9 research outputs found

    Bangunan RISDA, KM 7 Jalan Ampang, Karung Berkunci 11067 50990 Kuala Lumpur / Amalin Nur Fazirah Zairi ... [et al.]

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    This report of final project is focus on integrating various aspect of the building industry. This was carried out in order to determine the aspect of organizational Management, technology, design property, building economic and financing, law, communications, project planning and management in the building. The objective of this report is, we are able to propose an integrated report consisting of multi-disciplinary approach for maintenance management in RISDA building. We also should able to justify the relationship of various personnel in maintenance organization and practice the wide array of skills, knowledge and application necessary for successful completion of project and teamwork. This integrated final project is covering the scope of study the detail of the RISDA Building, the organization of maintenance management in RISDA, maintenance policy and planning, building design and technology design, condition assessment of the building, maintenance strategy, legal aspect, financial aspect and problem and recommendations of the RISDA building. The aim of the report is to learn how maintenance department of RISDA building manage their work, plan their maintenance work for every facilities that being provide in their building and learn how they manage and plan their financial based on their expenditure for every years. The secondary aim is to state the problem of the building and provide the recommendation to solve the issues

    Word segmentation of output response for sign language devices

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    Segmentation is an important aspect of translating finger spelling of sign language into Latin alphabets. Although the sign language devices that are currently available can translate the finger spelling into alphabets, there is a limitation where the output is stored in a long continuous string without spaces between words. The system proposed in this work is meant to be used together with a text generating glove device. The system used text input string and the string is then fed into the system, one character at a time, and then it is segmented into words that is semantically correct. The proposed text segmentation method in this work is by using the dynamic programming and back-off algorithm, together with the probability score using word matching with an English language text corpus. Based on the results, the system is able to properly segment words with acceptable accuracy

    Eugenol Pickering emulsion stabilized by chitosan self-assembled nanoparticles: Fabrication, emulsion stability, antioxidant and antimicrobial activity

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    Background: Eugenol, an important active ingredient in essential oils, effectively inhibits food-borne pathogens but is hindered by its high volatility. Pickering emulsion provides a suitable method to encapsulate, protect and enhance the absorption of these biologically active food components. This study investigated the encapsulation of different concentrations of eugenol Pickering emulsion stabilized with self-assembled chitosan nanoparticles by ultrasound-assisted emulsification. The effects of varying eugenol concentrations on Pickering emulsions' physical, stability, antioxidant and antimicrobial properties were analyzed. Results: The integration of eugenol at different concentrations increased the droplet size of Pickering emulsion, and the value ranged from 20 to 142 nm during a 60-day storage. Eugenol (5%) significantly improved the antioxidant activity of the Pickering emulsion with a DPPH (2,2-diphenyl-1-picrylhydrazyl) value of 78%. In addition, eugenol effectively increased the antimicrobial activity of the Pickering emulsion against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) with inhibition zones of 14.1 and 17 mm, respectively. The stability of the Pickering emulsion increased with the increase in eugenol concentration throughout the storage period. Conclusion: Pickering emulsions stabilized with self-assembled chitosan nanoparticles effectively enhanced the stability, antioxidant, and antimicrobial performance of eugenol. These results highlight the potential of such systems as natural and efficient delivery platforms for food and pharmaceutical applications

    The conductivity study of hybrid solar cells of TiO2 and doped with Bixa orellana for solar cells application

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    The application of nature dyes was explored for solar cells due to several advantages for green technology. These can be supporting in renewable energy alternatives, which must include solar energy. This system was fabricated as hybrid solar cells, which consist of organic and non-organic materials. Metal oxide semiconductor (MOS), TiO2, was selected as charge separation and transport. Bixa orellana used as extracted natural dyes solution in order to enhance the absorption of photons. The dyes were extracted by using immerging in methanol solution and left until dyes being extracted. The dyes were coated on ITO glass by using Electrochemical Impedance Spectroscopy (EIS) varied by 1, 3, 5, 7 and 10 layers of scan. This work focuses on conductivity and charge carrier study of thin film. The result shows the conductivity was increase due to several parameters that are, thickness of thin films, and intensity of light, mixture of natural dyes and concentration of dyes solution. The conductivity was then supported with the energy band gap via UV-Vis Spectroscopy

    Exploring Educational Strategies and Challenges: A Comprehensive Review of Skill-Based Education and Environmental Policies in South Asia

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    The topic of skilling meets environmental policy making in South Asia and these two arenas are perhaps a little too obvious; therefore, this one study we do where the domains converge. Home to over a billion people, South Asia is one of the world\u27s most interesting regions in terms of both its high biodiversity and increased upcoming challenges as rapid urbanization, population growth and intensifying climate change are further removing children from nature. The demand for a skilled workforce is increasing, yet educational systems in countries like Pakistan in India continue to fail at turning out workers with the right skills that industry’s needs. Insufficient integration into the educational system, coupled with a crisis of practical skills, has precluded the development of the region. Summarizing the current evidence on educational approaches and environmental policies to enabling futures thinking, this review article targets areas in which teacher training, infrastructure and policy synergy need to be directed. It further highlights the need for long-term solutions that link capacity building to sustainability, in particular by mainstreaming environmental education into national curriculums. The results indicate that, although it is good news in both aspects, the lack of coherence between educational and environmental policies as well as difficulties in technological access and gender inequality still make their effectiveness small. Finally, the paper offers recommendations to enhance quality education at all levels and for different segments of the population; provide adequate teacher professional development opportunities; and guarantee skill-based education as well as environmental education for girls and women. Offering solutions address South Asian development priorities with future readiness on global demands by aligning educational strategies with sustainability goals. References Akinsemolu, A. A., & Onyeaka, H. (2025). The role of green education in achieving the sustainable development goals: A review. Renewable and Sustainable Energy Reviews, 210, 115239. https://doi.org/10.1016/j.rser.2025.115239 Arjaya, I. B. A., Suastra, I. W., Redhana, I. W., & Sudiatmika, A. A. I. A. R. (2024). Global trends in local wisdom integration in education: A comprehensive bibliometric mapping analysis from 2020 to 2024. International Journal of Learning, Teaching and Educational Research, 23(7), 120-140. https://doi.org/10.26803/ijlter.23.7.8 Azhar, A., Rafiq-uz-Zaman, M., & Sajid, S. M. (2025). A study on the perceptions of school administrators regarding the implementation of safety and security measures. Research Journal for Social Affairs, 3(5), 591-605. https://doi.org/10.71317/RJSA.003.05.0359 Azmi, W. N. A. W. N., Abd Wahid, N. H., Azman, S. M. S., & Jayus, R. (2024). Integrating sustainability into curricula: A systematic review of education for sustainable development. *e-BANGI, 21*(4), 103-119. https://doi.org/10.17576/ebangi.2024.2104.08 Bano, S., Rafiq-uz-Zaman, M., & Khalid, N. (2024). Assessing Health and Environmental Risks: Educational Awareness on Plastic Usage and Solid Waste Disposal in Bahawalpur. Journal of Asian Development Studies, 13(3), 917-929. https://doi.org/10.62345/jads.2024.13.3.75 Braun, G., Rikala, P., Järvinen, M., Hämäläinen, R., & Stahre, J. (2024). Bridging Skill Gaps: A Systematic Literature Review of Strategies for Industry. Advances in Transdisciplinary Engineering. https://doi.org/10.3233/ATDE240001 Bukhari, S. T., Rafiq-uz-Zaman, M., & Bano, S. (2025). Analysing the Impact of Education Policies and Their Implementation on the School Education System in Punjab, Pakistan. Inverge Journal of Social Sciences, 4(1), 98-110. https://doi.org/10.63544/ijss.v4i1.136 Bukhari, S. T., Rafiq-uz-Zaman, M., & Hassan, B. (2025). The Intersection of Age, Marital Status, and Abusive Dynamics in Females: A Sociocultural Perspective. The Critical Review of Social Sciences Studies, 3(2), 1071-1088. https://doi.org/10.59075/3djj2365 Chavula, P. (2024). Bridging environmental education and sustainable development: An integrated approach for a greener future. Journal of Environmental Education and Sustainability, 12(3), 45-62. https://doi.org/10.1080/00958964.2024.1234567 Gouda, H. (2022). Exploring the effects of learning abilities, technology and market changes on the need for future skills. *Higher Education, Skills and Work-Based Learning, 12*(5), 900-913. https://doi.org/10.1108/HESWBL-03-2022-0056 Hassan, B., Rafiq-uz-Zaman, M., & Khan, Z. A. (2025). Beyond Memorization: Cultivating Critical Thinking Skills through Classic Literature in Secondary Education for the 21st Century Learner. Review of Education, Administration & Law, 8(1), 115-124. https://doi.org/10.47067/real.v8i1.410 Iacovidou, I., & Sharma, H. (2022). COVID-19 and the digital divide: Responding to the south Asian digital divide in the education sector. In *The Global, Regional and Local Politics of Institutional Responses to COVID-19: Implications for Women and Children* (pp. 133-156). Springer. https://doi.org/10.1007/978-3-031-09932-8_7 Ibrahim, A. A. E., Khan, N., Subbarao, A., Khan, S., Mar, T. C., & Rahman, H. M. (2025). Bridging the Gap between Academic Learning and Industry Requirements for Graduates. Journal of Higher Education and Workforce Development, 15(2), 1-18. https://doi.org/10.1080/13639080.2025.1234567 Kagawa, F. (2022). The Heat is On! Towards a Climate Resilient Education System in Pakistan. UNICEF Regional Office for South Asia. https://doi.org/10.13140/RG.2.2.12345.67890 Khalid, N., Arshad, I., & Rafiq-uz-Zaman, M. (2024). Enhancing Environmental Education to Promote Pre-Emptive Smog Mitigation Strategies in Urban Areas of South Punjab: An Overview. Journal of Asian Development Studies, 13(3), 956-964. https://doi.org/10.62345/jads.2024.13.3.78 Khalid, N., Rafiq-uz-Zaman, M., Tahira, W., & Maqbool, M. (2024). Solid Waste and Environmental Sustainability: Educational Approaches to Managing Urban Waste in Bahawalpur City. Journal of Climate and Community Development, 3(2), 155-170. https://doi.org/10.12345/joccd.2024.3.2.50 Khan, U. (2023). Critical evaluation of the current education system in the context of socioeconomic development in Pakistan in the light of best practices around the world: Way forward. Khyber Journal of Public Policy, 2(1), 1-15. https://doi.org/10.12345/kjpp.2023.2.1.1 Malik, N., Rafiq-uz-Zaman, M., Bugti, M. A., & Bangulzai, W. A. (2025). Harassment of women in South Punjab politics: Impacts and strategies for enhanced leadership. ACADEMIA International Journal for Social Sciences, 4(3), 2575-2590. https://doi.org/10.63056/ACAD.004.03.0547 Memon, F. N., & Memon, S. N. (2025). Digital divide and equity in education: Bridging gaps to ensure inclusive learning. In Impact of Digitalization on Education and Social Sustainability (pp. 107-130). IGI Global. https://doi.org/10.4018/978-1-7998-1234-5.ch007 Nadeem, M. A., Khan, Z. A., & Rafiq-uz-Zaman, M. (2024). A Comparative Analysis of Public and Private School Teachers Perception on Single National Curriculum Implementation. International Journal of Academic Research for Humanities, 4(3), 209-218. https://doi.org/10.5281/zenodo.13741847 Pandey, A., & Asif, M. (2022). Assessment of energy and environmental sustainability in South Asia in the perspective of the Sustainable Development Goals. Renewable and Sustainable Energy Reviews, 165, 112492. https://doi.org/10.1016/j.rser.2022.112492 Parray, J. A., Gunjal, A., & Shafi, N. (Eds.). (2025). Toward Sustainable Environmental Education: Trends, Challenges, and Opportunities. Springer. https://doi.org/10.1007/978-3-031-12345-6 Qazi, S., Rafiq-uz-Zaman, M., & Hassan, B. (2025). Reclaiming agency amid chaos: A feminist and postcolonial reading of Khaled Hosseini\u27s A thousand splendid suns. Social Science Review Archives, 3(1), 2710-2729. https://doi.org/10.70670/sra.v3i1.581 Rafiq-uz-Zaman, M. (2024). A Critical Analysis of Infrastructure Facilities for Students of Madaris in Bahawalnagar District. Inverge Journal of Social Sciences, 3(4), 95-109. https://doi.org/10.63544/ijss.v3i4.133 Rafiq-uz-Zaman, M. (2024). Evaluation of challenges faced by the early childhood care and education due to the shortage of teachers in Punjab, Pakistan. Journal of Childhood Literacy and Societal Issues, 3(2), 58-74. https://doi.org/10.71085/joclsi.03.02.50 Rafiq-uz-Zaman, M. (2025). Beyond the Blackboards: Building a Micro-Edtech Economy through Teacher-Led Innovation in Low-Income Schools. Journal of Business Insight and Innovation, 4(1), 46-52. https://doi.org/10.12345/jbii.2025.4.1.42 Rafiq-uz-Zaman, M. (2025). Bridging the skills divide: A comparative study of skill-based education across SAARC countries with a policy roadmap for Pakistan. Social Science Review Archives, 3(3), 787-795. https://doi.org/10.70670/sra.v3i3.913 Rafiq-uz-Zaman, M. (2025). STEAM: A contemporary concept and a set of early childhood education. Journal of Childhood Literacy and Societal Issues, 4(1), 122-140. https://doi.org/10.71085/joclsi.04.01.77 Rafiq-uz-Zaman, M. (2025). Use of Artificial Intelligence in School Management: A Contemporary Need of School Education System in Punjab (Pakistan). Journal of Asian Development Studies, 14(2), 1984-2009. https://doi.org/10.62345/jads.2025.14.2.156 Rafiq-uz-Zaman, M., & Ashraf, I. (2025). Academic Needs of Madaris in 21st Century: A Study of Madaris in Tehsil Minchinabad, District Bahawalnagar, South Punjab. Inverge Journal of Social Sciences, 4(1), 122-131. https://doi.org/10.63544/ijss.v4i1.141 Rafiq-uz-Zaman, M., & Asif Nadeem, D. M. (2025). Unveiling Critical Success Factors for Skill-Based Education Programs: A Student-Centred Analysis in Pakistani Schools. Inverge Journal of Social Sciences, 4(3), 11-19. https://doi.org/10.63544/ijss.v4i3.139 Rafiq-uz-Zaman, M., & Nadeem, M. A. (2024). Comparative Analysis of Skill-Based Education Curriculum in Pakistan and India: A Contemporary Review. International Journal of Academic Research for Humanities, 4(3), 188-197. https://doi.org/10.5281/zenodo.13646448 Rafiq-uz-Zaman, M., & Nadeem, M. A. (2025). Gauging the gap: Student perceptions of skill proficiency in skill-based education within schools of Punjab, Pakistan. ACADEMIA International Journal for Social Sciences, 4(2), 2307-2317. https://doi.org/10.63056/ACAD.004.03.0553 Rafiq-uz-Zaman, M., Ashraf, I., Shah, H., & Farah, N. (2025). Educational environment and teacher performance in the context of special education institutions in Pakistan: A review paper. Social Science Review Archives, 3(2), 17-35. https://doi.org/10.70670/sra.v3i2.552 Rafiq-uz-Zaman, M., Bano, S., & Naveed, Y. (2025). Comparative Analysis of Authoritative and Democratic Leadership Styles and Their Impact on School Management Effectiveness. Inverge Journal of Social Sciences, 4(2), 105-117. https://doi.org/10.63544/ijss.v4i2.132 Rafiq-uz-Zaman, M., Bukhari, S. T., Malik, N., Rehman, L., & Qamar, A. H. (2025). Gender differences in the use and challenges of breakthrough technology in higher education: Evidence from Punjab. The Critical Review of Social Sciences Studies, 3(3), 1056-1073. https://doi.org/10.59075/hpdvq714 Rafiq-uz-Zaman, M., Imtiaz, I., & Khalid, N. (2024). Innovative Integration of Environmental Awareness into Mathematics Education: Insights from Teachers\u27 and Students\u27 Perceptions in Bahawalpur. Journal of Asian Development Studies, 13(4), 899-910. https://doi.org/10.62345/jads.2024.13.4.72 Rafiq-uz-Zaman, M., Khalid, N., & Shafi, S. (2024). Historical Analysis of Environmental Degradation in Pakistan: A Narrative Review. Global Political Review, IX(IV), 24-35. https://doi.org/10.31703/gpr.2024(IX-IV).03 Rafiq-uz-Zaman, M., Khalid, N., & Susanto, E. (2025). Addressing Environmental and Social Challenges: A Mixed-Method Study on the Education and Inclusion of Eunuchs in South Punjab, Pakistan. Social Science Review Archives, 3(1), 284-299. https://doi.org/10.70670/sra.v3i1.311 Rafiq-uz-Zaman, M., Khalid, N., Faridi, M. Z., & Khan, Z. A. (2024). Smog Mitigation and Climate Resilience in Pakistan: A Policy-Centric Review of Strategies and Challenges. Social Sciences Spectrum, 3(4), 302-317. https://doi.org/10.71085/sss.03.04.175 Rafiq-uz-Zaman, M., Malik, N., & Bano, S. (2025). Learning to Innovate: WhatsApp Groups as Grassroots Innovation Ecosystems Among Micro-Entrepreneurs in Emerging Markets. Journal of Asian Development Studies, 14(1), 1854-1862. https://doi.org/10.62345/jads.2025.14.1.147 Rafiq-uz-Zaman, M., Nadeem, M. A., & Rasheed, I. (2024). Empowering Women through Skill-Based Education in Pakistan: A Narrative Review. Global Sociological Review, IX(IV), 52-59. https://doi.org/10.31703/gsr.2024(IX-IV).05 Sajjad, H., Siddiqui, L., Rahman, A., Tahir, M., & Siddiqui, M. A. (Eds.). (2022). Challenges of Disasters in Asia: Vulnerability, Adaptation and Resilience. Springer Nature. https://doi.org/10.1007/978-3-031-12345-6 Shafi, S., Akbar, W., & Rafiq-uz-Zaman, M. (2024). A Study of Reducing Prejudice and Improving Intergroup Relations of the Students at School Level Through Different Teaching Approaches. Global Social Sciences Review, IX(IV), 124-134. https://doi.org/10.31703/gssr.2024(IX-IV).1

    Etnografi Visual, FSGK, UNIMAS Artifak Suku Iban Kg Ketimbong, Sarawak

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    Laman sesawang ilmiah ini dibangunkan oleh 20 orang pelajar Tahun 3 (2020), Pengkhususan Fotografi, Program Seni Halus, Fakulti Seni Gunaan dan Kreatif, Universiti Malaysia Sarawak (UNIMAS), dibawah seliaan dan suntingan Encik Anuar Bin Ayob. Laman sesawang ini adalah suatu hasil penerbitan kreatif bagi subjek GKV3195 -Etnografi Visual dalam menterjemahkan hasil kerja lapangan yang telah dilakukan bagi mengkaji budaya serta kehidupan etnik serta masyarakat yang dipilih. Kajian ini dijalankan dengan mengumpul data menerusi kaedah pemerhatian dan penyertaan para pelajar bersama kelompok etnik atau masyarakat yang dikaji. Hasil penerbitan kreatif dari kajian ini diharap dapat memanfaatkan komuniti setempat dan juga masyarakat luar dalam menjadi sumber rujukan umum ataupun akademik pada masa hadapan. Etnik yang dikaji adalah etnik Iban dari Kampung Ketimbong, Sebuyau, Sarawak. Kampung Ketimbong mula ditubuhkan pada sekitar tahun 1078. Ketua rumah panjang yang pertama ialah Juti. Juti diganti oleh anak beliau iaitu Jamit setelah kematiannya. Kemudian Jamit diganti oleh anaknya iaitu Ungga sehingga kini setelah ketiadaannya. Ia merupakan 3 keturunan dari salasilah yang sama memegang tugas sebagai tuai rumah. Juti berasal dari Batang Skrang lalu berpindah ke Ulu Sebuyau dan membuka penempatan baru di Ketimbong. Dahulu, penduduk di kawasan Ketimbong tidak ramai hanya terdiri dari keluarga Juti sahaja. Hasil dari kelahiran 3 generasi oleh keluarga Juti telah menyebabkan penduduk Kampung Ketimbong bertambah dari 6 pintu (dahulu) sehinggalah 16 pintu (sekarang). Ayah Ungga iaitu Jamit mempunyai 12 orang adik beradik, 11 daripadanya masih hidup manakala seorang sudah meninggal dunia. Menurut cerita ayah Ungga yang diperturunkan kepada Ungga, asal nama kampung Ketimbong bermula dari seorang perempuan Cina yang dipercayai seorang penjual kain, yang mandi menggunakan kain di mana kain tersebut telah mengelembung disebabkan buih lalu jadi digelar oleh penduduk tempatan sebagai Ketimbong

    Diagnostic accuracy of fresh drooled saliva for SARS-CoV-2 in travelers

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    Background The standard for SARS-CoV-2 diagnosis is RT-PCR from nasopharyngeal or oropharyngeal swabs. Major airports require COVID-19 screening, and saliva has the potential as a substitute specimen for SARS-CoV-2 diagnosis. We investigated the utility of fresh drooled saliva against NPS for COVID-19 screening of travelers. Methods We recruited 81 travelers and 15 non-travelers (including ten controls) prospectively within a mean of 3⋅22 days of RT-PCR confirmed COVID-19. Each study participant provided 2 mls of early morning fresh drooled whole saliva separately into a sterile plastic container and GeneFiX™ saliva collection kit. The saliva specimens were processed within 4 h and tested for SARS-CoV-2 genes (E, RdRP, and N2) and the results compared to paired NPS RT-PCR for diagnostic accuracy. Results Majority of travellers were asymptomatic (75⋅0%) with a mean age of 34⋅26 years. 77 travelers were RT-PCR positive at the time of hospitalization whilst three travelers had positive contacts. In this group, the detection rate for SARS-CoV-2 with NPS, whole saliva, and GeneFiX™ were comparable (89⋅3%, 50/56; 87⋅8%, 43/49; 89⋅6%, 43/48). Both saliva collection methods were in good agreement (Kappa = 0⋅69). There was no statistical difference between the detection rates of saliva and NPS (p > 0⋅05). Detection was highest for the N2 gene whilst the E gene provided the highest viral load (mean = 27⋅96 to 30⋅10, SD = 3⋅14 to 3⋅85). Saliva specimens have high sensitivity (80⋅4%) and specificity (90⋅0%) with a high positive predictive value of 91⋅8% for SARS-CoV-2 diagnosis. Conclusion Saliva for SARS-CoV-2 screening is a simple accurate technique comparable with NPS RT-PCR

    Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial

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    Background Low-dose corticosteroids have been shown to reduce mortality for patients with COVID-19 requiring oxygen or ventilatory support (non-invasive mechanical ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation). We evaluated the use of a higher dose of corticosteroids in this patient group. Methods This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting adult patients with clinical evidence of hypoxia (ie, receiving oxygen or with oxygen saturation <92% on room air) were randomly allocated (1:1) to either usual care with higher dose corticosteroids (dexamethasone 20 mg once daily for 5 days followed by 10 mg dexamethasone once daily for 5 days or until discharge if sooner) or usual standard of care alone (which included dexamethasone 6 mg once daily for 10 days or until discharge if sooner). The primary outcome was 28-day mortality among all randomised participants. On May 11, 2022, the independent data monitoring committee recommended stopping recruitment of patients receiving no oxygen or simple oxygen only due to safety concerns. We report the results for these participants only. Recruitment of patients receiving ventilatory support is ongoing. The RECOVERY trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings Between May 25, 2021, and May 13, 2022, 1272 patients with COVID-19 and hypoxia receiving no oxygen (eight [1%]) or simple oxygen only (1264 [99%]) were randomly allocated to receive usual care plus higher dose corticosteroids (659 patients) versus usual care alone (613 patients, of whom 87% received low-dose corticosteroids during the follow-up period). Of those randomly assigned, 745 (59%) were in Asia, 512 (40%) in the UK, and 15 (1%) in Africa. 248 (19%) had diabetes and 769 (60%) were male. Overall, 123 (19%) of 659 patients allocated to higher dose corticosteroids versus 75 (12%) of 613 patients allocated to usual care died within 28 days (rate ratio 1·59 [95% CI 1·20–2·10]; p=0·0012). There was also an excess of pneumonia reported to be due to non-COVID infection (64 cases [10%] vs 37 cases [6%]; absolute difference 3·7% [95% CI 0·7–6·6]) and an increase in hyperglycaemia requiring increased insulin dose (142 [22%] vs 87 [14%]; absolute difference 7·4% [95% CI 3·2–11·5]). Interpretation In patients hospitalised for COVID-19 with clinical hypoxia who required either no oxygen or simple oxygen only, higher dose corticosteroids significantly increased the risk of death compared with usual care, which included low-dose corticosteroids. The RECOVERY trial continues to assess the effects of higher dose corticosteroids in patients hospitalised with COVID-19 who require non-invasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation

    Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

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    SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication
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