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Objective: The purpose of this study was to determine the efficacy of a 3D-printed aneurysm simulation model (3DPM) in educating patients and improving physicians’ comprehension and performance.Methods: This prospective study involved 40 patients who were diagnosed with unruptured intracranial aneurysms (UIAs) and scheduled for surgical clipping or endovascular coiling and randomly divided into two groups (the 3DPM group and the non-3DPM group). The 3DPM was used in preoperative consultation with patients and intraoperatively referenced by surgeons. The patients, 7 neurosurgical residents, and 10 surgeons completed questionnaires (5-point Likert scale) to determine the usefulness of the 3DPM.Results: Patients in the 3DPM group had significantly higher scores in terms of their understanding of the disease (mean 4.85 vs. 3.95, p

This study aimed to develop accurate and explainable machine learning models for three psychomotor behaviors of delirium for hospitalized adult patients. A prospective pilot study was conducted with 33 participants admitted to a long-term care facility between August 10 and 25, 2020. During the pilot study, we collected 560 cases that included 33 clinical variables and the survey items from the short confusion assessment method (S-CAM), and developed a mobile-based application. Multiple machine learning algorithms, including four rule-mining algorithms (C4.5, CBA, MCAR, and LEM2) and four other statistical learning algorithms (LR, ANNs, SVMs with three kernel functions, and random forest), were validated by paired Wilcoxon signed-rank tests on both macro-averaged F1 and weighted average F1-measures during the 10-times stratified 2-fold cross-validation. The LEM2 algorithm achieved the best prediction performance (macro-averaged F1-measure of 49.35%; weighted average F1-measure of 96.55%), correctly identifying adult patients at delirium risk. In the pairwise comparison between predictive powers observed from independent models, the LEM2 model showed a medium or large effect size between 0.4925 and 0.8766 when compared with LR, ANN, SVM with RBF, and MCAR models. We have confirmed that acute consciousness in S-CAM assessment is closely associated with different predictors for screening three psychomotor behaviors of delirium: 1) education level, dementia type or its level, sleep disorder, dehydration, and infection in mixed-type delirium; 2) gender, education level, dementia type, dehydration, bedsores, and foley catheter in hyperactive delirium; and 3) pain, sleep disorder, and haloperidol use in hypoactive delirium.

Objective The pathology of post-traumatic stress disorder (PTSD) is associated with changes in brain structure and function, especially in the amygdala, medial prefrontal cortex, hippocampus, and insula. Survivors of tragic accidents often experience psychological stress and develop post-traumatic stress symptoms (PTSS), regardless of the diagnosis of PTSD. This study aimed to evaluate electroencephalographic changes according to PTSS in victims of a single traumatic event. Methods This study enrolled 60 survivors of the Sewol ferry disaster that occurred in 2014 from Danwon High School and collected electroencephalographic data through 19 channels twice for each person in 2014 and 2015 (mean 451.88 [standard deviation 25.77] days of follow-up). PTSS was assessed using the PTSD Checklist-Civilian Version (PCL-C) and the participants were divided into two groups according to the differences in PCL-C scores between 2014 and 2015. Electroencephalographic data were converted to three-dimensional data to perform low-resolution electrical tomographic analysis. Results Significant electroencephalographic changes over time were observed. The group of participants with worsened PCL-C score showed an increased change of delta slow waves in Brodmann areas 13 and 44, with the largest difference in the insula region, compared to those with improved PCL-C scores. Conclusion Our findings suggests that the electrophysiological changes in the insula are associated with PTSS changes.

This paper presents a review of Tactile Sensing Systems, with an emphasis on their application to the non-invasive characterization of tumors. Emulating the perceptual mechanism of the human skin, the Tactile Sensing Systems characterize tumors using touch sensors by quantifying the mechanical properties such as size and elasticity. The authors survey several tactile transduction methods: capacitive, piezoresistive, piezoelectric, magnetic, and optical. The advantages and disadvantages of different tactile sensors are discussed. The complex human sense of touch is emulated using tactile sensor data, novel data processing algorithms, and near real-time interpretation in a human-readable format. Tactile Sensing Systems utilize tactile sensors and other subsystems to come up with accurate mechanical properties of the touched objects. We review Elasticity Determination Systems, which are a special case of Tactile Sensing Systems. These systems are based on capacitive sensors, piezoelectric sensors, elastography, and optical tactile sensors. Then the optical Tactile Sensing System is discussed in detail; architecture, sensing principle, and algorithms to compute a risk score. Moreover, a survey of multimodal Tactile Sensing Systems, which broaden the capabilities of existing tactile sensing systems, is presented. The paper concludes with discussions and future research directions.

Purpose Adolescent depression can have a chronic course; hence, the importance of adherence to antidepressant medication for successful treatment outcomes is emphasized. This study aimed to examine different adherence measures and identify clinical factors that influence adherence in adolescent depression. Patients and Methods A prospective study was conducted for patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition from outpatient psychiatric settings at Korea University Medical Center, Guro Hospital. Patient demographics were obtained from a questionnaire, interview, and review of chart records. Adherence was assessed by four methods (Medication Event Monitoring System [MEMS], pill count, clinical rating scale, and patient's self-report). The Toronto Side Effect Scale was used to evaluate side effects, and specific depressive symptoms were assessed using the Hamilton Rating Scale for Depression and Childhood Depression Inventory-Korean version. The Multidimensional Scale of Perceived Social Support was administered to analyze social support, and the Parenting Stress Index-Short Form was used to evaluate parental stress levels. We used concordance correlation analysis to evaluate the relationship among the four adherence measures and the relationship between adherence level and clinical factors. Results Overall, the study enrolled 48 outpatients (mean age 16.33±1.93 years). The mean duration of illness was 1.27±2.17 years. Adherence rates for MEMS, clinician rating scale, pill count, and self-report after conversion to dichotomous measures were 67.5%, 48.9%, 60.0%, and 56.3%, respectively. Only the duration of illness remained significantly correlated with MEMS (r = 0.510, p =0.001). Conclusion Pill count exhibited a higher degree of agreement with MEMS adherence than the other two adherence measures, possibly indicating that pill count may be a considerably reliable measure of adherence. Furthermore, MEMS adherence was positively correlated with disease duration, suggesting that the longer the duration of illness, the higher the adherence.

Purpose Previous studies have reported conflicting results on the influence of seasons on post-cataract surgery endophthalmitis incidences. This study aimed to investigate the seasonality associated with the incidence of postoperative endophthalmitis, and to evaluate its association with climate variables in South Korea. Setting South Korea. Design Retrospective cohort study. Methods The postoperative endophthalmitis incidences were identified using the Health Insurance Review and Assessment Service claim data from July 2014 to June 2017. The monthly climate data were obtained from the Korea Meteorological Administration. The incidences of endophthalmitis were analyzed by the month of the year, and by the season. The association between postoperative endophthalmitis and the climatic variables, including mean temperature, relative humidity, precipitation, and hours of sunshine, was investigated. Results The incidences were the highest in July, and they were the most prevalent during the summer months, although fewer cataract surgeries were performed in the summer months than during the rest of the year. The postoperative endophthalmitis incidences tended to increase with increasing relative humidity and increasing precipitation. Conclusions The incidences of post-cataract surgery endophthalmitis peaked during the hot and humid months. Understanding the seasonal and climatic influences on postoperative infection might help in risk stratification and outcome improvisation after the cataract surgery is performed.

A Thomson scattering diagnostic system was developed and successfully measured electron temperature and density of core plasma (R = 0.35 m) in Versatile Experiment Spherical Torus (VEST). However, the current system is able to measure only a single time point in a shot. Therefore, upgrade of the Thomson scattering system has been prepared and is in progress to obtain the time evolution. The upgrade is focused on three parts. First, the laser injection system is improved by introducing a burst mode laser with the energy of 2 J and repetition rate of 1 kHz for 10 ms. Furthermore, the laser injection optics is improved to minimize the optical loss. Second, minimum etendue limit of the collection optics is increased by employing a fiber bundle of three single-core fibers. Finally, a data acquisition system is prepared to record the burst laser signals for high sampling rate. Oscilloscope envelope mode is adopted and tested for measuring ten burst laser signal with 1.25 GS/s. Through the upgrade, the time evolution of electron temperature and density is expected to be measured in a single shot with enhanced signal-to-noise ratio.

Photobiomodulation therapy (PBMT) effects an important role in neural regeneration and function enhancement, such as expression of nerve growth factor and nerve regeneration, in neuronal tissues, and inhibition of cell death by amyloid beta in neurons is inhibited by PBMT. However, there no studies evaluated the effects of PBMT on oxidative stress in the hippocampus. The aim of this study is to evaluate the effects of PBMT on oxidative stress in the hippocampus. This study assessed the anti-oxidative effect, the expression of BDNF and antioxidant enzymes, as well as the activation of cAMP response element binding (CREB) and extracellular signal-regulated kinase (ERK) signal transduction pathways assess using a hippocampal cell line (HT-22) and mouse organotypic hippocampal tissues by PBMT (LED, 660 nm, 20 mW/cm2). PBMT inhibited HT-22 cell death by oxidative stress and increased BDNF expression via ERK and CREB signaling pathway activation. In addition, PBMT increased BDNF expression in hippocampal organotypic slices and the levels of phosphorylated ERK and CREB, which were reduced by oxidative stress, as well as the expression of the antioxidant enzyme superoxide dismutase. These data demonstrate that PBMT inhibits hippocampal damage induced by oxidative stress and increases the expression of BDNF, which can be used as an alternative to treat a variety of related disorders that lead to nerve damage. Activation and redox homeostasis in neuronal cells may be a notable mechanism of the 660-nm PBMT-mediated photobioreactivity.

A Thomson scattering (TS) system has been developed on Versatile Experiment Spherical Torus (VEST) to measure the electron temperature and the density. In VEST, it is quite challenging to measure TS signals because the energy of the utilized pulsed laser and the target electron density are low, 0.85 J and ∼5 × 1018 m−3, respectively. Furthermore, the difficulties caused by filter specifications have to be resolved because of the use of commercial interference filters with broad bandwidth and poor blocking at the laser wavelength. Therefore, we especially optimize the placement order of the filter sets based on the evaluation of the relative errors to overcome the poor spectral resolution. In addition, the amount of the stray light that penetrating filters is reduced by vacuum components such as baffles, louvres, and a viewing dump. With the careful installation and the optimization of the system, we can develop an efficient Thomson scattering system. Recently, TS signals have been successfully measured from the ohmic plasmas, and the electron temperature and the density are determined by analyzing the signals with the Bayesian method.

Objective To evaluate the association between balance function and asymmetry of knee extension strength in an elderly Korean population. Methods The strength of the knee extensors in each leg was measured in 306 community-dwelling elderly subjects (age, 76.70±4.85 years) and 25 young healthy subjects (age, 34.23±8.93 years). Based on the difference in strength of both legs, the elderly subjects were divided into symmetric (n=128) and asymmetric (n=178) strength groups using an asymmetry cutoff 20%. We determined the postural control ability of the subjects using InBody posturography, Berg Balance Scale (BBS), Timed Up and Go test (TUG) and Short Physical Performance Battery (SPPB). The sway index (SI) of the subjects in four positions was assessed using posturography. Results The group with asymmetric strength presented a significantly higher SI than the group with symmetric strength, in the normal position with eyes open and eyes open on pillows. In the normal position with the eyes closed and in postures with the eyes closed on pillows, the statistical analysis revealed no significant differences between the two groups. The three tests for physical performance (BBS, TUG, and SPPB) show no statistically significant difference between the two groups. Conclusion The asymmetric strength group showed a significantly lower balance than the group with symmetric strength based on several posturographic parameters. Ambulatory elderly individuals with asymmetry in knee extension strength, showed deficits in balance control even in normal clinical tests.

This study explores the various effects of technology trade on the sustainable market value of firms in 36 OECD member countries using panel data estimations. To proxy technology trade activities, our study uses the technology export and import growths of intellectual property rights (IPRs). We suggest that technology imports, proxied by IPR imports, increase the market value of firms in our sample countries. The net technology imports (exports) are also positively (negatively) associated with the sustainable value of the firms. We use panel data regression to analyze the specific effects of the trade (i.e., imports and exports) of technology assets, proxied by IPRs, on the market value of firms proxied by country benchmark composite stock returns in 36 OECD member countries. For robustness, our study uses an instrumental variable estimation to check for the possible effects of endogeneity biases for the baseline results. System dynamic panel regressions further examine the effect of the dependent variable’s persistence. We find evidence of nonlinear effects for IPR exports and net IPR trade on the sustainable market value of firms. The positive effect of technology imports on the market value of firms is stronger at the lower and middle levels of the distribution of the firm value of stock returns, and this suggest heterogenous effects of technology trade across the quantiles. Overall, the empirical findings from our panel study suggest that the positive effects of technology trade for the market value of firms are due to the effect of its imports rather than exports.

Objective To investigate the differences in biomechanical parameters measured by gait analysis systems between healthy subjects and subjects with plantar fasciitis (PF), and to compare biomechanical parameters between 'normal, barefooted' gait and arch building gait in the participants. Methods The researchers evaluated 15 subjects (30 feet) with bilateral foot pain and 15 subjects (15 feet) with unilateral foot pain who had a clinical diagnosis of PF. Additionally, 17 subjects (34 feet) who had no heel pain were recruited. Subjects were excluded if they had a traumatic event, prior surgery or fractures of the lower limbs, a leg length discrepancy of 1 cm or greater, a body mass index greater than 35 kg/m2, or had musculoskeletal disorders. The participants were asked to walk with an arch building gait on a treadmill at 2.3 km/hr for 5 minutes. Various gait parameters were measured. Results With the arch building gait, the PF group proved that gait line length and single support line were significantly decreased, and lateral symmetry of the PF group was increased compared to that of the control group. The subjects with bilateral PF displayed significantly increased maximum pressure over the heel and the forefoot during arch building gait. In addition, the subjects with unilateral PF showed significantly increased maximum pressure over the forefoot with arch building gait. Conclusion The researchers show that various biomechanical differences exist between healthy subjects and those with PF. Employing an arch building gait in patients with PF could be helpful in changing gait patterns to normal biomechanics.

Major depressive disorder is a major mental disorder affecting adolescents. Cortical thickness provides a sensitive measure of age-associated changes. Previous studies using cortical thickness analysis reported inconsistent results on brain structural changes in adolescent major depressive disorder. The neuroanatomical substrates of major depressive disorder in adolescents are not fully understood. We aimed to compare the anatomical structures of the brain in first-onset drug-naive adolescents with major depressive disorder to normal controls. Twenty-seven first-episode drug-naive adolescents with major depressive disorder and an equal number of age-matched control subjects were scanned on a 3T MRI scanner. Comparisons between those two groups were performed using surface-based morphometry analysis for cortical thickness and volumetric analysis of subcortical gray matter. The correlations between morphometric indexes and clinical measures (Hamilton depression rating scale score or children's depression inventory score) were also calculated. We found that the cortical area is thinner in major depressive disorder patients than in controls, specifically in the left occipital area (precuneus and cuneus, cluster-level family-wise corrected P < 0.05). The hippocampus volume was also smaller in major depressive disorder patients than in the control group. No significant correlations were found between morphometric indexes (average cortical thickness extracted from the left precuneus cluster and hippocampal volume) and clinical measures. The left occipital cortical regions may have a role in the pathophysiology of adolescent major depressive disorder, and the involvement of the hippocampus is important for pathogenic changes even in the early stages of major depressive disorder.

Prolonged monitoring is more likely to result in an accurate diagnosis of atrial fibrillation patients than intermittent or short-term monitoring. In this study, we present an implantable ECG sensor to monitor atrial fibrillation patients in real time. The developed implantable sensor is composed of a micro controller unit, analog to digital converter, signal transmitter, antenna, and two electrodes. The sensor detects ECG signals from the two electrodes and transmits these signals to the external receiver that is carried by the patient. The sensor continuously transmits signals, so its battery consumption rate is extremely high. To overcome this problem, we consider using a wireless power transmission module in the sensor module. This module helps the sensor charge power wirelessly without holding the battery in the body. The size of the integrated sensor is approximately 0.12 inch x 1.18 inch x 0.19 inch. This sensor size is appropriate enough for cardiologists to insert the sensor into patients without the need for a major surgery. The data sampling rate was 300 samples/sec, and the frequency was 430 Hz for signal and power transmission. To verify the validation of the developed sensor, the small animal experiments were conducted.

Photodamage is extrinsically induced by overexposure to ultraviolet (UV) radiation, and it increases the risk of various skin disorders. Therefore, discovery of novel biomarkers of photodamage is important. In this study, using LC–MS/MS analysis of epidermis from UVB-irradiated hairless mice, we identified 57 proteins whose levels changed after UVB exposure, and selected 7 proteins related to the tricarboxylic acid (TCA) cycle through pathway analysis. Dihydrolipoyl dehydrogenase (DLD) was the only TCA cycle-associated protein that showed a decreased expression after the UVB exposure. We also performed targeted analysis to detect intermediates and products of the TCA cycle using GC–TOF-MS. Interestingly, malic acid and fumaric acid levels significantly decreased in the UVB-treated group. Our results demonstrate that DLD and its associated metabolites, malic acid and fumaric acid, may be candidate biomarkers of UVB-induced skin photoaging. Additionally, we showed that Aloe vera, a natural skin moisturizer, regulated DLD, malic acid and fumaric acid levels in UVB-exposed epidermis. Our strategy to integrate the proteome and targeted metabolite to detect novel UVB targets will lead to a better understanding of skin photoaging and photodamage. Our study also supports that A. vera exerts significant anti-photodamage activity via regulation of DLD, a novel UVB target, in the epidermis. Biological significance This study is the first example of an integration of proteomic and metabolite analysis techniques to find new biomarker candidates for the regulation of the UVB-induced skin photoaging. DLD, malic acid, and fumaric acid can be used for development of cosmeceuticals and nutraceuticals regulating the change of skin metabolism induced by the UVB overexposure. Moreover, this is also the first attempt to investigate the role of the TCA cycle in photodamaged epidermis. Our integration of the proteomic and targeted metabolite analyses will lead to a better understanding of the unidentified photobiological results from UVB-irradiated models and can elicit new diagnostic and treatment strategies based on altered metabolism.

Purpose– The purpose of this paper is to estimate the impacts of women's education on the mean age of women at first birth (denoting the timing of fertility) and total fertility rate (TFR, denoting the level of fertility) using cross-country panel data.Design/methodology/approach– The estimations proceed in two steps: first, the timing and level of fertility regressions are separately estimated, and second, two regressions are estimated at the same time as a form of a system equation to accommodate the correlations between error terms.Findings– It is found that a higher women's education tends to delay of child birth or family formation. In addition, there exists a negative relationship between the female secondary school enrollment ratio and TFR, meaning that the opportunity costs of childbearing and rearing increases when the level of women's education enhances. However, the authors have also found that the impacts of women's higher education on TFR is statistically insignificant in a few cases of estimations without sample selections.Originality/value– Fertility decline is a shift of childbearing to older ages. The delay of child birth or family formation is the major cause of the recent fertility decline, because a late women's age at first birth reduces the chances of having any further children. This implies that the timing and level of fertility are highly correlated to each other. In particular, many studies showed that women's education and employment have been identified as major parameters for the increase in women's age at first birth. Nonetheless, little attention has been paid to an empirical analysis of the relationship between women's education and the timing of fertility. Therefore, this paper is an extension of previous studies, estimating the relationship between women's education and the timing and level of fertility at the same time.

This article investigates the role of financial market development on business cycle volatility in the economy of Korea, using time-series data for the period 1967 to 2010. The financial market development and business cycle volatility are measured by three different variables of financial deepening and a moving-average SD of real GDP, respectively. We construct a long-run causality index, as suggested by Granger and Lin (1995), in the context of cointegrated systems and vector error correction model. The estimates indicate that the measures of financial deepening, related to the role of financial institutions, mitigate cyclical fluctuations in the long run, whereas the reverse impacts are rarely evidenced. However, ‘the ratio of M2 to nominal GDP’ as a measure of financial deepening has an intensifying effect on business cycle. Based on the findings, we can infer that financial market reforms will not decrease business cycle volatility quickly.

Palpation techniques are widely used in medical procedures to detect the presence of lumps or tumors in the soft breast tissues. Since these procedures are very subjective and depend on the skills of the physician, it is imperative to perform detailed a scientific study in order to develop more efficient medical sensors to measure and generate palpation parameters. In this research, we propose an optical-based, artificial palpation sensor for lesion characterization. This has been developed using a multilayer polydimethylsiloxane optical waveguide. Light was generated at the critical angle to reflect totally within the flexible and transparent waveguide. When a waveguide was compressed by an external force, its contact area would deform and cause the light to scatter. The scattered light was captured by a high-resolution camera and saved as an image format. To test the performance of the proposed system, we used a realistic tissue phantom with embedded hard inclusions. The experimental results show that the proposed sensor can detect inclusions and provide the relative value of size, depth, and Young’s modulus of an inclusion.

Tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) was recently identified as a member of the TNF superfamily of structurally related cytokines. It regulates TNF-α and numerous cellular responses. We investigated whether TWEAK is upregulated in human middle ear cholesteatoma compared to the skin of the normal external auditory canal (EAC). The expression of TWEAK was analyzed using reverse transcription-polymerase chain reaction, Western blotting and immunohistochemical staining. TWEAK expression was correlated with that of TNF-α as determined by Western blotting. The expression of TWEAK and TNF-α protein was stronger in cholesteatoma tissue than in EAC skin. TWEAK was expressed to a greater degree in the suprabasal layer in the cholesteatoma than in EAC skin. The expression of TWEAK was correlated more closely with single-stranded DNA than Ki-67 immunohistochemically. These findings imply that TWEAK plays an important role in modulating TNF-α expression and apoptosis in cholesteatoma.

Women entrepreneurs are not as involved in economic activities as should be expected, despite the growing number of women entrepreneurs and increased government support in Korea. This study aims to...

The activation of cyclic adenosine monophosphate (cAMP) response element-binding protein (CREB) via phosphorylation in the hippocampus is an important signaling mechanism for enhancing memory processing. Although melatonin is known to increase CREB expression in various animal models, the signaling mechanism between melatonin and CREB has been unknown in vitro. Thus, we confirmed the signaling pathway between the melatonin receptor 1 (MT1) and CREB using melatonin in HT-22 cells. Melatonin increased MT1 and gradually induced signals associated with long-term memory processing through phosphorylation of Raf, ERK, p90RSK, CREB, and BDNF expression. We also confirmed that the calcium, JNK, and AKT pathways were not involved in this signaling pathway by melatonin in HT-22 cells. Furthermore, we investigated whether melatonin regulated the expressions of CREB-BDNF associated with long-term memory processing in aged HT-22 cells. In conclusion, melatonin mediated the MT1-ERK-p90RSK-CREB-BDNF signaling pathway in the in vitro long-term memory processing model and increased the levels of p-CREB and BDNF expression in melatonin-treated cells compared to untreated HT-22 cells in the cellular aged state. Therefore, this paper suggests that melatonin induces CREB signaling pathways associated with long-term memory processing in vitro.

As the influences of science and technology on its national economy have increased, each country has devised various funding programs for research and development (R&D) projects. Numerous studies have been conducted to evaluate the performance of such R&D projects. In most studies, the performances were measured in terms of an ordinal Likert scale, but they were treated as continuous variables. Much important information can be buried when a categorical Likert scale is treated as continuous variable. In this paper, we treat Likert scales as categorical and apply quantification method II to analyze the relationship between short- to mid-term performance factors and long-term impact factor of R&D projects. We apply the proposed approach to the survey data obtained from the Science and Technology Promotion Fund in Korea. The results of this paper are expected to contribute to a better understanding of the impact of R&D funding.

In this paper, we report the improved and integrated matrix-type superconducting fault current limiter (MFCL). The new MFCL proposed in this work has a structure that easily improves the quench characteristics of superconducting elements. This integrated MFCL is simply constructed by mounting a trigger element and superconducting elements in a single reactor, whereas older MFCL designs require several complex reactors for proper operation. Also this integrated type of structure provides a uniform and strong magnetic field with superconducting elements, compared with an old type MFCL. We designed and characterized the integrated MFCL with 1 times 3 superconducting modules and 2 times 3 superconducting modules. From experimental results, we confirmed that our integrated MFCL had advantages including a compact design, better quench characteristics and an easily adjustable increment of the capacity for fault current limiting.

The internet music market is a new profit-making entity and is growing rapidly due to its extension into the mobile device market. Introduction of the portable multimedia player (PMP), which is the next generation of MP3-players, will influence a customer's audio and video service preference. The internet music market needs to develop a new business model (BM) for PMPs. This article examines new BMs for customer preference via a conjoint analysis. In addition, we investigate customers' willingness to pay (WTP) using a multinomial logit model. The study helps with the decision-making procedure for designing a BM adaptable to new technology development.