 subscales (αs ranging from 0.65 to 0.76) but the Obsessive Compulsive subscale (α = 0.53). Item deletion did not increase reliability for any of the measures or its subscales.Anxious Clinging), EI (EQi-YV), and mental health symptoms (RCADS-30). As expected, there was a moderate positive correlation between PI and AC. Both PI and AC showed strong positive correlations of similar magnitude with the total RCADS-30 score , and a similar pattern of significant positive correlations with the different RCADS-30 subscales, ranging from 0.251 (AC and separation anxiety) to 0.50 (AC and panic disorder). EI was not significantly associated with total scores of mental health symptoms, nor with any of the anxiety subscales. However, there was a significant negative correlation between EI and major depression, with an absolute magnitude similar to the positive correlations of major depression with PI and with AC. This pattern of correlations suggests that both PI and AC might be potential predictors of worse mental health, while EI would only be negatively associated with depression.2 = 0.279) and the smallest for the generalized anxiety subscale (R2 = 0.073). The inclusion of AC as a predictor significantly increased accounted-for variation in all cases but one . The significant increment in explained variance ranged from 2.8%  to 14.2% . Besides, in all of these cases (with the exception of obsessive compulsive disorder), AC was a stronger predictor  than the AFQ-Y17 score. In the specific case of major depression, which also included EQi-YV score as a predictor, both the inclusion of AFQ-Y17 and AC scores resulted in successive significant increments in accounted-for-variance , with the EQi-YV being the strongest (negative) predictor followed by AC.In order to determine the relative contribution of PI (as measured by the AFQ-Y17) and the AC facet of EA in accounting for variation in mental health symptoms, we conducted a series of hierarchical linear regression analyses with the RCADS-30 total score and all RCADS subscale scores as criterion variables. In each model, AFQ-Y17 score was introduced first as a predictor, then the AC score was introduced in the second step. For the major depression subscale, the analysis included another predictor, EI . In this case, EQi-YV score was introduced as predictor in the first step, AFQ-Y17 score in the second step, and the AC score in the third step. This study attempted to examine whether, and how, different aspects of inflexibility regarding private events (both aversive and appetitive) were associated with anxiety and depression symptoms in children and adolescents and, more specifically, the relative contribution of these aspects in accounting for variation in these symptoms. To that end, we used a typical PI measure based on responding to aversive private events, a recent measure of EA focused on responding to appetitive private events, and a general, trait-like measure of EI, since EI is a typical variable in the study of emotion regulation and its impact on mental health.Since the EAS is a relatively unexplored measure and, to date, it has never been used with children and adolescents, we examined its psychometric properties before conducting any correlational or regression analyses. Prior research with this measure ,40 showeM = 31.61) [M = 113.12) [M = 47.09) [The analysis of the descriptives showed that the mean scores for EI and anxiety and depression symptoms were consistent with prior research. The average RCADS-30 total score was very close to that from a recent validation of the scale with a non-clinical sample of similarly aged children (= 31.61) . Likewis 113.12) . However= 47.09) . A possi= 47.09)  found th= 47.09) . There i= 47.09) . Since t= 47.09) . This seThe observed pattern of correlations amongst the EQi-YV, the AFQ-Y17, the EAS AC subscale, and the RCADS-30  yields some interesting results. EI, as measured with the EQi-YV, was generally not related to the other measures. Regarding PI and AC, this measure of EI, based on a model with a strong trait-like component, did not appear to converge with specific measures targeting the more context-dependent, learned responses to private events. Regarding mental health symptoms, EI presented a moderate to strong negative correlation with depression, but not with any of the anxiety subscales or with the RCADS-30 total scale. This is unlike previous research with children that found an association between EI (as measured with the EQi-YV) and anxiety ,20. The The pattern of associations amongst the different aspects of inflexibility regarding private events was theoretically coherent and very similar to the findings from the only two prior studies on EA with adults ,40. The This study has some limitations that need to be mentioned and that lead us to be cautious in considering its findings. First, it examined only a relatively small convenience sample of schoolchildren from a single school. Future studies might attempt to explore the differential contributions of psychological inflexibility regarding aversive and appetitive private events with more representative non-clinical samples, and also with clinical samples whose emotional experience differs from the normative socio-emotional developmental pattern . Second, the measure of EA that we used is the only available measure so far for this construct, but it has only been tested with adults. Our preliminary findings show that EA  appears to play a relevant role in predicting anxiety and depression symptoms, which would justify further research on the specific adaptation of the EAS  for children/adolescents, with larger samples and proper psychometric guarantees. Third, we used a typical measure of global EI with a strong trait-like component. As mentioned above, it is possible that using a different measure of EI, more focused on aspects of emotion regulation, would yield a different pattern of relationships with PI, EA, and anxiety and depression symptoms. Fourth, the administration of the different instruments was not counterbalanced. Future studies like those suggested above  might control for potential effects of presentation order.In sum, the results of the present study suggest that specific and malleable constructs targeting the individual’s response to their private events, such as PI and the AC dimension of EA, constitute relevant predictors of mental health symptoms. Particularly, they underscore the relevance of considering how flexibly children respond to positive emotions and other appetitive private events, and not only to aversive private events. A growing literature is providing evidence about the role of PI as a risk factor for mental health problems during childhood and adolescence, and the potential beneficial effects of interventions aimed at enhancing PF, such as ACT. However, the focus of existing PI measures and associated interventions is fundamentally on how the individual relates to aversive private events. While this seems logical in the context of intervention with clinical patients who are suffering and thus frequently undergoing aversive experiences, perhaps a focus on how flexibly children respond to appetitive private events would be relevant for prevention. Future studies might undertake a deeper examination of these aspects of PI as potential targets for preventative interventions.