An Empirical Approach to Analyzing the Effects of Stress on Individual Creativity in Business Problem-Solving: Emphasis on the Electrocardiogram, Electroencephalogram Methodology.

In this study, experiments were conducted on 30 subjects by means of electrocardiogram (ECG) and electroencephalogram (EEG) methodologies as well as a money game to examine the effects of stress on creativity in business problem-solving. The study explained the relationship between creativity and human physiological response using the biopsychosocial model of challenge and threat. The subjects were asked to perform a cognitive mapping task. Based on the brain wave theory, we identified the types of brain waves and locations of brain activities that occurred during the creative problem-solving process in a business environment and studied the effects of stress on creativity. The results of the experiments showed significant differences in creativity in business problem-solving depending on whether or not stress was triggered. Differences were found in the time domain (SDNN, RMSSD) and frequency domain (HF, LF/HF ratio) of heart rates, a physiological stress indicator, between the stress group and the no-stress group. A brain wave analysis confirmed that alpha waves increased in the frontal lobe of the brain during creative business problem-solving but decreased when the subjects were under stress, during which beta waves in the brain increased. This study seeks to examine creativity in business problem-solving by studying the effects of stress on human physiological response and cognitive functions in the hope of providing a new and objective interpretation of existing research results.

Functional Outcomes and Physical Performance of Knee Osteoarthritis Patients After Ultrasound-Guided Genicular Nerve Radiofrequency Ablation.

OBJECTIVE: To elucidate the effectiveness of ultrasound-guided genicular nerve radiofrequency ablation in alleviating pain as well as its effects on functional outcomes, quality of life and physical performance in knee osteoarthritis patients. DESIGN: Prospective observational study. SETTING: Patients were recruited within one community hospital. SUBJECTS: Patients with knee osteoarthritis. METHODS: The subjects underwent ultrasound-guided radiofrequency ablation of genicular nerves after showing a positive response to a diagnostic block. Outcome assessments were performed at baseline and at 2 and 12 weeks posttreatments using the 36-item Short Form Health Survey (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a physical performance evaluation including balance tests, quadriceps muscle strength test, two-minute walking test and knee joint proprioception test. RESULTS: Thirteen out of 38 patients were eligible for genicular nerve radiofrequency ablation. There were significant improvements from baseline to posttreatment in the numeric rating scale score, physical health domain score of SF-36, and pain and stiffness domain scores of the WOMAC. Regarding physical performance, the step test result significantly improved over the 12 weeks of follow-up. On the other hand, no significant deteriorations in the single leg stance test, isokinetic quadriceps muscle strength test, knee joint proprioception test or two-minute walking test results were observed after radiofrequency ablation of genicular nerves. CONCLUSIONS: Radiofrequency ablation of genicular nerves may significantly alleviate pain and improve functional outcomes in knee osteoarthritis patients. More importantly, static balance control and quadriceps muscle strength were preserved and there was a change of proprioception in the good direction.

Exploring a Fuzzy Rule Inferred ConvLSTM for Discovering and Adjusting the Optimal Posture of Patients with a Smart Medical Bed.

Several countries nowadays are facing a tough social challenge caused by the aging population. This public health issue continues to impose strain on clinical healthcare, such as the need to prevent terminal patients' pressure ulcers. Provocative approaches to resolve this issue include health information technology (HIT). In this regard, this paper explores one technological solution based on a smart medical bed (SMB). By integrating a convolutional neural network (CNN) and long-short term memory (LSTM) model, we found this model enhanced performance compared to prior solutions. Further, we provide a fuzzy inferred solution that can control our proposed proprietary automated SMB layout to optimize patients' posture and mitigate pressure ulcers. Therefore, our proposed SMB can allow autonomous care to be given, helping prevent medical complications when lying down for a long time. Our proposed SMB also helps reduce the burden on primary caregivers in fighting against staff shortages due to public health issues such as the increasing aging population.

Understanding E-Commerce Consumers' Repeat Purchase Intention: The Role of Trust Transfer and the Moderating Effect of Neuroticism.

The dominant position of e-commerce is especially being articulated in the retailing industry once again due to several constraints that the world faces in the COVID-19 pandemic era. In this regard, this study explores the significant role of trust transfer (from offline to online) and the moderating effect of consumers' neurotic traits in the framework of trust-satisfaction-repurchase intention in the e-commerce context based on a survey with 406 Korean e-commerce consumers. Moreover, a prediction-oriented segmentation (POS) technique combined with structural equation models (SEM) was utilized to reveal consumers' probable hidden heterogeneous characteristics. The outcomes of the global model SEM analysis indicate that offline-online trust transference occurs in e-commerce, and the conveyed trust significantly influences satisfaction and consumers' repeat purchase intention through satisfaction. Neuroticism also has significant positive effects on trust transfer in the global model. However, results in three subgroups generated by POS show heterogeneous characteristics that considerably differed from the global model test results. The implications from this study will be beneficial to field practitioners in the e-commerce industry in addressing the importance of trust transfer, negative neurotic traits as well as heterogeneous aspects of consumers.

Predictors of nasogastric tube removal in patients with stroke and dysphagia.

Dysphagia is present in 25-50% of patients with stroke. Therefore, studying the probability of nasogastric tube removal in such patients before discharge from the rehabilitation ward is crucial. In this study, we developed a model to predict the outcome of dysphagia in patients with stroke. A retrospective study was performed from May 2015 to December 2018. We reviewed the medical charts of all patients with a diagnosis of stroke receiving nasogastric tube feeding. Patients were divided into weaned and nonweaned groups to compare baseline characteristics and functional status. The weaned and nonweaned groups comprised 55 and 65 patients, respectively. In the final logistic regression analysis model, the Barthel index at admission, lip closing status, ability to answer simple questions and functional independence before stroke were used to develop a predictive model (Logit = 0.8942 × functional independence before this stroke + 1.1279 × ability to answer simple question + 0.5345 × lip-close status + 0.0546 × Barthel index at admission - 2.2805). The optimal cutoff point based on Youden's index was more than -0.8403 with a sensitivity and specificity of 85.45 and 73.85%, respectively. The positive predicted value was 73.44%. In patients with stroke and dysphagia, a high Barthel index, intact lip closing status, ability to answer simple questions and better functional status before stroke appeared to affect nasogastric tube removal before discharge from the rehabilitation ward. Based on the final regression model, the proposed equation will help physicians and speech pathologists in planning patient care.

Integrating Text-Mining and Balanced Scorecard Techniques to Investigate the Association between CEO Message of Homepage Words and Financial Status: Emphasis on Hospitals.

(1) Background: The Chief Executive Officer's (CEO's) message on a hospital's homepage on the Internet contains various components, such as the hospital's future vision, promises to customers, availability of upgraded services and public activities. This statement usually includes non-financial information as well as financial information about the corporate entity owning/operating the hospital. In addition, it provides useful information about not only the company's goals and vision, but also firm performance targets and strategies for the future. This study aims to investigate associations between the CEO's message and the financial status of the institution. We used the balanced scorecard framework to analyze what content on the hospital's homepage is related to the hospital's various financial ratios. (2) Methods: We adopted a text-mining method to extract significantly repeated keywords from the CEO's message on the hospital's website. Then, we classified these keywords using a balanced scorecard approach. To examine the relationship between keywords in the CEO's message and the hospital's financial ratios, a t-test was conducted for the difference in the term frequency divided by inverse document frequency (TF-IDF) mean of the home page contents and its relationship with the views of the balanced scorecard framework. (3) Results: According to our empirical results on 65 samples collected from local hospitals, there are some significant relationships between the qualitative content of the hospital's homepage and the quantitative financial ratios that indicate profitability, activity, leverage, liquidity, and accumulating reserves for proper business purposes. (4) Conclusions: The introduction section of a homepage is the part most accessible to customers, containing the aims and ideals of the hospital and reflecting the institution's values and visions. In addition, in the coverage of financial status, the organization can either emphasize financial strength or focus on other areas to divert attention from any weakness shown in the financial information. This study reminds us of the importance of the hospital website's disclosure, and what can be inferred from the financial status of the hospital. It also highlights the need for reconciliation and harmony between the quantitative data, financial statements, and qualitative data in the CEO's message. (5) Implications: To the best of our knowledge, this paper is the first research attempting to investigate the relationship between text on the hospital's homepage and the hospital's financial ratios using text-mining techniques and the balanced scorecard framework. Hospitals play a crucial role in a country's welfare and healthcare industry. Nevertheless, in many countries, hospital organizations tend to remain a source of critical fiscal deficits due to ineffective and sloppy management. We expect that the result of this paper can provide hospital managers with useful information to address that situation.

Identifying High-Risk Factors of Depression in Middle-Aged Persons with a Novel Sons and Spouses Bayesian Network Model.

It has been reported repeatedly that depression in middle-aged people may cause serious ramifications in public health. However, previous studies on this important research topic have focused on utilizing either traditional statistical methods (i.e., logistic regressions) or black-or-gray artificial intelligence (AI) methods (i.e., neural network, Support Vector Machine (SVM), ensemble). Previous studies lack suggesting more decision-maker-friendly methods, which need to produce clear interpretable results with information on cause and effect. For the sake of improving the quality of decisions of healthcare decision-makers, public health issues require identification of cause and effect information for any type of strategic healthcare initiative. In this sense, this paper proposes a novel approach to identify the main causes of depression in middle-aged people in Korea. The proposed method is the Sons and Spouses Bayesian network model, which is an extended version of conventional TAN (Tree-Augmented Naive Bayesian Network). The target dataset is a longitudinal dataset employed from the Korea National Health and Nutrition Examination Survey (KNHANES) database with a sample size of 8580. After developing the proposed Sons and Spouses Bayesian network model, we found thirteen main causes leading to depression. Then, genetic optimization was executed to reveal the most probable cause of depression in middle-aged people that would provide practical implications to field practitioners. Therefore, our proposed method can help healthcare decision-makers comprehend changes in depression status by employing what-if queries towards a target individual.

The Unobserved Heterogeneneous Influence of Gamification and Novelty-Seeking Traits on Consumers' Repurchase Intention in the Omnichannel Retailing.

As information technology continues to provide a platform for any business willing to engage in diverse channels, it has ushered in a continuous evolution of ways to attract and maintain a given customer base. One of the latest trends seen in the retailing industry is the implementation of an omnichannel business strategy. As a result, the number of businesses now implementing such a strategy has led to a lack of differentiation amongst competitors. Therefore, it is no surprise that omnichannel retailers have had to rethink and acquire a new competitive advantage through the exploration of new and innovative strategic activities. Prior work on services has shown gamification to be a successful strategy in enhancing customer loyalty, promoting positive word-of-mouth, and enhancing greater engagement with the offered service. Also, offering hedonic values (one of gamification's main premises) has been an effective strategy for engaging customers as well as promoting repeat purchase intentions. Despite this, the potential effects of gamification within an omnichannel setting is not yet explored, and thus the rationale of this study. In exploring this gap, we employed means-end chain theory as a basis in which to discover the potential of gamification. Additionally, as gamification is a novel method in omnichannel research, this paper strived to explore the moderating effect of the novelty-seeking traits and unobserved heterogeneous behaviors of consumers. This research was based on 440 valid questionnaires in a survey dataset from Amazon M-Turk. The results provided strong evidence of the underlying proposition within the research models. Specifically, this study showed that gamification could be a potential unique feature used for engaging consumers onto one's platform, especially consumers with a novelty-seeking trait. We did, however, find that this finding does not apply to the case for all consumers. Therefore, the implication of this research suggests to practitioners that its implementation should be approached through an opt-in rather than a compulsory option.

Consumer Decision-Making Creativity and Its Relation to Exploitation-Exploration Activities: Eye-Tracking Approach.

Modern consumers face a dramatic rise in web-based technological advancements and have trouble making rational and proper decisions when they shop online. When they try to make decisions about products and services, they also feel pressured against time when sorting among all of the unnecessary items in the flood of information available on the web. In this sense, they need to use consumer decision-making creativity (CDMC) to make rational decisions. However, unexplored research questions on this subject remain. First, in what ways do task difficulty and time constraints affect visual attention on exploitative and exploratory activities differently? Second, how does the location of the reference (i.e., hints) influence the level of visual attention to exploitative and exploratory activities depending on affordance theory? Third, how do exploratory and exploitative activities affect CDMC? Eye-tracking experiments were conducted with 70 participants to obtain relevant metrics such as total fixation duration (TFD), fixation count (FC), and visit count (VC) to answer these research questions. Our findings suggest that task difficulty influences exploitative activity, whereas time constraint is related to the exploratory activity. The result of the location of hints aligns with the affordance theory for the exploitative activity. Besides, exploratory activity positively affected CDMC, but exploitative activity did not show any effect.

Predicting Factors Affecting Adolescent Obesity Using General Bayesian Network and What-If Analysis.

With the remarkable improvement in people's socioeconomic living standards around the world, adolescent obesity has increasingly become an important public health issue that cannot be ignored. Thus, we have implemented its use in an attempt to explore the viability of scenario-based simulations through the use of a data mining approach. In doing so, we wanted to explore the merits of using a General Bayesian Network (GBN) with What-If analysis while exploring how it can be utilized in other areas of public health. We analyzed data from the 2017 Korean Youth Health Behavior Survey conducted directly by the Korea Centers for Disease Control & Prevention, including 19 attributes and 11,206 individual data points. Our simulations found that by manipulating the amount of pocket money-between $60 and $80-coupled with a low-income background, it has a high potential to increase obesity compared with other simulated factors. Additionally, when we manipulated an increase in studying time with a mediocre academic performance, it was found to potentially increase pressure on adolescents, which subsequently led to an increased obesity outcome. Lastly, we found that when we manipulated an increase in a father's education level while manipulating a decrease in mother's education level, this had a large effect on the potential adolescent obesity level. Although obesity was the chosen case, this paper acts more as a proof of concept in analyzing public health through GBN and What-If analysis. Therefore, it aims to guide health professionals into potentially expanding their ability to simulate certain outcomes based on predicted changes in certain factors concerning future public health issues.

Using Eye Tracking to Explore Consumers' Visual Behavior According to Their Shopping Motivation in Mobile Environments.

Despite a strong shift to mobile shopping trends, many in-depth questions about mobile shoppers' visual behaviors in mobile shopping environments remain unaddressed. This study aims to answer two challenging research questions (RQs): (a) how much does shopping motivation like goal orientation and recreation influence mobile shoppers' visual behavior toward displays of shopping information on a mobile shopping screen and (b) how much of mobile shoppers' visual behavior influences their purchase intention for the products displayed on a mobile shopping screen? An eye-tracking approach is adopted to answer the RQs empirically. The experimental results showed that goal-oriented shoppers paid closer attention to products' information areas to meet their shopping goals. Their purchase intention was positively influenced by their visual attention to the two areas of interest such as product information and consumer opinions. In contrast, recreational shoppers tended to visually fixate on the promotion area, which positively influences their purchase intention. The results contribute to understanding mobile shoppers' visual behaviors and shopping intentions from the perspective of mindset theory.

Comparative effectiveness of ultrasound and paraffin therapy in patients with carpal tunnel syndrome: a randomized trial.

BACKGROUND: Conclusive evidence indicating an effective treatment for carpal tunnel syndrome (CTS), a common entrapment neuropathy, is lacking. Ultrasound therapy (US therapy) has long been used as one of the combination treatments for CTS. In addition, paraffin bath therapy has been applied widely as a physical modality in treating patients with hand conditions. The purpose of this randomized trial was to compare the efficacy of combining a wrist orthosis with either US therapy or paraffin bath therapy in treating CTS patients. METHODS: Patients with CTS were randomized into two groups. All patients received a wrist orthosis. Twice per week, one group underwent paraffin therapy, and the other group underwent ultrasound therapy. Each patient received a questionnaire, physical examination and nerve conduction study of the upper extremities before and after treatment for eight weeks. RESULTS: Sixty patients were recruited, and 47 completed the study. Statistical analysis revealed significant improvements in symptom severity scores in both groups. After adjusting for age, gender and baseline data, the analysis of covariance revealed a significant difference in the functional status score between two groups. CONCLUSIONS: The combination of ultrasound therapy with a wrist orthosis may be more effective than paraffin therapy with a wrist orthosis. TRIAL REGISTRATION: Clinicaltrial.gov: NCT02278289 Oct 28, 2014.

Ultrasonographic median nerve changes under tendon gliding exercise in patients with carpal tunnel syndrome and healthy controls.

STUDY DESIGN: Case control study. PURPOSE OF THE STUDY: To evaluate the ultrasonographic median nerve changes under tendon gliding exercise in patients with carpal tunnel syndrome (CTS) and healthy controls. METHODS: Seventy-three patients with CTS and 53 healthy volunteers were consecutively recruited. Each subject underwent a physical examination, nerve conduction studies and ultrasonographic examinations of the median nerve during tendon gliding exercises. RESULTS: Significant changes in the cross-sectional area of the median nerve were found while moving from the straight position to the hook position and from the hook position to the fist position. There were also significant changes in the flattening ratio when moving from the hook position to the fist position. CONCLUSIONS: Ultrasonography revealed that the median nerve was compressed in the fist position in both CTS patients and healthy volunteers. Thus, forceful grasping should be avoided during tendon gliding exercises performed in the fist position. LEVEL OF EVIDENCE: 3b.

An empirical analysis of online gamers' perceptions of game items: modified theory of consumption values approach.

The aims of this article are (1) to propose a modified theory of consumption values (MTCV) for investigation of online gamer perceptions of the value of purchasable game items and (2) to apply the developed MTCV to multiple game genres and player age groups. To address these aims, 327 valid questionnaires were obtained and analyzed. The original theory of consumption values (TCV) was modified to apply to the specific characteristics of online games. The original TCV specifies five types of consumption values: functional value, social value, emotional value, conditional value, and epistemic value. After revising the TCV to apply to the examination of online games, we proposed that the MTCV be composed of character competency value, enjoyment value, visual authority value, and monetary value. The validity of the MTCV was proven by statistically analyzing the responses provided by the 327 valid questionnaires. To examine the second aim, experiments were conducted to examine the MTCV in three online game genres-massive multiplayer online role-playing games, first-person shooters games, and casual games. The second aim was also studied via questionnaires that examined the ages of online gamers. It was determined that massive multiplayer online role-playing games players regard visual authority value and monetary value as more important than do casual gamers. It was also determined that younger gamers tend to be more interested in visual authority, whereas older gamers tend to be more interested in character competency. This research provides a foundation for future studies to extend the MTCV to consider other user factors, such as cultural effects.

Enhanced avatar design using cognitive map-based simulation.

With the advent of the Internet era and the maturation of electronic commerce, strategic avatar design has become an important way of keeping up with market changes and customer tastes. In this study, we propose a new approach to an adaptive avatar design that uses cognitive map (CM) as a what-if simulation vehicle. The main virtue of the new design is its ability to change specific avatar design features with objective consideration of the subsequent effects upon other design features, thereby enhancing user satisfaction. Statistical analyses of focus group interview results with a group of experts majoring in avatars and CM showed that our proposed approach could be used to effectively analyze avatar design in an adaptive and practical manner when the market situation is changing.