The impact of smoking on mortality in the face of population ageing: the example of Germany

Background Despite weak tobacco control, smoking in Germany has steadily declined over the last 25 years. As policymakers often expect that this trend will also reflect in a declining associated public health burden, I sought to quantify trends in smoking-attributable mortality (SAM) and to explore the impact of population ageing. Methods Smoking and mortality statistics from 1992 to 2018 were obtained from the German Statistical Office, from which SAM was calculated separately for each cause of death causally associated with smoking using Levin's formula for population-attributable fractions. The impact of population ageing was explored by comparing crude and age-standardized SAM, respectively. To estimate the impact of population ageing on future SAM, a forward projection until 2040 was modelled assuming continuation of smoking trends and constant mortality rates. Results About 126.900 deaths were attributable to smoking in Germany in 2018. Since 1992, total SAM declined only slightly, while stronger decreases were seen in age-adjusted SAM. Differences between crude and age-standardized SAM seem to be particularly striking in men. The forward projection of SAM suggests that recent increases in smoking in the middle aged as well as population ageing dynamics will lead to further steady increases within the next two decades in both sexes to about 138.250. Conclusions Results indicate that past decreases in SAM due to declines in smoking were largely compensated by population ageing. In the next two decades, current smoking trends and population ageing will lead to a steady increase in SAM. Only by taking determined immediate policy action could significant inroads into reducing the smoking-associated disease burden be achieved. Also, given still significant smoking rates in middle and old age, there is tremendous potential to curb the associated public health burden by intensifying cessation programs. Key messages Contrary to common expectations among policymakers, the smoking-attributable public health burden will strongly increase in the next decades in Germany. Determined immediate policy action is required to halt or attenuate these trends.

Physical density estimations of single- and dual-energy CT using material-based forward projection algorithm: a simulation study

Objectives: This study aims to evaluate the accuracy of physical density prediction in single-energy CT (SECT) and dual-energy CT (DECT) by adapting a fully simulation-based method using a material-based forward projection algorithm (MBFPA). Methods: We used biological tissues referenced in ICRU Report 44 and tissue substitutes to prepare three different types of phantoms for calibrating the Hounsfield unit (HU)-to-density curves. Sinograms were first virtually generated by the MBFPA with four representative energy spectra (i.e. 80 kVp, 100 kVp, 120 kVp, and 6 MVp) and then reconstructed to form realistic CT images by adding statistical noise. The HU-to-density curves in each spectrum and their pairwise combinations were derived from the CT images. The accuracy of these curves was validated using the ICRP110 human phantoms. Results: The relative mean square errors (RMSEs) of the physical density by the HU-to-density curves calibrated with kV SECT nearly presented no phantom size dependence. The kV–kV DECT calibrated curves were also comparable with those from the kV SECT. The phantom size effect became notable when the MV X-ray beams were employed for both SECT and DECT due to beam-hardening effects. The RMSEs were decreased using the biological tissue phantom. Conclusion: Simulation-based density prediction can be useful in the theoretical analysis of SECT and DECT calibrations. The results of this study indicated that the accuracy of SECT calibration is comparable with that of DECT using biological tissues. The size and shape of the calibration phantom could affect the accuracy, especially for MV CT calibrations. Advances in knowledge: The present study is based on a full simulation environment, which accommodates various situations such as SECT, kV–kV DECT, and even kV–MV DECT. In this paper, we presented the advances pertaining to the accuracy of the physical density prediction when applied to SECT and DECT in the MV X-ray energy range. To the best of our knowledge, this study is the first to validate the physical density estimation both in SECT and DECT using human-type phantoms.

Technical Development of Junior, Beginners, Advanced and Performers, Involving Proprioceptive Training, in the 110 M Hurdles

A component that we chose to analyze is the psychological one, highlighted by the coordinative capacities and the proprioceptive sensations that, within the sport training of the 110 m hurdles, we analyze through kinematic recordings and develop through individualized programs of proprioceptive exercises. The subjects were advised about the potential for error correction and the progress that can be achieved by repeated and continuous analysis of the mistakes made by them during the phases of the running of the hurdles, but also by an individualized proprioceptive training program, oriented to an impulse with a as sharp an angle as possible, a faster passage, grouped and balanced in the flight phase and a safe landing, oriented towards a forward projection of the CGM, to allow an optimal continuation of the running between the hurdles.

Learning Speech Production and Perception through Sensorimotor Interactions

Action and Perception are closely linked in many behaviors necessitating a close coordination between sensory and motor neural processes so as to achieve a well-integrated smoothly evolving task performance. To investigate the detailed nature of these sensorimotor interactions, and their role in learning and executing the skilled motor task of speaking, we analyzed ECoG recordings of responses in the high-γ band (70 Hz-150 Hz) in human subjects while they listened to, spoke, or silently articulated speech. We found elaborate spectrotemporally-modulated neural activity projecting in both forward (motor-to-sensory) and inverse directions between the higher-auditory and motor cortical regions engaged during speaking. Furthermore, mathematical simulations demonstrate a key role for the forward projection in learning to control the vocal tract, beyond its commonly-postulated predictive role during execution. These results therefore offer a broader view of the functional role of the ubiquitous forward projection as an important ingredient in learning, rather than just control, of skilled sensorimotor tasks.

Physical Density Estimations of Single- and Dual-energy CT Using Material-based Forward Projection Algorithm

Purpose: This study aims to evaluate the accuracy of physical density prediction in single-energy CT (SECT) and dual-energy CT (DECT) by adapting a fully simulation-based method using a material-based forward projection algorithm (MBFPA). Methods: We used biological tissues referenced in ICRU Report 44 and tissue substitutes to prepare three different types of phantoms for calibrating the HU-to-density curves. Sinograms were first virtually generated by the MBFPA with four representative energy spectra (i.e. 80 kV, 100 kV, 120 kV, and 6 MV) and then reconstructed to form realistic CT images by adding statistical noise. The HU-to-density curves in each spectrum and their pairwise combinations were derived from the CT images. The accuracy of these curves was validated using the ICRP110 human phantoms.Results: The relative mean square errors (RMSEs) of the physical density by the HU-to-density curves calibrated with kV SECT nearly presented no phantom size dependence. The kV-kV DECT calibrated curves were also comparable with those from the kV SECT. The phantom size effect became notable when the MV X-ray beams were employed for both SECT and DECT due to beam hardening effects. The RMSEs were decreased using the biological tissue phantom.Conclusions: Simulation-based density prediction can be useful in the theoretical analysis of SECT and DECT calibrations. The results of this study indicated that the accuracy of SECT calibration is comparable with that of DECT using biological tissues. The size and shape of the calibration phantom could affect the accuracy, especially for MV CT calibrations.

The impact of smoking on deaths and disease in the face of population ageing: the example of Germany

Background Despite weak tobacco control, smoking in Germany has steadily declined over the last 25 years. As policymakers expect that this trend will reflect in a declining associated public health burden, I sought to quantify trends in smoking-attributable mortality (SAM) and smoking-attributable cancer incidence (SACI) and to explore the impact of population ageing. Methods Smoking and mortality statistics from 1992 to 2017 were obtained from the German Statistical Office, from which SAM was calculated separately for each cause of death causally associated with smoking. Cancer incidence data from 1999 to 2016 was obtained from the German Cancer Registry, and SACI was calculated separately for each cancer site causally associated with smoking. The impact of population ageing was explored by comparing crude and age-standardized SAM and SACI, respectively. To estimate the impact of population ageing on future SAM and SACI, a forward projection until 2035 was modelled. Results Preliminary results suggest that total SAM and SACI only slightly declined over time, while stronger decreases were seen in age-adjusted SAM and SACI. Differences between crude and age-standardized SAM and SACI seem to be particularly striking in men. The forward projection of SAM and SACI suggests that population ageing will lead to further steady increases within the next two decades in both sexes. Conclusions Results indicate that past decreases in SAM and SACI due to declines in smoking were largely compensated by population ageing. In the next two decades, population ageing will lead to a steady increase in SAM and SACI. Only by taking determined immediate action with a comprehensive set of evidence-based tobacco control polices could significant inroads into reducing the smoking-associated disease burden be achieved. Also, given still significant smoking rates in middle and old age, there is tremendous potential to curb the associated public health burden by intensifying cessation programs. Key messages Contrary to common expectations among policymakers, the smoking-attributable public health burden will strongly increase in the next decades. Determined immediate policy action is required to halt or attenuate these trends.

Morfologi dan Morfometri Nematoda Sista Kentang (Globodera spp.) Asal Dataran Tinggi Dieng, Jawa Tengah

The Morphology and Morphometry of Potato Cyst Nematodes (Globodera spp.) from Dataran Tinggi Dieng, Central JavaIn Indonesia, the potato cyst nematode (PCN) was first reported in 2003, at potato plantation in Batu, East Java. Golden cyst (Globodera rostochiensis) was detected in Bandung, West Java; Banjarnegara, Central Java; Batu, East Java; and Gowa, South Sulawesi, whereas the pale cyst (G. pallida) has been reported at limited distribution in Dataran Tinggi Dieng (Central Java). The aim of this research was to identify the Globodera species of Dataran Tinggi Dieng based on morphological and morphometrical methods. Soil samples were collected from Dieng plateau at 30 selected potato plantations ranging from 1 100 – 2 100 m above sea level. The identification of PCN was done by observing the morphological and morphometrical key characters of cysts and second juveniles (J2). Two species of Globodera, that are G. rostochiensis and G. pallida, were identified from soil samples. The key characters of G. pallida including distinct forward projection of J2 stylet knob, granek’s ratio value less than 3, and number of cuticular ridges between vulval basin and anus are less than 12 were identified. There were 25 specimens that having granek’s ratio less than 3, and 10 specimens having cuticular ridges number less than 12. G. rostochiensis which has the shape of a stylet knob protrudes posteriorly and the value of the granek’s ratio greater than 3.5 was identified in 30 specimens.

An iterative reconstruction algorithm for pole figure inversion using total variation regularization

This paper describes a new discrete method for inverting X-ray pole figures to estimate the orientation distribution function (ODF). The method employs the equal-volume `cubochoric' representation for uniform discretization of orientation space, SO(3). The forward-projection model is combined with an anisotropic total variation term to iteratively determine the ODF. The efficacy of the new method is evaluated with both model and experimental data and compared with existing discrete and series expansion methods.