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Objective/Background Patients with epilepsy have disrupted sleep architecture and a higher prevalence of sleep disturbance. Moreover, obstructive sleep apnea (OSA) is more common among patients with refractory epilepsy. Few studies have compared subjective sleep quality, sleep architecture, and prevalence of OSA between patients with refractory epilepsy and those with medically controlled epilepsy. Therefore, this study aimed to evaluate the differences in sleep quality, sleep architecture, and prevalence of OSA between patients with refractory epilepsy and patients with medically controlled epilepsy. Patients This retrospective case–control study included 38 patients with refractory epilepsy and 96 patients with medically controlled epilepsy. Sleep parameters and indices of sleep-related breathing disorders were recorded by standard in-laboratory polysomnography. The scores from sleep questionnaires on sleep quality and daytime sleepiness were compared between the two groups. Results Patients with refractory epilepsy versus medically controlled epilepsy had statistically significantly decreased rapid eye movement (REM) sleep (13.5 ± 6.1% vs. 16.2 ± 6.1%) and longer REM latency (152.2 ± 84.1 min vs. 117.2 ± 61.9 min). Further, no differences were found in the prevalence of sleep-related breathing disorders, subjective sleep quality, prevalence of daytime sleepiness, and quality of life. Although not statistically significant, patients with refractory epilepsy have a lower rate of OSA compared with those with medically controlled epilepsy (21.1% vs. 30.2%). Conclusions Patients with refractory epilepsy had more disrupted REM sleep regulation than those with medically controlled epilepsy. Although patients with epilepsy have a higher risk of OSA, in this study patients with refractory epilepsy were not susceptible to OSA.

An inclusive and encompassing model that portrays the relationship between learning cycle and knowledge types has not been adequately covered in the relevant literature. Although both have been the...

Differing from multi-touch that aims to distinguish the number of fingers used (e.g. one finger and two fingers), this study develops a method where the touch screen can distinguish the “user’s different fingers”, and the user can use different fingers to operate different function commands on a touch screen. Several experiments were conducted to measure the time needed to operate certain software functions in the conventional way “address book mode” and the proposed method of “finger identification”. The results indicate that the design of finger identification could enhance the efficiency of operating software. Based on the experimental results, this concept contributes to the extension of multiple operations and applications of smart phones and PC tablets.

Background Oral antiseizure medications (ASMs) are first-line treatments for patients with epilepsy. However, ASMs may alter sleep architecture, adversely affecting patient outcomes. The meta-analysis aimed to elucidate the effect of ASMs on sleep architecture. Methods PubMed, Embase, and Cochrane Central database (up to Febrary 2021) were searched for randomized control trials (RCT) with effects of ASMs on polysomnography parameters. A meta-analysis using a random-effects model was performed. We did not set limitation to the participants with underlying diagnosis of epilepsy. Results Eighteen randomized-controlled trials fulfilled the eligibility criteria. The effects of five main groups of ASMs (sodium channel blockers, calcium channel blockers, GABA enhancers, synaptic vesicle glycoprotein 2A [SV2A] ligand, and broad-spetrum ASMs) on slow-wave sleep (SWS), rapid eye movement (REM) sleep, and sleep efficiency (SE) were analyzed. Compared with placebo, calcium channel blockers and GABA enhancers significantly increased SWS. GABA enhancers also decreased REM sleep percentage, whereas calcium channel blockers significantly increased SE. Sodium channel blockers, SV2A ligand and broad-spectrum ASMs did not affect SWS, REM sleep, or SE. The subgroup analysis revealed that gabapentin, pregabalin, and tiagabine increased the percentage of SWS. Tiagabine also decreased REM sleep, whereas pregabalin increased SE. Finally, levetiracetam did not affect SWS, REM sleep, and SE. Conclusions This meta-analysis indicated that ASMs can have a statistically significant effect on sleep parameters; the effect differs between ASMs.

Background Shift work is a workschedule, since industrial era and some employees work in shift. It causes a desynchronization of the biological clock with consequences on sleep amount and quality, such as insomnia and easy fatigue. Obstructive sleep apnea (OSA) is one of the sleep problems that are getting more and more attention, but studies on the association between shift work and OSA were rare. Herein, we aimed to conduct a systematic review and meta-analysis to investigate the association between shift work and possible OSA. Methods This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We queried PubMed, Embase, and Web of Science databases using a related set of keywords. The inclusion criteria were as follows: (1) participants were adult employees hired by a company or organization; (2) exposure was shift work; and (3) outcome was possible OSA according to examination or assessment. Results We included six studies in the systematic review and five studies were selected for further meta-analysis. A random-effects model showed an association of shift work with a small, non-significant increase in possible OSA cases (pooled prevalence relative risk = 1.05; 95% CI 0.85–1.30; p = 0.65). This association occurred in both healthcare and non-healthcare workers group. Conclusion The association between shift work and possible OSA remains inconclusive and could be small if not negligible. Future studies should assess the association between specific work schedules and specific OSA definitions. Trial registration number PROSPERO ID: CRD42020156837

Opioids are the cornerstone of palliative pain management. Opioids work on the mu-opioid receptor as an agonist for the treatment of pain. Repeated exposure to opioids over time can lead to undesired desensitization of the antinociceptive receptor while sensitizing the N-methyl-D-aspartate (NMDA) pathway, causing a paradoxical effect where the treatment of pain creates more sensitivity to certain stimuli. This phenomenon is known as opioid-induced hyperalgesia (OIH). Methadone, a synthetic opioid, may be more effective for pain and offers advantages over other opioids in specific clinical situations due to its partial antagonistic effect on the NMDA pathway. We describe a unique case where as needed (prn) and continuous intravenous (IV) methadone was effective in relieving OIH caused by high doses of IV Dilaudid for intractable cancer pain at the end of life. Given its unique pharmacokinetics, effective pain control, and the prevention of suffering from OIH, methadone should be considered earlier on in palliative pain management, especially in those patients predicted to require high levels of opioid dosing.

Background Integrated positron emission tomography/computer tomography (PET/CT) image quality assurance ensures accurate, reproducible, and quantitative assessment of comparable scanner performance. We performed a preliminary multicenter PET/CT imaging quality assurance test with a fillable tomographic phantom in six medical centers in Taiwan. Methods The phantom was filled with fixed proportions of fluorine-18 radionuclide solution in the background and with different spheres to simulate cold and hot lesions, and body background radioactivity. Imaging acquisitions were performed by using recommended parameters in different sites according to different brand names of the instrument. All imaging was subjectively scored by eight experienced nuclear medicine physicians as the spatial resolution of four hot vials (score 0-4), six cold spheres (score 0-6), and six cold rod areas (score 0-6), and overall satisfaction (score 0-5). Interobserver correlation and receiver operating characteristic (ROC) curve were analyzed. Results The detection ability of hot vials, cold spheres, and cold rods was 4.0 ± 0.1, 5.2 ± 0.8, and 3.8 ± 0.9, respectively. Overall satisfaction was 4.0 ± 0.8. The ROC analysis revealed that the area under the curve for hot vials, cold spheres, and cold rods was 0.984, 0.887, and 0.928 respectively. The interobserver correlation for detectability of cold spheres and cold rods was 0.88 and 0.96, respectively. Conclusion The results of the study indicated that (1) PET/CT imaging quality assurance for comparable scanner performance could be established on the basis of a standard phantom and (2) good interobserver correlation can be observed for those with accurate and interpretable results.

Knowledge map systems KMSs have recently received widespread attention. A review of the literature shows that relatively few studies explicitly address the issues of implementation and user evaluation of the system and are limited in application. In view of this dilemma, this study aims to integrate the key features of knowledge assets maps, knowledge sources maps, knowledge structure maps, and knowledge task maps in order to develop an operational KMS. Also, the technology acceptance model was used as the theoretical basis for the assessment of user acceptance of the system, which is validated using structural equation modeling. In terms of user acceptance assessment, our empirical results shows that the perceived usefulness and perceived ease of use will positively affect user attitude toward the proposed KMS. Also, our results suggest that social defense negatively moderates the effect of attitude toward the system on behavior intention. Furthermore, we found that the management system also positively moderates the effect of attitude toward the system on behavior intention. On the basis of theoretical evaluation and empirical investigation, we hope that the proposed construction of a knowledge system can serve as references for both academic and related practical fields.

Knowledge management (KM) capability has been influential in explaining customer relationship management (CRM) performance. However, how it affects every customer's touch points is beyond the current literature. In this research, customer life cycle management (CLCM) is employed to examine the interrelationships of KM and CRM performance. By focusing on CLCM as part of a broad CRM initiative, this research aims to explore KM capabilities that affect CLCM and relate them with overall CRM performance. With the moderating role of information technology (IT), results show that every KM capability variable has a different effect on each phase of CLCM, and hence on customer satisfaction and loyalty. This study offers insights for managers in their efforts to further improve their CRM through looking at CLCM.

Smartphone operation currently follows the graphical user interface operation framework. Each of a product’s functions is executed by clicking or sliding the function icon. The graphical user interface is simple and easy to learn, and the vision-oriented operation was applicable to personal computers in the past. However, this design may not be suitable for multi-operational smartphones, for example, those that use in a dynamic operating environment. This study designs a method for using sliding operation on a touch screen in which a simple sliding operation is linked to multiple audio signals. With this design, the user can quickly activate the product’s functions using a sliding operation combined with audio signals without relying on vision. Thus, the diverse operational needs of smartphone users can be satisfied. With the foregoing discussion, the present study hopes to provide an improved and practical user interface for Taiwan’s mobile phone industry.

In order to make a correct diagnosis of idiopathic Parkinson's disease (PD), it is essential to exclude atypical parkinsonian features, such as early dementia, fall, and autonomic dysfunction. Rheumatoid arthritis (RA), which is a systemic inflammatory disorder, although most patients present in a polyarticular manner. Still some may also present with extra-articular involvement including skin, lung, heart, and the central or peripheral nervous systems. A possible pathogenetic link between RA and PD are proposed. However, the coexistence of RA and progressive supranuclear palsy (PSP) is rarely reported. Here, we report a parkinsonian patient with a newly diagnosed flare-up RA presenting with early falls, postural instability and supra-nuclear gaze palsy, which suggestive of clinically probable PSP. Furthermore, the parkinsonian features respond to anti-rheumatic agents, but not levodopa. Finally, the patient looks like a clinical possible PD. In summary, Parkinsonian patient with newly diagnosed flare-up RA can present with clinically probable PSP. Unbearably painful limb contracture is a clue of the coexistence of RA. Both typical and atypical parkinsonian features respond dramatically to anti-rheumatic medication, but not levodopa.

This study investigated radiation exposures from nuclear medicine patients by systematically comparing the dose rates calculated using various source models, ranging from simplified point, line, and cylinder sources to high-quality anthropomorphic phantoms. Three widely used radionuclides, (99m)Tc, (18)F, and I(131), were considered in these source models with uniform or organ-dependent distributions. Conducting Monte Carlo simulations with anthropomorphic phantoms is a realistic but time-consuming approach. The point source model is simple but too conservative, overestimating dose rates by approximately a factor of 2 at a distance of 30 cm and by 30-40% at 1 m. Both the line and cylinder source models provided improved estimates, reducing the overestimation of dose rates to 10-20% at distances of interest. The line source model was comparable to the cylinder source model because of the offset of two competing effects (i.e., attenuation and buildup) caused by the source volume. The influence of various photon energies and cylinder sizes on the result of compensating errors was examined to evaluate the effective range of the line source model. The line source model, which is relatively easy to implement and predicts slightly conservative dose rates, is considered the most practical method for calculating dose rates near radioactive patients. An application of the line source model to 51 post-thyroidectomy patients in Taiwan was demonstrated. The consistency between calculations and measurements was satisfactory after considering the room-scattering effect.

This research aims to advance our understanding of the relationship between exploitative learning and new product development (NPD) efficiency by investigating four novel contextual variables. Based on a survey of 193 NPD projects in information technology firms located in Taiwan, we used hierarchical moderated regression analysis to test our research hypotheses. The results reveal that the relationship between exploitation and NPD efficiency is positively moderated by managerial strategic consensus and the cognitive capabilities of team members. Our findings suggest that NPD project teams engaging in exploitation yield improved NPD efficiency when the cognitive capabilities of team members and strategic consensus between managers are present. If firms desire to leverage exploitation to succeed in the highly volatile IT industry, they must recognize and create conditions under which exploitation will bring about desirable outcomes.

The virtually multiple mouse wheels is a new input device; however, as it has not yet been supported by application software, the left scroll and right scroll can only operate a few software functions. In this study, computer software is combined with a virtually multiple mouse wheel to intercept left and right scroll signals in the background, which are converted into the start signal of software and sent to the application software in order that software functions can be operated. The left scroll and right scroll operate the preset function, and the user software interface implemented in this study enables the user to set the function to be operated, thus, meeting different users' requirements. In addition, the software interface can detect the software of the mouse cursor, and the mouse wheel function is automatically adjusted according to the software. This mouse wheel not only senses the different scroll positions of the finger, it also automatically distinguishes different software environments, which provides diversified software function responses, thus, it is called the intelligent mouse wheel.

This study aims to design a two-stage sliding function. First, plural function instructions are grouped into a functional classification, and a sliding operation is divided into anterior sliding and posterior sliding. Anterior sliding selects the functional classification, which contains the function instructions, while posterior sliding selects the function instruction to be executed. The operation and application of a sliding gesture to the smart phone and tablet PC can be greatly expanded by this design.

High-energy neutrons (>10 MeV) contribute substantially to the dose fraction but result in only a small or negligible response in most conventional moderated-type neutron detectors. Neutron dosemeters used for radiation protection purpose are commonly calibrated with (252)Cf neutron sources and are used in various workplace. A workplace-specific correction factor is suggested. In this study, the effect of the neutron spectrum on the accuracy of dose measurements was investigated. A set of neutron spectra representing various neutron environments was selected to study the dose responses of a series of Bonner spheres, including standard and extended-range spheres. By comparing (252)Cf-calibrated dose responses with reference values based on fluence-to-dose conversion coefficients, this paper presents recommendations for neutron field characterisation and appropriate correction factors for responses of conventional neutron dosemeters used in environments with high-energy neutrons. The correction depends on the estimated percentage of high-energy neutrons in the spectrum or the ratio between the measured responses of two Bonner spheres (the 4P6_8 extended-range sphere versus the 6″ standard sphere).

For BNCT treatments, in addition to tumor target doses, non-negligible doses will result in all the remaining organs of the body. This work aims to evaluate the effective dose as well as the average absorbed doses of each of organs of patients with brain tumor treated in the BNCT epithermal neutron beam at THOR. The effective doses were evaluated according to the definitions of ICRP Publications 60 and 103 for the reference male and female computational phantoms developed in ICRP Publication 110 by using the MCNP5 Monte Carlo code with the THOR-Y09 beam source. The effective dose acquired in this work was compared with the results of our previous work calculated for an adult hermaphrodite mathematical phantom. It was found that the effective dose for the female voxel phantom is larger than that for the male voxel phantom by a factor of 1.2-1.5 and the effective dose for the voxel phantom is larger than that for the mathematical phantom by a factor of 1.3-1.6. For a typical brain tumor BNCT, the effective dose was calculated to be 1.51Sv and the average absorbed dose for eye lenses was 1.07Gy.

TPS LINAC is essentially concatenated by three consecutive sections of linear accelerators with a nominal output of 2.25 W (150 MeV, 5 nC, 3 Hz) electron beam. A 15 m long transfer line used to guide accelerated electrons from the LINAC outlet to the beam dump. For ensuring radiation safety of personnel around the area, gamma-ray and neutron dose rates outside the LINAC room were repeatedly measured and reviewed during the commissioning. If all the accelerated electrons are perfectly dumped as we wish, radiation dose rates outside the shielding should be as low as comparable to the natural background level. To be able to clearly identify radiation changes above background levels and perform reliable dose rate measurements, high-sensitivity radiation detectors are necessary. This paper presents the design and characteristics of these detectors and a data analysis of the measured results taken during a full-power LINAC operation. NSRRC is now constructing its second light source facility called Taiwan Photon Source (TPS) to meet the increasing demand for brighter synchrotron X-ray source. Focusing on a low-emittance design, the TPS will become one of the brightest synchrotron light sources in the world. The accelerator system consists of a 3.0-GeV electron storage ring with a circumference of 518.4 m, a concentric booster synchrotron with a circumference of 496.8 m, and a pre-injector of 150-MeV electron LINAC. Due to some delay of the TPS civil construction, NSRRC has built a simple rectangular shielding room made of 1 m thick concrete for the assembly and acceptance test of the outsourcing LINAC.

This paper undertakes an analysis of a movement to establish a sports lottery in Taiwan that focuses on a specific set of debates during the developing process. Methodologically, this study uses a qualitative case-study approach, which was based on documentary material and interviews, to generate a framework by which to analyse governance of Taiwan's specific system. The article argues that actors who present various resources and interests have constrained or enabled policies when seeking to achieve their preferred ends. Given a changing governance context, actors may no longer simply impose their will; they must negotiate with the other interested parties and organisations. Meanwhile, a balance between interests can be achieved only through competition, negotiation and cooperation between actors.

Even though scholars have placed considerable focus on studying the attitudes and intentions towards using the virtual market (marketspace), there are still few studies that examine the potential effect of the physical market (marketplace) on the virtual market. The physical and virtual markets have some substitution effects; as users utilize the virtual market more frequently, they use the physical market less regularly. Under this premise, factors relating to the physical market may have a potential effect on the user's acceptance of the virtual market. The primary goal of this study was to explore the factors that affect the attitude and intention towards switching from the physical to the virtual market in the context of online banking. In total, 400 questionnaires were sent out and 250 effective questionnaires were returned, for an effective recovery rate of 62.5%. Factor analysis and regression analysis were used to examine the hypotheses. The results showed that perceived usefulness, perceived ease of use and offline trust have positive effects on attitude towards switching. Additionally, offline loyalty and switching costs had negative significant influence on attitude towards switching. Moreover, attitude towards switching had a positive effect on the behavior intention to switch. Finally, computer self-efficacy moderates the effect of attitudes and behavior intention towards switching to online banking.

The primary goal of this research is to design “virtually multiple mouse wheels”. Virtually multiple wheels are defined as wheels that provide multiple manipulation positions for scrolling by the finger. A sensor senses the manipulation position of the finger, and issues a corresponding auxiliary signal, which allows the wheel to have multiple manipulation modes, that is, each of the manipulation positions is used as a separate virtual wheel. Through this design, a single mouse wheel can be turned into multiple mouse wheels, enhancing the operation efficiency of software functions. Several experiments are conducted to compare the time needed to operate software functions with the traditional combination of “mouse click + toolbar” and with the proposed “virtually multiple mouse wheels”. The results indicate that the design of virtually multiple mouse wheels can enhance the efficiency of operating software functions. Based on the experimental results, this concept is provided to assist designers a direction for devising extended applications of a single wheel.

Rationale: Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is an autoimmune disorder that can be controlled and reversed by immunotherapy. The presentation of NMDA receptor encephalitis varies, but NMDA receptor encephalitis is seldom reported in patients with both bilateral teratomas and preexisting brain injury. Patient concerns: A 28-year-old female with a history of traumatic intracranial hemorrhage presented acute psychosis, seizure, involuntary movement, and conscious disturbance with a fulminant course. Anti-NMDA receptor antibody was identified in both serum and cerebrospinal fluid, confirming the diagnosis of anti-NMDA receptor encephalitis. Bilateral teratomas were also identified during tumor survey. Diagnoses: anti-N-methyl-D-aspartate receptor encephalitis. Interventions: Tumor resection and immunotherapy were performed early during the course. Outcomes: The patient responded well to tumor resection and immunotherapy. Compared with other reports in the literature, her symptoms rapidly improved without further relapse. Lessons: This case report demonstrates that bilateral teratomas may be related to high anybody titers and that the preexisting head injury may be responsible for lowering the threshold of neurological deficits. Early diagnosis and therapy are crucial for a good prognosis in such patients.

The word “fall” does not usually strike fear in the hearts of most people. But it should. Falls are all too common in the geriatric population, and they have devastating consequences. They are the leading cause of injury and death by injury in adults over the age of 65 years.1 One of 3 community-dwelling older adults falls each year, with 24% of those who fall sustaining serious injuries and 6% sustaining fractures.2 In the year 2000, falls cost the US health care system more than $19 billion, a number that is expected to increase to $54.9 billion by 2020.3 A person who falls may subsequently experience pain, hospitalization, surgical intervention, admission to a nursing home, decreased overall functional ability, poorer quality of life, or a fear of falling.

The site dose rate of a spent-fuel storage facility to the populace is a major concern in a radiation protection project. Shielding analysis of the facility must be performed to ensure that the nearby dose rates are within regulation limitations. The purpose of this study was to simulate an independent spent-fuel storage installation (ISFSI) storage facility with different methods and different conditions for validation and analysis. The discrete ordinates code DORT and the SKYSHINE III code were used for the cask surface flux estimation and the site dose rate calculation, respectively. The Monte Carlo code MCNP was also utilized to estimate the surface dose rate and site dose rate by its subsequent calculation. Various cask decay heats (23, 14, and 7 kW/cask) were considered as the source conditions. Afacility layout composed of 30 casks was also simulated by the MCNP code and analyzed for the cask self-shielding effect to a certain detecting point. For a single storage cask, comparisons of the site dose rates calculated by different methods were carried out at variant distances. For the layout simulation, the calculated results indicated that the self-shielding effect could be roughly classified into several groups according to the location of the storage cask, and a factor could be assigned to each group. These classified factors might help to infer the site dose in variant layout designs. The site dose rates calculated by different codes were compared for the whole facility, too. In spite of the similar dose rates on the cask surface, the difference of site dose rates changes with decay heat. The layout study of the ISFSI facility could offer information to make the site dose estimation more efficient as many layout assessments are needed.

To investigate the unexpected skin dose increase from intensity-modulated radiation therapy (IMRT) on vacuum cushions and carbon-fiber couches and then to modify the dosimetric plan accordingly. Eleven prostate cancer patients undergoing IMRT were treated in prone position with a vacuum cushion. Two under-couch beams scattered the radiation from the vacuum cushion and carbon-fiber couch. The IMRT plans with both devices contoured were compared with the plans not contouring them. The skin doses were measured using thermoluminescent dosimeters (TLDs) placed on the inguinal regions in a single IMRT fraction. Tissue equivalent thickness was transformed for both devices with the relative densities. The TLD-measured skin doses (59.5 +/- 9.5 cGy and 55.6 +/- 5.9 cGy at left and right inguinal regions, respectively) were significantly higher than the calculated doses (28.7 +/- 4.7 cGy; p = 2.2 x 10(-5) and 26.2 +/- 4.3 cGy; p = 1.5 x 10(-5)) not contouring the vacuum cushion and carbon-fiber couch. The calculated skin doses with both devices contoured (59.1 +/- 8.8 cGy and 55.5 +/- 5.7 cGy) were similar to the TLD-measured doses. In addition, the calculated skin doses using the vacuum cushion and a converted thickness of the simulator couch were no different from the TLD-measured doses. The recalculated doses of rectum and bladder did not change significantly. The dose that covered 95% of target volume was less than the prescribed dose in 4 of 11 patients, and this problem was solved after re-optimization applying the corrected contours. The vacuum cushion and carbon-fiber couch contributed to increased skin doses. The tissue-equivalent-thickness method served as an effective way to correct the dose variations.

PurposeIn an age of rapid knowledge expansion, external knowledge sources are available in abundance. The purpose of this paper is to focus on the way in which firms can effectively internalize explicit knowledge and direct it into the tacit knowledge of employees, thereby enhancing the organization's competitiveness (knowledge internalization).Design/methodology/approachAn exploratory research is adapted to discuss the issue of knowledge internalization based on learning cycle theory. A theoretical framework is developed which provides an analytical perspective on the knowledge internalization.FindingsThe results of this study reveal that an “incomplete learning cycle” is one of the reasons why explicit knowledge could not be successfully converted into tacit knowledge. Hence, when a more complete learning cycle is followed, explicit knowledge is more easily converted into tacit knowledge.Research limitations/implicationsThis study's results can be considered as a stepping‐stone for future rigorous theoretical and empirical investigations.Originality/valueThis paper seeks to develop a framework of knowledge internalization based on learning cycle theory that will serve as reference for both the academic and business communities.

In order to overcome the obstacles in traditional experimenting and practical training courses, as well as in enhancing the functions of the present e-learning system, the study took sensor network technology as the foundation in developing a web services system. The system will be able to make presentations of the students ‘operations and results on an immediate basis, allowing the students to be guided adequately as they face problems during experiment and practical training.

The purpose of this research is introduce the design of an improved graphical user interface (GUI) and verifies the operational efficiency of the proposed interface. Until now, clicking the toolbar with the mouse is the usual way to operate software functions. In our research, we designed an improved graphical user interface – a tool ball that is operated by a mouse wheel to perform software functions. Several experiments are conducted to measure the time needed to operate certain software functions with the traditional combination of “mouse click + tool button” and the proposed integration of “mouse wheel + tool ball”. The results indicate that the tool ball design can accelerate the speed of operating software functions, decrease the number of icons on the screen, and enlarge the applications of the mouse wheel.