Effectiveness of traffic management at Kajang SILK Highway

The traffic management centre is a place of operational monitoring and supervision activities at all highways under the Malaysian Highway Authority. The purpose of this centre is to help gather and disseminate information related to traffic to the users. The information presented by them is accurate and constantly updated from time to time. However, are highway users in Malaysia aware of the existence of this traffic management centre? How can traffic management centre help them to determine their travel times and fast routes especially during the festive seasons? Therefore, researchers have outlined some of the objectives to assist in obtaining information about this study. The main objective of this study is to measure the level of consumer awareness of the highway traffic management centre. In addition, the second objective of this study is to examine the factors causing traffic congestion. Besides, researchers also want to investigate the drivers’ attitudes during the congestion which will lead to an accident and congestion and thus propose measures to raise the level of awareness and measures that can be taken to reduce traffic congestion. The technique used to carry out this study is a fuzzy conjoint model. The questionnaire distributed will be administered by the researcher himself. The level of consumer awareness will be measured through the likert scale which uses fuzzy linguistic variables such as one to five scale (never, sometimes, uncertain, ever, always). This study is conducted on users who use the Kajang SILK highway through the Toll Plaza Sg. Ramal. At the end of the study, the researcher hoped that this study would help the authorities, especially the Malaysian Highway Authority and other management in improving the traffic management centre

The potential utilization of ultra-high performance concrete for bridge construction in Malaysia

Ultra-High Performance Concrete (UHPC) is considered to be quite a new technology in Malaysia and it is still in the early stage of implementation as far as bridge design and construction in this country is concerned. Bridge Design Division, Public Works Department (PWD) has taken the initiative to study and to begin utilising UHPC in designing a 300 m long bridge crossing the Perak River between Kg. Seberang Manong (Kg Menglembu) to Kuala Kangsar, Perak. The purpose of using UHPC is to reduce the number of intermediate piers that need to be constructed within the river channel in order to minimize the impact of debris flow disaster. This will allow free flow of logs thus avoiding them from being trapped and could possibly damage the piers during flooding. The bridge has 5 spans with the longest span of 70 m in length that uses UHPC in its construction. In this bridge construction, it is quite impossible to use typical normal concrete commonly utilize in conventional concrete bridge project that normally limits the span length to only 40 m. This project is also a pilot project in PWD that uses Malaysia Civil Engineering Standard Method of Measurement (MYCESMM), replacing the current Malaysian Standard Method for Measurement of Civil Engineering Construction. The MYCESMM covers a wider range of civil engineering works. This project is expected to contribute towards delivering cost effective civil engineering projects through the adoption of best practices in the preparation of the bills of quantities (BQ). The successful application and construction of this pilot project will have a great prospect in encouraging more projects to use UHPC and MYCESMM in the upcoming projects in Malaysi

Empirically based rainfall threshold for landslides occurrence in Cameron Highlands, Malaysia

High-intensity rainfall has been recognized as the main factor of the landslide events in Cameron Highlands. Locating at an abrupt altitude with high intensity rainfall annually caused many attempts of slope failures in this area. This catastrophe weakens the socio-economy and situates the people of Cameron Highlands in difficulty since they lost their source of income. The application of the early warning system is one of the effective methods to reduce the losses from this unforeseen circumstance. It could be coordinated by developing a dependable rainfall intensity-duration (I-D) threshold for estimating the shallow landslide. By identifying twelve historical landslides in Cameron Highlands, the important variables from the rainfall intensity-duration parameter can be acquired. The proposed empirical rainfall intensity-duration (I-D) threshold for Cameron Highlands has been figured out as 0..075 I D 29.09 − = (I = rainfall intensity in mm/hr and D = duration in hour). Furthermore, to identify the formulation of I-D threshold from other regions, a comparison has been carried out by identifying the I-D threshold proposed by various researchers, which shows a reasonably higher value for the I-D thresholds of Cameron Highlands. This trend occurs due to the fact that rainwater requires more time to adequately seep into the thicker layer of soil in order to trigger the slope failure

Rainfall-induced landslides in Cameron Highland area, Malaysia

Cameron Highland is classified as one of the landslide-prone areas in Malaysia due to its hilly landform. It has been discovered that the landslides in Cameron Highland were mainly triggered by the intense rainfall since the area encountered high amount of rainfall throughout the year. This study is carried out to evaluate the correlation between the rainfall intensity- duration (I-D) and the landslide occurrences in the Cameron Highland area. Twelve cases of landslides in the study area had been selected for conducting the analysis of rainfall intensity- duration (I-D) that triggers the landslides. The important variables from the analysis such as the maximum rainfall intensity (I) and the duration of rainfall series (D) have been applied to establish the empirical rainfall intensity-duration (I-D) threshold for Cameron Highland landslide areas. Based on the study, by utilising the logarithmic scale graph and applying a power-law model from the general equation of I= αD-β , the empirical I-D threshold for Cameron Highland landslide was determined as I = 29.088D-0.075 (I = rainfall intensity in mm/hr and D = duration in hour). The empirical (I-D) threshold can be a functional mechanism for the Early Warning System (EWS) once it is further developed, that enable the relevant authority to prepare mitigation measures such as evacuation, spreading information to the civilian in order to prevent major losses and casualties due to the landslide event

Improvement of problematic soil using crumb rubber tyre

Construction on problematic soil that has low bearing capacity, low shear strength, high compressibility, and high water-content will interfere with the smooth construction process and will affect time and cost due to repetitive maintenance. Pavement built on problematic soil as its subgrade is exposed to pavement failures, such as fatigue cracking, longitudinal cracking, and pumping, owing to swelling or shrinkage due to moisture variation and differential settlement. Therefore, improvement of the ground needs to commence so as to improve its load bearing capacity, in order to sustain the load on top of it. Consequently, the main aim of this study is to determine the effectiveness of crumb tyre rubber mixed with soil samples as one of the soil stabilisation techniques and to establish the optimum usage percentage of crumb tyre rubber as a stabiliser. Clayey sand soil was mixed with 5%, 10% and 15% of crumb tyre rubber by weight of the soil sample and was tested for physical properties, such as particle size distribution and plasticity index. In obtaining the changes in strength, mixed clayey sand-crumb tyre rubber samples were subjected to compaction and California Bearing Ratio (CBR) tests. The results showed that the increment of crumb tyre rubber percentage as an additive, increased the CBR value and therefore enhanced the strength of the modified soil. However, the crumb tyre rubber stabiliser affected the optimum moisture content and maximum dry density of the modified samples by decreasing their values. The optimum percentage of crumb tyre rubber mixture was found to be 10% by weight at the end of this study. These findings indicate that the measured crumb tyre rubber is suitable for supporting the clayey sand soil for the subgrade of pavement construction

Paediatric COVID-19 mortality: a database analysis of the impact of health resource disparity

Background The impact of the COVID-19 pandemic on paediatric populations varied between high-income countries (HICs) versus low-income to middle-income countries (LMICs). We sought to investigate differences in paediatric clinical outcomes and identify factors contributing to disparity between countries.Methods The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) COVID-19 database was queried to include children under 19 years of age admitted to hospital from January 2020 to April 2021 with suspected or confirmed COVID-19 diagnosis. Univariate and multivariable analysis of contributing factors for mortality were assessed by country group (HICs vs LMICs) as defined by the World Bank criteria.Results A total of 12 860 children (3819 from 21 HICs and 9041 from 15 LMICs) participated in this study. Of these, 8961 were laboratory-confirmed and 3899 suspected COVID-19 cases. About 52% of LMICs children were black, and more than 40% were infants and adolescent. Overall in-hospital mortality rate (95% CI) was 3.3% [=(3.0% to 3.6%), higher in LMICs than HICs (4.0% (3.6% to 4.4%) and 1.7% (1.3% to 2.1%), respectively). There were significant differences between country income groups in intervention profile, with higher use of antibiotics, antivirals, corticosteroids, prone positioning, high flow nasal cannula, non-invasive and invasive mechanical ventilation in HICs. Out of the 439 mechanically ventilated children, mortality occurred in 106 (24.1%) subjects, which was higher in LMICs than HICs (89 (43.6%) vs 17 (7.2%) respectively). Pre-existing infectious comorbidities (tuberculosis and HIV) and some complications (bacterial pneumonia, acute respiratory distress syndrome and myocarditis) were significantly higher in LMICs compared with HICs. On multivariable analysis, LMIC as country income group was associated with increased risk of mortality (adjusted HR 4.73 (3.16 to 7.10)).Conclusion Mortality and morbidities were higher in LMICs than HICs, and it may be attributable to differences in patient demographics, complications and access to supportive and treatment modalities

Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83-0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders

Implementation of Recommendations on the Use of Corticosteroids in Severe COVID-19

Importance: Research diversity and representativeness are paramount in building trust, generating valid biomedical knowledge, and possibly in implementing clinical guidelines. Objectives: To compare variations over time and across World Health Organization (WHO) geographic regions of corticosteroid use for treatment of severe COVID-19; secondary objectives were to evaluate the association between the timing of publication of the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial (June 2020) and the WHO guidelines for corticosteroids (September 2020) and the temporal trends observed in corticosteroid use by region and to describe the geographic distribution of the recruitment in clinical trials that informed the WHO recommendation. Design, setting, and participants: This prospective cohort study of 434 851 patients was conducted between January 31, 2020, and September 2, 2022, in 63 countries worldwide. The data were collected under the auspices of the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC)-WHO Clinical Characterisation Protocol for Severe Emerging Infections. Analyses were restricted to patients hospitalized for severe COVID-19 (a subset of the ISARIC data set). Exposure: Corticosteroid use as reported to the ISARIC-WHO Clinical Characterisation Protocol for Severe Emerging Infections. Main outcomes and measures: Number and percentage of patients hospitalized with severe COVID-19 who received corticosteroids by time period and by WHO geographic region. Results: Among 434 851 patients with confirmed severe or critical COVID-19 for whom receipt of corticosteroids could be ascertained (median [IQR] age, 61.0 [48.0-74.0] years; 53.0% male), 174 307 (40.1%) received corticosteroids during the study period. Of the participants in clinical trials that informed the guideline, 91.6% were recruited from the United Kingdom. In all regions, corticosteroid use for severe COVID-19 increased, but this increase corresponded to the timing of the RECOVERY trial (time-interruption coefficient 1.0 [95% CI, 0.9-1.2]) and WHO guideline (time-interruption coefficient 1.9 [95% CI, 1.7-2.0]) publications only in Europe. At the end of the study period, corticosteroid use for treatment of severe COVID-19 was highest in the Americas (5421 of 6095 [88.9%]; 95% CI, 87.7-90.2) and lowest in Africa (31 588 of 185 191 [17.1%]; 95% CI, 16.8-17.3). Conclusions and relevance: The results of this cohort study showed that implementation of the guidelines for use of corticosteroids in the treatment of severe COVID-19 varied geographically. Uptake of corticosteroid treatment was lower in regions with limited clinical trial involvement. Improving research diversity and representativeness may facilitate timely knowledge uptake and guideline implementation

ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19

The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 dataset is one of the largest international databases of prospectively collected clinical data on people hospitalized with COVID-19. This dataset was compiled during the COVID-19 pandemic by a network of hospitals that collect data using the ISARIC-World Health Organization Clinical Characterization Protocol and data tools. The database includes data from more than 705,000 patients, collected in more than 60 countries and 1,500 centres worldwide. Patient data are available from acute hospital admissions with COVID-19 and outpatient follow-ups. The data include signs and symptoms, pre-existing comorbidities, vital signs, chronic and acute treatments, complications, dates of hospitalization and discharge, mortality, viral strains, vaccination status, and other data. Here, we present the dataset characteristics, explain its architecture and how to gain access, and provide tools to facilitate its use