Sustainable Mosque Designs from the Perspectives of Social Inclusion: Comparisons of Four Mosques in Kuala Lumpur, Malaysia

One of the major conflicts continuously occurring in Malaysia is the issue of race and religious relationships. Today, houses of worship in Malaysia have always been seen as isolated entities that can add to race relations and nation-building conflicts. This issue has led to the planning of houses of worship as nation-building elements in forging social inclusion among the different religious buildings of other faiths. Therefore, this research aims to evaluate mosques' social inclusion characteristics, which can contribute to the more extensive framing of Malaysian planning policy on the sustainable design of houses of worship. To reflect the ideal of SDG 11, Sustainable cities and communities and SDG 16, Peace, justice and strong institutions, it is essential to identify social inclusivity as one of the primary design approaches for any Islamic institutions and mosques designs. Should the mosques be part of the nation-building entities and not just community centres for each faith? This research covers selected case studies mainly in Kuala Lumpur, representing the city with the most educated and diverse multi-faith context. Four significant mosques were selected and studied through observations and interviews data collection approach. The research findings indicate that elements such as scale, massing, permeability, visibility, territoriality, and iconic imagery are essential to design criteria for mosques. Significantly, this research provides suggestions and guidelines for designers and committee leaders of all religions in Malaysia to re-look at the activities and planning aspects of their houses of worship. Furthermore, it helps to promote inclusive elements such as social interaction, tolerance, and understanding of different religious beliefs. Hence, accepting these multi-faith centres will create a more integrated, harmonious and sustainable community.

Gestational age-related neonatal survival at a tertiary health institution in Nigeria: The age of fetal viability dilemma

Background: Although the official age of fetal viability in Nigeria is 28 weeks, there are pockets of reports some anecdotal, of survival of babies delivered at younger gestational age (GA) from different parts of the country. The routine resuscitation and management of premature infants born before the official age of fetal viability (28 weeks) is likely to generate important ethical and medical concerns that are bound to influence our approach to the management of such infants. Aim: To determine the GAspecific neonatal mortality and survival among preterm deliveries at the National Hospital Abuja. Subjects and Methods: A retrospective review of relevant data from the National Hospital Neonatal Registry Database based on the Research Electronic Data Capture software (REDCap) was undertaken to determine the mortality rate of preterm babies managed in the neonatal intensive care unit (NICU) from January 2017 to February 2018. Disaggregated GA specific mortality rates were also computed to determine the fetal age at which extra uterine neonatal survival rate was at least 50%. Gestational age estimation was based on mothers’ last menstrual period (LMP) in over 96% of cases.Results: Sixty-three (63) of 305 preterm babies admitted died during hospitalization giving a mortality rate of 20.7%. This was significantly higher than the mortality rate among term babies (7.5%, P=0.01) hospitalized over the same period. Antenatal corticosteroid use was low (11.2%), 188 (25.8%) received CPAP for Respiratory Distress Syndrome (RDS), and none of the babies received surfactant or mechanical ventilation. There were no survivors among babies delivered at GA of 22-25 weeks (11, 3.6%). However, the survival rate at 26 weeks gestation was 53.8%, and this subsequently increased, reaching a peak of 96.5% survival at 35 weeks. RDS accounted for 53.9% of all deaths. Conclusion: It is concluded that the survival rate (53.8%) of babies at GA of 26 weeks despite minimal antenatal interventions and limited postnatal respiratory support was reasonably high, and this could serve the basis for discussions for a downward review of the age of fetal viability in Nigeria. Key words: Gestational age. Fetal viabilit

Penanaman dan Manfaat Tanaman Obat Keluarga (TOGA) di Desa Karya Bhakti Kabupaten Kampar

Upaya Kesehatan Bersumber daya Manusia merupakan wujud nyata peran serta masyarakat dalam pembangunan kesehatan sebagai pemicu kegiatan pemberdayaan masyarakat, salah satunya adalah TOGA (Tanaman Obat Keluarga). TOGA merupakan beberapa jenis tanaman obat pilihan yang dapat ditanam di pekarangan rumah. Keberadaan TOGA di lingkungan rumah sangat penting, terutama bagi keluarga yang tidak memiliki akses untuk pelayanan kesehatan.  Nama kegiatan pengabdian masyarakat ini adalah ”Penanaman dan Manfaat Tanaman Obat Keluarga (TOGA) di Desa Karya Bhakti Kabupaten Kampar”. Tujuan dari kegiatan ini adalah untuk membantu warga menghidupkan kembali TOGA yang sudah terbengkalai dan memudahkan warga jika membutuhkan tanaman obat. Pengabdian masyarakat ini melibatkan tokoh masyarakat dan warga

Degradabilidad ruminal de forrajes y residuos de cosecha en bovinos Brown Swiss

The aim of this study was to determine the degradability of the association of forages and crop residues commonly used to feed cattle in the Huancavelica Region. The forage associations were white clover-Italian ryegrass and red clover-dactylis, while the harvest residues were maize, oat straw, peas, beans and quinoa. For the determination of the degradability of dry matter (DM), crude protein (CP) and neutral detergent fibre (NDF), three rumen fistulated Brown Swiss cattle were used. Samples of forages and harvest residues were placed in nylon bags and incubated for 4, 8, 12, 24, 48, 72 and 96 hours. Time zero (t0) was used for the calculation of the soluble fraction. The DM, CP and NDF degradability were influenced by forages and crop residues (p<0.05). The greater potential degradability of the DM and CP, and effective degradability of the DM, CP and NDF give the white clover-Italian ryegrass a good nutritional potential for ruminants. The constant rate (C) of degradation, potential degradability and effective degradability of the CP allows to consider the residues of peas, beans and quinoa as food resources of high nutritional quality. On the contrary, the effective degradability of the PC at the passage rate of 5%/h indicates that maize and oat straw are medium quality foods.El objetivo del trabajo fue determinar la degradabilidad de asociación de forrajes y de residuos de cosecha comúnmente utilizados en la Región de Huancavelica en la alimentación de bovinos. Se evaluaron las asociaciones trébol blanco-ryegrass italiano y el trébol rojo-dactylis, y los residuos de cosecha: maíz chala, paja de avena, arveja, habas y quinua. Para la determinación de la degradabilidad de la materia seca (MS), proteína cruda (PC) y fibra detergente neutra (FDN) se utilizaron tres bovinos Brown Swiss, fistulados en el rumen. Los forrajes y los residuos de cosecha fueron colocados en sacos de nylon e incubados por 4, 8, 12, 24, 48, 72 y 96 horas. El tiempo cero (t0) fue utilizado para el cálculo de la fracción soluble. Las degradabilidades de la MS, PC y FDN fueron influenciadas por los forrajes y residuos de cosecha (p<0.05). La mayor degradabilidad potencial de la MS y PC, y degradabilidad efectiva de la MS, PC y FDN le confieren al trébol blanco-ryegrass italiano un buen potencial nutritivo para los rumiantes. La tasa constante (C) de degradación, degradabilidad potencial y degradabilidad efectiva de la PC permite considerar a los residuos de arveja, habas y quinua como recursos alimenticios de alta calidad nutricional. Por el contrario, la degradabilidad efectiva de la PC a la tasa de pasaje de 5%/h indica que el maíz chala y la paja de avena son alimentos de mediana calidad

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Impact of urban configurations on air temperature in Kuala Lumpur

Rapid population growth causes the trend of high-rise buildings in the urban area. The modification of urban surface generates the poor scenario of microclimate, which mainly contributes to the increase of Urban Heat Island (UHI) intensity. UHI mitigation strategy is urged among planners and designers to ensure urban development meets the climate change adaptation agenda. Urban climatology studies mostly focus on the urban canyon geometry of the Height to Width (H/W) aspect ratio and Sky View Factor (SVF). There is lacking justification on the relationship of urban configurations and microclimate in the hot and humid region, especially in Kuala Lumpur. This study aims to investigate the impact of urban configurations on the air temperature. Four urban configurations; Courtyard, U, Courtyard Canyon and Canyon were simulated by using ENVI-met 3.1. The urban configurations study was set in two sites located in Kuala Lumpur with the East – West and North – South canyon directions. The results showed that the urban configurations generate impact on the mean of air temperature. The drop of nocturnal air temperature indicated that the UHI was worse in Courtyard configuration in both East – West and North – South canyon directions. The results also confirm that the reduction of the Sky View Factor (SVF) in urban configurations encourage the increase of the UHI intensity. The finding of this study stresses that the solar radiation was majorly influenced by the urban configurations which was significantly correlated to the results of air temperature. The finding suggests planners and designers to strategise the urban configurations according to the setting of the canyon direction during the preliminary design and planning stage