The association between adherence to cancer screening programs and health literacy. A systematic review and meta-analysis

The effectiveness of a cancer screening program relies on its adherence rate. Health literacy (HL) has been investigated among the factors that could influence such participation, but the findings are not always consistent. The aim of this meta-analysis was to summarize the evidence between having an adequate level of HL (AHL) and adherence to cancer screening programs. PubMed, Scopus, and Web of Science were searched. Cross-sectional studies, conducted in any country, that provided raw data, unadjusted or adjusted odds ratio (OR) on the associations of interest were included. The quality of the studies was assessed with the Newcastle-Ottawa Scale. Inverse-variance random effects methods were used to produce pooled ORs and their associated confidence interval (CI) stratified by time interval (e.g., undergoing screening in the last period, or at least once during lifetime) for each cancer type, considering unadjusted and adjusted estimates separately. A sensitivity analysis was performed for those studies providing more estimates. Overall, 15 articles of average-to-good quality were pooled. We found a significant association between AHL and higher screening participation for breast, cervical and colorectal cancer, independently of other factors, both overall (N = 7, aOR = 1.73; 95% CI: 1.27–2.36; N = 3, aOR = 1.64; 95% CI: 1.30–2.09; and N = 5, aOR = 1.25, 95% CI: 1.12–1.39, respectively) and in most time-stratified analyses. The sensitivity analyses confirmed these results. Health literacy seems to be critical for an effective cancer prevention. Given the high prevalence of illiterate people across the world, a long-term action plan is needed

Converse mode piezoelectric coefficient for lead zirconate titanate thin film with interdigitated electrode

The use of interdigitated electrodes (IDEs) in conjunction with ferroelectric thin films shows many attractive features for piezoelectric MEMS applications. In this work, growth of {1 0 0}-textured lead zirconate titanate (PZT) thin films was achieved on insulating MgO buffered, oxidized silicon substrates. IDEs were fabricated by lift-off techniques and cantilevers were formed by dicing. The deflection upon application of a sweeping voltage was measured as large signal response in parallel to the ferroelectric polarization (PV loop). Likewise, the small signal piezoelectric response was measured in parallel to the capacitance-voltage (CV) measurement. In this way, a complete picture of the ferroelectric-piezoelectric element was obtained. From the deflection, the in-plane piezoelectric stress in the PZT thin film was derived and, from this, the effective piezoelectric coefficients. For the latter, two types were defined: an engineering type corresponding to the average value along the IDE, which can directly be compared to coefficient of a parallel plate electrode (PPE) capacitor and a second one that approximately yields the idealized coefficient governing between the electrode fingers. The IDE structures were experimentally compared with PPE structures of identical film thickness. The resulting coefficients were of opposite sign, as expected. In spite of a much better polarization loop, the IDE device showed a lower average piezoelectric stress. The estimated peak value between the fingers was about the same as in the PPE device, corresponding to about 20 C m(-2). Nevertheless, the result is very promising for cases where compressive piezoelectric stresses are required and for preventing cracking due to large piezoelectric tensile stresses in PPE systems

Biologically guided driver modeling: the stop behavior of human car drivers

This paper presents a principled approach to the modeling of human drivers--applied to stop behavior--by uniting recent ideas in cognitive science and optimal control. With respect to the former, we invoke the affordance competition hypothesis, according to which human behavior is produced by resolving the competition between action affordances that are simultaneously instantiated in response to the environment. From the theory of optimal control, we deploy motor primitives based on minimum jerk as the potential suite of actions. Furthermore, we invoke a layered control architecture, which carries out action priming and action selection sequentially, to model the biological affordance competition process. Motor output may be directed to distinct motor channels, which may be partially inhibited, e.g., to model gas pedal release saturation. Within this architecture, two types of motor units--''deceleration'' acting on a gas pedal channel and ''brake'' acting on a brake pedal channel--are sufficient to model, with remarkable accuracy, the various phases that can be observed in human maneuvers in stopping a car, namely: gas release, gas chocked, brake, and final brake release at stop. The model is validated using experimental data collected in 16 different stop locations, from roundabouts to traffic lights. We also carry out a comparison with the well-known Intelligent Driver Model, discuss the scaling of this framework to more general driving scenarios and finally give an example application where the driver model is used, within a mirroring process, to infer the human driver intentions