Search results for: sentinel epidemiological surveillance
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 727

Search results for: sentinel epidemiological surveillance

247 Security as the Key Factor in Contemporary Tourism: Specificities Identified from the Analysis of Responders' Attitudes

Authors: Petar Kurecic, Josipa Penic

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The paper represents a product of mentor-graduate student cooperation, developed at the graduate study of Business Economics, major Tourism. The analysis was made through the anonymous questionnaire filled by the respondents from Croatia. Following the latest threatening events and having in mind those yet to come, it can be concluded that no country can benefit from the tourism industry if at the same time does not develop its security system as an integral part of the standard tourist offer. Analyzing the trends in contemporary tourism, the safety and security issues became the decisive factors for the choice of a certain destination. Consequently, countries must not perceive security systems and measures as an unnecessary expense but as an essential element in organizing their tourist services. All hotels and respectable tourist agencies should have a crisis management, with detailed, thoroughly elaborated procedures for emergency situations. Tourists should be timely informed about the potential dangers and risks and the measures taken to prevent them, as well as on procedures for emergency situations. Additionally, it would be good to have mobile applications that would enable tourists to make direct emergency calls with instructions on behavior in crisis situations. It is also essential to implement and put into effect sophisticated security measures such as using surveillance cameras, controlling access to buildings, information exchange with colleagues and neighbors, reporting the suspicious occurrences to the security services, and training staff for crisis management. The security issue is definitely one of the crucial factors in the development of tourism in a certain country.

Keywords: security, security measures in tourism, tourism, tourist destinations

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246 Spatial Analysis in the Impact of Aquifer Capacity Reduction on Land Subsidence Rate in Semarang City between 2014-2017

Authors: Yudo Prasetyo, Hana Sugiastu Firdaus, Diyanah Diyanah

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The phenomenon of the lack of clean water supply in several big cities in Indonesia is a major problem in the development of urban areas. Moreover, in the city of Semarang, the population density and growth of physical development is very high. Continuous and large amounts of underground water (aquifer) exposure can result in a drastically aquifer supply declining in year by year. Especially, the intensity of aquifer use in the fulfilment of household needs and industrial activities. This is worsening by the land subsidence phenomenon in some areas in the Semarang city. Therefore, special research is needed to know the spatial correlation of the impact of decreasing aquifer capacity on the land subsidence phenomenon. This is necessary to give approve that the occurrence of land subsidence can be caused by loss of balance of pressure on below the land surface. One method to observe the correlation pattern between the two phenomena is the application of remote sensing technology based on radar and optical satellites. Implementation of Differential Interferometric Synthetic Aperture Radar (DINSAR) or Small Baseline Area Subset (SBAS) method in SENTINEL-1A satellite image acquisition in 2014-2017 period will give a proper pattern of land subsidence. These results will be spatially correlated with the aquifer-declining pattern in the same time period. Utilization of survey results to 8 monitoring wells with depth in above 100 m to observe the multi-temporal pattern of aquifer change capacity. In addition, the pattern of aquifer capacity will be validated with 2 underground water cavity maps from observation of ministries of energy and natural resources (ESDM) in Semarang city. Spatial correlation studies will be conducted on the pattern of land subsidence and aquifer capacity using overlapping and statistical methods. The results of this correlation will show how big the correlation of decrease in underground water capacity in influencing the distribution and intensity of land subsidence in Semarang city. In addition, the results of this study will also be analyzed based on geological aspects related to hydrogeological parameters, soil types, aquifer species and geological structures. The results of this study will be a correlation map of the aquifer capacity on the decrease in the face of the land in the city of Semarang within the period 2014-2017. So hopefully the results can help the authorities in spatial planning and the city of Semarang in the future.

Keywords: aquifer, differential interferometric synthetic aperture radar (DINSAR), land subsidence, small baseline area subset (SBAS)

Procedia PDF Downloads 154
245 Generation of Medical Waste in Hospitals in Interior of São Paulo, Brazil

Authors: Silvia Carla Da Silva André, Angela Maria Magosso Takayanagui

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Introduction: The Medical Waste (MW) are responsible per 2% of total waste generated for a city and has merited attention due the risks that offers to the public health and environment, representing an important aspect in waste management. In Brazil, the Resolution 306/04 of the National Health Surveillance Agency classifies the MW into 5 groups as follows: Group A (GA) biological, Group B (GB) chemical, Group C (GC) radioactive waste, Group D (GD) common, and Group E (GE) sharps. Objective: This study aimed to determine the amount of waste generated in hospitals of Ribeirão Preto, São Paulo, Brazil. Material and Methods: This is a field research, exploratory, using quantitative variables. The survey was conducted in 11 hospitals in Ribeirão Preto, located in the State of São Paulo, Brazil. It is noted that the study sample included general hospitals, skilled, university, maternity, and psychiatric; public, private, and philanthropic; and large, medium, and small. To quantify the MW, the weighing of the waste was held for six days, following methodology adapted from PAHO. Data were analyzed using descriptive statistics, determining the average global generation of MW and for each group. This research was carried out after approval by the Ethics in Research of the University of São Paulo. Thus, in order to comply with the ethical principles of research, to present the results hospitals were numbered from 1 to 11. Results: The data revealed a greater generation of biological waste among teaching hospitals, which can be justified by the use of materials for the realization of techniques.

Keywords: environmental health, management of medical waste, medical waste, public health

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244 Capture-recapture to Estimate Completeness of Pulmonary Tuberculosis with Two Sources

Authors: Ratchadaporn Ungcharoen, Lily Ingsrisawang

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Capture-recapture methods are popular techniques for indirect estimation the size of wildlife populations and the completeness of cases in epidemiology and social sciences. The aim of this study was to estimate the completeness of pulmonary tuberculosis cases confirmed by two sources of hospital registrations and surveillance systems in 2013 in Nakhon Pathom province, Thailand. Several estimators of population size were considered: the Lincoln-Petersen estimator, the Chapman estimator, the Chao’s lower bound estimator, the Zelterman’s estimator, etc. We focus on the Chapman and Chao’s lower bound estimators for estimating the completeness of pulmonary tuberculosis from two sources. The retrieved pulmonary tuberculosis data from two sources were analyzed and bootstrapped for 30 samples, with 241 observations from source 1 and 305 observations from source 2 per sample, for additional exploration of the completeness of pulmonary tuberculosis. The results from the original data show that the Chapman’s estimator gave the estimation of a total 360 (95% CI: 349-371) pulmonary tuberculosis cases, resulting in 57% estimated completeness cases. But the Chao’s lower bound estimator estimated the total of 365 (95% CI: 354-376) pulmonary tuberculosis cases and its estimated completeness cases was 55.9%. For the results from bootstrap samples, the Chapman and the Chao’s lower bound estimators gave an estimated 347 (95% CI: 309-385) and 353 (95% CI: 315-390) pulmonary tuberculosis cases, respectively. If for two sources recoding systems are available, record-linkage and capture-recapture analysis can be useful for estimating the completeness of different registration system. Both Chapman and Chao’s lower bound estimator approaches produce very close estimates.

Keywords: capture-recapture, Chao, Chapman, pulmonary tuberculosis

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243 Toxicological Effects of Atmospheric Fine Particulate Matter on Human Bronchial Epithelial Cells: Metabolic Activation, Genotoxicity and Epigenetic Modifications

Authors: M. Borgie, Z. Dagher, F. Ledoux, A. Verdin, F. Cazier, H. Greige, P. Shirali, D. Courcot

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In October 2013, the International Agency for Research on Cancer (IARC) classified outdoor air pollution and fine particulate matter (PM2.5) as carcinogenic to humans. Despite the clearly relationship established by epidemiological studies between PM exposure and the onset of respiratory and cardiovascular diseases, uncertainties remain about the physiopathological mechanisms responsible for these diseases. The aim of this work was to evaluate the toxicological effects of two samples of atmospheric PM2.5 collected at urban and rural sites on human bronchial epithelial cells, BEAS-2B, especially to investigate the metabolic activation of organic compounds, the alteration of epigenetic mechanisms (i.e. microRNAs genes expression), the phosphorylation of H2AX and the telomerase activity. Our results showed a significant increase in CYP1A1, CYP1B1, and AhRR genes expression, miR-21 gene expression, H2AX phosphorylation and telomerase activity in BEAS-2B cells after their exposure to PM2.5, both in a dose and site-dependent manner. These results showed that PM2.5, especially urban PM, are able to induce the expression of metabolizing enzymes which can provide metabolic biotransformation of organic compounds into more toxic and carcinogenic metabolites, and to induce the expression of the oncomiR miR-21 which promotes cell growth and enhances tumor invasion and metastasis in lung cancer. In addition, our results have highlighted the role of PM2.5 in the activation of telomerase, which can maintain the telomeres length and subsequently preventing cell death, and have also demonstrated the ability of PM2.5 to induce DNA breaks and thus to increase the risk of mutations or chromosomal translocations that lead to genomic instability. All these factors may contribute to cell abnormalities, and thus the development of cancer.

Keywords: BEAS-2B cells, carcinogenesis, epigenetic alterations and genotoxicity, PM2.5

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242 Molecular Identification and Genotyping of Human Brucella Strains Isolated in Kuwait

Authors: Abu Salim Mustafa

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Brucellosis is a zoonotic disease endemic in Kuwait. Human brucellosis can be caused by several Brucella species with Brucella melitensis causing the most severe and Brucella abortus the least severe disease. Furthermore, relapses are common after successful chemotherapy of patients. The classical biochemical methods of culture and serology for identification of Brucellae provide information about the species and serotypes only. However, to differentiate between relapse and reinfection/epidemiological investigations, the identification of genotypes using molecular methods is essential. In this study, four molecular methods [16S rRNA gene sequencing, real-time PCR, enterobacterial repetitive intergenic consensus (ERIC)-PCR and multilocus variable-number tandem-repeat analysis (MLVA)-16] were evaluated for the identification and typing of 75 strains of Brucella isolated in Kuwait. The 16S rRNA gene sequencing suggested that all the strains were B. melitensis and real-time PCR confirmed their species identity as B. melitensis. The ERIC-PCR band profiles produced a dendrogram of 75 branches suggesting each strain to be of a unique type. The cluster classification, based on ~ 80% similarity, divided all the ERIC genotypes into two clusters, A and B. Cluster A consisted of 9 ERIC genotypes (A1-A9) corresponding to 9 individual strains. Cluster B comprised of 13 ERIC genotypes (B1-B13) with B5 forming the largest cluster of 51 strains. MLVA-16 identified all isolates as B. melitensis and divided them into 71 MLVA-types. The cluster analysis of MLVA-16-types suggested that most of the strains in Kuwait originated from the East Mediterranean Region, a few from the African group and one new genotype closely matched with the West Mediterranean region. In conclusion, this work demonstrates that B. melitensis, the most pathogenic species of Brucella, is prevalent in Kuwait. Furthermore, MLVA-16 is the best molecular method, which can identify the Brucella species and genotypes as well as determine their origin in the global context. Supported by Kuwait University Research Sector grants MI04/15 and SRUL02/13.

Keywords: Brucella, ERIC-PCR, MLVA-16, RT-PCR, 16S rRNA gene sequencing

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241 Revealing of the Wave-Like Process in Kinetics of the Structural Steel Radiation Degradation

Authors: E. A. Krasikov

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Dependence of the materials properties on neutron irradiation intensity (flux) is a key problem while usage data of the accelerated materials irradiation in test reactors for forecasting of their capacity for work in realistic (practical) circumstances of operation. Investigations of the reactor pressure vessel steel radiation degradation dependence on fast neutron fluence (embrittlement kinetics) at low flux reveal the instability in the form of the scatter of the experimental data and wave-like sections of embrittlement kinetics appearance. Disclosure of the steel degradation oscillating is a sign of the steel structure cyclic self-recovery transformation as it take place in self-organization processes. This assumption has received support through the discovery of the similar ‘anomalous’ data in scientific publications and by means of own additional experiments. Data obtained stimulate looking-for ways to management of the structural steel radiation stability (for example, by means of nano - structure modification for radiation defects annihilation intensification) for creation of the intelligent self-recovering material. Expected results: - radiation degradation theory and mechanisms development, - more adequate models of the radiation embrittlement elaboration, - surveillance specimen programs improvement, - methods and facility development for usage data of the accelerated materials irradiation for forecasting of their capacity for work in realistic (practical) circumstances of operation, - search of the ways for creating of the radiation stable self-recovery intelligent materials.

Keywords: degradation, radiation, steel, wave-like kinetics

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240 Civilian and Military Responses to Domestic Security Threats: A Cross-Case Analysis of Belgium, France, and the United Kingdom

Authors: John Hardy

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The domestic security environment in Europe has changed dramatically in recent years. Since January 2015, a significant number of domestic security threats that emerged in Europe were located in Belgium, France and the United Kingdom. While some threats were detected in the planning phase, many also resulted in terrorist attacks. Authorities in all three countries instituted special or emergency measures to provide additional security to their populations. Each country combined an additional policing presence with a specific military operation to contribute to a comprehensive security response to domestic threats. This study presents a cross-case analysis of three countries’ civilian and military responses to domestic security threats in Europe. Each case study features a unique approach to combining civilian and military capabilities in similar domestic security operations during the same time period and threat environment. The research design focuses on five variables relevant to the relationship between civilian and military roles in each security response. These are the distinction between policing and military roles, the legal framework for the domestic deployment of military forces, prior experience in civil-military coordination, the institutional framework for threat assessments, and the level of public support for the domestic use of military forces. These variables examine the influence of domestic social, political, and legal factors on the design of combined civil-military operations in response to domestic security threats. Each case study focuses on a specific operation: Operation Vigilant Guard in Belgium, Operation Sentinel in France, and Operation Temperer in the United Kingdom. The results demonstrate that the level of distinction between policing and military roles and the existence of a clear and robust legal framework for the domestic use force by military personnel significantly influence the design and implementation of civilian and military roles in domestic security operations. The findings of this study indicate that Belgium, France and the United Kingdom experienced different design and implementation challenges for their domestic security operations. Belgium and France initially had less-developed legal frameworks for deploying the military in domestic security operations than the United Kingdom. This was offset by public support for enacting emergency measures and the strength of existing civil-military coordination mechanisms. The United Kingdom had a well-developed legal framework for integrating civilian and military capabilities in domestic security operations. However, its experiences in Ireland also made the government more sensitive to public perceptions regarding the domestic deployment of military forces.

Keywords: counter-terrorism, democracy, homeland security, intelligence, militarization, policing

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239 A Comparative, Epidemiological Study of Acute Renal Colic Presentations to Major Academic Emergency Departments in Doha, Qatar and Melbourne, Australia

Authors: Sameer A. Pathan, Biswadev Mitra, Zain A. Bhutta, Isma Qureshi, Elle Spencer, Asmaa A. Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A. Cameron

Abstract:

Background: This study aimed to compare epidemiology, clinical presentations, management and outcomes of renal colic presentations in two major academic centers and discuss potential implications of these results for the applicability of current evidence in the management of renal colic. Methods: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of one year from August 1, 2012, to July 3, 2013. Cases were identified using ICD-9-CM codes, and an electronic template was used to record the data on predefined clinical variables. Results: A total of 12,223 from the HGH-ED and 384 from The Alfred ED were identified as renal colic presentations during the study period. The rate of renal colic presentations at the HGH-ED was 27.9 per 1000 ED visits compared to 6.7 per 1000 ED visits at The Alfred ED. Patients presenting to the HGH-ED were significantly younger [34.9 years (29.0- 43.4) than The Alfred ED [48 years (37-60); P < 0.001]. The median stone size was larger in the HGH-ED group [6 (4-8) mm] versus The Alfred ED group [4 (3-6) mm, P < 0.001]. The intervention rate in the stone-positive population was significantly higher in the HGH-ED group as opposed to The Alfred ED group (38.7% versus 11.9%, p<0.001). At the time of discharge, The Alfred ED group received less analgesic prescriptions (55.8% versus 83.5%, P < 0.001) and more tamsulosin prescriptions (25.3% versus 11.7%, P < 0.001). Conclusions: Renal colic presentations to the HGH-ED, Qatar, were younger, with larger stone size, compared to The Alfred ED, whereas, medical expulsion therapy use was higher at the Alfred ED. Differences in epidemiology should be considered while tailoring strategies for effective management of patients with renal colic in the given setting.

Keywords: kidney stones, urolithiasis, nephrolithiasis, renal colic, epidemiology

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238 The Epidemiological Study on Prevalence of Giardia lamblia among Children in Esfahan City of Iran

Authors: Shahla Rostamirad

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Purpose: Giardiasis is a widespread infection in humans caused by Giardia lamblia. The prevalence of this parasite among children in Isfahan of Iran is unknown. This study intended to estimate Giardia lamblia infection prevalence and identify possible associated risk factors in a healthy pediatric population living in the Isfahan, a metropolitan city of Iran. Methods: Between September 2010 and March 2012, 1448 stool sample from children with clinical manifestation that refer to clinical lab in Isfahan city for stool examination were collected and analyzed. About 1218 samples were positive for parasitic disease. All of samples were examined and diagnosed by direct examination and formalin-ether concentration of stools. Results: A total of 1218 positive cases were analyzed in this study. The findings showed that 92.5% of patients were infected by protozoa and 7.5 percent with helminth infection. The highest and lowest rate of infection belongs to Giardia lamblia and Entamoeba histolytica with 75% and 1.1%, respectively. Other infection cases were included of Blastocystys hominis 9.9%, E. coli 6.5%, H. nana 1.3%, Enterobious vermicolaris 4% and Ascaris lumbricoides 2.2% percent. The population studied revealed a gender distribution of 53.2% male and 46.8% female. Age distribution was 57.3% between 0-5 years and 42.7% between 6-15 years.The prevalence was higher among children aged 0-5 years (57.8%), than among older children (42.2%). Conclusion: The prevalence of protozoan parasite, especially Giardiasis, in children residing in the region of Isfahan is high. Several risk factors were associated with this prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between Giardia lamblia and H. pylori seems an important issue deserving further investigation in order to promote prevention or treatment strategies. Other risk factor include presence of Helicobacter pylori infection, living in houses with own drainage system and reported household, pet contact, especially with cat and dog.

Keywords: Giardia duodenalis, prevalence, risk factors, children, Isfahan, Iran

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237 Design of an Acoustic Imaging Sensor Array for Mobile Robots

Authors: Dibyendu Roy, V. Ramu Reddy, Parijat Deshpande, Ranjan Dasgupta

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Imaging of underwater objects is primarily conducted by acoustic imagery due to the severe attenuation of electro-magnetic waves in water. Acoustic imagery underwater has varied range of significant applications such as side-scan sonar, mine hunting sonar. It also finds utility in other domains such as imaging of body tissues via ultrasonography and non-destructive testing of objects. In this paper, we explore the feasibility of using active acoustic imagery in air and simulate phased array beamforming techniques available in literature for various array designs to achieve a suitable acoustic sensor array design for a portable mobile robot which can be applied to detect the presence/absence of anomalous objects in a room. The multi-path reflection effects especially in enclosed rooms and environmental noise factors are currently not simulated and will be dealt with during the experimental phase. The related hardware is designed with the same feasibility criterion that the developed system needs to be deployed on a portable mobile robot. There is a trade of between image resolution and range with the array size, number of elements and the imaging frequency and has to be iteratively simulated to achieve the desired acoustic sensor array design. The designed acoustic imaging array system is to be mounted on a portable mobile robot and targeted for use in surveillance missions for intruder alerts and imaging objects during dark and smoky scenarios where conventional optic based systems do not function well.

Keywords: acoustic sensor array, acoustic imagery, anomaly detection, phased array beamforming

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236 Association of Human Immunodeficiency Virus with Incident Autoimmune Hemolytic Anemia: A Population-Based Cohort Study in Taiwan

Authors: Yung-Feng Yen, I-an Jen, Yi-Ming Arthur Chen

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The molecular mimicry between human immunodeficiency virus (HIV) protein and red blood cell (RBC) antigens could induce the production of anti-RBC autoantibodies. However, the association between HIV infection and subsequent development of autoimmune hemolytic anemia (AIHA) remains unclear. This nationwide population-based cohort study aimed to determine the association between incident AIHA and HIV in Taiwan. From 2000–2012, we identified adult people living with HIV/AIDS (PLWHA) from the Taiwan centers for disease control HIV Surveillance System. HIV-infected individuals were defined by positive HIV-1 western blot. Age- and sex-matched controls without HIV infection were selected from the Taiwan National Health Insurance Research Database for comparison. All patients were followed until Dec. 31, 2012, and observed for occurrence of AIHA. Of 171,468 subjects (19,052 PLWHA, 152,416 controls), 30 (0.02%) had incident AIHA during a mean follow-up of 5.45 years, including 23 (0.12%) PLWHA and 7 (0.01%) controls. After adjusting for potential confounders, HIV infection was found to be an independent risk factor of incident AIHA (adjusted hazard ratio [AHR], 20.9; 95% confidence interval [CI], 8.34-52.3). Moreover, PLWHA receiving HAART were more likely to develop AIHA than those not receiving HAART (AHR, 10.8; 95% CI, 2.90-40.1). Additionally, the risk of AIHA was significantly increased in those taking efavirenz (AHR, 3.15; 95% CI, 1.18-8.43) or atazanavir (AHR, 6.58; 95% CI, 1.88-22.9) component of the HAART. In conclusion, HIV infection is an independent risk factor for incident AIHA. Clinicians need to be aware of the higher risk of AIHA in PLWHA.

Keywords: autoimmune disease , hemolytic anemia, HIV, highly active antiretroviral treatment

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235 Epidemiology of Private Prehospital Calls over the Last Decade in South Africa

Authors: Rhodine Hickman, Craig Wylie, Michael G. McCaul

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Introduction: The World Health Organisation has called on governments around the world to recognise emergency conditions as a global public health problem and respond with appropriate steps for effective preventative strategies. However, to understand the magnitude of the problem, good quality epidemiological data is required. This is especially challenging in low and middle-income countries, where routine data is scarce, specifically within the prehospital setting. Methods: We conducted a retrospective cross-sectional study of a national prehospital private sector EMS database. The database being the property of ER24 (private Emergency Medical Services (EMS) company in South Africa) contains claims submitted by the majority of ambulance services in South Africa during the period between 1 January 2008 to 28 March 2017. We used descriptive statistics and control charts to describe the data using STATA 14. Results: 299,257 calls were included in the analysis. The top clinical conditions requiring ambulance transport were transport accidents (10% of total call volume) and ischaemic heart disease (4.4%). The number of transport accidents consistently increased between 2009 and 2014 and reached beyond the limit for normal variation in 2015. Victims of transport accidents required basic life support services 60% of the time with 80% of injuries being minor to moderate. The frequency of ischaemic heart disease had a steady incline from 2011 to 2016. Advanced life support services were required about 50% of the time, with 60% of patients needing urgent care. Conclusion: Transport accidents, followed by ischaemic heart disease, are the most prevalent conditions in South African private EMS. There is a potential to address these conditions by developing the capacity of low and mid-level providers in trauma and advanced EMS providers in ischaemic heart disease.

Keywords: emergency care, emergency medicine, prehospital providers, South Africa

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234 Integrated Free Space Optical Communication and Optical Sensor Network System with Artificial Intelligence Techniques

Authors: Yibeltal Chanie Manie, Zebider Asire Munyelet

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5G and 6G technology offers enhanced quality of service with high data transmission rates, which necessitates the implementation of the Internet of Things (IoT) in 5G/6G architecture. In this paper, we proposed the integration of free space optical communication (FSO) with fiber sensor networks for IoT applications. Recently, free-space optical communications (FSO) are gaining popularity as an effective alternative technology to the limited availability of radio frequency (RF) spectrum. FSO is gaining popularity due to flexibility, high achievable optical bandwidth, and low power consumption in several applications of communications, such as disaster recovery, last-mile connectivity, drones, surveillance, backhaul, and satellite communications. Hence, high-speed FSO is an optimal choice for wireless networks to satisfy the full potential of 5G/6G technology, offering 100 Gbit/s or more speed in IoT applications. Moreover, machine learning must be integrated into the design, planning, and optimization of future optical wireless communication networks in order to actualize this vision of intelligent processing and operation. In addition, fiber sensors are important to achieve real-time, accurate, and smart monitoring in IoT applications. Moreover, we proposed deep learning techniques to estimate the strain changes and peak wavelength of multiple Fiber Bragg grating (FBG) sensors using only the spectrum of FBGs obtained from the real experiment.

Keywords: optical sensor, artificial Intelligence, Internet of Things, free-space optics

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233 Breast Cancer Metastasis Detection and Localization through Transfer-Learning Convolutional Neural Network Classification Based on Convolutional Denoising Autoencoder Stack

Authors: Varun Agarwal

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Introduction: With the advent of personalized medicine, histopathological review of whole slide images (WSIs) for cancer diagnosis presents an exceedingly time-consuming, complex task. Specifically, detecting metastatic regions in WSIs of sentinel lymph node biopsies necessitates a full-scanned, holistic evaluation of the image. Thus, digital pathology, low-level image manipulation algorithms, and machine learning provide significant advancements in improving the efficiency and accuracy of WSI analysis. Using Camelyon16 data, this paper proposes a deep learning pipeline to automate and ameliorate breast cancer metastasis localization and WSI classification. Methodology: The model broadly follows five stages -region of interest detection, WSI partitioning into image tiles, convolutional neural network (CNN) image-segment classifications, probabilistic mapping of tumor localizations, and further processing for whole WSI classification. Transfer learning is applied to the task, with the implementation of Inception-ResNetV2 - an effective CNN classifier that uses residual connections to enhance feature representation, adding convolved outputs in the inception unit to the proceeding input data. Moreover, in order to augment the performance of the transfer learning CNN, a stack of convolutional denoising autoencoders (CDAE) is applied to produce embeddings that enrich image representation. Through a saliency-detection algorithm, visual training segments are generated, which are then processed through a denoising autoencoder -primarily consisting of convolutional, leaky rectified linear unit, and batch normalization layers- and subsequently a contrast-normalization function. A spatial pyramid pooling algorithm extracts the key features from the processed image, creating a viable feature map for the CNN that minimizes spatial resolution and noise. Results and Conclusion: The simplified and effective architecture of the fine-tuned transfer learning Inception-ResNetV2 network enhanced with the CDAE stack yields state of the art performance in WSI classification and tumor localization, achieving AUC scores of 0.947 and 0.753, respectively. The convolutional feature retention and compilation with the residual connections to inception units synergized with the input denoising algorithm enable the pipeline to serve as an effective, efficient tool in the histopathological review of WSIs.

Keywords: breast cancer, convolutional neural networks, metastasis mapping, whole slide images

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232 A Power Management System for Indoor Micro-Drones in GPS-Denied Environments

Authors: Yendo Hu, Xu-Yu Wu, Dylan Oh

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GPS-Denied drones open the possibility of indoor applications, including dynamic arial surveillance, inspection, safety enforcement, and discovery. Indoor swarming further enhances these applications in accuracy, robustness, operational time, and coverage. For micro-drones, power management becomes a critical issue, given the battery payload restriction. This paper proposes an application enabling battery replacement solution that extends the micro-drone active phase without human intervention. First, a framework to quantify the effectiveness of a power management solution for a drone fleet is proposed. The operation-to-non-operation ratio, ONR, gives one a quantitative benchmark to measure the effectiveness of a power management solution. Second, a survey was carried out to evaluate the ONR performance for the various solutions. Third, through analysis, this paper proposes a solution tailored to the indoor micro-drone, suitable for swarming applications. The proposed automated battery replacement solution, along with a modified micro-drone architecture, was implemented along with the associated micro-drone. Fourth, the system was tested and compared with the various solutions within the industry. Results show that the proposed solution achieves an ONR value of 31, which is a 1-fold improvement of the best alternative option. The cost analysis shows a manufacturing cost of $25, which makes this approach viable for cost-sensitive markets (e.g., consumer). Further challenges remain in the area of drone design for automated battery replacement, landing pad/drone production, high-precision landing control, and ONR improvements.

Keywords: micro-drone, battery swap, battery replacement, battery recharge, landing pad, power management

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231 Preparation of Wireless Networks and Security; Challenges in Efficient Accession of Encrypted Data in Healthcare

Authors: M. Zayoud, S. Oueida, S. Ionescu, P. AbiChar

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Background: Wireless sensor network is encompassed of diversified tools of information technology, which is widely applied in a range of domains, including military surveillance, weather forecasting, and earthquake forecasting. Strengthened grounds are always developed for wireless sensor networks, which usually emerges security issues during professional application. Thus, essential technological tools are necessary to be assessed for secure aggregation of data. Moreover, such practices have to be incorporated in the healthcare practices that shall be serving in the best of the mutual interest Objective: Aggregation of encrypted data has been assessed through homomorphic stream cipher to assure its effectiveness along with providing the optimum solutions to the field of healthcare. Methods: An experimental design has been incorporated, which utilized newly developed cipher along with CPU-constrained devices. Modular additions have also been employed to evaluate the nature of aggregated data. The processes of homomorphic stream cipher have been highlighted through different sensors and modular additions. Results: Homomorphic stream cipher has been recognized as simple and secure process, which has allowed efficient aggregation of encrypted data. In addition, the application has led its way to the improvisation of the healthcare practices. Statistical values can be easily computed through the aggregation on the basis of selected cipher. Sensed data in accordance with variance, mean, and standard deviation has also been computed through the selected tool. Conclusion: It can be concluded that homomorphic stream cipher can be an ideal tool for appropriate aggregation of data. Alongside, it shall also provide the best solutions to the healthcare sector.

Keywords: aggregation, cipher, homomorphic stream, encryption

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230 Prevalence of Trichomonas Tenax in Patients with Pulmonary Disease and Watersheds and Its Potential Implications for Pulmonary Virus Infection

Authors: Pei Chi Fang, Wei Chen Lin

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Trichomonas tenax is a microaerophilic oral protozoan found in patients with poor oral hygiene. It participates in the inflammatory process of periodontal disease and can potentially be aspirated into the lungs, giving rise to pulmonary trichomoniasis. However, the precise roles of T. tenax in the pulmonary system remain largely unexplored and warrant comprehensive epidemiological investigation. To assess the prevalence of T. tenax infection, we collected bronchoalveolar lavage fluid (BALF) samples from hospitalized patients with lung diseases. A specific nested PCR approach was employed to determine prevalence rates, yielding 21 positive cases out of 61 samples from Ditmanson Medical Foundation Chia-Yi Christian Hospital, and 11 positive cases out of 55 samples from National Cheng Kung University Hospital. Furthermore, there is a critical need for comprehensive data regarding the presence of T. tenax in environmental surface watersheds. In this context, we present findings from investigations in the Yanshuei and Donggang river basins in southern Taiwan, which are crucial sources for public drinking water in the region. In order to elucidate potential implications on pulmonary virus infections, we conducted an analysis of gene expression level changes in H292 cell line after exposure to T. tenax. Our findings revealed significant regulation of multiple virus-related genes, including IFI44L and IFITM3. Ongoing research endeavors are focused on identifying the key components within T. tenax responsible for these observed effects. Crucially, this study lays the groundwork for a preliminary understanding of T. tenax prevalence in patients with pulmonary diseases. It also seeks to establish a meaningful correlation between lung infections and oral hygiene practices, with the ultimate aim of informing distinct treatment and prevention strategies.

Keywords: parasitology, genes, virus, human health, infection, lung

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229 Use of Galileo Advanced Features in Maritime Domain

Authors: Olivier Chaigneau, Damianos Oikonomidis, Marie-Cecile Delmas

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GAMBAS (Galileo Advanced features for the Maritime domain: Breakthrough Applications for Safety and security) is a project funded by the European Space Program Agency (EUSPA) aiming at identifying the search-and-rescue and ship security alert system needs for maritime users (including operators and fishing stakeholders) and developing operational concepts to answer these needs. The general objective of the GAMBAS project is to support the deployment of Galileo exclusive features in the maritime domain in order to improve safety and security at sea, detection of illegal activities and associated surveillance means, resilience to natural and human-induced emergency situations, and develop, integrate, demonstrate, standardize and disseminate these new associated capabilities. The project aims to demonstrate: improvement of the SAR (Search And Rescue) and SSAS (Ship Security Alert System) detection and response to maritime distress through the integration of new features into the beacon for SSAS in terms of cost optimization, user-friendly aspects, integration of Galileo and OS NMA (Open Service Navigation Message Authentication) reception for improved authenticated localization performance and reliability, and at sea triggering capabilities, optimization of the responsiveness of RCCs (Rescue Co-ordination Centre) towards the distress situations affecting vessels, the adaptation of the MCCs (Mission Control Center) and MEOLUT (Medium Earth Orbit Local User Terminal) to the data distribution of SSAS alerts.

Keywords: Galileo new advanced features, maritime, safety, security

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228 Investigate the Side Effects of Patients With Severe COVID-19 and Choose the Appropriate Medication Regimens to Deal With Them

Authors: Rasha Ahmadi

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In December 2019, a coronavirus, currently identified as SARS-CoV-2, produced a series of acute atypical respiratory illnesses in Wuhan, Hubei Province, China. The sickness induced by this virus was named COVID-19. The virus is transmittable between humans and has caused pandemics worldwide. The number of death tolls continues to climb and a huge number of countries have been obliged to perform social isolation and lockdown. Lack of focused therapy continues to be a problem. Epidemiological research showed that senior patients were more susceptible to severe diseases, whereas children tend to have milder symptoms. In this study, we focus on other possible side effects of COVID-19 and more detailed treatment strategies. Using bioinformatics analysis, we first isolated the gene expression profile of patients with severe COVID-19 from the GEO database. Patients' blood samples were used in the GSE183071 dataset. We then categorized the genes with high and low expression. In the next step, we uploaded the genes separately to the Enrichr database and evaluated our data for signs and symptoms as well as related medication regimens. The results showed that 138 genes with high expression and 108 genes with low expression were observed differentially in the severe COVID-19 VS control group. Symptoms and diseases such as embolism and thrombosis of the abdominal aorta, ankylosing spondylitis, suicidal ideation or attempt, regional enteritis were observed in genes with high expression and in genes with low expression of acute and subacute forms of ischemic heart, CNS infection and poliomyelitis, synovitis and tenosynovitis. Following the detection of diseases and possible signs and symptoms, Carmustine, Bithionol, Leflunomide were evaluated more significantly for high-expression genes and Chlorambucil, Ifosfamide, Hydroxyurea, Bisphenol for low-expression genes. In general, examining the different and invisible aspects of COVID-19 and identifying possible treatments can help us significantly in the emergency and hospitalization of patients.

Keywords: phenotypes, drug regimens, gene expression profiles, bioinformatics analysis, severe COVID-19

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227 Border Control and Human Rights Violations: Lessons Learned from the United States and Potential Solutions for the European Union

Authors: María Elena Menéndez Ibáñez

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After the terrorist attacks of 9/11, new measures were adopted by powerful countries and regions like the United States and the European Union in order to safeguard their security. In 2002, the US created the Department of Homeland Security with one sole objective; to protect American soil and people. The US adopted new policies that made every immigrant a potential terrorist and a threat to their national security. Stronger border control became one of the key elements of the fight against organized crime and terrorism. The main objective of this paper is to compare some of the most important and radical measures adopted by the US, even those that resulted in systematic violations of human rights, with some of the European measures adopted after the 2015 Paris attacks of 2015, such as unlawful detainment of prisoners and other measures against foreigners. Through the Schengen agreement, the European Union has tried to eliminate tariffs and border controls, in order to guarantee successful economic growth. Terrorists have taken advantage of this and have made the region vulnerable to attacks. Authorities need to strengthen their surveillance methods in order to safeguard the region and its stability. Through qualitative methods applied to social sciences, this research will also try to explain why some of the mechanisms proven to be useful in the US would not be so in Europe, especially because they would result in human rights violations. Finally, solutions will be offered that would not put the whole Schengen Agreement at risk. Europe cannot reinstate border control, without making individuals vulnerable to human rights violations.

Keywords: border control, immigration, international cooperation, national security

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226 Exposure to Ionizing Radiation Resulting from the Chernobyl Fallout and Childhood Cardiac Arrhythmia: A Population Based Study

Authors: Geraldine Landon, Enora Clero, Jean-Rene Jourdain

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In 2005, the Institut de Radioprotection et de Sûreté Nucléaire (IRSN, France) launched a research program named EPICE (acronym for 'Evaluation of Pathologies potentially Induced by CaEsium') to collect scientific information on non-cancer effects possibly induced by chronic exposures to low doses of ionizing radiation with the view of addressing a question raised by several French NGOs related to health consequences of the Chernobyl nuclear accident in children. The implementation of the program was preceded by a pilot phase to ensure that the project would be feasible and determine the conditions for implementing an epidemiological study on a population of several thousand children. The EPICE program focused on childhood cardiac arrhythmias started in May 2009 for 4 years, in partnership with the Russian Bryansk Diagnostic Center. The purpose of this cross-sectional study was to determine the prevalence of cardiac arrhythmias in the Bryansk oblast (depending on the contamination of the territory and the caesium-137 whole-body burden) and to assess whether caesium-137 was or not a factor associated with the onset of cardiac arrhythmias. To address these questions, a study bringing together 18 152 children aged 2 to 18 years was initiated; each child received three medical examinations (ECG, echocardiography, and caesium-137 whole-body activity measurement) and some of them were given with a 24-hour Holter monitoring and blood tests. The findings of the study, currently submitted to an international journal justifying that no results can be given at this step, allow us to answer clearly to the issue of radiation-induced childhood arrhythmia, a subject that has been debated for many years. Our results will be certainly helpful for health professionals responsible for the monitoring of population exposed to the releases from the Fukushima Dai-ichi nuclear power plant and also useful for future comparative study in children exposed to ionizing radiation in other contexts, such as cancer radiation therapies.

Keywords: Caesium-137, cardiac arrhythmia, Chernobyl, children

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225 The Experiences of Claiming Welfare Benefits for People with Disabilities in the UK

Authors: Jennifer McNeill

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Over the years UK Governments have extended the use of welfare conditionality to more marginalised groups. Whereas in the past, disabled people’s rights to unconditional welfare were defended, significant numbers of disabled people have in recent years been re-classified as ‘fit for work’ as a result of this policy shift towards increased conditionality targeting more welfare service user groups. This paper discusses findings from a five-year project exploring the ethics and efficacy of welfare conditionality. Drawing on repeat interviews over three years with 58 disabled welfare service users across England and Scotland, the paper explores the experience of, and impact of conditionality upon, disabled participants. In particular, participants described the process of claiming disability-related benefits as stigmatising, with some describing the medical assessments as demeaning, traumatic and even painful. The medical assessments are conducted by private contractors and participants felt they were treated unfairly, under suspicion and under surveillance. This finding is important in line with a recent UN report concerned with the practice of such assessments. The findings reveal that notions of ‘deservedness’ are embedded in this system as disabled recipients argue for their entitlement to welfare claims relative to what are deemed to be less deserving groups of benefit claimants. This indicates an increasing competition ethic within different sections of the most marginalised social groups that facilitate further forms of social fragmentation, particularly in relation to opposition to benefit cuts and other changes requiring concerted and organised forms of resistance. The impact of media and political scapegoating of the most marginal has generated divisions within even those who position themselves as legitimate recipients.

Keywords: disability, medical assessments, stigma, welfare conditionality

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224 Post-Soviet LULC Analysis of Tbilisi, Batumi and Kutaisi Using of Remote Sensing and Geo Information System

Authors: Lela Gadrani, Mariam Tsitsagi

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Human is a part of the urban landscape and responsible for it. Urbanization of cities includes the longest phase; thus none of the environment ever undergoes such anthropogenic impact as the area of large cities. The post-Soviet period is very interesting in terms of scientific research. The changes that have occurred in the cities since the collapse of the Soviet Union have not yet been analyzed best to our knowledge. In this context, the aim of this paper is to analyze the changes in the land use of the three large cities of Georgia (Tbilisi, Kutaisi, Batumi). Tbilisi as a capital city, Batumi as a port city, and Kutaisi as a former industrial center. Data used during the research process are conventionally divided into satellite and supporting materials. For this purpose, the largest topographic maps (1:10 000) of all three cities were analyzed, Tbilisi General Plans (1896, 1924), Tbilisi and Kutaisi historical maps. The main emphasis was placed on the classification of Landsat images. In this case, we have classified the images LULC (LandUse / LandCover) of all three cities taken in 1987 and 2016 using the supervised and unsupervised methods. All the procedures were performed in the programs: Arc GIS 10.3.1 and ENVI 5.0. In each classification we have singled out the following classes: built-up area, water bodies, agricultural lands, green cover and bare soil, and calculated the areas occupied by them. In order to check the validity of the obtained results, additionally we used the higher resolution images of CORONA and Sentinel. Ultimately we identified the changes that took place in the land use in the post-Soviet period in the above cities. According to the results, a large wave of changes touched Tbilisi and Batumi, though in different periods. It turned out that in the case of Tbilisi, the area of developed territory has increased by 13.9% compared to the 1987 data, which is certainly happening at the expense of agricultural land and green cover, in particular, the area of agricultural lands has decreased by 4.97%; and the green cover by 5.67%. It should be noted that Batumi has obviously overtaken the country's capital in terms of development. With the unaided eye it is clear that in comparison with other regions of Georgia, everything is different in Batumi. In fact, Batumi is an unofficial summer capital of Georgia. Undoubtedly, Batumi’s development is very important both in economic and social terms. However, there is a danger that in the uneven conditions of urban development, we will eventually get a developed center - Batumi, and multiple underdeveloped peripheries around it. Analysis of the changes in the land use is of utmost importance not only for quantitative evaluation of the changes already implemented, but for future modeling and prognosis of urban development. Raster data containing the classes of land use is an integral part of the city's prognostic models.

Keywords: analysis, geo information system, remote sensing, LULC

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223 Surveillance of Hepatitis C Virus Genotype Circulating in North India

Authors: Shantanu Prakash, Suruchi Shukla, Amita Jain

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Introduction: The hepatitis C virus (HCV) is a major public health problem and a leading cause of chronic liver disease. Injection drug use and individuals receiving blood and blood products are the primary modes of HCV transmission. Our study aims to establish the prevalent genotypes/ subtypes of HCV circulating in Uttar Pradesh, North India, as reported from a tertiary care hospital. Methods: It is a retrospective observational analysis of consecutive 404 HCV RNA positive cases referred to our hospital during September 2014 to April 2017. The study was approved by an institutional ethics committee. Written informed consent was taken from each participant. Clinical and demographic details of these patients were recorded using predesigned questionnaires. All the laboratory testing was carried on stored serum sample of enrolled cases. Genotyping of all 404 strains was done by Sanger’s sequencing of the core region. The phylogenetic analysis of 179 HCV strains with high -quality sequencing data was performed. Results: The distribution of prevalent genotypes/ subtypes as noted in the present study was; Genotype (GT)1a [n-101(25%)], GT1b [n-12(2.9%)], GT1c [1(0.25%)], GT3a [275(68.07%)], GT3b [9(2.2%)], GT3g [2(0.49%)], GT3i [3(0.74%)], and GT4a [1(0.24%)]. HCV genotypes GT2, GT5 and GT6 were not detected from our region. Sequence analysis showed high genotypic variability in HCV GT3. Phylogenetic analysis showed that HCV GT3 and GT1 circulating in our region were related to Indian strains reported earlier. Conclusions: HCV genotypes 3a and 1a are commonest circulating genotypes in Uttar Pradesh (UP), India.

Keywords: Hepatitis C virus, genetic variation, bioinformatics, genotype, HCV

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222 Urban Design as a Tool to Address Safety in a Crime Ridden Area: A Case Study of Malviya Nagar, New Delhi

Authors: Shramana Mondal

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As a city is growing in population, sprawl, and complexity, use of public spaces increases variably and thus ensuring safety for the people becomes an utmost priority. While active monitoring measures may be necessary in some places, urban design can play a major role in devising self-policing and encourage active public life. This paper aims to explore the various spatial and psychological reasons for the occurrence of crime and the role of ‘urban design’ to address this issue. In this research, the principles of urban design are examined, as well as projected on actual site by addressing the issue with urban design principles. In this review the sociological, psychological, typological and morphological factors are addressed which affect the safety of a space and the possible framing guidelines, controls and urban design strategies are explored to address a safe neighborhood. On the basis of statistical survey, the residential and street network of Malviya Nagar in Delhi is chosen as the area of demonstration. The programs inhibit a safe neighborhood and a movement network that are addressed based on the four principles of natural surveillance, territoriality, community building, and connectivity. The paper concludes with a discussion of the urban design as an effective tool by creating an intense active zone with mixed use feature to ensure throughout activity and also ensuring safe pedestrian zone by introducing sense of community feeling and territoriality thus achieving active, useful and public friendly space.

Keywords: crime, public life, safety, urban design

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221 Epidemiological Correlates of Adherence to Anti-Hypertensive Treatment in Primary Health Care Setting of Ludhiana, Punjab

Authors: Sangeeta Girdhar, Amanat Grewal, Nahush Bansal

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Introduction: There is an increasing burden of hypertension in India. The morbidity and mortality arising from complications are mainly due to non-adherence to medication, unhealthy dietary habits, and lack of physical activity. Non-adherence is a well-recognised factor contributing to inadequate control of high blood pressure. Adherence to pharmacotherapy for hypertension varies from 43% to 88%. Non-adherence is influenced by various socio-demographic factors. Understanding these factors is useful in managing non-adherence. Therefore, the study was planned to determine adherence among hypertensives and factors associated with non-adherence to treatment. Methodology: A cross-sectional study was conducted at Urban Health Training Centre of Dayanand Medical College and Hospital Ludhiana. Patients attending the OPD over a period of 3 months were included in the study. Prior ethical approval was obtained, and informed consent was taken from subjects. A predesigned semi-structured questionnaire was applied, which included socio-demographic profile, treatment-seeking behaviour, adherence to the antihypertensive medication, lifestyle factors (intake of alcohol, smoking, consumption of junk food, high salt intake) contributing to the development of the disease. Reasons for non-adherence to the therapy were also explored. Data was entered into excel, and SPSS 26 version was used for analysis. Results: A total of 186 individuals were interviewed. Out of these, 113 females (60.8%) and 73 males (39.2%) participated in the study. Mean age of participants was 60.9 ± 10.7 years. Adherence to anti-hypertensive treatment was found in 68.3% of the participants. It was observed that adherence was more in literate individuals as compared to illiterate (p value- 0.78). Adherence was lower among smokers (33.3%) and alcohol consumers (53.8%) as compared to non-users (69.4% and 70.6%, respectively). The predominant reasons for skipping medications were discontinuing medication when feeling well, forgetfulness and unawareness. Conclusion: There is a need to generate awareness regarding the importance of adherence to therapy among patients. Intensive health education and counselling of the patients is the need of the hour.

Keywords: hypertension, anti-hypertensive, adherence, counselling

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220 Rising STI Prevalence among MSM Clients in Calabar, Nigeria: A Call to Action

Authors: Ugoh Kelechi Melford, Anene O.

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Introduction: Evidence has shown that there are increasing rates of new HIV and other STI infections occurring among Men who have Sex with Men (MSM) in Nigeria, with the prevalence 3 times higher than the general population as reported by the 2011 National Integrated Bio Behavioral Surveillance Survey. The poor state of health care and support services hinders our effort to control the high rates of these new infections among MSM. Methods: The Initiative for Improved Male Health (IMH-Initiative) works to provide a safe space for young MSM living with HIV to access comprehensive palliative care and support, as well as referrals for other services through drama and dance competitions. An STI assessment was conducted in IMH-Initiative’s Community Center in Calabar, for gay men and other MSM. An STI history was conducted for all clients who visited the community clinic specifically for HCT and STI counseling and referrals within a 5 month period, and their data were collated. Results: 61 MSM were diagnosed, and reported the following in the last 6 months. 49 where living with HIV. 46 had previous histories of untreated anal warts. 20 had previous histories of treated Gonorrhea by self-medication and herbs. 21 had untreated boils and rashes around the genitals. 10 clients where living with HIV, and reported untreated penile and rectal gonorrhea. All clients indicated that there were not comfortable discussing STI infections with staff of public hospitals. Conclusion: It is evident that a reasonable number of STI infections among MSM are not completely treated or ignored. This thereby increases the individual’s risk of HIV infection, and cripples HIV prevention programming in Nigeria. HIV programs targeting MSM must incorporate STI syndromic management, so as to increase access to non-stigmatized diagnosis and treatment of STIs. Also, access to STI drugs for clients cannot be overemphasized.

Keywords: MSM, IBBSS, STI, IMH

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219 Dietary Micronutritient and Health among Youth in Algeria

Authors: Allioua Meryem

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Similar to much of the developing world, Algeria is currently undergoing an epidemiological transition. While mal- and under-nutrition and infectious diseases used to be the main causes of poor health, today there is a higher proportion of chronic, non-communicable diseases (NCDs), including cardiovascular disease, diabetes mellitus, cancer, etc. According to estimates for Algeria from the World Health Organization (WHO), NCDs accounted for 63% of all deaths in 2010. The objective of this study was the assessment of eating habits and anthropometric characteristics in a group of youth aged 15 to 19 years in Tlemcen. This study was conducted on a total effective of 806 youth enrolled in a descriptive cross-sectional study; the classification of nutritional status has been established by international standards IOTF, youth were defined as obese if they had a BMI ≥ 95th percentile, and youth with 85th ≤ BMI ≤ 95th percentile were defined as overweight. Wc is classified by the criteria HD, Wc with moderate risk ≥ 90th percentile and Wc with high risk ≥ 95th percentile. The dietary assessment was based on a 24-hour dietary recall assisted by food records. USDA’S nutrient database for Nutrinux® program was used to analyze dietary intake. Nutrients adequacy ratio was calculated by dividing daily individual intake to dietary recommended intake DRI for each nutrient. 9% of the population was overweight, 3% was obese, 7.5% had abdominal obesity, foods eaten in moderation are chips, cookies, chocolate 1-3 times/day and increased consumption of fried foods in the week, almost half of youth consume sugary drinks more than 3 times per week, we observe a decreased intake of energy, protein (P < 0.001, P = 0.003), SFA (P = 0.018), the NAR of phosphorus, iron, magnesium, vitamin B6, vitamin E, folate, niacin, and thiamin reflecting less consumption of fruit, vegetables, milk, and milk products. Youth surveyed have eating habits at risk of developing obesity and chronic disease.

Keywords: food intake, health, anthropometric characteristics, Algeria

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218 Madness in Susanna Kaysen’s Girl, Interrupted: A Focouldian Reading

Authors: Somaye Sabetnia

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This paper is accomplished to probe Susanna Kaysen’s memoir Girl, Interrupted in the light of Michel Foucault’s theory of madness comprehensively set forth in his History of Madness (1961). It is an endeavor to analysis this novel based on Foucault’s idea of madness. In his archeological study of madness, Foucault introduces a way to perceive madness and its association with dominant discourses. He argues that the concept of madness is constructed within the social context, and different institutions affect its definition. Furthermore, he takes into consideration how each era treats madness, and affirms that in modern times, people considered mad are exiled out of cities, confined in madhouses, and later in clinics where they are treated with drugs. Set after World War II, the novel under observation highlights women’s conditions in which they were becoming a housewife or following their own desires; in fact, choosing the second one results in labeling mad. The protagonist of novel is labeled 'mad,' and is hence impelled to go to asylums where so-called patients are under the vigilant surveillance of the authorities to go through the process of 'normalization.' To discern how she is considered 'mad,' this article probes the dominant discourse of the time when the stories take place to provide a better understanding of madness under the impact of social, cultural, and political conditions. It examines how a so-called mad considered 'Other' and treated after being confined by the disciplinary system of the asylum in a panoptic world. In addition to, it describes the aim of treatment is to punish and control a patient not to cure. This article aims to indicate that Susanna Kaysen tries to picture what is defined as women’s madness is the result of the patriarchal society of the post-war America as well as the mental illness has nothing to do with blood; it is rather the result of the social inequality of the age.

Keywords: clinical treatment, disciplining and punishment, dominant discourse, normalization, other, panoptic world, reason vs. unreason

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