Investigating individual preferences for new mobility services: the case of “mobility as a service” products

In just a few years, the Mobility as a Service (MaaS) concept has gone from an idea discussed by very few, to being a prominent topic in any transportation related debate. However, within this time, there have only been few rigorous studies that explore the various aspects of MaaS. This thesis aims to contribute to existing knowledge by providing empirical evidence on individual preferences for MaaS plans and their components. In doing so, first desk-research is conducted to summarise existing MaaS schemes and outline the MaaS ecosystem. Next, MaaS surveys that are able to capture individual preferences for MaaS products are designed and specific challenges in the design process identified. The MaaS surveys, including MaaS plan stated preference experiments, are applied in two case study areas of London and Greater Manchester. Using the novel data collected, individual preferences for MaaS plans are examined using two distinct studies: (1) a mixed methods research conducted in London, which expands the survey by adding a qualitative (in-depth interview) element to examine user preferences for MaaS plans and the ways individuals choose between them; and (2) a latent class choice model based on data collected from Manchester to examine whether there is heterogeneity in preferences. Finally, implications for industry and policy stakeholders are discussed as well as interventions that can best support the widespread adoption of MaaS. The results of this thesis show there is interest in the concept of MaaS among potential users as many see value in a single app that integrates different transport modes into a single service. In general, individuals are hesitant in purchasing pre-payed MaaS plans and would be more comfortable with a pay-as-you-go product option. While many people are reluctant towards MaaS plans, the results indicate that heterogeneity exists in preferences towards them and there are different user groups based on socio-demographic characteristics and current mobility habits. Smaller, less expensive plans including modes such as public transport and bike sharing can be used to target students or middle-income people with have high overall mode usage. Larger, more expensive plans that include modes such as taxi and car sharing in addition to public transport, will be attritive to individuals who are likely younger, male, well-educated, have higher income and already use many transport modes. Older population groups, individuals with low income and those that do not use any transport modes or are uni-modal are least likely to adopt MaaS plans. The thesis also provides insights into individuals’ preferences towards transport modes within MaaS plans. The analysis showed that respondents classify modes within MaaS plans into three categories: ‘essential’ modes that are pivotal to the individual and which they most likely already frequently use; ‘considered’ modes are those that they would be willing to include but may not yet use; and ‘excluded’ modes are those that they definitely do not want in their plans and would eliminate any plan that included these. Public transport consistently proved to be an essential mode, while taxi, car sharing and bike sharing could be ‘essential’, ‘considered’ or ‘excluded’ depending on the characteristics of the individual. The main contributions of this thesis are the novel data collected in two case study cities about individuals’ preferences for MaaS plans and the findings gained through the analysis providing insights into possible target audiences and product designs for MaaS plans

Antioxidants at Newborns

Humans possess defense mechanisms against free radicals: enzymatic and non-enzymatic antioxidants. Antioxidant defense is deficient in newborns and can be enhanced by the action of reactive oxygen species, generated by perinatal diseases such as respiratory distress or asphyxia. Prematurity itself will be associated with deficient antioxidant mechanisms, which are primarily enzymatic, but also non-enzymatic. Under oxidative stress conditions, antioxidant defense is overcome and thus, low-molecular weight free iron is released, which is not bound to transferrin and will play a role in Fenton’s reaction, catalyzing lipid peroxidation. The generated ROS will in turn influence antioxidant defense mechanisms, stimulating their synthesis, as an adaptation mechanism of the body in response to the presence of increased ROS levels

Preterm Birth and Inflammation

Half of all preterm births are caused or triggered by an inflammation at fetal-maternal interface. The sustained inflammation that preterm neonates are exposed is generated by maternal chorioamnionitis, premature rupture of membranes. This inflammation will facilitate the preterm labor, but also plays an important role in development of disease like: bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, intraventricular hemorrhage and periventricular leukomalacia. Preterm neonates have immature immune system. The fragile co-regulation between immune defense mechanisms and immunosuppression (tolerance) is often disturbed at this category of patients. They are at high risk of sepsis due to this imbalance between the defense and suppression mechanisms but also several injuries can contribute to the onset or perpetuation of sustained inflammation. They experience altered antigen exposure in contact with hospital-specific germs, artificial devices, drugs, nutritional antigens, and hypoxia or hyperoxia. This is more significant at extremely preterm infants less than 28 weeks of gestation as they have not developed adaptation processes to tolerate maternal and self-antigens

Current concepts in granulomatous immune responses

Persistent irritants that are resistant to innate and cognate immunity induce granulomas. These macrophage-dominated lesions that partially isolate the healthy tissue from the irritant and the irritant induced inflammation. Particles, toxins, autoantigens and infectious agents can induce granulomas. The corresponding lesions can be protective for the host but they can also cause damage and such damage has been associated with the pathology of more than a hundred human diseases. Recently, multiple molecular mechanisms underlying how normal macrophages transform into granuloma-inducing macrophages have been discovered and new information has been gathered, indicating how these lesions are initiated, spread and regulated. In this review, differences between the innate and cognate granuloma pathways are discussed by summarizing how the dendritic cell-T cell axis changes granulomatous immunity. Granuloma lesions are highly dynamic and depend on continuous cell replacement. This feature provides new therapeutic approaches to treat granulomatous diseases

Antioxidant Capacity of Preterm Neonates Assessed by Hydrogen Donor Value

Background and objectives: Premature newborns have a number of oxidative stress-inducing disorders. Antioxidant defense is deficient in premature newborns. Hydrogen donors can be used to evaluate the non-enzymatic antioxidant defense. By measuring hydrogen donors, a group of antioxidants can be assessed: tocopherol, ascorbic acid, and glutathione. These represent the most relevant group of non-enzymatic antioxidants. The main aim of this study was to evaluate the non-enzymatic antioxidant defense capacity of premature newborns by measuring hydrogen donors. Materials and Methods: We evaluated the non-enzymatic antioxidant capacity by hydrogen donor measurement in 24 premature newborns with various oxidative stress-inducing disorders and in 14 premature newborns without oxidative stress-inducing conditions. Statistical analysis was performed using the Statistica program (v. 8, StatSoft, Round Rock, TX, USA). Differences between groups were tested with Wilcoxon matched test for quantitative paired data or Mann–Whitney test for quantitative independent data. The Z test for proportions was used to compare qualitative data among subgroups. Results: Hydrogen donors in the study group had a significantly lower value on the first day of life compared to the value of the control group. Also, the hydrogen donor value in the study group was significantly lower on the first day compared to the third day of life (p < 0.05). Neonates with mild respiratory distress (14 cases) had increased hydrogen donor values on their third day of life compared to the first day of life. Conclusions: The antioxidant capacity is influenced by oxidative stress-inducing disorders. Respiratory distress influenced the hydrogen donor value and antioxidant defense. Antioxidant defense gradually improves after birth according to gestational age

The Behaviour of Protein Carbonyls in Newborns with Birth Respiratory Distress and Asphyxia

Objective: A prospective study was carried out in premature newborns with respiratory distress syndrome (RDS) and asphyxia at birth in order to identify and analyze the effects of RDS on proteins. Material and Methods: Protein peroxidation was studied using the Reznick spectrophotometric method. The study group included 14 premature newborns with respiratory distress and asphyxia at birth. The control group included 13 newborns that were born on term, eutrophic and healthy. The determinations were carried out using venous blood. Statistical data analyses were performed using Statistica software. The comparisons between groups (study and controls) were performed by applying parametric and non-parametric tests according with the type of distribution. Results: Statistically significant correlations were found between the value of protein carbonyls (PC) and the weight of premature newborns in the case group (p < 0.05), as well as between the PC value and the presence of respiratory distress due to surfactant deficiency in the study group. The average PC value in the study group was higher in the third day as compared with the first day. The PC value was significantly higher in the control group as compared with study group. Conclusion: The results of our study revealed that the respiratory distress in the premature newborn and oxygen therapy stimulate the peroxidation of proteins

Is it possible to use the Toll-like receptors as biomarkers for neonatal sepsis? Review of the recent literature

Background. Sepsis continues to be one of the main death causes in the neonate population. The toll-like receptors are molecules that express in the plasma or endosomal membrane and recognize endosomal or microorganism components. While aiming at the identification of new neonatal sepsis biomarkers, the toll-like receptors (TLR) have been considered that some of them overexpress in contact with the bacterial components. Methods. Research in the PubMed database has been made by the following criteria: Inclusion criteria (PubMed database, Period 2005-2022, English & Humans, generated 29, Meta-Analysis - 0, Review - 6, Systematic Review - 0), Exclusion criteria (Studies on animal models, Articles with merely didactical content, Articles regarding only one of the words researched either only neonatal sepsis or TLR in another context than together, Articles that are not directly connected with the topic). Based on the above-mentioned criteria 13 articles were consulted, of which 7 articles included in vivo studies, 6 with in vitro studies. Conclusions. The data of the present review and the current diagnostic method point at the fact that TLRs increase in the conditions of the presence of the inflammatory syndrome. Their dosing during in the neonatal sepsis is possible, but the non-specific overexpression is not a diagnostic

Association Analysis of the Cerebral Fractional Tissue Oxygen Extraction (cFTOE) and the Cerebral Oxygen Saturation (crSaO₂) with Perinatal Factors in Preterm Neonates: A Single Centre Study

(1) Background: Near-infrared spectroscopy (NIRS) is a non-invasive, easily performed method of monitoring brain oxygenation. The regional cerebral oxygen saturation (crSaO2) and the cerebral fractional tissue oxygen extraction (cFTOE) evaluated by NIRS provide more accurate information on brain oxygenation than the blood oxygen saturation. We investigated the effect of perinatal factors on cerebral oxygenation of preterm newborns. (2) Methods: We conducted a longitudinal study with 48 preterm newborns 2 was measured and cFTOE was calculated foreach patient. (3) Results: One-way ANOVA showed no significant main effect of IVH severity on crSaO2 and cFTOE (p > 0.05); there was a tendency toward statistical significance concerning the difference between the means of crSaO2 (p = 0.083) and cFTOE (p = 0.098). Patients with intraventricular haemorrhage (IVH) had a lower mean of crSaO2 and a higher mean of cFTOE (59.67 ± 10.37% vs. 64.92 ± 10.16% for crSaO2; 0.37 ± 0.11 vs. 0.32 ± 0.11 for cFTOE) compared to those with no IVH. Significantly lower values of crSaO2 and higher values of cFTOE were found in neonates receiving inotropic treatment (p p = 0.0026). No significant association between the maternal hypertension treatment and the cerebral oxygenation of preterms was found. (4) Conclusions: This study showed a decreased cerebral oxygen saturation of preterms with IVH, inotrope support and apnoea episodes

Parental factors associated with intrauterine growth restriction

Introduction. Linear growth failure is caused by multiple factors including parental factors. Objective. The aim of this study was to evaluate parental risk factors for intrauterine growth restriction (IUGR) on a population of Romanian newborn infants in a tertiary level maternity facility for a period of 2.5 years. Methods. A retrospective matched case-control study was conducted in the Emergency County Hospital of Cluj-Napoca, a university hospital in North-Western Romania. The sample was selected from 4,790 infants admitted to the Neonatal Ward at 1st Gynecology Clinic between January 2012 and June 2014. Results. The age of mothers was significantly lower in the IUGR group compared to controls (p=0.041). A significantly higher percentage of mothers had hypertension in the IUGR group compared to those in the control group (p<0.05). No other significant differences were identified with regard to the investigated characteristics of mothers between IUGR infants compared to controls (p>0.13). The age of fathers of infants with IUGR proved significantly lower compared to controls (p=0.0278). The analysis of infants’ comorbidities revealed no significant difference between groups for respiratory distress, hyperbilirubinemia, hypocalcaemia, and heart failure (p>0.27). Intracranial hemorrhage, necrotizing enterocolitis and hypoglycemia were significantly higher in the IUGR group compared to controls. The logistic regression identified hypertension as a significant risk factor for IUGR (OR=2.4, 95% CI [1.3-4.5]). Conclusion. Although the age of the mothers and fathers proved significantly lower in the IUGR group compared to controls, only hypertension in the mothers proved significant risk factors for IUGR