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Aims: The objective was to evaluate whether sodium intake, assessed with the gold standard 24-h urinary collections, was related to long-term incidence of death, cardiovascular disease (CVD) and diabetes mellitus (DM). Methods:A cohort of 4630 individuals aged 25-64 years collected 24-h urine samples in 1979-2002 and were followed up to 14 years for the incidence of any CVD, coronary heart disease (CHD), stroke, heart failure (HF) and DM event, and death. Cox proportional hazards models were used to estimate the association between the baseline salt intake and incident events and adjusted for baseline age, body mass index, serum cholesterol, prevalent DM, and stratified by sex and cohort baseline year. Results: During the follow-up, we observed 423 deaths, 424 CVD events (288 CHD events, 142 strokes, 139 HF events) and 161 DM events. Compared with the highest quartile of salt intake, persons in the lowest quartile had a lower incidence of CVD (hazard ratio [HR] 0.70; 95% confidence interval [CI], 0.51-0.95,p = .02), CHD (HR 0.63 [95% CI 0.42-0.94],p = .02) and DM (HR 0.52 [95% CI 0.31-0.87],p = .01). The results were non-significant for mortality, HF, and stroke. Conclusion: High sodium intake is associated with an increased incidence of CVD and DM.

Research and commercial approaches on electronic voting (e-Voting) exist and the recently emerged blockchain technology has given this research area yet another boost. However, one may claim that the actual deployment of e-Voting is at its infancy, mainly due to election integrity issues such as vote non-tampering, voter anonymity, and vote verifiability (even though the last two may seem contradictory). The integration of cryptography and blockchain technology in a single framework could provide a solid foundation for secure, anonymous and still verifiable electronic voting. This paper presents the TrustedEVoting (TeV) framework, a blockchain-based approach, that wraps not only the required key elements for secure and verifiable e-Voting but also additional features such as support for re-voting, post-election vote check and voting channel preference. The last one is important as the transition from traditional physical voting to e-Voting is not immediate and TeV framework makes provision for a multiple-channel approach for voting.

Background Regular fish and omega-3 consumption may have several health benefits and are recommended by major dietary guidelines. Yet, their intakes remain remarkably variable both within and across populations, which could partly owe to genetic influences. Objective To identify common genetic variants that influence fish and dietary eicosapentaenoic acid plus docosahexaenoic acid (EPA+DHA) consumption. Design We conducted genome-wide association (GWA) meta-analysis of fish (n = 86,467) and EPA+DHA (n = 62,265) consumption in 17 cohorts of European descent from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium Nutrition Working Group. Results from cohort-specific GWA analyses (additive model) for fish and EPA+DHA consumption were adjusted for age, sex, energy intake, and population stratification, and meta-analyzed separately using fixed-effect meta-analysis with inverse variance weights (METAL software). Additionally, heritability was estimated in 2 cohorts. Results Heritability estimates for fish and EPA+DHA consumption ranged from 0.13-0.24 and 0.12-0.22, respectively. A significant GWA for fish intake was observed for rs9502823 on chromosome 6: each copy of the minor allele (Freq(A) = 0.015) was associated with 0.029 servings/day (similar to 1 serving/month) lower fish consumption (P = 1.96x10(-8)). No significant association was observed for EPA+DHA, although rs7206790 in the obesity-associated FTO gene was among top hits (P = 8.18x10(-7)). Post-hoc calculations demonstrated 95% statistical power to detect a genetic variant associated with effect size of 0.05% for fish and 0.08% for EPA+DHA. Conclusions These novel findings suggest that non-genetic personal and environmental factors are principal determinants of the remarkable variation in fish consumption, representing modifiable targets for increasing intakes among all individuals. Genes underlying the signal at rs72838923 and mechanisms for the association warrant further investigation.

PurposeThe purpose of this paper is to present ReProTool Version 2.0, a software tool that is used for the European Credit Transfer System (ECTS) and the Bologna Process re‐engineering of academic programmes. The tool is the result of an 18 months project (February 2012‐July 2013) project, co‐financed by the European Regional Development Fund and the Republic of Cyprus through the Research Promotion Foundation (www.reprotool.com).Design/methodology/approachThe project entails the development and pilot use of ReProTool, a software tool that will support the design and development of university academic programmes using Learning Outcomes and the European Credit Transfer System (ECTS) of the Bologna Process. The paper briefly describes the various stages of the project: Identification of User and System Requirements; System Analysis and Design; and Software Development. More specifically, it presents the results of on‐line questionnaires distributed to students and academics aiming at extracting the user requirements of the system. Based on these results and the results from interviews with experts and literature review, the system was designed. The underlying database is thus presented. The implementation details and the system architecture are also presented. Various screenshots of the system are used in the paper to exemplify the functionality of the tool.FindingsThe ECTS process and the supporting methodologies are quite complex and complicated, requiring the involvement of all education stakeholders (faculty, students, industry, etc.). The lack of a software tool to support the available methodologies and the involved stakeholders makes the process even more complex, laborious and difficult to complete. The authors are currently developing such tool. The availability of a free software tool will therefore simplify the process and help all Universities in their effort to obtain the ECTS label and help them towards the full implementation of the Bologna Process directives.Originality/valueThe paper presents the software tool ReProTool, which will provide support to the Tuning Methodology, also taking into consideration state‐of‐the‐art developments in the area of ECTS, Learning outcomes and the European Qualifications Framework and will thus make it possible for Universities to re‐engineer their academic programs in line with ECTS, achieve ECTS certification/label and fulfill the Bologna Process directives. This will result in the improvement of academic programs offered by Universities and the creation of compatible programmes across Europe, so that students and faculty will be able to utilize the Erasmus and other mobility programmes and participate in exchange visits. Without the use of such a tool, the application of such methodologies is really a non‐trivial, error‐prone task. This is a very demanding task and very few Universities in Europe have managed to obtain the ECTS label.

ObjectiveThe aim of the study is to elucidate differences in adults’ diet by education, and to analyse the associations between dietary facilitators, education and dietary fat quality.DesignIn all, one-third of subjects from the national FINRISK health survey were invited to participate in the FINDIET 2007 Survey. A 48 h dietary interview was used for dietary data and personal background data were collected by the health survey questionnaire.SettingRepresentative sample from five regions in Finland in spring 2007.SubjectsA total of 1576 adults, participation rate 60 %.ResultsOil used in cooking differed by education. Instead perception of cardiovascular risk, or the following of a cholesterol-lowering diet, were equal across all educational categories. The diet of men with low education contained less protein and carbohydrates, more fat and more SFA and MUFA than that of highly educated men. The diet of women with low education contained less PUFA, vitamin C and vitamin E than in the highly educated category. High education remained a significant determinant for the lower intake of SFA in men, and for the higher intake of PUFA in women, after adjusting for the determinants and facilitators of dietary behaviour and age. The lower intake of SFA was also associated with following a cholesterol-lowering diet in both genders. In addition to education, the intake of unsaturated fatty acids was determined by the oil used in cooking by women, and by frequent lunches served by caterers for men.ConclusionsIn dietary behaviour, awareness and reporting of cholesterol-lowering diet seem to indicate a tendency to control the intake of saturated fat. Health messages are likely to enhance tools for increasing the intake of PUFA, in addition to reducing the intake of SFA.

Many measures have been proposed to summarize the prognostic ability of the Cox proportional hazards (CPH) survival model, although none is universally accepted for general use. By contrast, little work has been done to summarize the prognostic ability of the stratified CPH model; such measures would be useful in analyses of individual participant data from multiple studies, data from multi-centre studies, and in single study analysis where stratification is used to avoid making assumptions of proportional hazards. We have chosen three measures developed for the unstratified CPH model (Schemper and Henderson's V , Harrell's C-index and Royston and Sauerbrei's D), adapted them for use with the stratified CPH model and demonstrated how their values can be represented over time. Although each of these measures is promising in principle, we found the measure of explained variation V very difficult to apply when data are combined from several studies with differing durations of participant follow-up. The two other measures considered, D and the C-index, were more applicable under such circumstances. We illustrate the methods using individual participant data from several prospective epidemiological studies of chronic disease outcomes.

Aim: To investigate to what extent the changes in traditional risk factors (total cholesterol, smoking, hypertension) explain the changes in socioeconomic (defined by occupational class and household income) differences in cardiovascular mortality in Finland during the past 20 years. Design: Study population comprised 14 642 men and women aged 35–64 years who were selected from population-based FINRISK surveys in 1987, 1992, 1997 or 2002 in three areas of Finland. The 1982 and 1987 FINRISK cohorts were used to determine a model for the probability of cardiovascular death based on risk factor values at the baseline for each socioeconomic group. These predicted changes in cardiovascular mortality were then contrasted with observed mortality rates in different socioeconomic groups to determine the contribution of the changes in risk factors to changes in actual mortality. Results: We found that among men during 1987–97, when risk factor levels were improving in all socioeconomic groups, the model explained 29–44% of the observed mortality decline. The risk factors explained a larger part of the decline among lower socioeconomic groups. During the period 1997–2002 the risk factor levels stopped improving in all socioeconomic groups but observed mortality rates kept declining. The predicted mortality rates were 16–34% of the observed rates during the period 1987–2002. Conclusions: Changes in traditional risk factors no longer provide a good explanation of the changes in cardiovascular mortality and its socioeconomic differences. However, risk factors did explain the cardiovascular mortality decline among lower socioeconomic groups.

Due to changing climate, population growth, and other factors the loss of life and damage to physical property has increased significantly in developing countries. The effects of these disasters can cause long term impacts on productivity and growth throughout the world. Although it is in the international community’s humanitarian and economic interests to provide aid to vulnerable populations, attempts to do this are often hampered by the challenges of coordination across cultures and organizations. It is estimated that $1 spent on preventative measures saves up to $7 in emergency response and rehabilitation; however coordination can be particularly difficult without the pressure of on-going emergency. Global preparedness can be improved by: (1) establishing a global pool of emergency management expertise, with shared frames of reference (terminology, knowledge base, models, frameworks, methodologies) and shared best practices; and (2) creating a foundation for better global collaboration by developing and testing models of local participatory governance in international collaboration for disaster preparedness.

The basic objective of developing an evacuation model is to supply the user with valid and valuable information on which conclusions concerning the safe evacuation from a building can be drawn. Several evacuation models have been developed over the last 15 years. In our opinion, many of these models are too narrowly focused, perhaps not meeting the needs of the decision maker. This paper discusses the objectives of evacuation studies and the selection of a suitable modelling technique relative to these objectives. We show that many different approaches to evacuation modelling are appropriate for different types of studies. In the discussion about different existing models and solution techniques, we present some of the basic philosophy lying behind the simulation model EVACSIM. EVACSIM has been developed to meet the need for an evacuation model that can combine knowledge about human behaviour with the ability to perform large-scale simulations of network processes. EVACSIM treats people as individuals and it has the capacity to collect any information of interest (in principle) regarding their movements, their exposure to potential accident effects and their time to exit the different parts of the structure. The role of an evacuation model in an evacuation analysis is also discussed.

Ekedahl KH, Jonsson B, Frobell RB. Validity of the fingertip-to-floor test and straight leg raising test in patients with acute and subacute low back pain: a comparison by sex and radicular pain. Objective To use self-reported disability (Roland-Morris Disability Questionnaire [RMDQ]) to assess the criterion validity of straight leg raising (SLR) test and flexion range of motion (ROM) (fingertip-to-floor test) before and after stratification by sex and presence/absence of radicular pain. Design Cross-sectional study. Setting Outpatient physical therapy clinic. Participants Subjects with acute/subacute low back pain with (n=40) and without (n=35) radicular pain. Interventions Not applicable. Main Outcome Measures We examined the relationship between RMDQ (reference variable) and SLR test and fingertip-to-floor test. The sample was stratified by presence/absence of radicular pain (categorized by the dichotomous slump test). Results In the entire sample, fair correlations were found between both physical impairment tests (ie, SLR test and flexion ROM) and self-reported disability (.27 r >.44). After stratification by sex, the correlation between RMDQ and flexion ROM and between RMDQ and nonside-specific SLR test increased in women but decreased in men. In those with radicular pain, good correlations were found between RMDQ and flexion ROM ( r =.68 for men and r =.70 for women), and moderate correlation was found between the RMDQ and SLR tests of the affected side in women ( r =.60), but only fair correlation was found between the RMDQ and SLR tests of the affected side in men ( r =.28). Conclusions After stratification by sex and presence/absence of radicular pain, the present study supports a good validity of the fingertip-to-floor test for both men and women with radicular pain. The SLR test, however, was of less value as an indicator of self-reported disability after stratification, especially for men.

The present communication architecture supporting control of the electric power grid makes it difficult to use the wealth of data collected at high rates in substations, retarding their use in new applications for controlling the grid. A flexible, real-time data network would make it possible to use these data for many more control and protection applications, potentially increasing the grid's reliability and increasing its operating efficiency. Applications that could use these data include: decentralised load frequency control; closed-loop voltage control; transient and small-signal stabilisation; and special protection schemes using data gathered over a wide area. Such applications and the flexibility of the underlying communication network imply greater data sharing between utilities, leading to new performance, availability and reliability requirements. This paper examines the security, trust and Quality of Service (QoS) requirements imposed by these applications and shows how they are met by mechanisms included in the GridStat middleware framework that we are developing.