Small Country Research Articles

MAINTENANCE AND UPDATE NATIONAL TOPOGRAPHIC DATA BASE IN HIGH FREQENCY USING MODERN PROCEDURES AND TECHNIQUES

Abstract. The state of Israel is a small country, in terms of area, with one the higher population growth rate among all the OECD countries. Hence, each year more than 50,000 housing units built and more than 1,500 km roads constructed in average, each year along the last decade.The Survey of Israel )SOI( is a National Mapping and Cadastral agency (NMCA) that holds the responsibility to update, maintain and disseminate the National Topographic Data Base (NTDB) to all of the governmental offices and municipalities, to utilize, plan and promote the construction of the public needs.Today, the reality is dynamic and the changes occurs every day, therefore, the users expect that the existing database will portray the current reality as possible. In order to address the user's requirements for rapid updating rate, the Survey of Israel promote a new and modern initiatives, including:Promote the cooperation and working relationship with the municipalities to rapidly update the streets, address and POI’s.Data Fusion from different governmental and municipalities data sources.Developing change detection techniques to update the buildings and roads layers.Developing new frameworks for the manual inspection and QA/QC procedures.Developing automatic tools to update the height component via high resolution DSM and DTM (50cm GSD).Disseminate quarterly the NTDB products to the users.Develop a modern processes management system for the update and QA workflowIn this article, we will demonstrate the initiatives and techniques that improved our NTDB updating rate to less than a year and a half in a national average.

ڕۆڵی قەتەر لەسەر ئاسایشی ووڵاتانی هاریکاری کەنداو لە دوای ساڵی ٢٠١٧

Qatar presents an impressive case by demonstrating its role as a small country with a major role in international relations theories and practices. This paper examines Qatar's role as a small state, in particular its quest for a high security position in international relations. It also illustrates the security role of the State of Qatar in the Gulf Cooperation Council countries, especially after the emergence of a conflict between Qatar and the rest of the Gulf Cooperation Council countries, especially (Saudi Arabia, the Emirates, Bahrain...) in 2017.In the international relations literature, small states rarely feature prominently in diplomatic relations due to their alleged lack of global power and importance. But Qatar, by virtue of its strategic geographical location and its great economic power that depends on oil and natural gas, has been able to play a prominent role in regional security and stability, and has made its region in the calculations of the major countries. This paper also argues that the Qatari leadership's refusal to remain in the shadows of its allies or rivals within the Gulf Cooperation Council has given it a single and influential position in foreign policy within the Middle East and beyond. Finally, this paper analyzes the important role that Qatar plays in terms of security and destabilization in the countries of the Gulf Cooperation Council.

Qatar’s role in the security of the Gulf Cooperation Council countries after 2017

Qatar presents an impressive case by demonstrating its role as a small country with a major role in international relations theories and practices. This paper examines Qatar’s role as a small state, in particular its quest for a high security position in international relations. It also illustrates the security role of the State of Qatar in the Gulf Cooperation Council countries, especially after the emergence of a conflict between Qatar and the rest of the Gulf Cooperation Council countries, especially (Saudi Arabia, the Emirates, Bahrain…) in 2017.In the international relations literature, small states rarely feature prominently in diplomatic relations due to their alleged lack of global power and importance. But Qatar, by virtue of its strategic geographical location and its great economic power that depends on oil and natural gas, has been able to play a prominent role in regional security and stability, and has made its region in the calculations of the major countries. This paper also argues that the Qatari leadership’s refusal to remain in the shadows of its allies or rivals within the Gulf Cooperation Council has given it a single and influential position in foreign policy within the Middle East and beyond. Finally, this paper analyzes the important role that Qatar plays in terms of security and destabilization in the countries of the Gulf Cooperation Council.

Structural gender inequalities and symptoms of postpartum depression in 40 countries

IntroductionThe extent to which structural gender inequality contributes to macro-level differences in postpartum depression (PPD) remains largely unknown.ObjectivesTo examine the association of structural gender inequalities with national-level prevalence estimates of PPD symptoms.MethodsMeta-analytically derived national-level estimates for the prevalence of PPD symptoms – based on the Edinburgh Postnatal Depression Scale (EPDS) – were combined with economic (e.g., income inequality), health (e.g., infant mortality rate), sociodemographic (e.g., urban population), and structural gender inequality variables (e.g., abortion policies) for 40 countries (276 primary studies). Data came from a prior meta-analysis on PPD prevalence and international agencies (e.g., UNICEF). Meta-regression techniques and traditional p-value based stepwise procedures, complemented with a Bayesian model averaging approach, were used for a robust selection of variables associated with national-level PPD symptom prevalence. Sensitivity analyses excluded primary studies with small sample sizes or countries lacking evidence for psychometric properties of the EPDS.ResultsIncome inequality (β = 0.04, 95% CI = 0.02 to 0.07) and abortion policies (β = 0.02, 95% CI = 0.00 to 0.03) were the only variables included in the final, adjusted model, accounting for 60.7% of the variance in PPD symptoms across countries. Gradual liberalizations of abortion policies were associated with a 2% decrease in national-level PPD symptom prevalence. Results were robust to sensitivity analyses.ConclusionsStructural gender inequalities might be social determinants of PPD, as the liberalization of abortion policies seem to impact women’s perinatal mental health on a population level. More research on structural gender inequality is needed to guide policy and practice.DisclosureNo significant relationships.

거란과 고려의 保州 영유권 분쟁

In the 10th century, Song in China, Kitan in Manchuria, and Goryeo in the Korean Peninsula were unified. However, territorial disputes frequently occurred as the three countries faced each other with borders centered on Kitan. In Liaodong, Kitan and Goryeo fought wars and diplomatic battles boringly over the Yalu River basin, which was Balhae‘s territory. With the accession of the sixth emperor(聖宗), his Eastern policy and Goryeo's northern policy clashed. Eventually, the Kitan invaded Goryeo, and with this opportunity, the two countries signed an agreement to make the southern part of the Yalu River a territory of Goryeo and the northern part a territory of Kitan. However, not only did he abandon his diplomatic cause and maintain effective control over the already ceded Boju(保州), but he also invaded again to return all six Gangdong states(江東六州). Boju is an area located in the lower reaches of the Yalu River and corresponds to the throat connecting Liaodong and the Korean Peninsula. Goryeo could not yield because it was a military hub and an important transportation and trade hub. Goryeo protested several times to destroy various facilities of Kitan built in Boju and further asked for the return of the site, but failed to achieve its intention. Goryeo had to win Boju on a strategic level, but it was not able to forcibly recapture Boju due to its weak military power. In such a situation, Jurchen rose and founded the Jin Dynasty, and due to the fierce offensive of the Jin, Kitan was in danger, so Goryeo had a chance to acquire Boju again. Goryeo used diplomatic means rather than physical means to compromise with Kitan and Jin. When Kitan withdrew his troops, delivered Naewonseong Fortress(來遠城) and Boju to Goryeo. Goryeo occupied Boju before the Jin's army and asked the Jin Dynasty to recognize their ownership. Jin Dynasty recognized the ownership of Goryeo in return for subservience to the stronger. Finally incorporated Boju into Goryeo's territory. In this way, Goryeo obtained six weeks of Gangdong and Boju by serve Kitan and Yeojin. Subservience to the stronger, in which a small country serves a large country, were international practices at the time. As long as they became a hegemonic power in Northeast Asia, it was a practical option for Goryeo. Goryeo acquired territory and maintained friendly relations between the two countries to minimize the war, which created favorable conditions for the development of Goryeo.

Importance of Mesohabitat for Nest-Site Selection in Breeding Eagle Owls (Bubo bubo): A Multi-Scale Model

Apex predators make excellent bioindicators of habitat quality and anthropogenic changes. Eagle owls (Bubo bubo) are such apex and keystone predators, who show preferential nest-site selection, usually away from human activities and habitation. However, Israel is a small country with a burgeoning human population. Hence, in order to understand the habitat requirements of eagle owls in central Israel, we conducted a multi-scale model analysis on their existing nest sites between 2006 and 2010. We identified 203 successful breeding attempts at 73 different sites. Our data suggested that the breeding population of the eagle owls was limited by the availability of quality nest locations, i.e., quarries, and caves. The probability of an eagle pair breeding increased with the presence of both quarries and caves, but was not related to mesohabitat properties. In addition, eagle owl breeding densities were positively related to the number of nest localities and to the planted woodlands. Furthermore, we found that eagle owls successfully raised their young regardless of the surrounding mesohabitat and sought the presence of other potential nest sites in the vicinity of the active nest sites, most likely due to the owls’ opportunistic and generalist hunting behavior, which facilitated the consumption of a wide prey base. Appropriate nest sites (quarries and caves) appeared to increase population numbers and, therefore, should be protected Further studies should determine whether increasing artificial nest sites and reclaiming abandoned quarries could increase eagle owl numbers in a sustainable manner.

A Brief Review of Chromatography in Croatia

Although the Republic of Croatia is a relatively small country geographically, it can boast numerous scientists who have left indelible marks in various scientific fields. However, this paper is exclusively about chromatography as one of the most important analytical techniques of our time. The development of chromatography in the Republic of Croatia and the role that three institutions have played in it—the Faculty of Chemical Engineering and Technology of the University of Zagreb, the Croatian Society of Chemical Engineers, and the Central European Group for Separation Sciences—will be briefly discussed.

A bibliometric analysis of research on terrestrial isopods.

Terrestrial isopods (Oniscidea) are crustaceans that thrive in terrestrial environments. This study provides an overview of the major topics in terrestrial isopod research during the last 70 years in order to provide an example of publication practices in invertebrate zoology and to examine how basic research in this area is transferred to its applications. Co-citation analysis and bibliographic coupling based on citation data from the Web of Science Core Collection was used. Findings show that while research on terrestrial isopods expanded in applicative research prioritised by research policies, basic research continues to flourish. The most productive countries in the field include the major developed economies and several smaller nations. In the smaller countries, as well as in France and Italy, the bulk of woodlouse research is performed at a few institutions with traditions in this field. Some of the most influential works have been published in periodicals or monographs that are not indexed in Web of Science or Scopus and lack impact factors. Conference proceedings represent some of the most influential publications in the field. Our findings indicate that smaller and developing economies make significant contributions in invertebrate zoology if their research organisations can achieve continuity of research on a topic. Another conclusion is that journal metrics may be a misleading descriptor of the impact of studies and researchers in this field. Ultimately, these results identify several examples of how basic research in invertebrate zoology leads to applications with considerable socio-economic impact.

In the Shadow of the Golden Calf.

Abstract The article offers the first comprehensive account of relations between Germany and Switzerland in the years 1919 to 1931 based on archival sources from both countries. Emphasising the interaction between finance and diplomacy, it provides new insights into the role played by the Swiss offshore centre for the German Reich after the First World War. During the inflationist period of 1919‒1923, as well as in the crisis of 1929‒1931, Switzerland, like the Netherlands, welcomed a huge amount of wealth from Germany while at the same time becoming an important creditor of the Reich. These developments had a significant impact on German internal and foreign policies at the time. Nevertheless, the article article argues that, despite the intensity of financial flows, Switzerland pursued a diplomatic course that was more plurilateral than the Netherlands. Even during the second part of the 1920s, when Swiss capital was placed on the German market in massive dimensions, there was no German orientation in Swiss foreign policy similar to what had happened in the years before the First World War. Switzerland’s foreign relations became more neutral during the 1920s. This article consequently proposes a nuanced perspective on the role of the small European countries in German foreign policy, highlighting the need to differentiate between them in spite of their common features and to consider, in a non-deterministic way, the interaction between finance and diplomacy.

Postoperative radiotherapy for meningiomas – a decision-making analysis

BackgroundThe management of meningiomas is challenging, and the role of postoperative radiotherapy is not standardized.MethodsRadiation oncology experts in Swiss centres were asked to participate in this decision-making analysis on the use of postoperative radiotherapy (RT) for meningiomas. Experts from ten Swiss centres agreed to participate and provided their treatment algorithms. Their input was converted into decision trees based on the objective consensus methodology. The decision trees were used as a basis to identify consensus and discrepancies in clinical routine.ResultsSeveral criteria used for decision-making in postoperative RT in meningiomas were identified: histological grading, resection status, recurrence, location of the tumour, zugzwang (therapeutic need to treat and/or severity of symptoms), size, and cell division rate. Postoperative RT is recommended by all experts for WHO grade III tumours as well as for incompletely resected WHO grade II tumours. While most centres do not recommend adjuvant irradiation for WHO grade I meningiomas, some offer this treatment in recurrent situations or routinely for symptomatic tumours in critical locations. The recommendations for postoperative RT for recurrent or incompletely resected WHO grade I and II meningiomas were surprisingly heterogeneous.ConclusionsDue to limited evidence on the utility of postoperative RT for meningiomas, treatment strategies vary considerably among clinical experts depending on the clinical setting, even in a small country like Switzerland. Clear majorities were identified for postoperative RT in WHO grade III meningiomas and against RT for hemispheric grade I meningiomas outside critical locations. The limited data and variations in clinical recommendations are in contrast with the high prevalence of meningiomas, especially in elderly individuals.

Energy security assessment of small Pacific Island Countries – Sustaining the call for renewable energy proliferation

Using a contemporary assessment framework, we assess the energy security status of small Pacific Island Countries (PICs) in line with its three broad perspectives. These perspectives – sovereignty, robustness, and resilience encapsulate vulnerabilities and threats to vital energy systems, including their respective political and economic strata. Based on a recently adopted regional energy security framework, we unpack these perspectives and generate a collective evaluative judgment of its impact across small PICs. The results resonate with the commonly held notion that energy security concerns are significant and likely to become more severe if expanding energy needs are not addressed through the proliferation of renewable and sustainable energy applications. Another emerging yet familiar concern is that the energy import bill will become more unsustainable for these cash-strapped islands. The findings demonstrate that PICs have severe constraints to overcome, especially with acquiring appropriate technologies and building institutional capacities to implement their respective energy policies and realise their critical energy targets.

The distribution of power within the EU: perspectives on a Ukrainian accession and a Turkish accession

On February 28th, 2022, Ukraine submitted an application concerning accession to the European Union. As Ukraine is already linked to the European Union through an Association Agreement and the Deep and Comprehensive Free Trade Agreement—signed in 2014—there might be a chance for the Ukraine to join the EU within the next decade. With about 41 million inhabitants, Ukraine is a rather large country and the 65% majority requirement under the EU’s Qualified Majority Voting rules would give Ukraine some significant power in a future EU28. Herein, it is shown how relative political power indices—as measured by the Banzhaf index—would change in the case of an EU enlargement to allow accession by Ukraine: The large economies would lose power and, surprisingly, many small countries would gain political power. Such perspectives might lead one to reconsider the voting procedures of the Council of the European Union at the EU level in the course of future negotiations on amendments to the Lisbon Treaty. The case of Turkey’s accession is also considered as is the case of Montenegro joining the European Union.

Thoracic surgery in Estonia.

Estonia, a small Northern European country with the population of 1.3 million, has two centres of thoracic surgery, both established in 1960s. One is in the capital Tallinn, and another in the university town Tartu. Both departments cover the full spectrum of thoracic surgery, apart from oesophageal cancer surgery, yet including paediatric operations and chest trauma management. However, the focus is on lung cancer surgery. Currently, the proportion of lung cancer cases treated surgically is 20% in Estonia. Between 2000 and 2015 the proportion of lobectomies increased from 53% to 76%, while pneumonectomies decreased from 28% to 8%. Although the absolute number of lung cancer operations in Estonia is small, upon need complex and extended resections are performed. In the last decades a considerable survival gain of lung cancer patients has been observed. Minimally invasive surgery is widely used since its implementation in 1995, with the list of indications constantly evolving. In 2005, first video-assisted thoracoscopic (VATS) thymectomy and lobectomy were performed. VATS as surgical access in lung cancer operations exceeded thoracotomy in 2015 and is currently considered in all cases. In 2018, the first uniportal VATS sleeve-lobectomy was performed. The lung transplant program is functioning together with other solid organ transplant programs only at the Tartu University Hospital. Up to now, 33 lung transplantations have been performed, including lobar transplantations, a paediatric case, a few urgent cases for patients on extracorporeal membrane oxygenation (ECMO), and two re-transplantations. General thoracic surgery is a separate monospeciality in Estonia with an independent 5-year residency program, which is arranged by the Medical Faculty of University of Tartu. In last years, thoracic surgery related research in Estonia has mainly focused on lung cancer detection and management. Currently, a national lung cancer screening program feasibility study is being led by thoracic surgeons.

Medical end-of-life decision-making in a small resource-poor Caribbean country: a mortality follow-back study of home deaths.

In resource-poor countries, including in Latin American and the Caribbean, empirical information about the characteristics and incidence of medical end-of-life decisions (MELDs)-withholding or withdrawing potentially life-prolonging medical treatments-is largely absent. The aim was to describe the incidence and decision-making characteristics of MELDs taken prior to the death of people who died at home in Trinidad and Tobago (T&T). A mortality follow-back study was used where a representative sample of deaths occurring at home in 2018 was drawn from death certificates at the national death registry. The general practitioners who certified the deaths were sent a questionnaire. The sample consisted of 309 adult deaths and the response rate was 31% (N=96). Physicians were: mostly male (79.2%), practiced medicine for more than twenty-years (63.5%), had no formal palliative care training (69.8%). Non-sudden deaths represented 76% (N=73), of these, medications to alleviate pain and symptoms in the last 7 days of life were administered in 65.8%, including opioids 21%. Potentially life-prolonging treatments were withheld in 9.6% but none withdrawn. No physician/patient discussions about various end-of-life treatment options occurred in 61.6%. Compared to physicians with no formal training in palliative care, those with training more often: prescribed or administered opioids in the last 7 days of life (35.7% vs. 11.1%, P=0.01), had discussions with patients about end-of-life treatment options (60.7% vs. 24.4%, P=0.002), and discussed medication use to alleviate pain and other symptoms with patients (50% vs. 17.8%, P=0.004). Differences in the care and treatment general practitioners provided to their patients could be associated with them having been formally trained in palliative care. The necessary support to further develop palliative care in T&T is needed.

Spatiotemporal Variation of Small Mammal Communities in Commercial Orchards across the Small Country

The diversity of small mammal communities is a measure of the sustainability of habitats, especially agricultural ones. Based on 2018–2020 data from 18 sites in Lithuania, we analysed factors related to diversity of such a community, specifically the relative abundances and proportions of common vole, striped field mouse, yellow-necked mouse, and bank vole. We assessed the influence of location (central, northern, eastern, southern, and western parts of the country), habitat type (orchards, berry plantations, control habitats), the year and season. The model explained 14.8–33.4% of the listed parameters with p < 0.005 or higher, with the exception of the dominance index and the proportion of the common vole. Time factor (year and season, p < 0.001) and site location (p < 0.05) had the highest influences, while that of habitat type was less significant. The results of this and the former research suggest that commercial orchards play a role in maintaining the diversity and abundance of small mammal communities in the agrolandscapes.

Situation Analysis and the Potential for Circularity of the Wastewater Sector in Lithuania

The concept of circular economy is one of the priority areas for economic development on which the current environmental policy of the European Union is based. Most existing European wastewater treatment plants were built and operated according to the concept of linear economy where wastewater and sewage sludge were considered as waste only. In fact, there is a wide range of possibilities to use them as a resource to recover materials and energy. Implementation of the concept of circular economy in a relatively small country requires a great deal of additional research and monitoring to assess the available potential. In this paper, data on municipal wastewater in agglomerations larger than population equivalent of 2000 were analyzed, and the situation is presented through indicators covering prevention, removal, reuse, recycling, and recovery. The novelty of this article is that it evaluates the circularity of Lithuanian wastewater treatment plants and their potential for the future. Thus far, the wastewater sector in the country has been found to largely comply with legal obligations, but very few solutions of circularity were found to be implemented.

Ocean Futures for the World’s Largest Yellowfin Tuna Population Under the Combined Effects of Ocean Warming and Acidification

The impacts of climate change are expected to have profound effects on the fisheries of the Pacific Ocean, including its tuna fisheries, the largest globally. This study examined the combined effects of climate change on the yellowfin tuna population using the ecosystem model SEAPODYM. Yellowfin tuna fisheries in the Pacific contribute significantly to the economies and food security of Pacific Island Countries and Territories and Oceania. We use an ensemble of earth climate models to project yellowfin populations under a high greenhouse gas emissions (IPCC RCP8.5) scenario, which includes, the combined effects of a warming ocean, increasing acidification and changing ocean chemistry. Our results suggest that the acidification impact will be smaller in comparison to the ocean warming impact, even in the most extreme ensemble member scenario explored, but will have additional influences on yellowfin tuna population dynamics. An eastward shift in the distribution of yellowfin tuna was observed in the projections in the model ensemble in the absence of explicitly accounting for changes in acidification. The extent of this shift did not substantially differ when the three-acidification induced larval mortality scenarios were included in the ensemble; however, acidification was projected to weaken the magnitude of the increase in abundance in the eastern Pacific. Together with intensive fishing, these potential changes are likely to challenge the global fishing industry as well as the economies and food systems of many small Pacific Island Countries and Territories. The modelling framework applied in this study provides a tool for evaluating such effects and informing policy development.

MODELING THE EVOLUTION OF AN AGGRESSIVE TOTALITARIAN REGIME: A GEOMETRIC APPROACH

The article is devoted to the methodology of modelling the evolution of an aggressive totalitarian regime. The methodology is grounded on the macroeconomic functions and their geometric reflection. Several models are built and analyzed in the article, such as the socio-political, military-economic and socio-economic evolution of totalitarian society; evolution of labour potential; goods’ net exports and production capacity of the country with a variable level of nationalization of the economy; changing economic potential during the war between a large totalitarian country and a small democracy country.
 The nowadays totalitarian regime (similar to the previous one) is based on the nationalization of the economy and the manipulation of information. The nationalization isn’t total now, but the means of manipulation have improved significantly. The authors suggested that the reduction of repression in a totalitarian country is not a sign of its liberalization. The economic growth leads to the impoverishment of the population, and economic crises – to its disqualification in quasi-market circumstances. Together they strengthen the regime's social base. High prices for low-tech goods increase the level of nationalization of the economy and, consequently, reduce the country's productive potential. Specialization in low-tech exports puts it in a "trap of nationalization", where the positive trade balance becomes impossible to even with lower levels of government regulation. Deteriorating global conditions for trade in low-tech goods create a situation of uncertainty when the level of nationalization can both fall and rise. The excess of maximum allowable losses over the minimum possible losses of a large totalitarian country becomes the "trigger" for open aggression. The fundamental asymmetry like the losses for the military-and-economic potential of a large totalitarian country and a small democratic country is the peculiarity of the clash between them.

From small country churches to explosion into megachurches: A modern Pentecostal cultural fit for the Assemblies of God in South Africa

This article examines the evolutionary journey of Assemblies of God in South Africa from small country churches into explosion of megachurches. This Pentecostal denomination is categorised as a classical Pentecostal church that evolved as a missionary church from the early twentieth century. It was officially registered in South Africa in 1917. Historically, it developed as small fellowships in small structures; however today, it has exploded into a huge denomination spread in some geographical locations as local megachurches. Through literature reviews, the objectives are to reveal the rationale behind this explosion, which are the church organisation, emphasis on education, entrepreneurship spirit, apostolic heritage and local church autonomy based on the group system. Results of this explosion are accounted to vigorous evangelism, and Bible-oriented religion such as kerygma, diakonia, koinonia and rhetorics to be culturally and contextually relevant. Assemblies of God embrace African gregarious worldviews and apostolic practices of ecclesial life. This apostolic outlook invokes the discussions on leadership principles. It also influences the church polity exercised by many African megachurches. Shifts from orthodox Pentecostal doctrines such as glossolalia, divine healing and eschatological expectations are examined. The conclusion is while the neo-Pentecostal movement replaces these doctrines by prosperity gospel, personal prophecies and motivational rhetorics instead of sound biblical hermeneutics, Assemblies of God in South Africa remain rooted in their evangelical and classical Pentecostal tradition.Intradisciplinary and/or interdisciplinary implications: This research study is a historical reflection based on Church History, Missiology, Pentecostal Studies, and invokes Practical Theology by referring to strong leadership principles, which leads to church stability. It further calls for Pentecostals to carry out self-examination regarding their fundamental doctrines that are invaded and influenced retrogressively by the neo-Pentecostal movement.

Whole-Genome Sequence Approach and Phylogenomic Stratification Improve the Association Analysis of Mutations With Patient Data in Influenza Surveillance.

Each year, seasonal influenza results in high mortality and morbidity. The current classification of circulating influenza viruses is mainly focused on the hemagglutinin gene. Whole-genome sequencing (WGS) enables tracking mutations across all influenza segments allowing a better understanding of the epidemiological effects of intra- and inter-seasonal evolutionary dynamics, and exploring potential associations between mutations across the viral genome and patient’s clinical data. In this study, mutations were identified in 253 Influenza A (H3N2) clinical isolates from the 2016-2017 influenza season in Belgium. As a proof of concept, available patient data were integrated with this genomic data, resulting in statistically significant associations that could be relevant to improve the vaccine and clinical management of infected patients. Several mutations were significantly associated with the sampling period. A new approach was proposed for exploring mutational effects in highly diverse Influenza A (H3N2) strains through considering the viral genetic background by using phylogenetic classification to stratify the samples. This resulted in several mutations that were significantly associated with patients suffering from renal insufficiency. This study demonstrates the usefulness of using WGS data for tracking mutations across the complete genome and linking these to patient data, and illustrates the importance of accounting for the viral genetic background in association studies. A limitation of this association study, especially when analyzing stratified groups, relates to the number of samples, especially in the context of national surveillance of small countries. Therefore, we investigated if international databases like GISAID may help to verify whether observed associations in the Belgium A (H3N2) samples, could be extrapolated to a global level. This work highlights the need to construct international databases with both information of viral genome sequences and patient data.