Search results for: NAAC accreditation criteria
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 903

Search results for: NAAC accreditation criteria

63 Energy Retrofitting Application Research to Achieve Energy Efficiency in Hot-Arid Climates in Residential Buildings: A Case Study of Saudi Arabia

Authors: A. Felimban, A. Prieto, U. Knaack, T. Klein

Abstract:

This study aims to present an overview of recent research in building energy-retrofitting strategy applications and analyzing them within the context of hot arid climate regions which is in this case study represented by the Kingdom of Saudi Arabia. The main goal of this research is to do an analytical study of recent research approaches to show where the primary gap in knowledge exists and outline which possible strategies are available that can be applied in future research. Also, the paper focuses on energy retrofitting strategies at a building envelop level. The study is limited to specific measures within the hot arid climate region. Scientific articles were carefully chosen as they met the expression criteria, such as retrofitting, energy-retrofitting, hot-arid, energy efficiency, residential buildings, which helped narrow the research scope. Then the papers were explored through descriptive analysis and justified results within the Saudi context in order to draw an overview of future opportunities from the field of study for the last two decades. The conclusions of the analysis of the recent research confirmed that the field of study had a research shortage on investigating actual applications and testing of newly introduced energy efficiency applications, lack of energy cost feasibility studies and there was also a lack of public awareness. In terms of research methods, it was found that simulation software was a major instrument used in energy retrofitting application research. The main knowledge gaps that were identified included the need for certain research regarding actual application testing; energy retrofitting strategies application feasibility; the lack of research on the importance of how strategies apply first followed by the user acceptance of developed scenarios.

Keywords: Energy efficiency, energy retrofitting, hot arid climate, Saudi Arabia.

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62 The Evaluation of New Generation Cardiovascular Risk Markers in Childhood Obesity

Authors: Mustafa M. Donma, Sule G. Kacmaz, Ahsen Yilmaz, Savas Guzel, Orkide Donma

Abstract:

Obesity, as excessive fat accumulation in the body, is a global health problem. The prevalence of obesity and its complications increase due to easy access to high-energy food and decreased physical activity. Cardiovascular diseases (CVDs) constitute a significant part of obesity-related morbidity and mortality. Since the effects of obesity on cardiovascular system may start during childhood without clinical findings, elucidating the mechanisms of cardiovascular changes associated with childhood obesity became more important. In this study, we aimed to investigate some biochemical parameters which may be involved in obesity-related pathologic processes of CVDs. One hundred and seventy-seven children were included in the study, and they were divided into four groups based upon WHO criteria and presence of the metabolic syndrome (MetS): children with normal-BMI, obesity, morbid obesity, and MetS. High-sensitive cardiac troponin T (hs-cTnT), cardiac myosin binding protein C (cMyBP-C), trimethylamine N-oxide (TMAO), soluble tumor necrosis factor-like weak inducer (sTWEAK), chromogranin A (CgA), multimerin-2 levels, and other biochemical parameters were measured in serum samples. Anthropometric measurements and clinical findings of the children were recorded. Statistical analyses were performed. Children with normal-BMI had significantly higher CgA levels than children with obesity, morbid obesity, and MetS (p < 0.05). Cardiac MyBP-C levels of children with MetS were significantly higher than of children with normal-BMI and OB children (p < 0.05). There was no significant difference in hs-cTnT, sTWEAK, TMAO and multimerin-2 between the groups (p>0.05). These results suggested that cMyBP-C and CgA molecules may be involved in the pathogenesis of obesity-related CVDs.

Keywords: biomarker, cardiovascular diseases, children, obesity

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61 Trial of Fecal Microbial Transplantation for the Prevention of Canine Atopic Dermatitis

Authors: Caroline F. Moeser

Abstract:

The skin-gut axis defines the relationship between the intestinal microbiota and the development of pathological skin diseases. Low diversity within the gut can predispose to the development of allergic skin conditions, and a greater diversity of the gastrointestinal microflora has been associated with a reduction of skin flares in people with atopic dermatitis. Manipulation of the gut microflora has been used as a treatment option for several conditions in people, but there is limited data available on the use of fecal transplantation as a preventative measure in either people or dogs. Six, 4-month-old pups from a litter of 10 were presented for diarrhea and/or signs of skin disease (chronic scratching, otitis externa). Of these pups, two were given probiotics with a resultant resolution of diarrhea. The other four pups were given fecal transplantation, either as a sole treatment or in combination with other treatments. Follow-up on the litter of 10 pups was performed at 18 months of age. At this stage, three out of the four pups that had received fecal transplantation had resolved all clinical signs and had no recurrence of either skin or gastrointestinal symptoms, the other pup had one episode of Malassezia otitis. Of the remaining six pups from the litter, all had developed at least one episode of Malassezia otitis externa within the period of five to 18 months of age. Two pups had developed two Malassezia otitis infections, and one had developed three Malassezia otitis infections during this period. Favrot’s criteria for the diagnosis of canine atopic dermatitis include chronic or recurrent Malassezia infections by the age of three years. Early results from this litter predict a reduction in the development of canine atopic disease in dogs given fecal microbial transplantation. Follow-up studies at three years of age and within a larger population of dogs can enhance understanding of the impact of early fecal transplantation in the prevention of canine atopic dermatitis.

Keywords: Canine atopic dermatitis, fecal microbial transplant, skin-gut axis, otitis

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60 Multi-Objective Optimal Design of a Cascade Control System for a Class of Underactuated Mechanical Systems

Authors: Yuekun Chen, Yousef Sardahi, Salam Hajjar, Christopher Greer

Abstract:

This paper presents a multi-objective optimal design of a cascade control system for an underactuated mechanical system. Cascade control structures usually include two control algorithms (inner and outer). To design such a control system properly, the following conflicting objectives should be considered at the same time: 1) the inner closed-loop control must be faster than the outer one, 2) the inner loop should fast reject any disturbance and prevent it from propagating to the outer loop, 3) the controlled system should be insensitive to measurement noise, and 4) the controlled system should be driven by optimal energy. Such a control problem can be formulated as a multi-objective optimization problem such that the optimal trade-offs among these design goals are found. To authors best knowledge, such a problem has not been studied in multi-objective settings so far. In this work, an underactuated mechanical system consisting of a rotary servo motor and a ball and beam is used for the computer simulations, the setup parameters of the inner and outer control systems are tuned by NSGA-II (Non-dominated Sorting Genetic Algorithm), and the dominancy concept is used to find the optimal design points. The solution of this problem is not a single optimal cascade control, but rather a set of optimal cascade controllers (called Pareto set) which represent the optimal trade-offs among the selected design criteria. The function evaluation of the Pareto set is called the Pareto front. The solution set is introduced to the decision-maker who can choose any point to implement. The simulation results in terms of Pareto front and time responses to external signals show the competing nature among the design objectives. The presented study may become the basis for multi-objective optimal design of multi-loop control systems.

Keywords: Cascade control, multi-loop control systems, multi-objective optimization, optimal control.

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59 A New Fuzzy DSS/ES for Stock Portfolio Selection using Technical and Fundamental Approaches in Parallel

Authors: H. Zarei, M. H. Fazel Zarandi, M. Karbasian

Abstract:

A Decision Support System/Expert System for stock portfolio selection presented where at first step, both technical and fundamental data used to estimate technical and fundamental return and risk (1st phase); Then, the estimated values are aggregated with the investor preferences (2nd phase) to produce convenient stock portfolio. In the 1st phase, there are two expert systems, each of which is responsible for technical or fundamental estimation. In the technical expert system, for each stock, twenty seven candidates are identified and with using rough sets-based clustering method (RC) the effective variables have been selected. Next, for each stock two fuzzy rulebases are developed with fuzzy C-Mean method and Takai-Sugeno- Kang (TSK) approach; one for return estimation and the other for risk. Thereafter, the parameters of the rule-bases are tuned with backpropagation method. In parallel, for fundamental expert systems, fuzzy rule-bases have been identified in the form of “IF-THEN" rules through brainstorming with the stock market experts and the input data have been derived from financial statements; as a result two fuzzy rule-bases have been generated for all the stocks, one for return and the other for risk. In the 2nd phase, user preferences represented by four criteria and are obtained by questionnaire. Using an expert system, four estimated values of return and risk have been aggregated with the respective values of user preference. At last, a fuzzy rule base having four rules, treats these values and produce a ranking score for each stock which will lead to a satisfactory portfolio for the user. The stocks of six manufacturing companies and the period of 2003-2006 selected for data gathering.

Keywords: Stock Portfolio Selection, Fuzzy Rule-Base ExpertSystems, Financial Decision Support Systems, Technical Analysis, Fundamental Analysis.

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58 Adaptive Design of Large Prefabricated Concrete Panels Collective Housing

Authors: Daniel M. Muntean, Viorel Ungureanu

Abstract:

More than half of the urban population in Romania lives today in residential buildings made out of large prefabricated reinforced concrete panels. Since their initial design was made in the 1960’s, these housing units are now being technically and morally outdated, consuming large amounts of energy for heating, cooling, ventilation and lighting, while failing to meet the needs of the contemporary life-style. Due to their widespread use, the design of a system that improves their energy efficiency would have a real impact, not only on the energy consumption of the residential sector, but also on the quality of life that it offers. Furthermore, with the transition of today’s existing power grid to a “smart grid”, buildings could become an active element for future electricity networks by contributing in micro-generation and energy storage. One of the most addressed issues today is to find locally adapted strategies that can be applied considering the 20-20-20 EU policy criteria and to offer sustainable and innovative solutions for the cost-optimal energy performance of buildings adapted on the existing local market. This paper presents a possible adaptive design scenario towards sustainable retrofitting of these housing units. The apartments are transformed in order to meet the current living requirements and additional extensions are placed on top of the building, replacing the unused roof space, acting not only as housing units, but as active solar energy collection systems. An adaptive building envelope is ensured in order to achieve overall air-tightness and an elevator system is introduced to facilitate access to the upper levels.

Keywords: Adaptive building, energy efficiency, retrofitting, residential buildings, smart grid.

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57 Probe-Assisted Axillary Lymph Node Biopsy Compared with Axillary Dissection in Breast Cancer: A Retrospective Study from the West of Iran

Authors: Morteza Alizadeh Foroutan, Hassan Moayeri, Keivan Sabooni, Motahareh Rouhi Ardeshiri

Abstract:

Breast cancer incidence is annually increasing in various parts of the world, and sentinel lymph node biopsy (SLNB) has turned into a new standard for care as a staging process in this regard. In the present study, the gamma probe technique was used for SLNB as a safe method with more accuracy and less complications. The study sought to compare the results of two surgical techniques, namely, axillary lymph node dissection (ALND) and SLNB, including epidemiological results and clinicopathological features of BC patients from the western provinces of Iran. In general, 420 BC women were identified who referred to the breast clinic in Sanandaj, Kurdistan province during 2017-2021. Of whom, 318 patients underwent breast surgery, and from these patients, 277 cases participated in the current study. Patients were divided into those undergoing ALND and SLNB. The criteria for complete dissection or axillary biopsy using the gamma probe were based on the results of clinical examinations and the presence of palpable lymph nodes. Overall complications after surgery belonged to 58 (18.9%) cases, including 15 (25.9%) and 43 (74.1%) patients in the SLNB and ALND groups, respectively (P = 0.74). Based on the findings, Seroma (60.3%) was the most reported complication in each group. Most patients had tumors in the upper-outer quadrant of their left breast. The mean of the tumor dimension in the SLNB and ALND groups was 2.1 ± 1.3 cm and 3.2 ± 1.8 cm, respectively, (P = 0.003). The benefits of breast-conserving surgery (BCS) with the SLNB technique are clearly undeniable and can be considered a method with less complications and a better prognosis. Accordingly, SLNB and BCS are favorable methods that can be performed, along with gamma probe technique, which is safe and accurate.

Keywords: Breast cancer, Sentinel lymph node biopsy, Axillary lymph node dissection, Gamma probe.

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56 Sustainable Intensification of Agriculture in Victoria’s Food Bowl: Optimizing Productivity with the use of Decision-Support Tools

Authors: M. Johnson, R. Faggian, V. Sposito

Abstract:

A participatory and engaged approach is key in connecting agricultural managers to sustainable agricultural systems to support and optimize production in Victoria’s food bowl. A sustainable intensification (SI) approach is well documented globally, but participation rates amongst Victorian farmers is fragmentary, and key outcomes and implementation strategies are poorly understood. Improvement in decision-support management tools and a greater understanding of the productivity gains available upon implementation of SI is necessary. This paper reviews the current understanding and uptake of SI practices amongst farmers in one of Victoria’s premier food producing regions, the Goulburn Broken; and it spatially analyses the potential for this region to adapt to climate change and optimize food production. A Geographical Information Systems (GIS) approach is taken to develop an interactive decision-support tool that can be accessible to on-ground agricultural managers. The tool encompasses multiple criteria analysis (MCA) that identifies factors during the construction phase of the tool, using expert witnesses and regional knowledge, framed within an Analytical Hierarchy Process. Given the complexities of the interrelations between each of the key outcomes, this participatory approach, in which local realities and factors inform the key outcomes and help to strategies for a particular region, results in a robust strategy for sustainably intensifying production in key food producing regions. The creation of an interactive, locally embedded, decision-support management and education tool can help to close the gap between farmer knowledge and production, increase on-farm adoption of sustainable farming strategies and techniques, and optimize farm productivity.

Keywords: Agriculture, decision-support management tools, GIS, sustainable intensification.

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55 Long-Term Durability of Roller-Compacted Concrete Pavement

Authors: Jun Hee Lee, Young Kyu Kim, Seong Jae Hong, Chamroeun Chhorn, Seung Woo Lee

Abstract:

Roller-compacted concrete pavement (RCCP), an environmental friendly pavement of which load carry capacity benefitted from both hydration and aggregate interlock from roller compacting, demonstrated a superb structural performance for a relatively small amount of water and cement content. Even though an excellent structural performance can be secured, it is required to investigate roller-compacted concrete (RCC) under environmental loading and its long-term durability under critical conditions. In order to secure long-term durability, an appropriate internal air-void structure is required for this concrete. In this study, a method for improving the long-term durability of RCCP is suggested by analyzing the internal air-void structure and corresponding durability of RCC. The method of improving the long-term durability involves measurements of air content, air voids, and air-spacing factors in RCC that experiences changes in terms of type of air-entraining agent and its usage amount. This test is conducted according to the testing criteria in ASTM C 457, 672, and KS F 2456. It was found that the freezing-thawing and scaling resistances of RCC without any chemical admixture was quite low. Interestingly, an improvement of freezing-thawing and scaling resistances was observed for RCC with appropriate the air entraining (AE) agent content; Relative dynamic elastic modulus was found to be more than 80% for those mixtures. In RCC with AE agent mixtures, large amount of air was distributed within a range of 2% to 3%, and an air void spacing factor ranging between 200 and 300 μm (close to 250 μm, recommended by PCA) was secured. The long-term durability of RCC has a direct relationship with air-void spacing factor, and thus it can only be secured by ensuring the air void spacing factor through the inclusion of the AE in the mixture.

Keywords: RCCP, durability, air spacing factor, surface scaling resistance test, freezing and thawing resistance test.

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54 A Hybrid Multi-Criteria Hotel Recommender System Using Explicit and Implicit Feedbacks

Authors: Ashkan Ebadi, Adam Krzyzak

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Recommender systems, also known as recommender engines, have become an important research area and are now being applied in various fields. In addition, the techniques behind the recommender systems have been improved over the time. In general, such systems help users to find their required products or services (e.g. books, music) through analyzing and aggregating other users’ activities and behavior, mainly in form of reviews, and making the best recommendations. The recommendations can facilitate user’s decision making process. Despite the wide literature on the topic, using multiple data sources of different types as the input has not been widely studied. Recommender systems can benefit from the high availability of digital data to collect the input data of different types which implicitly or explicitly help the system to improve its accuracy. Moreover, most of the existing research in this area is based on single rating measures in which a single rating is used to link users to items. This paper proposes a highly accurate hotel recommender system, implemented in various layers. Using multi-aspect rating system and benefitting from large-scale data of different types, the recommender system suggests hotels that are personalized and tailored for the given user. The system employs natural language processing and topic modelling techniques to assess the sentiment of the users’ reviews and extract implicit features. The entire recommender engine contains multiple sub-systems, namely users clustering, matrix factorization module, and hybrid recommender system. Each sub-system contributes to the final composite set of recommendations through covering a specific aspect of the problem. The accuracy of the proposed recommender system has been tested intensively where the results confirm the high performance of the system.

Keywords: Tourism, hotel recommender system, hybrid, implicit features.

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53 A Retrospective Drug Utilization Study of Antiplatelet Drugs in Patients with Ischemic Heart Disease

Authors: K. Jyothi, T. S. Mohamed Saleem, L. Vineela, C. Gopinath, K. B. Yadavender Reddy

Abstract:

Objective: Acute coronary syndrome is a clinical condition encompassing ST segments elevation myocardial infraction, Non ST segment is elevation myocardial infraction and un stable angina is characterized by ruptured coronary plaque, stress and myocardial injury. Angina pectoris is a pressure like pain in the chest that is induced by exertion or stress and relived with in the minute after cessation of effort or using sublingual nitroglycerin. The present research was undertaken to study the drug utilization pattern of antiplatelet drugs for the ischemic heart disease in a tertiary care hospital. Method: The present study is retrospective drug utilization study and study period is 6months. The data is collected from the discharge case sheet of general medicine department from medical department Rajiv Gandhi institute of medical sciences, Kadapa. The tentative sample size fixed was 250 patients. Out of 250 cases 19 cases was excluded because of unrelated data. Results: A total of 250 prescriptions were collected for the study according to the inclusion criteria 233 prescriptions were diagnosed with ischemic heart disease 17 prescriptions were excluded due to unrelated information. out of 233 prescriptions 128 are male (54.9%) and 105 patients are were female (45%). According to the gender distribution, the prevalence of ischemic heart disease in males are 90 (70.31%) and females are 39 (37.1%). In the same way the prevalence of ischemic heart disease along with cerebrovascular disease in males are 39 (29.6%) and females are 66 (62.6%). Conclusion: We found that 94.8% of drug utilization of antiplatelet drugs was achieved in the Rajiv Gandhi institute of medical sciences, Kadapa from 2011-2012.

Keywords: Angina pectoris, aspirin, clopidogrel, myocardial infarction.

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52 Prioritization Assessment of Housing Development Risk Factors: A Fuzzy Hierarchical Process-Based Approach

Authors: Yusuf Garba Baba

Abstract:

The construction industry and housing subsector are fraught with risks that have the potential of negatively impacting on the achievement of project objectives. The success or otherwise of most construction projects depends to large extent on how well these risks have been managed. The recent paradigm shift by the subsector to use of formal risk management approach in contrast to hitherto developed rules of thumb means that risks must not only be identified but also properly assessed and responded to in a systematic manner. The study focused on identifying risks associated with housing development projects and prioritisation assessment of the identified risks in order to provide basis for informed decision. The study used a three-step identification framework: review of literature for similar projects, expert consultation and questionnaire based survey to identify potential risk factors. Delphi survey method was employed in carrying out the relative prioritization assessment of the risks factors using computer-based Analytical Hierarchical Process (AHP) software. The results show that 19 out of the 50 risks significantly impact on housing development projects. The study concludes that although significant numbers of risk factors have been identified as having relevance and impacting to housing construction projects, economic risk group and, in particular, ‘changes in demand for houses’ is prioritised by most developers as posing a threat to the achievement of their housing development objectives. Unless these risks are carefully managed, their effects will continue to impede success in these projects. The study recommends the adoption and use of the combination of multi-technique identification framework and AHP prioritization assessment methodology as a suitable model for the assessment of risks in housing development projects.

Keywords: Risk identification, risk assessment, analytical hierarchical process, multi-criteria decision.

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51 Probiotic Potential and Antimicrobial Activity of Enterococcus faecium Isolated from Chicken Caecal and Fecal Samples

Authors: Salma H. Abu Hafsa, A. Mendonca, B. Brehm-Stecher, A. A. Hassan, S. A. Ibrahim

Abstract:

Enterococci are important inhabitants of the animal intestine and are widely used in probiotic products. A probiotic strain is expected to possess several desirable properties in order to exert beneficial effects. Therefore, the objective of this study was to isolate, characterize and identify Enterococcus sp. from chicken cecal and fecal samples to determine potential probiotic properties. Enterococci were isolated from chicken ceca and feces of thirty three clinically healthy chickens from a local farm. In vitro studies were performed to assess antibacterial activity of the isolated LAB (using agar well diffusion and cell free supernatant broth technique against Salmonella enterica serotype Enteritidis), survival in acidic conditions, resistance to bile salts, and their survival during simulated gastric juice conditions at pH 2.5. Isolates were identified by biochemical carbohydrate fermentation patterns using an API 50 CHL kit and API ZYM kits and by sequenced 16S rDNA. An isolate belonging to E. faecium species exhibited inhibitory effect against S. enteritidis. This isolate producing a clear zone as large as 10.30 mm or greater and was able to grow in the coculture medium and at the same time, inhibited the growth S. enteritidis. In addition, E. faecium exhibited significant resistance under highly acidic conditions at pH 2.5 for 8 h and survived well in bile salt at 0.2% for 24 h and showing ability to survive in the presence of simulated gastric juice at pH 2.5. Based on these results, E. faecium isolate fulfills some of the criteria to be considered as a probiotic strain and therefore, could be used as a feed additive with good potential for controlling S. Enteritidis in chickens. However, in vivo studies are needed to determine the safety of the strain.

Keywords: Acid tolerance, antimicrobial activity, Enterococcus faecium, probiotic.

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50 Evaluating Generative Neural Attention Weights-Based Chatbot on Customer Support Twitter Dataset

Authors: Sinarwati Mohamad Suhaili, Naomie Salim, Mohamad Nazim Jambli

Abstract:

Sequence-to-sequence (seq2seq) models augmented with attention mechanisms are increasingly important in automated customer service. These models, adept at recognizing complex relationships between input and output sequences, are essential for optimizing chatbot responses. Central to these mechanisms are neural attention weights that determine the model’s focus during sequence generation. Despite their widespread use, there remains a gap in the comparative analysis of different attention weighting functions within seq2seq models, particularly in the context of chatbots utilizing the Customer Support Twitter (CST) dataset. This study addresses this gap by evaluating four distinct attention-scoring functions—dot, multiplicative/general, additive, and an extended multiplicative function with a tanh activation parameter — in neural generative seq2seq models. Using the CST dataset, these models were trained and evaluated over 10 epochs with the AdamW optimizer. Evaluation criteria included validation loss and BLEU scores implemented under both greedy and beam search strategies with a beam size of k = 3. Results indicate that the model with the tanh-augmented multiplicative function significantly outperforms its counterparts, achieving the lowest validation loss (1.136484) and the highest BLEU scores (0.438926 under greedy search, 0.443000 under beam search, k = 3). These findings emphasize the crucial influence of selecting an appropriate attention-scoring function to enhance the performance of seq2seq models for chatbots, particularly highlighting the model integrating tanh activation as a promising approach to improving chatbot quality in customer support contexts.

Keywords: Attention weight, chatbot, encoder-decoder, neural generative attention, score function, sequence-to-sequence.

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49 Micropropagation and in vitro Conservation via Slow Growth Techniques of Prunus webbii (Spach) Vierh: An Endangered Plant Species in Albania

Authors: Valbona Sota, Efigjeni Kongjika

Abstract:

Wild almond is a woody species, which is difficult to propagate either generatively by seed or by vegetative methods (grafting or cuttings) and also considered as Endangered (EN) in Albania based on IUCN criteria. As a wild relative of cultivated fruit trees, this species represents a source of genetic variability and can be very important in breeding programs and cultivation. For this reason, it would be of interest to use an effective method of in vitro mid-term conservation, which involves strategies to slow plant growth through physicochemical alterations of in vitro growth conditions. Multiplication of wild almond was carried out using zygotic embryos, as primary explants, with the purpose to develop a successful propagation protocol. Results showed that zygotic embryos can proliferate through direct or indirect organogenesis. During subculture, stage was obtained a great number of new plantlets identical to mother plants derived from the zygotic embryos. All in vitro plantlets obtained from subcultures underwent in vitro conservation by minimal growth in low temperature (4ºC) and darkness. The efficiency of this technique was evaluated for 3, 6, and 10 months of conservation period. Maintenance in these conditions reduced micro cuttings growth. Survival and regeneration rates for each period were evaluated and resulted that the maximal time of conservation without subculture on 4ºC was 10 months, but survival and regeneration rates were significantly reduced, specifically 15.6% and 7.6%. An optimal period of conservation in these conditions can be considered the 5-6 months storage, which can lead to 60-50% of survival and regeneration rates. This protocol may be beneficial for mass propagation, mid-term conservation, and for genetic manipulation of wild almond.

Keywords: Micropropagation, minimal growth, storage, wild almond.

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48 Modern Seismic Design Approach for Buildings with Hysteretic Dampers

Authors: Vanessa A. Segovia, Sonia E. Ruiz

Abstract:

The use of energy dissipation systems for seismic applications has increased worldwide, thus it is necessary to develop practical and modern criteria for their optimal design. Here, a direct displacement-based seismic design approach for frame buildings with hysteretic energy dissipation systems (HEDS) is applied. The building is constituted by two individual structural systems consisting of: 1) a main elastic structural frame designed for service loads; and 2) a secondary system, corresponding to the HEDS, that controls the effects of lateral loads. The procedure implies to control two design parameters: a) the stiffness ratio (α=Kframe/Ktotal system), and b) the strength ratio (γ=Vdamper/Vtotal system). The proposed damage-controlled approach contributes to the design of a more sustainable and resilient building because the structural damage is concentrated on the HEDS. The reduction of the design displacement spectrum is done by means of a damping factor (recently published) for elastic structural systems with HEDS, located in Mexico City. Two limit states are verified: serviceability and near collapse. Instead of the traditional trial-error approach, a procedure that allows the designer to establish the preliminary sizes of the structural elements of both systems is proposed. The design methodology is applied to an 8-story steel building with buckling restrained braces, located in soft soil of Mexico City. With the aim of choosing the optimal design parameters, a parametric study is developed considering different values of હ and ઻. The simplified methodology is for preliminary sizing, design, and evaluation of the effectiveness of HEDS, and it constitutes a modern and practical tool that enables the structural designer to select the best design parameters. 

Keywords: Damage-controlled buildings, direct displacementbased seismic design, optimal hysteretic energy dissipation systems

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47 Associations between Metabolic Syndrome and Bone Mineral Density and Trabecular Bone Score in Postmenopausal Women with Non-Vertebral Fractures

Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

Abstract:

Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m2), B – 442 females with obesity (BMI >29.9 kg/m2)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

Keywords: Bone mineral density, trabecular bone score, metabolic syndrome, fracture.

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46 Sustainability Analysis and Quality Assessment of Rainwater Harvested from Green Roofs: A Review

Authors: Mst. Nilufa Sultana, Shatirah Akib, Muhammad Aqeel Ashraf, Mohamed Roseli Zainal Abidin

Abstract:

Most people today are aware that global climate change is not just a scientific theory but also a fact with worldwide consequences. Global climate change is due to rapid urbanization, industrialization, high population growth and current vulnerability of the climatic condition. Water is becoming scarce as a result of global climate change. To mitigate the problem arising due to global climate change and its drought effect, harvesting rainwater from green roofs, an environmentally-friendly and versatile technology, is becoming one of the best assessment criteria and gaining attention in Malaysia. This paper addresses the sustainability of green roofs and examines the quality of water harvested from green roofs in comparison to rainwater. The factors that affect the quality of such water, taking into account, for example, roofing materials, climatic conditions, the frequency of rainfall frequency and the first flush. A green roof was installed on the Humid Tropic Centre (HTC) is a place of the study on monitoring program for urban Stormwater Management Manual for Malaysia (MSMA), Eco-Hydrological Project in Kuala Lumpur, and the rainwater was harvested and evaluated on the basis of four parameters i.e., conductivity, dissolved oxygen (DO), pH and temperature. These parameters were found to fall between Class I and Class III of the Interim National Water Quality Standards (INWQS) and the Water Quality Index (WQI). Some preliminary treatment such as disinfection and filtration could likely to improve the value of these parameters to class I. This review paper clearly indicates that there is a need for more research to address other microbiological and chemical quality parameters to ensure that the harvested water is suitable for use potable water for domestic purposes. The change in all physical, chemical and microbiological parameters with respect to storage time will be a major focus of future studies in this field.

Keywords: Green roofs, INWQS, MSMA-SME, Rainwater harvesting.

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45 A Framework for an Automated Decision Support System for Selecting Safety-Conscious Contractors

Authors: Rawan A. Abdelrazeq, Ahmed M. Khalafallah, Nabil A. Kartam

Abstract:

Selection of competent contractors for construction projects is usually accomplished through competitive bidding or negotiated contracting in which the contract bid price is the basic criterion for selection. The evaluation of contractor’s safety performance is still not a typical criterion in the selection process, despite the existence of various safety prequalification procedures. There is a critical need for practical and automated systems that enable owners and decision makers to evaluate contractor safety performance, among other important contractor selection criteria. These systems should ultimately favor safety-conscious contractors to be selected by the virtue of their past good safety records and current safety programs. This paper presents an exploratory sequential mixed-methods approach to develop a framework for an automated decision support system that evaluates contractor safety performance based on a multitude of indicators and metrics that have been identified through a comprehensive review of construction safety research, and a survey distributed to domain experts. The framework is developed in three phases: (1) determining the indicators that depict contractor current and past safety performance; (2) soliciting input from construction safety experts regarding the identified indicators, their metrics, and relative significance; and (3) designing a decision support system using relational database models to integrate the identified indicators and metrics into a system that assesses and rates the safety performance of contractors. The proposed automated system is expected to hold several advantages including: (1) reducing the likelihood of selecting contractors with poor safety records; (2) enhancing the odds of completing the project safely; and (3) encouraging contractors to exert more efforts to improve their safety performance and practices in order to increase their bid winning opportunities which can lead to significant safety improvements in the construction industry. This should prove useful to decision makers and researchers, alike, and should help improve the safety record of the construction industry.

Keywords: Construction safety, contractor selection, decision support system, relational database.

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44 An Anthropometric Index Capable of Differentiating Morbid Obesity from Obesity and Metabolic Syndrome in Children

Authors: Mustafa M. Donma

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Circumference measurements may give meaningful information about the varying stages of obesity. Some formulas may be derived from a number of body circumference measurements to estimate body fat. Waist (WC), hip (HC) and neck (NC) circumferences are currently the most frequently used measurements. The aim of this study was to develop a formula derived from these three anthropometric measurements for the differential diagnosis of morbid obesity with and without metabolic syndrome (MetS), MOMetS+ and MOMetS-, respectively. 187 children were recruited from the pediatrics outpatient clinic of Tekirdag Namik Kemal University, Faculty of Medicine. Signed informed consent forms were taken from the participants. The study was carried out according to the Helsinki Declaration. The study protocol was approved by the institutional non-interventional ethics committee of Tekirdag Namik Kemal University Medical Faculty. The study population was divided into four groups as normal-body mass index (N-BMI) (n = 35), obese (OB) (n = 44), morbid obese (MO) (n = 75) and MetS (n = 33). Age- and gender-adjusted BMI percentile values were used for the classification of groups. The children in MetS group were selected based upon the nature of the MetS components described as MetS criteria. Anthropometric measurements, laboratory analysis and statistical evaluation confined to study population were performed. BMI values were calculated. A circumference index, advanced Donma circumference index (ADCI) was presented as WC*HC/NC. The statistical significance degree was chosen as p < 0.05. BMI values were 17.7 ± 2.8, 24.5 ± 3.3, 28.8 ± 5.7, 31.4 ± 8.0 kg/m2, for N-BMI, OB, MO, MetS groups (p = 0.001), respectively. An increasing trend from N-BMI to MetS was observed. However, the increase in MetS group compared to MO group was not significant. For the new index, significant differences were obtained between N-BMI and OB, MO, MetS groups (p = 0.001). A significant difference between MO and MetS groups was detected (p = 0.043). A significant correlation was found between BMI and ADCI. In conclusion, in spite of the strong correlation between BMI and ADCI values obtained when all groups were considered, ADCI, but not BMI, was the index, which was capable of differentiating cases with morbid obesity from cases with morbid obesity and MetS.

Keywords: Anthropometry, body mass index, childhood obesity, body circumference, metabolic syndrome.

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43 Forms of Promotion and Dissemination of Traditional Local Wisdom: Creating Occupations among the Elderly in Noanmueng Community, Muang Sub-District, Baan Doong District, Udonthani Province

Authors: Pennapa Palapin

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This research sought to discover the forms of promotion and dissemination of traditional local wisdom that are used to create occupations among the elderly at Noanmueng Community, Muang Sub-District, Baan Doong District, Udornthani Province. The criteria used to select the research sample group were: having a role involved in the promotion and dissemination of traditional local wisdom to create occupations among the elderly; being an experienced person who the residents of Noanmueng Community find trustworthy; and having lived in Noanmueng Community for a long time so as to be able to see the development and change that occurs. A total of 16 persons were thus selected. Data was gathered through a qualitative study, using semi-structured indepth interviews. The collected data was then summarized and discussed according to the research objectives. Finally, the data was presented in narrative format. Results found that the identifying traditional local wisdom of the community (which grew from the residents’ experience and beneficial usage in daily life, passed down from generation to generation) was the weaving of cloth and basketry. As for the manner of promotion and dissemination of traditional local wisdom, these skills were passed down through teaching by example to family members, relatives and others in the community. This was largely the initiative of the elders or elderly members of the community. In order for the promotion and dissemination of traditional local wisdom to create occupations among the elderly, the traditional local wisdom should be supported in every way through participation of the community members. For example, establish a museum of traditional local wisdom for the collection of traditional local wisdom in various fields, both from the past and present innovations. This would be a source of pride for the community, simultaneously helping traditional local wisdom to become widely known and to create income for the community’s elderly. Additional ways include organizing exhibitions of products made by traditional local wisdom, finding both domestic and international markets, as well as building both domestic and international networks aiming to find opportunities to market products made by traditional local wisdom.

Keywords: Traditional local wisdom, Occupation, Elderly.

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42 Curriculum Development of Successful Intelligence Promoting for Nursing Students

Authors: Saranya Chularee, Tawa Chularee

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Successful intelligence (SI) is the integrated set of the ability needed to attain success in life, within individual-s sociocultural context. People are successfully intelligent by recognizing their strengths and weaknesses. They will find ways to strengthen their weakness and maintain their strength or even improve it. SI people can shape, select, and adapt to the environments by using balance of higher-ordered thinking abilities including; critical, creative, and applicative. Aims: The purposes of this study were to; 1) develop curriculum that promotes SI for nursing students, and 2) study the effectiveness of the curriculum development. Method: Research and Development was a method used for this study. The design was divided into two phases; 1) the curriculum development which composed of three steps (needs assessment, curriculum development and curriculum field trail), and 2) the curriculum implementation. In this phase, a pre-experimental research design (one group pretest-posttest design) was conducted. The sample composed of 49 sophomore nursing students of Boromarajonani College of Nursing, Surin, Thailand who enrolled in Nursing care of Health problem course I in 2011 academic year. Data were carefully collected using 4 instruments; 1) Modified essay questions test (MEQ) 2) Nursing Care Plan evaluation form 3) Group processing observation form (α = 0.74) and 4) Satisfied evaluation form of learning (α = 0.82). Data were analyzed using descriptive statistics and content analysis. Results: The results revealed that the sample had post-test average score of SI higher than pre-test average score (mean difference was 5.03, S.D. = 2.84). Fifty seven percentages of the sample passed the MEQ posttest at the criteria of 60 percentages. Students demonstrated the strategies of how to develop nursing care plan. Overall, students- satisfaction on teaching performance was at high level (mean = 4.35, S.D. = 0.46). Conclusion: This curriculum can promote the attribute of characteristic of SI person and was highly required to be continued.

Keywords: Curriculum Development, Nursing Education, Successful Intelligence, Thinking ability.

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41 Well-Being of Lagos Urban Mini-Bus Drivers: The Influence of Age and Marital Status

Authors: Bolajoko I. Malomo, Maryam O. Yusuf

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Lagos urban mini bus drivers play a critical role in the transportation sector. The current major mode of transportation within Lagos metropolis remains road transportation and this confirms the relevance of urban mini-bus drivers in transporting the populace to their various destinations. Other modes of transportation such as the train and waterways are currently inadequate. Various threats to the well-being of urban bus drivers include congested traffic typical of modern day lifestyles, dwindling financial returns due to long hours in traffic, fewer hours of sleep, inadequate diet, time pressure, and assaults related to fare disputes. Several healthrelated problems have been documented to be associated with urban bus driving. For instance, greater rates of hypertension, obesity and cholesterol level have been reported. Research studies are yet to identify the influence of age and marital status on the well-being of urban mini-bus drivers in Lagos metropolis. A study of this nature is necessary as it is culturally perceived in Nigeria that older and married people are especially influenced by family affiliation and would behave in ways that would project positive outcomes. The study sample consisted of 150 urban mini-bus drivers who were conveniently sampled from six (6) different terminuses where their journey begins and terminates. The well-being questionnaire was administered to participants. The criteria for inclusion in the study included the ability to read in English language and the confirmation that interested participants were on duty and suited to be driving mini-buses. Due to the nature of the job of bus driving, the researcher administered the questionnaires on participants who were free and willing to respond to the survey. All participants were males of various age groups and of different marital statuses. Results of analyses conducted revealed no significant influence of age and marital status on the well-being of urban mini-bus drivers. This indicates that the well-being of urban mini bus drivers is not influenced by age or marital status. The findings of this study have cultural implications. It negates the popularly held belief that older and married people care more about their well-being than younger and single people. It brings to fore the need to also identify and consider other factors when certifying people for the job of urban bus driving.

Keywords: Age, Lagos metropolis, marital status, well-being of urban mini bus drivers.

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40 Analyzing the Historical Ayazma Bath within the Scope of Integrated Preservation and Specifying the Criteria for Reuse

Authors: Meryem Elif Çelebi Yakartepe, Ayşe Betül Gökarslan

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Today, preservation of the historical constructions in "single construction" scale creates an inadequate preservation model in terms of the integrity of the historical environment in which they are located. However, in order to preserve these structures forming this integrity with a holistic approach, the structures either need to continue their unique functions or to be reshaped for function conforming to today's comfort conditions brought by the modern life.

In this work, the preservation of Ayazma Social Complex located in Ayazma Neighborhood of Üsküdar, one of the most important historical districts of İstanbul, with integrated preservation method has been discussed. In the conventional Turkish architecture, the social complex is a structure complex formed via constructing the public buildings required for the daily life of the people living in a settlement. Thus, the preservation of the social complexes within the scope of "integrated preservation" has gained importance. Ayazma Social Complex that forms the examination area of this work consists of a mosque in its center and structures around this mosque such as sultan mansion, time assignment center, primary school, stores, bath and water reservoirs. Mosque, sultan mansion and the water reservoirs survived to today as mostly preserved status. However, time assignment center, primary school and the stores didn't survive to today and new structures were built on their plots. The bath was mostly damaged and only the wall residues survive to today. Thus, it's urgent and crucial especially carry out the preservation restoration of the bath in accordance with integrated preservation principles. The preservation problems of the bath based on the social complex were determined as a working method and preservation suggestions were made to overcome these problems and to include the bath into daily life. Furthermore, it was suggested that the bath should be reshaped for a different function in order to be preserved with the social complex.

Keywords: Üsküdar, Ayazma Complex, Ayazma Bath, Conservation, Restoration.

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39 Designing for Sustainable Public Housing from Property Management and Financial Feasibility Perspectives

Authors: Kung-Jen Tu

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Many public housing properties developed by local governments in Taiwan in the 1980s have deteriorated severely as these rental apartment buildings aged. The lack of building maintainability considerations during project design phase as well as insufficient maintenance funds have made it difficult and costly for local governments to maintain and keep public housing properties in good shape. In order to assist the local governments in achieving and delivering sustainable public housing, this paper intends to present a developed design evaluation method to be used to evaluate the presented design schemes from property management and financial feasibility perspectives during project design phase of public housing projects. The design evaluation results, i.e. the property management and financial implications of presented design schemes that could occur later during the building operation and maintenance phase, will be reported to the client (the government) and design schemes revised consequently. It is proposed that the design evaluation be performed from two main perspectives: (1) Operation and property management perspective: Three criteria such as spatial appropriateness, people and vehicle circulation and control, property management working spaces are used to evaluate the ‘operation and PM effectiveness’ of a design scheme. (2) Financial feasibility perspective: Four types of financial analyses are performed to assess the long term financial feasibility of a presented design scheme, such as operational and rental income analysis, management fund analysis, regular operational and property management service expense analysis, capital expense analysis. The ongoing Chung-Li Public Housing Project developed by the Taoyuan City Government will be used as a case to demonstrate how the presented design evaluation method is implemented. The results of property management assessment as well as the annual operational and capital expenses of a proposed design scheme are presented.

Keywords: Design evaluation method, management fund, operational and capital expenses, rental apartment buildings.

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38 Health Psychology Intervention – Identifying Early Symptoms in Neurological Disorders

Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people as shown in the Thompson Cortisol Hypothesis. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and poststimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: Cortisol, Electromyography, Neurology, Yawning.

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37 The Application of Dynamic Network Process to Environment Planning Support Systems

Authors: Wann-Ming Wey

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In recent years, in addition to face the external threats such as energy shortages and climate change, traffic congestion and environmental pollution have become anxious problems for many cities. Considering private automobile-oriented urban development had produced many negative environmental and social impacts, the transit-oriented development (TOD) has been considered as a sustainable urban model. TOD encourages public transport combined with friendly walking and cycling environment designs, however, non-motorized modes help improving human health, energy saving, and reducing carbon emissions. Due to environmental changes often affect the planners’ decision-making; this research applies dynamic network process (DNP) which includes the time dependent concept to promoting friendly walking and cycling environmental designs as an advanced planning support system for environment improvements.

This research aims to discuss what kinds of design strategies can improve a friendly walking and cycling environment under TOD. First of all, we collate and analyze environment designing factors by reviewing the relevant literatures as well as divide into three aspects of “safety”, “convenience”, and “amenity” from fifteen environment designing factors. Furthermore, we utilize fuzzy Delphi Technique (FDT) expert questionnaire to filter out the more important designing criteria for the study case. Finally, we utilized DNP expert questionnaire to obtain the weights changes at different time points for each design criterion. Based on the changing trends of each criterion weight, we are able to develop appropriate designing strategies as the reference for planners to allocate resources in a dynamic environment. In order to illustrate the approach we propose in this research, Taipei city as one example has been used as an empirical study, and the results are in depth analyzed to explain the application of our proposed approach.

Keywords: Environment Planning Support Systems, Walking and Cycling, Transit-oriented Development (TOD), Dynamic Network Process (DNP).

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36 Education and Assessment of Civil Employees in e-Government: The Case of a Moodle Based Platform

Authors: Stamatios A. Theocharis, George A. Tsihrintzis

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One of the most important factors for the success of e-government is training and preparing the workforce of the public sector. As changes and innovation in the public sector progress at a very slow pace and more slowly than in the private sector, issues related to human resources require special care. This is because the workforce will eventually seize the opportunities of the technological solutions used in e-Government. Thus, the central administration should provide employees with continuous and focused training not only on new technologies but also on a wide range of subjects and also improve interdepartmental interaction.

To achieve all this, new methods and training tools need to be implemented in addition to assessment of the employees. In this spirit, we propose the development of an educational platform with user personalization features. We propose the development of this platform using Moodle as the basic tool. Incorporating a personalization mechanism is very important since different employees have different backgrounds, education levels, computer skills, or different capability to develop further. Key features of the proposed platform include, besides typical e-learning tools, communities organized in order to exchange experiences and knowledge, groups of users based on certain criteria, automatic evaluation of users and potential self-education and self-assessment. In its fully developed form, this platform can be part of a more comprehensive knowledge management system for the public sector.

Keywords: e-Government, civil employees education, education technologies.

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35 Critical Success Factors Influencing Construction Project Performance for Different Objectives: Procurement Phase

Authors: Samart Homthong, Wutthipong Moungnoi

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Critical success factors (CSFs) and the criteria to measure project success have received much attention over the decades and are among the most widely researched topics in the context of project management. However, although there have been extensive studies on the subject by different researchers, to date, there has been little agreement on the CSFs. The aim of this study is to identify the CSFs that influence the performance of construction projects, and determine their relative importance for different objectives across five stages in the project life cycle. A considerable literature review was conducted that resulted in the identification of 179 individual factors. These factors were then grouped into nine major categories. A questionnaire survey was used to collect data from three groups of respondents: client representatives, consultants, and contractors. Out of 164 questionnaires distributed, 93 were returned, yielding a response rate of 56.7%. Using the mean score, relative importance index, and weighted average method, the top 10 critical factors for each category were identified. The agreement of survey respondents on those categorised factors were analysed using Spearman’s rank correlation. A one-way analysis of variance was then performed to determine whether the mean scores among the various groups of respondents were statistically significant. The findings indicate the most CSFs in each category in procurement phase are: proper procurement programming of materials (time), stability in the price of materials (cost), and determining quality in the construction (quality). They are then followed by safety equipment acquisition and maintenance (health and safety), budgeting allowed in a contractual arrangement for implementing environmental management activities (environment), completeness of drawing documents (productivity), accurate measurement and pricing of bill of quantities (risk management), adequate communication among the project team (human resource), and adequate cost control measures (client satisfaction). An understanding of CSFs would help all interested parties in the construction industry to improve project performance. Furthermore, the results of this study would help construction professionals and practitioners take proactive measures for effective project management.

Keywords: Critical success factors, procurement phase, project life cycle, project performance.

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34 A Retrospective Study of Vaginal Stenosis Following Treatment of Cervical Cancers and the Effectiveness of Rehabilitation Interventions

Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: Dilator, sexually active, vaginal dilation, vaginal stenosis.

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