Individual Trials Research Articles

#783 Individualized net benefit of intensive blood pressure lowering among older adults in SPRINT

Abstract Background and Aims The optimal blood pressure (BP) target for older adults remains controversial. This study aimed to determine whether results from the Systolic Blood Pressure Intervention Trial (SPRINT) could be tailored to individual trial participants using risk estimates and simulated preferences about the relative importance of multiple outcomes related to BP lowering. Method This analysis included 4,850 SPRINT participants age ≥65 years. Parsimonious Cox models were internally validated to predict the absolute difference in risk between intensive versus standard BP lowering in each SPRINT participant for all-cause death, cardiovascular outcomes, cognitive outcomes, and serious adverse events. Treatment effects were combined using simulated preference weights into an individualized net benefit, which represents the weighted sum of risk differences across outcomes. Individualized net benefits among older SPRINT participants were compared across categories of age (65-74 years vs. ≥ 75 years), frailty (fit, less fit, and frail), and polypharmacy status. Results When simulating preferences for older adults who view death, cardiovascular events, and cognitive impairment as much more important than the harms of BP lowering, the median (IQR) individualized net benefit was 5% (3%, 7%), and 100% had a net benefit that favoured intensive BP lowering. When simulating benefits and harms to have similar importance, the median (IQR) individualized net benefit was 2% (1%, 3%), and 95.4% had a positive net benefit. In subgroup analyses, the predicted net benefit of intensive BP lowering was significantly greater among those with advanced age, frailty, and polypharmacy compared with lower risk individuals (P<0.001 for all comparisons). Conclusion Almost all older participants in SPRINT had a predicted net benefit that favoured intensive BP control, but the degree of net benefit varied considerably. Personalizing BP targets for older adults according to each person's estimated risks and preferences may provide more refined BP target recommendations.

Bed rest impairs the vestibular control of balance.

Prolonged bed rest impairs standing balance but the underlying mechanisms are uncertain. Previous research suggests strength loss is not the cause, leaving impaired sensorimotor control as an alternative. Here we examine vestibular control of posture in 18male volunteers before and after 60days of bed rest. Stochastic vestibular stimulation (SVS) was used to evoke sway responses before, 1 and 6days after bed rest under different head yaw orientations. The directional accuracy and precision of these responses were calculated from ground reaction force vectors. Bed rest caused up to 63% increases in spontaneous standing sway and 31% reductions in leg strength, changes which were uncorrelated. The increase in sway was exacerbated when the eyes were closed. Mean directions of SVS-evoked sway responses were unaffected, being directed towards the anodal ear and rotating in line with head orientation in the same way before and after bed rest. However, individual trial analysis revealed 25%-30% increases in directional variability, which were significantly correlated with the increase in spontaneous sway (r=0.48-0.71; P≤0.044) and were still elevated on day 6 post-bed rest. This reveals that individual sway responses may be inappropriately oriented, a finding masked by the averaging process. Our results confirm that impaired balance following prolonged bedrest is not related to loss of strength. Rather, they demonstrate that the sensorimotor transformation process which converts vestibular feedback into appropriately directed balance responses is impaired. KEY POINTS: Prolonged inactivity impairs balance but previous research suggests this is not caused by loss of strength. Here we investigated vestibular control of balance before and after 60days of bed rest using electrical vestibular stimulation (EVS) to evoke sway responses. Spontaneous sway significantly increased and muscle strength reduced following bed rest, but, in keeping with previous research, these two effects were not correlated. While the overall accuracy of EVS-evoked sway responses was unaffected, their directional variability significantly increased following bed rest, and this was correlated with the increases in spontaneous sway. We have shown that the ability to transform head-centred vestibular feedback into an appropriately directed body sway response is negatively affected by prolonged inactivity; this may contribute to the impaired balance commonly observed following bed rest.

Exploring physiological stress response evoked by passive translational acceleration in healthy adults: a pilot study utilizing electrodermal activity and heart rate variability measurements.

Passive translational acceleration (PTA) has been demonstrated to induce the stress response and regulation of autonomic balance in healthy individuals. Electrodermal activity (EDA) and heart rate variability (HRV) measurements are reliable indicators of the autonomic nervous system (ANS) and can be used to assess stress levels. The objective of this study was to investigate the potential of combining EDA and HRV measurements in assessing the physiological stress response induced by PTA. Fourteen healthy subjects were randomly assigned to two groups of equal size. The experimental group underwent five trials of elevator rides, while the control group received a sham treatment. EDA and HRV indices were obtained via ultra-short-term analysis and compared between the two groups to track changes in the ANS. In addition, the complexity of the EDA time series was compared between the 4s before and the 2-6s after the onset of PTA to assess changes in the subjects' stress levels in the experimental group. The results revealed a significant increase in the skin conductance response (SCR) frequency and a decrease in the root mean square of successive differences (RMSSD) and high frequency (HF) components of HRV. In terms of stress assessment, the results showed an increase in the complexity of the EDA time series 2-6s after the onset of PTA. These results indicate an elevation in sympathetic tone when healthy subjects were exposed to a translational transport scenario. Furthermore, evidence was provided for the ability of EDA complexity to differentiate stress states in individual trials of translational acceleration.

Effect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis

Sodium-glucose co-transporter-2 (SGLT2) inhibitors have been studied in patients with heart failure, type 2 diabetes, chronic kidney disease, atherosclerotic cardiovascular disease, and acute myocardial infarction. Individual trials were powered to study composite outcomes in one disease state. We aimed to evaluate the treatment effect of SGLT2 inhibitors on specific clinical endpoints across multiple demographic and disease subgroups. In this systematic review and meta-analysis, we queried online databases (PubMed, Cochrane CENTRAL, and SCOPUS) up to Feb 10, 2024, for primary and secondary analyses of large trials (n>1000) of SGLT2 inhibitors in patients with heart failure, type 2 diabetes, chronic kidney disease, and atherosclerotic cardiovascular disease (including acute myocardial infarction). Outcomes studied included composite of first hospitalisation for heart failure or cardiovascular death, first hospitalisation for heart failure, cardiovascular death, total (first and recurrent) hospitalisation for heart failure, and all-cause mortality. Effect sizes were pooled using random-effects models. This study is registered with PROSPERO, CRD42024513836. We included 15 trials (N=100 952). Compared with placebo, SGLT2 inhibitors reduced the risk of first hospitalisation for heart failure by 29% in patients with heart failure (hazard ratio [HR] 0·71 [95% CI 0·67-0·77]), 28% in patients with type 2 diabetes (0·72 [0·67-0·77]), 32% in patients with chronic kidney disease (0·68 [0·61-0·77]), and 28% in patients with atherosclerotic cardiovascular disease (0·72 [0·66-0·79]). SGLT2 inhibitors reduced cardiovascular death by 14% in patients with heart failure (HR 0·86 [95% CI 0·79-0·93]), 15% in patients with type 2 diabetes (0·85 [0·79-0·91]), 11% in patients with chronic kidney disease (0·89 [0·82-0·96]), and 13% in patients with atherosclerotic cardiovascular disease (0·87 [0·78-0·97]). The benefit of SGLT2 inhibitors on both first hospitalisation for heart failure and cardiovascular death was consistent across the majority of the 51 subgroups studied. Notable exceptions included acute myocardial infarction (22% reduction in first hospitalisation for heart failure; no effect on cardiovascular death) and heart failure with preserved ejection fraction (26% reduction in first hospitalisation for heart failure; no effect on cardiovascular death). SGLT2 inhibitors reduced heart failure events and cardiovascular death in patients with heart failure, type 2 diabetes, chronic kidney disease, and atherosclerotic cardiovascular disease. These effects were consistent across a wide range of subgroups within these populations. This supports the eligibility of a large population with cardiorenal-metabolic diseases for treatment with SGLT2 inhibitors. None.

Development of Electronic Test Instruments Through Vinesa to Improve Statistical Reasoning Ability on Tendency Central Materials

This study aims to assess the feasibility of developing an e-test instrument for statistics courses on central tendency material so that student learning outcomes can increase. The analysis used in this research is quantitative and descriptive. This research method uses 20 students. Methods of data collection using tests, observations, interviews, and questionnaires The procedures carried out in developing the test instrument are: 1) compiling test specifications; 2) writing test questions; 3) reviewing the item items; 4) conducting test trials; 5) analyzing the item items; 6) revising the test; 7) compiling the test; 8) carrying out the test; and 9) interpreting the test results. The ADDIE model is used in this development research. The results of the feasibility of developing electronic test instruments were stated to be valid with: a) the results of validating the material were very feasible (96%); b) the results of validating learning media were very feasible (94%). If c) the results of validating learning designs were very feasible (94%), d) the results of individual trials were very feasible (81%), and e) the results of small group trials were very feasible (82%), then the development of electronic test instruments is very feasible for use in statistical learning.

Hierarchical modelling of variance components makes analysis of resolvable incomplete block designs more efficient

The standard approach to variance component estimation in linear mixed models for alpha designs is the residual maximum likelihood (REML) method. One drawback of the REML method in the context of incomplete block designs is that the block variance may be estimated as zero, which can compromise the recovery of inter-block information and hence reduce the accuracy of treatment effects estimation. Due to the development of statistical and computational methods, there is an increasing interest in adopting hierarchical approaches to analysis. In order to increase the precision of the analysis of individual trials laid out as alpha designs, we here make a proposal to create an objectively informed prior distribution for variance components for replicates, blocks and plots, based on the results of previous (historical) trials. We propose different modelling approaches for the prior distributions and evaluate the effectiveness of the hierarchical approach compared to the REML method, which is classically used for analysing individual trials in two-stage approaches for multi-environment trials.

The Accompanying Effect in Responses to Auditory Perturbations: Unconscious Vocal Adjustments to Unperturbed Parameters.

The present study examined whether participants respond to unperturbed parameters while experiencing specific perturbations in auditory feedback. For instance, we aim to determine if speakers adjust voice loudness when only pitch is artificially altered in auditory feedback. This phenomenon is referred to as the "accompanying effect" in the present study. Thirty native Mandarin speakers were asked to sustain the vowel /ɛ/ for 3 s while their auditory feedback underwent single shifts in one of the three distinct ways: pitch shift (±100 cents; coded as PT), loudness shift (±6 dB; coded as LD), or first formant (F1) shift (±100 Hz; coded as FM). Participants were instructed to ignore the perturbations in their auditory feedback. Response types were categorized based on pitch, loudness, and F1 for each individual trial, such as Popp_Lopp_Fopp indicating opposing responses in all three domains. The accompanying effect appeared 93% of the time. Bayesian Poisson regression models indicate that opposing responses in all three domains (Popp_Lopp_Fopp) were the most prevalent response type across the conditions (PT, LD, and FM). The more frequently used response types exhibited opposing responses and significantly larger response curves than the less frequently used response types. Following responses became more prevalent only when the perturbed stimuli were perceived as voices from someone else (external references), particularly in the FM condition. In terms of isotropy, loudness and F1 tended to change in the same direction rather than loudness and pitch. The presence of the accompanying effect suggests that the motor systems responsible for regulating pitch, loudness, and formants are not entirely independent but rather interconnected to some degree.

The effect of increased fruit and vegetable consumption on blood pressure and lipids: a pooled analysis of six randomised controlled fruit and vegetable intervention trials.

Increasing fruit and vegetable (FV) consumption is associated with reduced cardiovascular disease risk in observational studies but with little evidence from randomised controlled trials (RCTs). The impact of concurrent pharmacological therapy is unknown. To pool data from six RCTs to examine the effect of increasing FV intake on blood pressure (BP) and lipid profile, also exploring whether effects differed by medication use. Across trials, dietary intake was assessed by diet diaries or histories, lipids by routine biochemical methods and BP by automated monitors. Linear regression provided an estimate of the change in lipid profile or BP associated with a one portion increase in self-reported daily FV intake, with interaction terms fitted for medication use. The pooled sample included a total of 554 participants (308 males and 246 females). Meta-analysis of regression coefficients revealed no significant change in either systolic or diastolic BP per portion FV increase, although there was significant heterogeneity across trials for systolic BP (I2= 73%). Neither adjusting for change in body mass index, nor analysis according to use of anti-hypertensive medication altered the relationship. There was no significant change in lipid profile per portion FV increase, although there was a significant reduction in total cholesterol among those not on lipid-lowering therapy (P < 0.05 after Bonferroni correction). Pooled analysis of six individual FV trials showed no impact of increasing intake on BP or lipids, but there was a total cholesterol-lowering effect in those not on lipid-lowering therapy.

Metabolic Acidosis in CKD: Pathogenesis, Adverse Effects, and Treatment Effects.

Metabolic acidosis is a frequent complication of chronic kidney disease and is associated with a number of adverse outcomes, including worsening kidney function, poor musculoskeletal health, cardiovascular events, and death. Mechanisms that prevent metabolic acidosis detrimentally promote further kidney damage, creating a cycle between acid accumulation and acid-mediated kidney injury. Disrupting this cycle through the provision of alkali, most commonly using sodium bicarbonate, is hypothesized to preserve kidney function while also mitigating adverse effects of excess acid on bone and muscle. However, results from clinical trials have been conflicting. There is also significant interest to determine whether sodium bicarbonate might improve patient outcomes for those who do not have overt metabolic acidosis. Such individuals are hypothesized to be experiencing acid-mediated organ damage despite having a normal serum bicarbonate concentration, a state often referred to as subclinical metabolic acidosis. Results from small- to medium-sized trials in individuals with subclinical metabolic acidosis have also been inconclusive. Well-powered clinical trials to determine the efficacy and safety of sodium bicarbonate are necessary to determine if this intervention improves patient outcomes.

Vasodilators for acute heart failure. A systematic review of randomized clinical trials with meta-analysis and trial sequential analysis

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Danish Cardiovascular Academy Novo Nordisk Foundation. Background Acute heart failure (AHF) is an increasing public health concern with limited evidence for current treatments, such as vasodilators. Recent studies have shown mixed results regarding the efficacy of vasodilation in AHF, leading to downgraded recommendations in European Society of Cardiology (ESC) 2021 guidelines. Method We conducted a systematic review of randomized clinical trials (RCTs) to assess vasodilator therapy's effectiveness in managing AHF. The search for relevant studies was conducted without restrictions across the major databases: Medline, Embase, Latin American and Caribbean Health Sciences Literature (LILACS), Web of Science, and the Cochrane Central Register of Controlled Trials. The study protocol was published and registered at PROSPERO, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. We included RCTs that compared vasodilators to standard care, placebo, no-intervention, or co-interventions. Our primary outcome was all-cause mortality, while secondary outcomes included serious adverse events (SAEs), tracheal intubation and length of hospital stay. Systolic blood pressure difference was an exploratory outcome. We assessed the risks of bias in individual trials using the Cochrane Collaboration risk of bias tool. Results We included 46 RCTs comprising 28,374 patients with AHF. Meta-analysis and Trial Sequential Analysis showed that vasodilators did not reduce the risk of all-cause mortality (risk ratio (RR) = 0.96, 95% CI: 0.90 to 1.03; I2 = 0%; P = 0.26). However, meta-analysis showed evidence of a beneficial effect of vasodilators in reducing the need for tracheal intubation (RR = 0.82, 95% CI: 0.68 to 0.99; I2 = 55.05%; P = 0.04). No evidence of a difference was seen in the risk of SAEs (RR = 1.01, 95% CI: 0.97 to 1.06; I2 = 0%; P = 0.50) or length of hospital stay (Mean difference (MD) = -0.28, 95% CI: -0.73 to 0.16; I2 = 69.84%; P = 0.28). Finally, a significant decrease in systolic blood pressure (MD = -6.26, 95% CI: -8.06 to -4.46; I2 = 90.51%; P &amp;lt; 0.01) was demonstrated. Conclusion In patients hospitalised with AHF, vasodilator therapy did not result in a reduction of all-cause mortality, SAEs or length of hospital stay. However, the need for tracheal intubations was significantly decreased.Forest plot of all-cause mortalityForest plot of Tracheal intubation

Meta‐analysis evaluating apixaban in patients with atrial fibrillation and end‐stage renal disease requiring dialysis

AbstractBackgroundWarfarin is considered the primary oral anticoagulant for patients with atrial fibrillation and end‐stage renal disease (ESRD) requiring dialysis. Although warfarin can offer significant stroke prevention in this population, the accompanying major bleeding risks make warfarin nearly prohibitive. Apixaban was shown to be superior to warfarin in preventing stroke or systemic embolism, with a lower risk of bleeding and mortality in a large, randomized trial of individuals with mostly normal renal function but none with ESRD.MethodsWe systematically reviewed evidence comparing apixaban versus warfarin for atrial fibrillation in this population, and evaluated outcomes of stroke or systemic embolism, and major bleeding using random‐effects models. The main safety outcome was major bleeding, and the main effectiveness outcome was stroke or systemic embolism.ResultsWe found five observational studies of 10 036 patients (2638 receiving apixaban, and 7398 receiving warfarin) meeting inclusion criteria. Pooled analysis demonstrated a significant reduction in major bleeding with apixaban as compared to warfarin (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.42–0.61; p &lt; .0001). Apixaban was also associated with a reduction in intracranial bleeding (OR 0.58, 95% CI 0.37–0.92; p = .02) and in gastrointestinal bleeding (OR 0.61, 95% CI 0.51–0.73; p &lt; .0001). Furthermore, apixaban was associated with a reduction in stroke/systemic embolism (OR 0.64, 95% CI 0.50–0.82; p &lt; .0001).ConclusionApixaban was associated with superior outcomes and reduced adverse events compared to warfarin in observational studies of patients with atrial fibrillation on dialysis. Randomized controlled studies are needed to confirm these findings.

Motor Imagery Classification Using Effective Channel Selection of Multichannel EEG.

Electroencephalography (EEG) is effectively employed to describe cognitive patterns corresponding to different tasks of motor functions for brain-computer interface (BCI) implementation. Explicit information processing is necessary to reduce the computational complexity of practical BCI systems. This paper presents an entropy-based approach to select effective EEG channels for motor imagery (MI) classification in brain-computer interface (BCI) systems. The method identifies channels with higher entropy scores, which is an indication of greater information content. It discards redundant or noisy channels leading to reduced computational complexity and improved classification accuracy. High entropy means a more disordered pattern, whereas low entropy means a less disordered pattern with less information. The entropy of each channel for individual trials is calculated. The weight of each channel is represented by the mean entropy of the channel over all the trials. A set of channels with higher mean entropy are selected as effective channels for MI classification. A limited number of sub-band signals are created by decomposing the selected channels. To extract the spatial features, the common spatial pattern (CSP) is applied to each sub-band space of EEG signals. The CSP-based features are used to classify the right-hand and right-foot MI tasks using a support vector machine (SVM). The effectiveness of the proposed approach is validated using two publicly available EEG datasets, known as BCI competition III-IV(A) and BCI competition IV-I. The experimental results demonstrate that the proposed approach surpasses cutting-edge techniques.

Plasma Branched-Chain Fatty Acids Reflect Dairy-Fat Intake in a Pilot Clinical Trial in Individuals with Prediabetes

Epidemiological studies often rely on fatty acid (FA) biomarkers of dairy-fat intake to represent diet history and to establish associations with cardiometabolic risk factors. However, a more robust body of direct research is needed to validate the currently utilized FA biomarkers as accurate representations of dairy-fat intake. Thus, our objectives were to i) compare the plasma FA profile of individuals with prediabetes following the consumption of a diet with full-fat (3.25%) yogurt (FFY diet) or non-fat yogurt (NFY diet) to evaluate their validity of currently utilized biomarkers and ii) identify additional FAs to serve as potential biomarkers. We hypothesized that the proportion of the unique dairy-derived FAs including odd-chain FAs (13:0, 15:0, 17:0, 19:0, 21:0, 23:0), branched-chain FAs ( iso-13:0, anteiso-13:0, iso-14:0, iso-15:0, anteiso-15:0, iso-16:0, iso-17:0, anteiso-17:0, iso-18:0), and the trans-FAs 16:1 trans-9 and 18:1 trans-11 would increase in plasma total lipids following the consumption of three daily servings of full-fat yogurt for three weeks. Our 8-week randomized, double-masked, controlled crossover study included six men and seven women aged 45-75 years old. Each experimental diet period, NFY diet and FFY diet, was three weeks in length. The arithmetic difference in fat (8% energy) between the NFY diet (30% fat) and the FFY diet (38% fat) was solely due to the dairy fat in the full-fat yogurt. Following each experimental diet period, fasting plasma samples were taken and analyzed for FA composition of plasma total lipids using gas-liquid chromatography. Consumption of the FFY diet resulted in no change in the proportion of total odd-chain FAs or the individual FAs 16:1 trans-9 and 18:1 trans-11, but the proportion of total branched-chain FAs was greater in response to the FFY diet ( P &lt; 0.01). For individual odd-chain and branched-chain FAs, the proportions of iso-17:0 and anteiso-17:0 were greater in response to the FFY diet ( P &lt; 0.01 for both); however, there were no differences in anteiso-15:0 or iso-15:0 proportions by diet. Results from this pilot trial suggest that commonly utilized FA biomarkers may not be suffciently robust to represent dairy-fat intake. Branched-chain FAs should be further explored for alternatives. Funding for this project was provided by National Dairy Council Nutrition Research Funding, a USDA Agriculture and Food Research Initiative National Institute of Food and Agriculture Predoctoral Fellowship, and a fellowship from the University of Vermont’s Food Systems Research Center. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Self-Defense and Political Rage

This Article considers how American political polarization and the substantive issues driving it raise unique challenges for adjudicating self-defense claims in contexts of political protest. We live in an age where roughly a quarter of the population believes it is at least sometimes justifiable to use violence in defense of political positions, making political partisans somewhat more likely to pose a genuine threat of bodily harm to opponents. Furthermore, the psychological literature shows that people are more likely to perceive threats from people with whom they politically disagree and that juries tend to evaluate reasonableness claims according to their own political positions. All three of these phenomena create challenges for the rule of law due to the increased risk that factually similar cases will turn out differently and that the justice system will merely recreate the monomaniacal, us-versus-them polarization of society at large. This Article surveys the relevant political science and psychological literature on partisanship and reasoning and proposes two interrelated solutions: one pragmatic, at the level of individual trials, and the other cultural, at the level of social discourse. It suggests that judges import what we know about the distortive effects of partisanship into the courtroom through the use of court-appointed psychological experts and jury instructions. Both have shown some success—if tailored precisely to the facts of a specific case—in correcting some forms of juror bias and reasoning errors. This Article further argues that incorporating these processes into the adjudication of politicized self-defense claims will have a broader, expressive value for society as a whole. Trials provide a model for truth-finding, which, for better or for worse, impacts how private citizens evaluate culpability in their day-to-day lives. If trials draw even some people’s attention to the ways in which partisan thinking can generate or justify acts of violence, they may be a force for moderation in how people deal with their political disagreements, which will have benefits far beyond the courtroom.

Development of Learning Modules for Entrepreneurship Courses to Train The Independence of Agricultural Product Technology Study Program Students

This research aims to produce a learning module for entrepreneurship courses to train student independence. The module was prepared in the form of a printed module. This module was created as an educational tool for entrepreneurship classes in the Faculty of Agriculture's Agricultural Product Technology Study Program, PGRI Banyuwangi University. The technique employed in developing this module is the ADDIE development model, this model is used because the development stages are simpler and the time used is not too long. The study's findings are in the form of an entrepreneurship learning module to determine the feasibility of using this module, trials have been carried out including individual trials and group trials. The individual trial involved 3 students, while the group involved 9 students. In this study, it was found that the confirmation from material experts was 92.5% and the media expert validation was 87.5% so that it could be categorized as very good. It is also carried out limited and group trials with the aim of seeing the feasibility of the products developed. The restricted trial's outcomes were as follows an average of 89.58%, meaning that the average can be categorized as excellent and the results of the group trial obtained an average of 90.26% so that the developed module is categorized as feasible and can train student independence.

PENGEMBANGAN LEMBAR KERJA PESERTA DIDIK BERBASIS CONTEXTUAL TEACHING LEARNING MATERI INTEGRAL TAK TENTU FUNGSI ALJABAR

This research aims to develop a Student Worksheet based on Contextual Teaching and Learning on social arithmetic material that is valid, practical and effective. The type of research used in this research is research and development (R&amp;D) with the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model. The data collection techniques used were validation sheets, student response questionnaires, and student learning outcomes tests. Meanwhile, the data analysis technique used is qualitative and quantitative data analysis. Based on research and discussion, the validation results from material experts are 83.33% with very feasible criteria, the validation results from media expert validators are 80% with very feasible criteria, and the validation results from language expert validators are 92% with very feasible criteria. The practicality test results of individual trial respondents were 73.66% with interesting and practical criteria, the results of small group trial respondents were 75.50% with the interesting and practical category, and the results of field trial respondents were 75.54% with interesting and practical categories. practical. The effectiveness results obtained an average value of 81% in the very effective category. Researchers hope that this LKPD can be used to improve students' abilities in the material of indefinite integrals in algebraic functions.

PENGEMBANGAN MEDIA PEMBELAJARAN BOOKLET ARLANSIA PADA MATA PELAJARAN PPKn UNTUK MENINGKATKAN HASIL BELAJAR KELAS III SEKOLAH DASAR

This research aims to produce an Arlansia booklet media for PPKn learning that is valid, practical and effective. The type of research used is Research and Development with the ADDIE model which consists of five stages, namely: 1) Analyze, needs analysis and curriculum analysis, 2) Design, designing and selecting the appearance of the Arlansia PPKn learning booklet media. 3) Development, validation of products that have been developed. 4) Implementation, the application of the product to determine the practicality of the PPKn learning Arlansia booklet, and 5) Evaluation, the evaluation of the PPKn learning Arlansia booklet to determine the advantages and disadvantages of developing the PPKn learning Arlansia booklet media. Data collection techniques are in the form of questionnaires to determine the validity and practicality of the media, validation questionnaires, student response questionnaires and teacher response questionnaires, as well as tests to determine the effectiveness of the media in the form of 10 multiple choice questions. The research results showed that the percentage value of media validation was 74%, material validation was 72% and language validation was 70% in the valid category, teacher response questionnaire results was 88%, individual trial student response questionnaires was 84%, group trial student response questionnaires small at 82% in the very practical category and effective questionnaire results at 91.6% in the very effective category. So it can be concluded that the development of arlansia booklet learning media at class III on PPKN subjects can be categorized as valid and practical for use in learning activities.

PENGEMBANGAN BAHAN AJAR IPS TERPADU BERKARAKTER SMP KELAS VII SEMESTER I

The use of instructional materials in the learning process in the classroom is paramount for teaching materials is one of the factors that affect the improvement of the quality of learning. Similarly, in the study of Social Sciences (IPS) in the Junior High School (SMP) has some problems, such as: its not integrated teaching materials or teaching social studies mostly still carried out separately. Research aims: (1) describe the product development process of teaching materials such as books of Social Sciences (IPS) integrated characterless, (2) describe the use of an integrated social studies teaching material characterless. Models development of teaching materials using the model of Dick and Carey (1994), while the steps are: (1) set a goal of learning, (2) analysis of learning, (3) identify the child's abilities and characteristics of students, (4) formulate specific goals, (5) developing test items, (6) develop learning strategies, (7) develop and choose the subject matter, (8) to design and conduct formative evaluation, (9) revise the learning. The average acquisition individual trials on the effectiveness of instructional materials is 79%, a small group test the effectiveness of teaching materials is 84.2%. Student pretest value reached 52.5% at the posttest value of 100% or the overall student has achieved the minimum completeness criteria (KKM). While to a large group of placement test, which means 80% proven effective teaching materials. Assessment of two (2) social studies teachers to gain teaching materials with an average value of 87%, as well as to aspects of the content material is very good quality is obtained with a percentage of 86% and design aspects with the percentage 76%. Based on the results of product testing can be concluded that the development of teaching materials based IPS Integrated Character Education classes VII Semester is fit for use and has a level of effectiveness and attractiveness, these teaching materials students can use independently. Keyword: Teaching Material, Integrated Social Science Characterless

PENGEMBANGAN E-BOOK INTERAKTIF UNTUK PEMBELAJARAN FISIKA SMP

This article is based on the development and design research. The research objective is (1) to develop interactive e-book physics that has pictures, video, animation, simulation, and voice as a source of learning physics (2) to develop interactive e-book of physics that can increase students' interest in learning physics. Model development used ADDIE model is proposed by Lee and Owens. Procedure development include: analysis, design, development, implementation, and evaluation. The results of individual trials and a small group of students at SMP Sari Putra Kota Jambi. Testing large group obtained an average value of 3.23 with the corresponding criteria/ right/ good/ easy. Based on the results of individual trials, small and large groups obtained in this study concluded that the interactive e-book for junior high school physics lessons appropriate for use as a source of learning physics junior level. Keyword: interactive e-book, learning physics

Webquest Sebagai Pembelajaran Dimasa Pandemi Covid-19 Pada Mata Pelajaran Sejarah Indonesia Kelas X Di Smk Nurul Huda Poncokusumo Kabupaten Malang

The pandemic disease outbreak due to corona virus disease (Covid-19) has affected learning activities at both elementary and tertiary levels. The government requires students to carry out online learning activities. One online learning alternative that can be implemented is WebQuest. WebQuest is a type of web-based learning that is inquiry-oriented. In developing this WebQuest, the model used is Web-Based Instructional Design with four stages: 1) Analysis Stage, 2) Concurrent Design Stage, 3) Implementation Stage, 4) Evaluation Stage. This research was applied to 40 students of class Results of WebQuest trials with 3 experts. The results of data analysis from design experts obtained an average percentage of 80% suitable for use. The results of media expert data analysis obtained an average percentage of 90% suitable for use. The results of material expert data analysis obtained an average percentage of 88% suitable for use. The results of individual data analysis obtained an average percentage of 86.6% suitable for use. The results of small group data analysis obtained an average percentage of 85.7% suitable for use. The results of field test data analysis obtained an average percentage of 83.1% suitable for use. The number of students who fulfill the SKM reaches a percentage level of 87.5%, so the product is said to be effective. Meanwhile, in individual trials, small groups and field trials, it can be concluded that the WebQuest that has been developed is valid and suitable for use in learning activities. Learning with WebQuest can be the main alternative for online learning during the Covid-19 pandemic. WebQuest makes it easy for students to access study material by simply opening one website page. Apart from the material in WebQuest, there are also assignments/activities that can attract students to learn using WebQuest.Keyword: WebQuest, Study activity in the time of Covid-19 Pandemic, Indonesian History.