Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Recently, there is a renewed debate concerning the role of perspective in vision. Morales et al. (2020) present evidence that, in the case of viewing a rotated coin, the visual system is sensitive to what has often been called “perspectival shapes.” It has generated vigorous discussions, including an online symposium by Morales and Cohen, an exchange between Linton (2021) and Morales et al. (2021), and most recently, a fierce critique by Burge and Burge (2022), in which they launch various conceptual (...) and empirical objections. Although Morales and Firestone (2022) have responded to them recently, and we are in agreement with Morales and Firestone in general, there are further problems in Burge and Burge (2022) that are worth highlighting. The main point of this comment is that what the Burge–Burge team call “viewpoint-dependent relational properties” are simply instances of what the Morales–Firestone team call “perspectival shapes”; the confusion arises from Burge and Burge’s misconstrual of Morales et al.’s claims. This shows that conceptually, the two teams are in large agreement, as Morales and Firestone (2022) also point out, and the focus should be put on the empirical disagreements, which has been covered by Morales and Firestone (2022). Relatedly, we argue that Burge and Burge (2022) misinterpret Morales et al. (2020) as supporting a new entity in perception science, and that this misinterpretation is a primary source of their apparent disagreement. This is worth pointing out because such misunderstanding generates many unnecessary quarrels that hinder progress. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

This paper presents an adaptive fuzzy sliding-mode controller for multiple Euler–Lagrange systems communicated with directed topology. Based on the graph theory and Lyapunov–Krasovskii functions, a delay-dependent sufficient condition for the existence of sliding surfaces is given in terms of linear matrix inequalities. The asymptotic stability is analyzed by using the Lyapunov method in the presence of unknown parametric dynamics, actuator faults, and time-varying delays. The usage of adaptive techniques is to adapt the unknown parameters so that the objective of globally (...) asymptotic stability is achieved. Finally, simulation results are provided to illustrate the effectiveness of the proposed control scheme. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

The purpose of this study is to explore the influence of consumers’ choice deferral behavior on their intertemporal choice preference. The empirical study shows that consumers’ choice deferral behavior can significantly affect their intertemporal decision preference through the level of hopefulness. Compared with non-choice deferral behavior, choice deferral behavior can improve the level of consumers’ sense of hopefulness, which then makes them prefer larger-longer interests in intertemporal decision-making. The effect of consumers’ sense of hopefulness on their intertemporal choice preference is (...) moderated by their perceived information integrity. When the perceived information integrity is low, the effect of hopefulness on intertemporal decision preference will be enhanced, but when the perceived information integrity is high, the effect of hopefulness on intertemporal decision preference will not be affected. In addition, the theoretical and practical significance of this study and the prospect of future research are also discussed. (shrink)

本书对方法论研究中的一些基本范畴、结构、功能和原理, 做出了科学的界定和阐发, 并在此基础上建立了方法学的理论体系.

Most complex real systems are found to have multiple layers of connectivity and required to be modelled as multiplex networks. One of the extremely critical problems is to reduce the congestion and enhance the transfer capacity, especially in real communication networks with a big data environment. A novel and effective strategy to improve traffic and control congestion is proposed by adding edges according to their weights which are defined by the topology structural properties. Furthermore, which layer is more effective when (...) our strategy is applied is discussed based on its topology structure. Adding edges between nodes whose product of multiplex network betweenness is the highest is confirmed to be more effective, particularly in the layer with stronger community structure. Simulation experiments on both computer-generated and real-world networks demonstrate that our strategy can enhance the transfer capacity of multiplex networks significantly, which is in good agreement with our analysis. (shrink)

The distinction between the first-person perspective (1PP) and the third-person perspective (3PP) has been widely regarded as fundamental and rigid, and many researchers hold that genuine bodily illusions can only be experienced from the 1PP. We applied VR technology to investigate whether this mainstream view is correct. In our experiments, the participants were immersed in a VR environment in which they saw a life-sized virtual body either from the 1PP or from the 3PP. They either passively received tactile stimulations and/or (...) actively interacted with a virtual soccer ball. Our VR system created novel visuo-motor-tactile correlations between the real and the virtual world: when the participant interacted with a real plastic soccer ball, he/she would feel corresponding tactile sensations and see the avatar performing the exact same movements. We found that a clear sense of ownership over the avatar was induced not only in the 1PP condition but also in the Passive-3PP and the Active-3PP conditions. We also observed evidence suggesting that it is possible to experience one’s body-location, 1PP-location, as well as self-location, both from the 1PP and from the 3PP. Together, we demonstrate that there is in fact no fundamental gap between embodied 1PP and embodied 3PP in the virtual world. (shrink)

BackgroundThe prognosis of hypertensive intracerebral hemorrhage is poor at high altitudes. The objective of this study was to explore whether hyperbaric oxygen can improve the results of computed tomography perfusion imaging and the neurological function of patients with HICH, and influence the hemoglobin concentration.MethodThe patients with HICH were treated with puncture and drainage. Twenty-one patients were treated with HBO after the operation, and the other patients received conventional treatment. CTP was performed twice, and all indices were measured. Scatter plots were (...) used to determine the effect of hemoglobin concentration on CTP imaging. Receiver operating characteristic curves were plotted to analyze the effects of hemoglobin concentration and hematoma volume on recovery results. The patients were followed up for 6 months.ResultsForty-one patients with HICH were treated with puncture and drainage. In total, 21 were treated with HBO after the operation, and 20 received conventional treatment as the control group. No significant differences in the CBV and CBF values of the two groups were noted before treatment. After 10 days, the values of CBV and CBF in the HBO group were significantly higher than those in the control group. A scatter diagram showed there was no significant in the HBO group, but significant correlation for the CBV and CBF values in the control group’s hematoma center and margin. The ROC curves showed that hematoma volume had an influence on prognosis of the control group. The Glasgow Coma Scale scores of the HBO group were significantly higher than those of the control group.ConclusionsHBO therapy can improve the postoperative CBV and CBF values of patients with HICH and ameliorate their prognoses. There was no significant correlation between HBO group and hemoglobin concentration on admission. (shrink)

Using Chinese listed companies as research setting, this paper constructs a measure of corporate competing culture through textual analysis on firms’ management discussion and analysis disclosures, and examines the impact of corporate competing culture on environmental investment. The results show that competing culture has a significant and positive impact on firms’ environmental investment, and the results remain robust to a battery of robustness tests. Moreover, the mediating analysis indicates that competing culture promotes corporate environmental investment through enhancing firms’ internal control (...) quality. Furthermore, the heterogeneity results show that the positive impact of corporate competing culture on environmental investment is more pronounced in firms with larger size, stronger corporate governance, in high-polluting industry, and located in less developed regions. Our findings shed light on the importance of corporate competing culture and provide practical implications for corporate sustainable development. (shrink)

This research examines wearable, fashionable interaction design to mediate the narrative and semiotic concepts found in technology and fashion. We discuss the principles of design anthropology using Taiwan proverbs to transmit the “people-situation-reason-object” method and analyze five case studies that provide new approaches for designers engaged in future industry. Design anthropology attempts to engage physiological and psychological design through technological function, meaning formation, and fashion aesthetics to achieve cognition between people and the environment. The wearable, fashionable interaction displays characteristics of (...) narrative and semantics transmitted through craft culture as well as collective, cheerful, and creative performance. It is a confident and innovative attempt, which bears a joyful and fundamental interface. This study takes two directions, with cultural thinking serving as the basis to establish a set of traditional craft designs and interactive objects that assist designers in using the senses to inform and initiate new lifestyle values. (shrink)

Man [sic.] follows the earth, earth follows the heaven, heaven follows the Tao and the Tao follows nature.– Lao Tzu (Tao Te Ching)Taoism, as an ancient traditional Chinese philosophy, not only prof...

Research in second language pragmatics has paid increasing attention to learners’ individual differences, but few studies have examined the relationship between learners’ willingness to communicate in L2 and their pragmatic competence. To this end, this study investigates the association between WTC and pragmatic awareness and comprehension of Chinese as a second language learners. A total of 80 CSL learners studying abroad in three universities in China participated in this study. Data were collected through a WTC questionnaire, a self-perceived communication competence (...) questionnaire, a pragmatic awareness judgment task, and a multiple-choice test for pragmatic comprehension. Statistical analyses were conducted to explore the relationship between the learners’ pragmatic awareness and pragmatic comprehension on the one hand and their WTC and SPCC in L2 on the other. The findings indicated that SPCC correlated positively with the learners’ L2 pragmatic comprehension, but not with their L2 pragmatic awareness. No correlation was found between WTC and pragmatic awareness and comprehension. The results suggest that SPCC may contribute to learners’ L2 pragmatic comprehension; some implications for teaching and future research directions are also discussed. (shrink)

Cellular reprogramming can manipulate the identity of cells to generate the desired cell types1– 3. The use of cell intrinsic components, including oocyte cytoplasm and transcription factors, can enforce somatic cell reprogramming to pluripotent stem cells4– 7. By contrast, chemical stimulation by exposure to small molecules offers an alternative approach that can manipulate cell fate in a simple and highly controllable manner8– 10. However, human somatic cells are refractory to chemical stimulation owing to their stable epigenome2,11,12 and reduced plasticity13,14; it (...) is therefore challenging to induce human pluripotent stem cells by chemical reprogramming. Here we demonstrate, by creating an intermediate plastic state, the chemical reprogramming of human somatic cells to human chemically induced pluripotent stem cells that exhibit key features of embryonic stem cells. The whole chemical reprogramming trajectory analysis delineated the induction of the intermediate plastic state at the early stage, during which chemical-induced dedifferentiation occurred, and this process was similar to the dedifferentiation process that occurs in axolotl limb regeneration. Moreover, we identified the JNK pathway as a major barrier to chemical reprogramming, the inhibition of which was indispensable for inducing cell plasticity and a regeneration-like program by suppressing pro-inflammatory pathways. Our chemical approach provides a platform for the generation and application of human pluripotent stem cells in biomedicine. This study lays foundations for developing regenerative therapeutic strategies that use well-defined chemicals to change cell fates in humans. (shrink)

This study investigated eye-movement patterns during emotion perception for children with hearing aids and hearing children. Seventy-eight participants aged from 3 to 7 were asked to watch videos with a facial expression followed by an oral statement, and these two cues were either consistent or inconsistent in emotional valence. Results showed that while normal-hearing children paid more attention to the upper part of the face, children with hearing aids paid more attention to the lower face after the oral statement was (...) presented. When there was an inconsistency between the visual and auditory cues, children with hearing aids were likely to increase attention to the upper face. The results revealed the underlying mechanism of deficits in emotion perception for hearing-impaired children. (shrink)

Background: Upper limb functional exercise has a positive effect on promoting the rehabilitation of upper limb function. However, little is known, about what drives postoperative patients to engage in and even maintain the advised exercises. This study integrated the health action process approach and the theory of planned behavior theory to investigate the psychosocial determinants on the initiation and maintenance of ULFE in breast cancer patients. In addition, this study also tests key hypotheses relating to reasoned and implicit pathways to (...) ULFE and its maintenance among postoperative patients with breast cancer.Methods: Purposive sampling was used to recruit patients from two breast cancer wards in a provincial hospital in Jiangsu, China. Patients completed self-reported questionnaire about constructs from integrated theories concerning ULFE at an initial time point : task self-efficacy, positive outcome expectations, negative outcome expectations, risk perception, attitude behavior, subjective norm, perceived behavioral control, behavioral intention, and ULFE-in hospital. Three months later, patients self-reported: maintenance self-efficacy, action planning, coping planning, recovery self-efficacy, and ULFE-maintenance.Results: The model has a good fit. For behavioral intention of ULFE, subjective norm and perceived behavioral control were positively directly related to behavioral intention. Regarding the initiation of ULFE, perceived behavioral control and behavioral intention had a direct positive relation to ULFE-IH. In the maintenance of ULFE, action planning, coping planning, maintenance self-efficacy, and recovery self-efficacy all had significant positive relation on ULFE-M. In addition, maintenance self-efficacy had a significant positive association on action planning, coping planning, and recovery self-efficacy. Coping planning was significantly predicted by behavioral intention. Additionally, behavioral intention is a mediator of subjective norm and perceived behavioral control to ULFE-IH. Action planning, coping planning, and recovery self-efficacy are mediators of maintaining self-efficacy to ULFE-M.Conclusions: This study presents the first attempt to integrate the health behavior model in ULFE in postoperative patients with breast cancer. The study has shown that the HAPA-TPB integrated model has good applicability and effectiveness to explain and predict ULFE initiation and maintenance. Future work can be considered to develop appropriate intervention strategies based on this integrated behavioral theory. (shrink)

Obtaining adequate informed consent from trauma patients is challenging and time-consuming. Healthcare providers must communicate complicated medical information to enable patients to make informed decisions. This study aimed to explore the challenges of obtaining valid consent and methods of improving the quality of the informed consent process for surgical procedures in trauma patients. We conducted a systematic review of relevant English-language full-text original articles retrieved from PubMed that had experimental or observational study design and involved adult trauma patients. Studies involving (...) informed consent in clinical or research trials were excluded. Titles and abstracts of searched articles were reviewed and relevant data were extracted with a structured form. Results were synthesized with a narrative approach. A total of 2044 articles were identified in the initial search. Only eight studies were included in the review for narrative synthesis. Six studies involved orthopedic surgeries, one involved nasal bone surgeries, and one involved trauma-related limb debridement. Only one study was conducted in an emergency department. Information recall was poor for trauma patients. Risk recall and comprehension were greater when written or video information was provided than when information was provided only verbally. Patient satisfaction was also greater when both written and verbal information were provided than when verbal information alone was provided; patients who received video information were more satisfied than patients who received written or verbal information. Many articles have been published on the subject of informed consent, but very few of these have focused on trauma patients. More empirical evidence is needed to support the success of informed consent for trauma patients in the emergency department, especially within the necessarily very limited time frame. To improve the informed consent process for trauma patients, developing a structured and standardized informed consent process may be necessary and achievable; its effectiveness would require evaluation. Adequately educating and training healthcare providers to deliver structured, comprehensive information to trauma patients is crucial. Institutions should give top priority to ensuring patient-centered health care and improved quality of care for trauma patients. (shrink)

Phronesis, or practical wisdom, is a capacity the possession of which enables one to make good practical judgments and thus fulfill the distinctive function of human beings. Nir Eisikovits and Dan Feldman convincingly argue that this capacity may be undermined by statistical machine-learning-based AI. The critic questions: why should we worry that AI undermines phronesis? Why can’t we epistemically defer to AI, especially when it is superintelligent? Eisikovits and Feldman acknowledge such objection but do not consider it seriously. In this (...) paper, we argue that there is a way to reconcile Eisikovits and Feldman with their critic by adopting the principle of epistemic heed, according to which we should exercise our rational capacity as much as possible while heeding a superintelligence’s output whenever possible. (shrink)

Based on the stress interaction theory, this research constructed a model to study the joint moderating effects of the perception reduction of employment opportunities under the COVID-19 epidemic on the employment pressure of college students. With two moderating variables introduced, employment policy support and job-searching self-efficacy, this research studied the mechanism and boundary conditions of perception reduction of employment opportunities on employment pressure of college students from both individual and environmental aspects. The study found that during the epidemic if college (...) students perceived fewer employment opportunities, they could have greater employment pressure from themselves, schools, and families; and that under the joint moderation of employment policy support and job-searching self-efficacy, the perception reduction of employment opportunities under the COVID-19 epidemic, the employment pressure of college students, universities, and families were connected, with different adjustment mechanisms. Based on empirical data, this research can provide theoretical enlightenment and practical guidance for the government, universities, and families to alleviate the employment pressure on college students during the epidemic. (shrink)

The question of what determines brain laterality for auditory cognitive processing is unresolved. Here, we demonstrate a swap of hemisphere dominance from right to left during semantic interpretation of Chinese lexical tones in native speakers using simultaneously recorded mismatch negativity response and behavioral reaction time during dichotic listening judgment. The mismatch negativity, which is a brain wave response and indexes auditory processing at an early stage, indicated right hemisphere dominance. In contrast, the behavioral reaction time, which reflects auditory processing at (...) a later stage, indicated a right ear listening advantage, or left hemisphere dominance. The observed swap of hemisphere dominance would not occur when the lexical tone was substituted with a meaningless pure tone. This swap reveals dependence of hemisphere labor division initially on acoustic and then on functional cues of auditory inputs in the processing from sound to meaning. (shrink)

Construction schedules play an important role in construction project management. However, during construction activities, risks may arise due to unexpected schedule changes, resulting in the ineffective delivery of projects. This study aims to reveal the law of schedule change risk propagation and to analyze the effects on the risk propagation through numerical simulations. First, construction projects are represented by activity-on-node networks. A model of risk propagation is then built based on a susceptible-infected model considering the effects of the nodal characteristics (...) on the propagation process. Next, the model is tested on a real-world project to examine cascading failures with varying parameters. The experimental results demonstrate that the model is effective in identifying the activities most capable of affecting a project schedule and evaluating the impact of schedule change risk propagation. This study will provide a basis for enhancing the robustness of AON networks and controlling the propagation of schedule change risks. (shrink)

Plato’s nephew Speusippus has been widely accepted as the historical person behind the mask of the anti-hedonists in Phlb. 42b–44c. This hypothesis is supported by, inter alia, the link between Socrates’ char- acterization of them as δυσχερεῖς and the frequent references of δυσχέρεια as ἀπορία to Speusippus in Aristotle’s Metaphysics MN. This study argues against assigning any privileged status to Speusippus in the assimilation of δυσχέρεια with ἀπορία. Instead, based on a comprehensive survey of how δυσχερ- words were used in (...) classical antiquity, the semantic shift of δυσχέρεια can be explained in an alternative way. (shrink)

This paper aims to clarify Plato’s notions of the natural and the neutral state in relation to hedonic properties. Contra two extreme trends among scholars—people either conflate one state with the other, or keep them apart as to establish an unsurmount- able gap between both states, I argue that neither view accurately reflects Plato’s position because the natural state is real and can coincide with the neutral state in part, whereas the latter, as an umbrella term, can also be realized (...) in a non-natural condition. The clarification of the relation between the two states will shed light on the degree to which Plato admits and constrains the hedonic value for a good human life; further, this will call attention to some (not well explored) parallel thoughts in the medical tradition to which Plato is indebted. (shrink)

Mismatch negativity of event-related potentials is a biomarker reflecting the preattentional change detection under non-attentional conditions. This study was performed to explore whether high self-related information could elicit MMN in the visual channel, indicating the automatic processing of self-related information at the preattentional stage. Thirty-five participants were recruited and asked to list 25 city names including the birthplace. According to the difference of relevance reported from the participants, we divided names of the different cities into high, medium, and low self-related (...) information. Visual MMN was elicited by high self-related information but not by medium self-related information, with an occipital–temporal scalp distribution, indicating that, under non-attentional condition, high self-related information can be effectively processed automatically in the preattentional stage compared with low self-related information. These data provided new electrophysiological evidence for self-related information processing. (shrink)

本书以欧洲的社会政治、经济历史为背景,以技术史为基础,以欧洲哲学史的历史脉络为主线,研究从古希腊到19世纪中叶哲学的技术思想,揭示出技术哲学由萌芽到产生的历史过程。.

Entrepreneurship is the main engine of economic development. This paper aims to explore the impact of high executives’ entrepreneurial spirituality on the business performance in China under the background of “mass entrepreneurship and innovation.” By analyzing the relevant literature of entrepreneurship, the connotation and elements of ES are determined. According to the relevant research, we design the questionnaire of ES and business performance. The questionnaire was distributed to 100 private enterprise entrepreneurs by equidistant sampling, and 74 valid questionnaires were recovered. (...) According to the questionnaire, responsibility has the highest score, followed by innovation, proactiveness, and risk-taking. The ES of women is slightly higher than that of men. The entrepreneurs with higher education also have higher score in ES. After analyzing the impact of different elements of ES on enterprise performance using structural equation modeling and regression equation model, it is found that: ES has a positive impact on enterprise performance. Different factors of ES have different effects on business performance, and innovation and proactiveness play the greatest role. There is an inverted U-shaped relationship between innovation, risk-taking, and business performance. (shrink)