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The lean startup approach (LSA) is extensively utilized by early-stage entrepreneurs, with “pivot” serving as a key pillar. However, there is a research gap concerning the boundary conditions impacting LSA and pivot decisions, especially when addressing societal challenges, as in the context of transformational entrepreneurship. In this regard, the healthcare sector, further compounded by a lack of research on startups and scale-ups, presents an embraced opportunity to provide multiple contributions for both theory and practice.

The present investigation employs a grounded approach to explore the experiences of the co-founders of a fast-growing Italian e-health startup. A narrative strategy was employed to organize conditions and evolving strategic action/interactions into three different pivoting phases of the startup – before the pivot, its enactment and aftermath – with primary and secondary data collected over a period of one year.

Pivoting in digital healthcare unfolded as a liminal experience marked by factors such as high regulation, multiple stakeholders, technological and symbolic ambivalence, resource-intensive demands and institutional actors acting as pathway pioneers, leading to an information overload and unforeseeable uncertainty to manage. These factors challenge entrepreneurs' ability to attain optimal distinctiveness, presenting the paradoxical need for vertical flexibility for scaling up.

By uniquely illuminating the sector’s constraints on entrepreneurial phenomena, this study provides a valuable guide for entrepreneurs and institutional actors in addressing societal challenges.

This study introduces a process model of transformational information crafting when pivoting, highlighting the role of entrepreneurs' transformational stance and platform-mediated solutions as engines behind strategies involving information breaking and transition, preceding knowledge-driven integration strategies.

With the rapid growth of the domestic lending industry, assessing whether the borrower of each loan is at risk of default is a pressing issue for financial institutions. Although there are some models that can handle such problems well, there are still some shortcomings in some aspects. The purpose of this paper is to improve the accuracy of credit assessment models.

In this paper, three different stages are used to improve the classification performance of LSTM, so that financial institutions can more accurately identify borrowers at risk of default. The first approach is to use the K-Means-SMOTE algorithm to eliminate the imbalance within the class. In the second step, ResNet is used for feature extraction, and then two-layer LSTM is used for learning to strengthen the ability of neural networks to mine and utilize deep information. Finally, the model performance is improved by using the IDWPSO algorithm for optimization when debugging the neural network.

On two unbalanced datasets (category ratios of 700:1 and 3:1 respectively), the multi-stage improved model was compared with ten other models using accuracy, precision, specificity, recall, G-measure, F-measure and the nonparametric Wilcoxon test. It was demonstrated that the multi-stage improved model showed a more significant advantage in evaluating the imbalanced credit dataset.

In this paper, the parameters of the ResNet-LSTM hybrid neural network, which can fully mine and utilize the deep information, are tuned by an innovative intelligent optimization algorithm to strengthen the classification performance of the model.