This paper evaluates the sustainability of traffic growth in Malaysia.The number of registered vehicles is used as an indication of traffic growth.Also, the number of registered buses is considered as an indication of public transportation usage. The results indicate that the traffic growth is mainly due to increases in the private cars motorcycles, while the rate of increase for buses is very small.The percentages for passenger cars and motorcycles are increasing while the percentage of buses is slightly dropping down, which is a negative indication regarding the traffic growth in Malaysia. The trends for the rate of vehicles per capita, unit GDP, and unit length of the road network have been discussed. Most of the trends indicate that the current growth trends of traffic in Malaysia are unsustainable. The paper also provides some recommendations for the Malaysian government to maintain a sustainable traffic growth in the country. 

The renin-angiotensin-aldosterone system (RAAS) plays a vital role in cardiovascular homeostasis by regulating blood pressure, salt, and water balance. The kidneys produce renin which converts angiotensinogen to angiotensin-1 (AT-I) and angiotensin-converting enzyme (ACE) to angiotensin-II (AT-II). AT-II binds to receptors in the adrenal cortex to release aldosterone. AT-II and aldosterone promote water and salt retention, vascular tone, and myocardial contractility. These physiological changes raise blood pressure and circulation. Reduced renal perfusion pressure sensed by baroreceptors and the sympathetic nervous system's β-adrenergic receptors trigger renin release and RAAS activation. RAAS restores hemodynamic stability in pathological states associated with low perfusion. This adaptive response is important for restoring perfusion and hemodynamic stability, but prolonged RAAS activation has deleterious effects on the cardiovascular system. Long-term mineralocorticoid exposure has been linked to left ventricular hypertrophy (LVH) and remodeling. AT-II activates fibroblasts and cardiac myocytes to promote cardiac remodeling. Blocking RAAS can eliminate the long-term negative effects of RAAS activation. Direct renin inhibitors, ACE inhibitors, angiotensin receptor blockers, and aldosterone antagonists are RAAS blockers.RAAS blockade improves mortality and hospitalization in systolic heart failure and acute myocardial infarction. RAAS blockade has not demonstrated the same benefits in other cardiac populations, such as those with preserved ejection fraction. Hypertrophic cardiomyopathy (HCM) causes LVH and asymmetric septal hypertrophy. When the outflow tract gradient exceeds 30 mmHg and is associated with septal hypertrophy, it is known as obstructive HCM. Dyspnea on exertion, syncope, and exertional angina are symptoms of HCM. RAAS activation worsens LVH by increasing blood pressure and by directly affecting cardiac myocytes with AT-II and aldosterone. RAAS blockade reverses myocardial fibrosis and slows HCM progression in animal models. We performed a meta-analysis of randomized clinical trials to further investigate the potential benefit of RAAS blockade in HCM patients. Although our findings included significant results for some of the RAAS blockade agents, these findings were not consistent throughout all the studies. Mavacamten, one of the newest treatments, has shown promising outcomes.

The trend for new urbanism which encourages public transportation usage has increasingly focused on pedestrian facilities. Pedestrian fac ilities can be defined as facilities that continuously provide pedestrians with safe access to land uses. Unfortunately, roadway design prioritizes the needs of motorists while putting pedestrians at ri sk. A number of studies have developed methods to determine pedestrian Level of Service (LOS). However, none have considered the road hierarchy which has a different design standard, level of road usage, access management and scope of pedestrian needs. This paper develops a pedestrian index (P-Index) which incorporates selected indicators according to road hierarchy in evaluating pedestrian facilities. The index is an analytical tool to rate pedestrian facilities using 5 star rating formats whereby the higher the number of stars, the better quality of facilities of a particular pedestrian segment. The method focuses on four indicators namely Facility, Mobility, Safety and Accessibility. Using Taman Bukit Indah, Johor Bahru as the study area, it was revealed that the overall quality of pedestrian facilities achieved three stars, which are interpreted as walkable. The rating scores of pedestrian facility are next incorporated into Google Maps to enable the public to visualise the rating score of pedestrian facilities. The index can also serve as an evaluation tool by the authorities for auditing purposes in the provision and monitoring of pedestrian facilities.

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