Delineation of the subthalamic nuclei on MRI is critical for deep brain stimulation surgery in patients with Parkinson’s disease. We propose this retrospective cohort study for quantitative analysis of MR signal-to-noise ratio, contrast, and signal difference-to-noise ratio of the STN on pre-operative three-dimensional stereotactic MRI in patients with medication-refractory PD. Forty-five consecutive patients with medication-refractory PD who underwent STN-DBS surgery in our hospital from January 2018 to June 2021 were included in this study. All patients had whole-brain 3D MRI, including (...) T2-weighted imaging, T2-weighted fluid-attenuated inversion recovery, and susceptibility-weighted imaging, at 3.0 T scanner for stereotactic navigation. The signal intensities of the STN, corona radiata, and background noise were obtained after placing regions of interest on corresponding structures. Quantitative comparisons of SNR, contrast, and SDNR of the STN between MR pulse sequences, including the T2WI, FLAIR, and SWI. Subgroup analysis regarding patients’ sex, age, and duration of treatment. We used one-way repeated measures analysis of variance for quantitative comparisons of SNR, contrast, and SDNR of the STN between different MR pulse sequences, and we also used the dependent t-test for the post hoc tests. In addition, we used Mann–Whitney U test for subgroup analyses. Both the contrast and SDNR were highest on FLAIR. The SNR was highest on SWI, and both the SNR and SDNR were lowest on T2WI. Subgroup analyses demonstrated significantly lower SDNR on SWI for patients receiving medication treatment for ≥13 years. In conclusion, on 3D stereotactic MRI of medication-refractory PD patients, the contrast and SDNR for the STN are highest on FLAIR, suggesting the optimal delineation of STN on FLAIR. (shrink)

Background Individual physicians and physician-associated factors may influence patients’/surrogates’ autonomous decision-making, thus influencing the practice of do-not-resuscitate orders. The objective of this study was to examine the influence of individual attending physicians on signing a DNR order. Methods This study was conducted in closed model, surgical intensive care units in a university-affiliated teaching hospital located in Northern Taiwan. The medical records of patients, admitted to the surgical intensive care units for the first time between June 1, 2011 and December 31, (...) 2013 were reviewed and data collected. We used Kaplan–Meier survival curves with log-rank test and multivariate Cox proportional hazards models to compare the time from surgical intensive care unit admission to do-not-resuscitate orders written for patients for each individual physician. The outcome variable was the time from surgical ICU admission to signing a DNR order. Results We found that each individual attending physician’s likelihood of signing do-not-resuscitate orders for their patients was significantly different from each other. Some attending physicians were more likely to write do-not-resuscitate orders for their patients, and other attending physicians were less likely to do so. Conclusion Our study reported that individual attending physicians had influence on patients’/surrogates’ do-not-resuscitate decision-making. Future studies may be focused on examining the reasons associated with the difference of each individual physician in the likelihood of signing a do-not-resuscitate order. (shrink)

In the real-world complex product design process, task allocating is an ongoing reactive process where the presence of unexpected design change is usually inevitable. Therefore, reallocating is necessary to respond to design change positively as a procedure to repair the affected task plan. General reallocating literature addressed the reallocating versions with fixed executing time. In this paper, a multi-objective reallocation model is developed with a feasible assumption that the task executing time is controllable. To illustrate this idea, a compressing executing (...) time strategy is proposed in CPD process, where the executing time can be controlled with a non-linear compression cost. When design change occurs during the executing, task-resource reallocating is required to absorb the interference effects. Reallocating implies an increase in design cost and system instability; the proposed method CETS can address this issue effectively. CETS considers three objectives: completing time, stability, and change-adaptation cost. An adaptive multi-objective hybrid genetic algorithm and tabu search is developed to solve this mathematical method. The computational results of specific simulation examples verify the superiority. It shows that CETS is sensitive to design change, and the proposed algorithm AMOGATS can be effective to achieve the allocating by coordinating the objective consistency. (shrink)

Transcranial direct current stimulation has been widely utilized in research settings and modulates brain activity. The application of anodal tDCS on the prefrontal cortex has indicated improvement in cognitive functioning. The cingulate cortex, situated in the medial aspect of the prefrontal cortex, has been identified as a core region performing cognitive functions. Most of the previous studies investigating the impact of stimulation on the prefrontal cortex stimulated the dorsolateral prefrontal cortex, however, the impact of stimulation on cingulate has not been (...) explored. The current study investigates the effect of stimulation on the resting-state functional connectivity of the anterior cingulate cortex with other regions of the brain and changes in behavioral results in a color-word Stroop task, which has repeatedly elicited activation in different regions of the cingulate. Twenty subjects were randomly assigned to the experimental and sham group, and their medial prefrontal area was stimulated using MRI compatible tDCS. Resting-state functional magnetic resonance imaging and cognitive Stroop task were monitored before, during, and after the stimulation. Neuroimaging results indicated a significant decrease in resting-state functional connectivity in the experimental group during and after stimulation as compared to before stimulation in two clusters including right insular cortex, right central operculum cortex, right frontal operculum cortex and right planum polare with the left anterior cingulate cortex selected as the seed. The behavioral results indicated a significant decrease in reaction time following stimulation in the experimental group compared to the sham group. Moreover, the change in functional connectivity in subcortical regions with L-ACC as the seed and change in RT was positively correlated. The results demonstrated that ACC has a close functional relationship with the subcortical regions, and stimulation of ACC can modulate these connections, which subsequently improves behavioral performance, thus, providing another potential target of stimulation for cognitive enhancement.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04318522. (shrink)

With the worldwide spread of the Internet, human activity has become permeated by digital media, which shapes communication and interaction and speeds up the improvement of the experience and diffusion of museum exhibitions. Contemporary museums must understand their audiences, especially with respect to online preferences and surfing involvement experiences. Museums are changing in an effort to attract young netizens to access and use museum resources. Virtual museums are increasingly using digital exhibitions to preserve and apply their collections and establishing online (...) community platforms to interact with young people. This study investigates the underlying mechanism of online community characteristics that enhance audiences’ emotional resonance and involvement. Results from a questionnaire survey of Taiwan undergraduate students show that perceived relevance and esteem improve their emotional resonance, which can attract new people and maintain existing relationships within their communities. Following flow theory, maintaining community relationship characteristics increases emotional resonance, which, in turn, enhances user involvement, but we found only small significant effects of emotional resonance on involvement. These findings illuminate the mechanism of the attitudinal relationship building and maintenance for online museum communities and advance the practical contributions of online museum community use and effects. (shrink)

Based on the expanded theory of planned behavior, this study first explores the configuration relationship between founder management and innovation by using the fuzzy-set qualitative comparative analysis. Based on the theory of planned behavior, this study divides the behavior intention of founders into three categories: Attitude, subjective norm, and perceived behavior control. Using fsQCA, we found that there are two ways to achieve high innovation input of enterprises. In combination with the two ways, the factors such as male and highly (...) educated founder, and large firm size can effectively increase the innovation input of firms, which is consistent with the three aspects of the behavioral intention of the theory of planned behavior, and it proves that the theory of planned behavior can effectively explain the configuration relation between the founder and firm innovation. In addition, this study finds that the innovation output is different from the innovation input, is dependent on the innovation ability of the firm itself, and is less influenced by the external environment. (shrink)

This study examines the effects of leader emotional intelligence, leadership styles, organizational commitment, and trust on job performance. A questionnaire was administered to the participants, who were real estate brokers in Kaohsiung City. Of the 980 questionnaires administered, 348 valid responses were received, indicating an effective response rate of 35.5%. Structural equation modeling was used for the analysis. The results show that leader emotional intelligence has a significant and positive effect on trust in supervisors, and transformational leadership and trust within (...) a team have significant and positive effects on job performance. In addition, organizational commitment has a significant and positive effect on job performance. Trust within a team mediates the significant and positive effect of leader emotional intelligence on job performance. Although transactional leadership has no direct, positive, and significant effects on employee job performance, trust in the workplace shaped by a leader’s leadership style will empower a team’s spirit and boost their morale, thereby indirectly affecting their job performance in a positive manner. (shrink)

This paper considers the debate between economists and philosophers about the role of values in economic analysis by examining the recent debate between Hilary Putnam and Sir Partha Dasgupta. It argues that although there has been a failure to communicate there is much more agreement than it seems. If Dasgupta's work is seen as part of the methodological tradition expounded by John Stuart Mill and John Neville Keynes, economists and philosophers will have a better basis for understanding each other. Unlike (...) the logical-positivist tradition, which treats facts and values as two mutually exclusive concepts, the Mill- Keynes tradition recognizes that facts and values are intertwined. Unlike the Smithian tradition, which blends the study of facts and normative rules, it divides economics into a science that studies "what is" and an art which considers "what ought to be done". (shrink)

This study explored calibrating a large item bank for use in multidimensional health measurement with computerized adaptive testing, using both item responses and response time (RT) information. The Activity Measure for Post-Acute Care is a patient-reported outcomes measure comprised of three correlated scales (Applied Cognition, Daily Activities, and Mobility). All items from each scale are Likert type, so that a respondent chooses a response from an ordered set of four response options. The most appropriate item response theory model for analyzing (...) and scoring these items is the multidimensional graded response model (MGRM). During the field testing of the items, an interviewer read each item to a patient and recorded, on a tablet computer, the patient’s responses and the software recorded RTs. Due to the large item bank with over 300 items, data collection was conducted in four batches with a common set of anchor items to link the scale. Van der Linden’s (2007) hierarchical modeling framework was adopted. Several models, with or without interviewer as a covariate and with or without interaction between interviewer and items, were compared for each batch of data. It was found that the model with the interaction between interviewer and item, when the interaction effect was constrained to be proportional, fit the data best. Therefore, the final hierarchical model with lognormal model for RT and the MGRM for response data was fitted to all batches of data via a concurrent calibration. Evaluation of parameter estimates revealed that (1) adding response time information did not affect the item parameter estimates and their standard errors significantly; (2) adding response time information helped reduce the standard error of patients’ multidimensional latent trait estimates, but adding interviewer as a covariate did not result in further improvement. Implications of the findings for follow up adaptive test delivery design are discussed. (shrink)

This study applies the concept of reported speech advanced by the renowned Russian literary scholar Mikhail Bakhtin to compare the argumentative styles of Mainland China and Taiwan. These societies in question are considered by many scholars as sharing the same argumentative style. The study reports that the Mainland debaters more frequently than the Taiwanese debaters maintained the authenticity of the quotations cited from ancient Confucian sources, whereas Taiwanese debaters paraphrased more frequently. On the other hand, this difference cannot be found (...) when debaters quoted from sources other than Ancient Confucians. The findings, according to Bakhtin, imply a contrast of monologic and dialogic tendencies toward authority, which results in a style difference between Mainland and Taiwan argumentation. (shrink)

Pain has not only sensory, but also emotional and cognitive, components. Some studies have explored the effect of pain on time perception, but the results remain controversial. Whether individual pain-related emotional and cognitive factors play roles in this process should also be explored. In this study, we investigated the effect of electrical stimulation–induced pain on interval timing using a temporal bisection task. During each task session, subjects received one of five types of stimulation randomly: no stimulus and 100 and 300 (...) ms of non-painful and painful stimulation. Pain-related emotional and cognitive factors were measured using a series of questionnaires. The proportion of “long” judgments of a 1,200-ms visual stimulus duration was significantly smaller with 300 ms painful stimulation than with no stimulus and 100 ms and 300 ms non-painful stimulation. The point of subjective equality did not differ among sessions, but the average Weber fraction was higher for painful sessions than for no-stimulus session. The pain fear score correlated positively with the PSE under 100 ms non-painful and painful and 300 ms painful stimulation. Pain catastrophizing and pain anxiety scores correlated significantly with the WF under no stimulus and 100 ms non-painful stimulation, respectively. These results suggest that electrical stimulation–induced pain affects temporal sensitivity, and that pain-related emotional and cognitive factors are associated with the processing of time perception. (shrink)

With the continuous progress and penetration of automated data collection technology, enterprises and organizations are facing the problem of information overload. The demand for expertise in data mining and analysis is increasing. Self-efficacy is a pivotal construct that is significantly related to willingness and ability to perform a particular task. Thus, the objective of this study is to develop an instrument for assessing self-efficacy in data mining and analysis. An initial measurement list was developed based on the skills and abilities (...) about executing data mining and analysis, and expert recommendations. A useful sample of 103 university students completed the online survey questionnaire. A 19-item four-factor model was extracted by exploratory factor analysis. Using the partial least squares-structural equation modeling technique, the model was cross-examined. The instrument showed satisfactory reliability and validity. The proposed instrument will be of value to researchers and practitioners in evaluating an individual’s abilities and readiness in executing data mining and analysis. (shrink)

The study analyzes the influential factors of consumers’ willingness to purchase gray-market smartphones by considering the model of novelty seeking, status consumption, integrity, and perceived risk. Attitude toward counterfeit is used as mediation in the model. The causalities in the model of problematic willingness of consumer to purchase gray-market smartphones are hypothesized. A total sample of 350 respondents with 238 effective samples is collected by interviewing with questionnaires at the service counters of telecommunications operators. Structure equation modeling (SEM) is adopted (...) in the analysis. Consumers’ attitude toward counterfeit goods is found to be positively related to the willingness of consumers to purchase gray-market smartphones, but perceived risk is negatively related to consumers’ willingness to purchase. As for personality constructs, integrity and status consumption are found to be negatively related to consumers’ attitude toward counterfeit goods, but novelty seeking is positively related to the attitude. Further, managerial implications for branded smartphone manufacturers and telecommunications regulators are provided by the research. (shrink)

Exploring the amplitude modulation phenomenon of chaotic signal has become a subject of great concern in recent years. This paper mainly concentrates on the preliminary study on amplitude modulation principle of a chaotic system. First, two 3D chaotic systems with quadratic product terms are introduced for studying the amplitude modulation phenomenon of chaotic signal. It is found that the signal amplitude of the first system can be controlled by partial quadratic coefficient. But for the second system, none of nonlinear coefficient (...) can be employed to control the signal amplitude. Then, the amplitude modulation principle of chaotic system is preliminarily studied by exploring the intrinsic relationship between nonzero equilibrium point and phase space trajectory, and it is further validated by introducing unified parameter to the two 3D chaotic systems. As a necessary condition, the principle provides a feasible and simple method for constructing and analyzing an amplitude modulation chaotic system. (shrink)

Although the prevalence of facial recognition-based COVID-19 surveillance tools and techniques, China does not have a facial recognition law to protect its residents’ facial data. Oftentimes, neither the public nor the government knows where people’s facial images are stored, how they have been used, who might use or misuse them, and to what extent. This reality is alarming, particularly factoring in the wide range of unintended consequences already caused by good-intentioned measures and mandates amid the pandemic. Biometric data are matters (...) of personal rights and national security. In light of worrisome technologies such as deep-fake pornography, the protection of biometric data is also central to the protection of the dignity of the citizens and the government, if not the industry as well. This paper discusses the urgent need for the Chinese government to establish rigorous and timely facial recognition laws to protect the public’s privacy, security, and dignity amid COVID-19 and beyond. (shrink)

Mathematics is an important foundation for the development of science education. In the past, when instructors taught mathematical concepts of geometry shapes, they usually used traditional textbooks and aids to conduct teaching activities, which resulted in students not being able to understand the principles completely. Nowadays, it has become a trend to integrate emerging technologies into mathematics courses and to use digital instructional aids. Emerging technologies can effectively enhance students’ sensory experience while strengthening their impressions and understandings of subject concepts. (...) In this paper, we apply virtual reality immersive technologies to develop a “virtual reality immersive learning mathematics geometry system,” which is used to teach mathematical geometry concepts. Teachers use the system to develop three basic mathematical geometry learning materials: “Triangular pyramid volume = 1/3 prism volume,” “Cone volume calculation,” and “Triangle center of gravity derivation.” In the experimental activity, the teacher uses virtual reality teaching aids to guide students to learn mathematical geometry concepts in a fun way so that they can achieve the effectiveness of immersive learning. This study explores the impact of using the virtual reality immersive learning mathematics geometry system on students’ technology acceptance, learning motivations, and learning performance. The experimental result showed that using the virtual reality immersive learning mathematics geometry system can improve the learning motivation and learning performance of students. The findings indicated that the experimental group had better learning outcomes after completing the learning tasks of three geometric units. The experimental group used the virtual reality immersive learning mathematics geometry system which can lead to better learning outcomes. According to the ARCS questionnaire, students in the experimental group were confident to understand new subjects. At the same time, the mode of completing the game can effectively give students a sense of accomplishment. The use of emerging technologies in the classroom can be an attractive learning mode for students. (shrink)