Existing Practices of Building Information Modeling (BIM) Implementation in the Public Sector

The Government of Malaysia has taken a proactive action by implementing the strategic ICT-driven or ICT-enabled transformation programmes and ICT plays a critical role in ensuring their efficient and effective implementation. However regardless the efforts, the implementation of BIM in Malaysia mostly on the private sector driven and it is still between BIM level 0 and BIM level 1. As many of countries across the globe have shown great interest and their public sector plays an important role in leading the market towards BIM adoption, the Government of Malaysia and its agencies by capitalising the existing hard and soft-infrastructures in Malaysia should play significant roles to help in stimulate BIM technology in Malaysia to be comparable with other developed countries. This paper through literature review aims to establish a clear understanding about the global BIM implementation in the public sector, to determine the public sector readiness to adopt BIM in Malaysia and to investigate the potential of BIM implementation within the public sector. In addition, suggestions on the focus of the other research papers on BIM implementation within the public sector will be included

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

The potential use of BIM through an electronic submission: A preliminary study

Globally, the public sector plays an important role in leading the market towards BIM adoption as they can be a catalyst towards better utilisation of BIM in the industry. Implementation of electronic submission for instance, may become a channel for the public sector to gather information within BIM environment, especially project development information from the design stage throughout the construction phase. The aim of this paper is to investigate the potential of BIM implementation within the public sector, specifically how BIM could be utilised to facilitate electronic submission. The research method applied for this study includes a literature review, interviews and qualitative analysis of the data collected. The study is limited mainly to the current status in the public sector. Therefore, semi-structured interviews were conducted with five professionals from the public sector agencies and the data gathered has been analysed using a content analysis procedure. Finally, the results have been used to create a proposed conceptual system environment for a BIM-based electronic system. This study shows that BIM can be very useful to facilitate electronic submission concerning building approval. The outcome is also presented as a conceptual design for BIM-based electronic submission for building plan applications which could support the public sector to adopt BIM

Genetic Diversity Assessment of MPOB-Senegal Oil Palm Germplasm Using Microsatellite Markers

Molecular characterization of oil palm germplasm is crucial in utilizing and conserving germplasm with promising traits. This study was conducted to evaluate the genetic diversity structures and relationships among 26 families of MPOB-Senegal oil palm germplasm using thirty-five microsatellite markers. High level of polymorphism (P=96.26%), number of effective allele (Ne=2.653), observed heterozygosity (Ho=0.584), expected heterozygosity (He=0.550), total heterozygosity (HT=0.666), and rare alleles (54) were observed which indicates that MPOB-Senegal germplasm has a broad genetic variation. Among the SSR markers, sMo00053 and sMg00133 were the most informative markers for discrimination among the MPOB-Senegal oil palm germplasm for having the highest private alleles and the rare alleles. For selection and conservation, oil palm populations with high rare alleles and Nei’s gene diversity index should be considered as these populations may possess unique genes for further exploitation

Development of growth chart for Malaysian children

Growth charts are internationally used as a tool for assessment of physical growth which reflects the nutritional status of children. It is used in public health for screening for malnutrition, and for monitoring children’s growth patterns. Poor physical growth is closely related to poor health status. Currently most countries are using WHO Child Growth Standards 2006 for children less than 5 years old and WHO Growth Reference 2007 for school-aged children and adolescents. Some countries have developed growth references for their population as an additional reference besides the WHO’s using nationally-representative data and revising them periodically. Differences in the socio-economic and health environment of each country may result in differences in the growth potential of its children. Therefore there is a need to develop current, country-specific growth references for children that can be used in public health screening for malnutrition. This report present the first growth chart developed for Malaysian children (length/height-for-age, weight-for-age, body mass index-for-age) and describes the methodological processes involved.The Malaysian Children Growth Chart (MyGC) was developed by using the nationally representative data from the Third National Health and Morbidity (NHMS III) conducted in 2006. The NHMS III was population based cross-sectional study using two-stage stratified sampling proportionate to population size throughout Malaysia. The weight and length/height measurements of all apparently healthy children (11,177 boys and 10,855 girls) age 0 to 18 years in selected households were taken.The data were screened for extreme values and outliers (biological implausible) and any extreme values and outliers were removed based on the recommendations of the WHO leaving a final sample of 10,454 boys and 10,259 girls. The LMS ChartMaker Pro software was used to derive age-related reference centiles and z-scores for the anthropometric data. This method is based on the assumption that anthropometric data can be converted to a standard normal distribution by a Box-Cox transformation for any given age. It summarizes the age-changing distribution by 3 curves, namely L (Box-Cox Power) which measures skewness (λ); M, the median at each age (μ); and S, the coefficient of variation by age (σ). Using penalised likelihood, the three curves are fitted as cubic splines by non-linear regression, and the extent of smoothing required is expressed in terms of smoothing parameters or equivalent degrees of freedom (edf). The optimal model was obtained by balancing smoothness of the curves (e.d.f) and the model goodness of fit (Q test of fit and detrended Q-Q plot). The sex-specific percentiles and z-score curves for, weight-for-age, length/height-for-age and BMI-for-age were generated. Weight-for-age. The weight observations of 5722 boys and 5550 girls aged 0 to 10 years were used in the final construction of the growth charts. We produced sex-specific weight-for-age percentile chart which comprised of 3rd, 15th, 50th, 85th and 97th percentile curves. For z-score charts, -3SD, - 2SD, -1SD, Median, 1SD and 2SD curves (+3SD z-scores for age 9 to 10 years could not be produced by the software therefore +3SD curve were not shown). Length/height-for-age. For both boys and girls birth to 2 years, recumbent length measurements were used to construct length-for-age percentile and z-score curves while standing height measurements were used for age 2 to 18 years old. The length measurements of 1018 boys and 981 girls aged 0 to 24 month were used to construct length-for-age percentile and z-score curves. For 24-216 months, height data of 9124 boys and 9083 girls were used. We present percentile and z-score curves for age ranges of birth to 2 years, 2 to 5 years and 5 to 18 years. BMI-for-age. BMI curves for birth to 2 years were constructed using length measurements, for 2-18 years using height measurements. For birth to 2 years, there were 1022 boys and 995 girls records with both weight and length and BMI observations. After data cleaning, BMI for 1018 boys and 995 girls records were used to generate BMI-for-age percentile and z-score curves. For 2 to 18 years, there were 9415 boys and 9225 girls records with both weight and length and BMI observations. After data cleaning, BMI for 9234 boys and 9070 girls records were used to generate BMI-for-age percentile and z-score curves. We present percentile and z-score curves for age ranges of birth to 2 years, 2 to 5 years and 5 to 18 years. Comparison of weight-for-age percentile between MyGC and WHO. From birth to 5 years, MyGC curves for boys and girls aged 0 to 5years were lower than WHO Growth Standard for all percentiles. From 5 to 10 years, the curves for 3rd, 15th, 50th and 85th percentiles for the MyGC were lower than the WHO corresponding percentiles. MyGC 97th percentile crossed the WHO 97th percentile at the age of between 5 to 6 years for boys and 7 years for girls. Therefore above these ages, if the MyGC cut-off point for obesity was used, children will be considerably less likely to be classified as obese. Comparison of length/height-for-age percentile between MyGC and WHO. All MyGC percentile curves were below their respective WHO curves except for median boys and girls below 1 year and the 97th percentile for boys age 2 to 5 years. Estimates of prevalence stunting (<3rd percentile) will be lower if MyGC is used compared to using WHO references. Comparison of BMI-for-age percentile between MyGC and WHO. All MyGC percentile curves were below their respective WHO curves except for the 97th percentile for boys and girls all ages and 85th percentile for boys and girls aged 5 to 18 years, MyGC percentile curve was above WHO growth reference. There is no apparent difference between MyGC 85th percentile curve for boys and girls 2 to 5 years and the corresponding WHO curve. In conclusion, there are differences between MyGC and WHO Child Growth Standards and WHO Growth Reference for children. WHO Child Growth Standards/Reference are likely to overdiagnose obesity, thinness/underweight and stunting for most age groups as compared to MyGC. Thus health practitioners who are using WHO Child Growth Standards/Reference should be aware of this possibility and exercise caution when assessing the children physical growth. MyGC is representative of the existing growth pattern of Malaysia children; therefore it can be used by nutritionists, dieticians, nurses and paediatricians and public health practitioners as an additional reference for screening and early management of malnutrition and for research purposes