Mode Choice Research Articles

Factors influencing diagnostic yield in ultrasound-guided omental biopsies: insights from a retrospective study.

To evaluate the safety, diagnostic accuracy, and factors influencing the diagnostic yield of ultrasound (US)-guided omental biopsies. This retrospective study included 109 patients who underwent US-guided omental biopsies between June 2020 and June 2024. Pre-biopsy diagnostic images (CT, MRI, or [18F]FDG PET/CT) were reviewed. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and adverse events were evaluated. Surgical or clinical diagnoses with follow-up served as the diagnostic reference standard. Associations between diagnostic yield and findings on pre-biopsy imaging and biopsy US were explored. The study achieved a technical success rate of 100%. Initial biopsy results showed a sensitivity of 82.6%, specificity of 100%, PPV of 100%, NPV of 60.5%, and diagnostic accuracy of 86.2%. The pre-biopsy imaging modality was not related to diagnostic accuracy. Ascites interposition on the puncture route was significantly higher in patients without diagnostic accuracy (73.3% vs. 30.9%, p = 0.002). Deeper lesions exhibited lower diagnostic accuracy (p = 0.003). No major or minor complications were associated with the biopsies. Percutaneous omental biopsy is an effective and safe method for evaluating omental abnormalities. Depth from the needle entry site and the presence of ascites along the puncture route were identified as factors affecting diagnostic accuracy. The choice of imaging modality did not impact diagnostic outcomes, highlighting the importance of lesion-specific factors in the planning of biopsies.

Willingness and determinants of elder care modes among elderly individuals: insights from underdeveloped regions in Western China.

The aim of the present study was to investigate the willingness of elderly individuals regarding their choice of elderly care modes in underdeveloped regions of Western China and to identify the key factors influencing the willingness. We distributed a total of 20 000 questionnaires using the multistage stratified cluster random sampling method, and successfully collected 19 460 of them. After conducting quality checks, we deemed 19 040 questionnaires valid for analysis. The survey covered seven cities, 24 counties, and 255 villages in Gansu Province. We conducted statistical analyses, including univariate χ2 test, Kruskal-Wallis test and multivariate logistic regression, to assess the willingness of elderly individuals regarding care modes and the factors influencing these choices. Among the 19 040 valid responses, 88.55% preferred home care, 5.01% opted for community care, 5.01% chose institutional care, 1.08% preferred mutual care, and 0.36% selected smart care. Elderly individuals who have a lower level of education, residence within a 15-minute walking distance to the nearest health care facility, and believe that elder care should rely on themselves or their children, etc. exhibit a higher willingness for choosing the home care mode (P < 0.05). Elderly individuals who believe that elderly care should be reliant on their children, and possess a greater knowledge for the combination of medical and elderly care, etc. exhibit a stronger willingness for choosing the community care (P < 0.05). Elderly individuals with lower educational level and lack endowment insurance, etc. exhibit a higher willingness for choosing the mutual care (P < 0.05). Elderly individuals who are not afflicted with chronic illnesses and reside within a 15-minute distance from the nearest medical centre exhibit a higher willingness for choosing the smart care mode (P < 0.05). In underdeveloped regions in China, home care continues to be the predominant choice among elderly individuals. However, the growing demand for diverse elderly care modes warrants attention. Multiple factors influence the willingness of elderly individuals when selecting care modes. This study offers valuable insights for policymakers, enabling government departments to implement targeted strategies and interventions to meet the diverse service needs of the elderly population effectively.

Does implicit attitude affect travel mode choice behaviors? A study of customized bus attraction to urban railway riders

ABSTRACT Urban railway (UR) systems in densely populated cities face oversaturation during peak hours, yet bus ridership keeps declining. Shifting some UR riders to buses is crucial. Customized bus (CB), a demand-responsive transit mode, could attract riders from congested rail systems. This study investigates mode choice behaviors between CB and UR, focusing on implicit and explicit attitudes. An online survey combining revealed and stated preference scenarios is designed, incorporating the implicit association tests and Likert-scale questions to measure the implicit and explicit attitudes. Multinomial logit models are adopted to analyze responses from 1,500 commuters. Then, investment strategies to enhance the attractiveness of CB are designed and simulated. Results show: (1) incorporating implicit and/or explicit attitudes significantly influenced choice behavior but does not improve the goodness-of-fit; (2) female and high-income individuals hold the most positive implicit attitudes toward CB; (3) equity-based resource allocation proves more effective than other strategies in enhancing attitudes.

The Impact of Task Difficulty, Environmental Color Complexity, and Teaching Models on AR-Assisted Subway Maintenance Training

This paper investigates whether different task difficulties, color complexity, and choice of instructional application mode affect cognitive load, usability, visual discomfort, and job performance in subway overhaul training tasks and compares the findings under AR learning modes with those under traditional paper-based learning manuals. This study had sixteen participants and used eight experimental conditions. Tests were completed for environmental color complexity, task difficulty, and instructional application mode. The experimental variables were analyzed using three-way analysis of variance. The results showed that the color complexity of the carriage environment did not affect the participants’ cognitive load and performance, but the use of AR glasses in subway maintenance was influenced by task difficulty and instructional application mode. For example, the AR image format reduced task completion time by an average of 25.9% for easy tasks, while the AR real-time format reduced head deflections by an average of 83.9%, suggesting that there is reliable potential for applying AR to subway overhaul training. This paper can provide a theoretical basis for developing training strategies for the different environments and tasks difficulties of subway maintenance.

Applying a time-geographical perspective to understand tourism mobilities of families with children who use wheelchairs

Individuals with disabilities encounter numerous challenges in the realm of tourism travel. Various constraints can affect their opportunities to engage in travel, influence their choice of destinations and modes of travel, and shape their overall tourism experiences. Research on tourism for individuals with disabilities has predominantly concentrated on identifying barriers to travel. This paper employs a time-geographical framework to extend beyond this focus, examining how various constraints are negotiated and the resultant outcomes for tourism trips. The study is based on interviews with Swedish parents whose children use wheelchairs. The findings indicate that these families face multiple constraints impacting their tourism opportunities and experiences, primarily related to rules, regulations, and inaccessible physical environments. Furthermore, the interviewed parents do not perceive their children’s disabilities as constraints but rather highlight the challenges of using a wheelchair in inaccessible tourism contexts. While some constraints are negotiated to facilitate tourism, not all desired tourism activities can be fully realised. Consequently, the families in this study exhibit rather routinised travel behaviour. An important finding is that families who travel with a child with a disability should be considered part of the family tourism market, rather than the disability tourism market.

Climate Risk and Foreign Direct Investment Entry Mode

ABSTRACTThe paper examines how climate risk impacts the strategic entry mode choices—between greenfield investments and cross‐border mergers and acquisitions (M&amp;As)—of multinational enterprises (MNEs) into foreign markets. Our study adds to existing literature through a cross‐countries empirical analysis and uses a newly developed dataset, the Multinational Revenue, Employment, and Investment Database (MREID), that accounts for how both physical and transition risks of climate change affect MNEs' entry mode choice. Physical risk refers to the tangible impacts of climate change such as extreme weather events, while transition risk involves regulatory and policy changes associated with moving towards a low‐carbon economy. Using data for 139 source countries and 134 destination countries over the period from 2010 to 2021, we find that an increase in the physical risk of climate change leads to MNEs choosing greenfield investment when entering a new market while a higher level of transition risk discourages greenfield investment. Physical risk has a negative and significant influence on MNEs' entry choice of using cross‐border M&amp;A. There is a positive and significant correlation between transition risk and cross‐border M&amp;A though such a relationship is not robust. Industrial‐level evidence shows a similar pattern in the majority of the industries. Our findings provide policymakers with guidelines helping to mitigate the negative impact of climate change on business decisions at the global level.

Urban Air Mobility demand forecasting: modeling evidence from the case study of Milan (Italy)

This paper presents the results of a demand forecasting study about the introduction of Urban Air Mobility (UAM) services in the metropolitan area of Milan (Italy). Demand forecasting is based on random utility mode choice models, which include factors related to the individuals’ perception of vertical take-off/landing and low altitude flying over urbanized areas. The use cases of UAM services include airport shuttles, intercity air connections, and “air-taxis”, i.e., UAM services for short-trips within the metropolitan area. Several scenarios have been considered based on the number of access points (“vertiports”) and UAM fare levels. The results indicate that airport shuttles have a modal share of trips to/from airports (for both business and leisure) in a range of 2-5%. They resulted to be more attractive than air-taxis, which have a modal share in a range of 1-3%. Furthermore, the probability of choosing UAM services for intercity travels decreases with the distance and the time required for access/egress to/from the vertiports, whose catchment areas are dependent on the level of service provided by competing modes (notably the presence of good railway and highway connections).

Sustainable Urban Mobility: Corridor Optimization to Promote Modal Choice, Reduce Congestion, and Enhance Livability in Hyderabad, Pakistan

This research aims to optimize corridors in Hyderabad, Sindh, to promote modal choice, reduce congestion, and enhance livability. This study focused on developing and evaluating multimodal wide corridor routing methods, analyzing the modal choice behavior of travelers using a generalized cost model and a mixed constant and separate user balance model, and implementing and assessing innovative road space management strategies. The data were collected using GIS (Geographical Information System) to compare the performance and impacts of the proposed methods and techniques with existing ones, such as shortest path, minimum interference, maximum capacity, and lane addition, using various performance measures, such as travel time, modal share, congestion level, environmental impact, safety, and equity. This research aims to optimize corridors in Hyderabad, Sindh, to encourage various transportation options, such as the BRT system and Peoples Bus Service, to reduce congestion and enhance livability by developing and accessing different methods and strategies. This study analyzed available data through a geospatial perspective to optimize corridors in Hyderabad, Sindh, focusing on multimodal routing methods, modal choice behavior, and innovative road space management strategies to enhance urban livability rather than relying on simulation software or field-collected data.

Modeling mode choice behaviors of commuters in car-dependent small country discrete choice models: A case study of Bahrain

Modeling mode choice behaviors of commuters in car-dependent small country discrete choice models: A case study of Bahrain

Analysis of Gender Differences in Modal Choice Among Residents of Coastal Communities of Yenagoa Metropolis in Bayelsa State, Nigeria

Analysis of Gender Differences in Modal Choice Among Residents of Coastal Communities of Yenagoa Metropolis in Bayelsa State, Nigeria

Cold atmospheric plasma restores skewed macrophage polarization in triple negative breast cancers via enhancing KAT6A acetylation.

Breast cancer is the most common cancer diagnosed and the second leading cause of death of cancer among women in the world, due to inappropriate diagnosis and choice of therapeutic approach. The molecular profiles of breast cancers may switch among subtypes during treatments, leading to a phenotype such as triple negative breast cancers (TNBCs) that is more difficult to treat. Cold atmospheric plasma (CAP) has been demonstrated by many studies on its efficacy in arresting the malignancies of multiple cancer types including TNBCs that lack surface receptor expression and are thus the most difficult to treat among breast cancers. By analyzing the genetic testing reports of a breast cancer clinical case misdiagnosed with BRCA1 mutation, we characterized the importance of KAT6A in driving disease progression of this patient. Through exploring genes differentially regulated under physical interactions between KAT6A and SMAD3, we proposed the KAT6A/SMAD3/IL6/CD163 molecular axis capable of driving macrophage M2 polarization in the immune microenvironment of breast cancers. Through examining the expression landscapes of KAT6A at both transcriptional and translational levels, we proposed a possible role of KAT6A acetylation in reducing its ability in acetylating SMAD3 and subsequent oncogenic roles. Through analyzing the whole transcriptome and acetylome of TNBC cells in response to CAP treatment, we predicted the efficacy of CAP in resolving TNBCs via increasing KAT6A acetylation, which were validated both in vitro and in vivo. Our study, for the first time, presented the role of CAP in re-polarizing macrophages from the M2 to M1 state in the microenvironment of breast cancers via elevating KAT6A acetylation, and warranted careful interpretation of patients' genetic testing reports by clinicians for the sake of minimizing mortalities due to inappropriate choice of therapeutic modalities.

When Refreshable Tactile Displays Meet Conversational Agents: Investigating Accessible Data Presentation and Analysis with Touch and Speech.

Despite the recent surge of research efforts to make data visualizations accessible to people who are blind or have low vision (BLV), how to support BLV people's data analysis remains an important and challenging question. As refreshable tactile displays (RTDs) become cheaper and conversational agents continue to improve, their combination provides a promising approach to support BLV people's interactive data exploration and analysis. To understand how BLV people would use and react to a system combining an RTD with a conversational agent, we conducted a Wizard-of-Oz study with 11 BLV participants, where they interacted with line charts, bar charts, and isarithmic maps. Our analysis of participants' interactions led to the identifcation of nine distinct patterns. We also learned that the choice of modalities depended on the type of task and prior experience with tactile graphics, and that participants strongly preferred the combination of RTD and speech to a single modality. In addition, participants with more tactile experience described how tactile images facilitated a deeper engagement with the data and supported independent interpretation. Our fndings will inform the design of interfaces for such interactive mixed-modality systems.

Discrete Continuous Travel Mode Choices based on Simulated Travel Demand: a MDCEV Model Application

Discrete Continuous Travel Mode Choices based on Simulated Travel Demand: a MDCEV Model Application

Freight mode choices for eco-friendly transport modes: An impact-analysis of modal shift measures

Freight mode choices for eco-friendly transport modes: An impact-analysis of modal shift measures

Modeling and analysis of freight mode choice behavior integrating grouped and repeated observations

Modeling and analysis of freight mode choice behavior integrating grouped and repeated observations

Differences in dialysis modality choice between immigrant and native populations in Barcelona, Spain.

Few studies have analyzed the freedom to choose their renal replacement treatment (RRT) modality in Spain. In a total of 673 patients with ACKD (stage 4 and 5) seen at the outpatient ACKD clinic of Hospital del Mar, Barcelona, Catalonia (Spain) from 2009 to 2020, we retrospectively compared immigrant and Spanish patients in order to analyze the impact of migration on RRT decision-making and its subsequent evolution in advanced CKD (ACKD) consultation and identifies the social and economic needs of this population. One hundred thirteen (16.8%) patients were immigrants and 560 were Spanish (83.2%). Migrants more frequently chose HD at a center (79.5%) than PD (12.5%) compared to Spaniards (HD 55.5% and 25% PD) despite being younger and more independent in basic and instrumental activities of daily living. Immigrant patients started RRT with lower eGFR (8.1 vs. 9.1 mL/min/1.73 m3) and after a shorter follow-up time in the ACKD consultation than the Spaniards (22 vs. 32 months). The language barrier was associated with a greater choice of center-based HD and active employment status favored the choice of PD. Spanish patients had a significantly higher relative risk of mortality compared with immigrant patients (HR = 3.27[95%CI:1.17-9.17], p = 0.024). However, after adjustment by age, this increased relative risk of mortality disappeared (HR 1.99[0.69-5.76], p = 0.206). Almost 60% individuals were not linked to social services. In conclusion, most immigrants in Barcelona choose center-HD versus DP despite being younger and more independent in basic and instrumental activities of daily living and being in a better condition than Spanish patients. Considering the socioeconomic and cultural needs of the immigrant population we serve is necessary to effectively reduce health inequities. Keywords: advanced chronic kidney disease, socioeconomic status, demographic factors, shared decision making, renal replacement therapy, peritoneal dialysis, conservative care, hemodialysis, renal transplantation, language barrier, social determinants of health, immigration, social determinants of health.

Population health strategies for health equity in chronic kidney disease management.

Chronic kidney disease (CKD) is a widespread health issue, affecting one out of every 10 adults. This prevalence is even higher among vulnerable and underserved populations, including low-income individuals, racial and ethnic minorities, and immigrants. Urban areas such as New York City and Los Angeles County offer municipal safety-net healthcare systems for these groups. Safety-net providers are essential to the healthcare landscape for vulnerable populations with chronic diseases including the Los Angeles County Health Services that exemplifies how effective population health strategies can be utilized to manage CKD and at-risk persons. These approaches focus on risk assessment, integrated practices, patient and care-partner education, cost reduction, and strategic partnerships. Kidney care tailored "Expected Practices" ensure that management strategies are equitable and based on clinical evidence. The eConsult system allows CKD patients' primary care providers to efficiently consult nephrologists, facilitating timely specialty care appointments through "Precision Scheduling." Priority goals include slowing CKD progression, equitable access to home dialysis, and preemptive kidney transplantation. As highlighted by Kalantar-Zadeh et al. in 2025 CJASN, advancing equitable kidney care through population health approaches support comprehensive and efficient CKD management, including diabetic kidney disease, in Los Angeles County's safety-net system. With a large, underserved patient population affected by CKD, urban safety-net healthcare systems like those in Los Angeles County emphasize early detection, multidisciplinary management, shared decision-making, and equitable access to CKD. They prioritize equitable access to home dialysis modality choice and kidney transplantation, aiming to improve outcomes and the quality-of-life for diverse patient groups.

Patient Perceptions of Pessaries for Treatment of Pelvic Organ Prolapse.

A vaginal pessary is a highly effective treatment for patients with pelvic organ prolapse (POP). Patient views of pessaries and how their beliefs affect whether they choose pessary treatment is unknown. Our objective of this study was to describe the knowledge, understanding, and patient concerns regarding pessary use for POP management. We performed a qualitative study of women presenting with POP who were counseled about pessary use at their initial urogynecology visit. Participants completed interviews, which were recorded, de-identified, and transcribed. Transcriptions were coded for major themes by 2 independent researchers. Twenty patients with an average age of 63 ± 8.5 years participated. Most identified as sexually active (60%) and the majority had a high school education or less (80%). Thematic saturation was reached with themes of "Failure", "Convenience," "Self-Image," "Sexual Relations," "Cleanliness/Hygiene," "Physical Barriers," "Knowledge Deficits," and "Discomfort." Many patients not only viewed a pessary as a less invasive alternative to surgery but also considered it a temporary treatment. Many patients disliked the idea of having a "foreign body" in place and felt it may affect their hygiene. Although most patients believed it would alleviate their POP symptoms, many had concerns about sexual intercourse, discomfort, and fear that it may fall out. Most participants who were not sexually active thought a pessary would increase their sexual confidence. Patient opinions about pessaries are often negative with preconceived notions surrounding utilization. Focused counseling addressing concerns and fears may improve a patient's comfort with a pessary as their choice of treatment modality.

The role of the (e-)bike: a mode choice model for short distances

The bicycle is a very important mode for travel in various countries, particularly in the Netherlands. However, it is in practice often modelled with less detail than other urban modes, such as the car and public transport. Moreover, the increasing use of e-bikes and the differences with conventional bikes show that more research into this transport mode is needed. E-bikes require less physical effort and allow higher speeds, making the e-bike suitable for longer distances. The goals of this research are to (1) create a mode choice model that predicts an accurate modal split for urban areas in the Netherlands and this model is used to (2) find significant factors that influence the modal split, in order to support municipalities of Dutch urban areas to stimulate the use of the (e-)bike. Within both goals, potential differences between conventional bikes and e-bikes are considered. A conceptual model, following from the literature, describes the assumed modal choice including factors relevant to cycling. Data was used mainly from the Dutch National Travel Survey (ODiN). Discrete choice models, a multinomial logit and a nested logit, are estimated to identify significant influencing factors. Results show that a nested logit model is the most explanatory one compared to the other models, with a rho-square-bar of 0.469. The model includes 15 main variables, 3 quadratic components and 4 interaction effects. The nested structure is formed by a correlation between the bike and the e-bike. The factors that show to be generally highly influential for the bike and the e-bike are the travel distance, owning a driver’s license and street density. The model is practically applicable for municipalities to form expectations in the modal shift for changes in their networks or policies. However, modelling these changes has not been validated and thus needs further research.

METHODOLOGY FOR OPTIMIZING THE FUNCTIONING OF THE OPTOELECTRONIC SURVEILLANCE SYSTEM

Context. Radar, thermal imaging, and video surveillance means are actively used in the protection of the state border. Together with the appropriate communication equipment, they allow to create optoelectronic surveillance systems, which are the basis for the intellectualization of border protection. The effectiveness of such systems is significantly affected by the peculiarities of their functional and structural design. A rational structural design, even in difficult physical and geographical conditions, allows for a high level of surveillance efficiency. However, the functional component also has a significant impact on improving the system efficiency. In many cases, the functioning of the elements of the optoelectronic surveillance system occurs under conditions of power supply restrictions. Such limitations determine the need for a rational choice of modes of use of certain types of surveillance equipment at certain time intervals in order to ensure effective surveillance, taking into account the time of day and weather conditions. The imperfection of the scientific and methodological apparatus for optimizing the functioning of optoelectronic surveillance systems determines the relevance of this study. Objective. The aim of the work is to develop a methodology for optimizing the optoelectronic surveillance system functioning by rationally selecting the modes of operation of different types of surveillance equipment in certain time intervals, taking into account the time of day and weather conditions in which they are used. Methods. The paper sets and investigates the two-criteria problem of choosing the modes of operation of different types of observation equipment of an optoelectronic surveillance system at separate time intervals, taking into account the time of day and weather conditions in which they are used, which ensures maximizing the efficiency of the optoelectronic surveillance system while minimizing the power consumed by active types of surveillance equipment in the presence of boundary restrictions on the efficiency and power consumed by the system. The proposed indicator for assessing the effectiveness of the system allows us to assess the level of impossibility of uncontrolled crossing of the perimeter of the protected area by an intruder. The peculiarity of this methodology is the possibility of ensuring a significant reduction in the level of energy consumption by the system components due to a slight decrease in the efficiency of monitoring. Results. The paper proposes an alternative approach to assessing the effectiveness of the optoelectronic surveillance system, the idea of which is that instead of assessing the effectiveness of surveillance over the entire sector of the controlled area of the border, the effectiveness of control is assessed only along the perimeter of this area. This approach significantly reduces the computational complexity of the problem of finding the value of efficiency which further simplifies the solution of problems of structural optimization of surveillance systems. A software and algorithmic implementation of the methodology for optimizing the functioning of an optoelectronic surveillance system is proposed. Using the developed software, a rational choice of modes of operation of certain types of surveillance equipment at certain time intervals was carried out taking into account the time of day and weather conditions. Conclusions. The use of the proposed methodology makes it possible to optimize the modes of operation of the optoelectronic surveillance system, taking into account the limiting factors in terms of efficiency and power consumption when using the same types of surveillance equipment on all towers of the system. A possible direction for improving the methodology is its adaptation to cases where different types of surveillance equipment are used on different towers of the system.