Limited Trials Research Articles

In-House Training Modules on Learning Media to Improve Information and Communication Technology Competence in Elementary School Teachers

In-house training (IHT) programs effectively address educational challenges in schools through a thorough needs analysis. While IHT programs are frequently conducted, the primary focus should be on enhancing the quality of training to meet the specific needs of institutions, roles, and individuals involved. At SDN 98, a notable issue is the low utilization of technology in the learning process despite adequate multimedia facilities. Among 17 classroom teachers, fewer than 25% are proficient in using computers for instruction, and only one or two teachers regularly use laptops. The use of LCD projectors is also rare. This situation highlights the urgent need to improve teachers' information and communication technology (ICT) skills. Consequently, this Study aims to enhance the ICT competencies of SDN 98 teachers through targeted training and the development of IHT modules. The research employs a research and development (R&D) method that includes eight stages: initial research, planning, product design, validation, revision, limited trials, and field trials. The developed IHT module received excellent evaluations, with an average score of 4.49 from respondents and 4.56 from instructors, indicating its practicality and effectiveness in enhancing teachers' ICT competencies.

ASK HEART GAME CARD DEVELOPMENT TO PROVIDE AN UNDERSTANDING OF MARRIAGE READINESS IN EARLY ADULTHOOD

This research aims to provide an understanding of marriage readiness in early adulthood through the media of the Tanya Hati card game as an effort to fulfill one of the developmental tasks in early adulthood. Apart from that, this research was carried out as a form of optimizing the Guidance and Counseling program through the development of Guidance and Counseling media in the form of game cards. The research method used is “Research and Development” using the ADDIE model (analysis, design, development, implementation and evaluation). Data collection through observation, interviews and questionnaires. The research results show that the Tanya Hati card game media developed is very suitable for use with an average result of 85% from expert assessments. Based on limited trials on 8 students, the heart question card game media obtained a score of 84%. The research results show that the development of the Tanya Hati card game media is valid and effective as a medium that provides an understanding of marriage readiness in early adulthood.

Badati Cultural Design as a Learning Model in Increasing Understanding and Awareness of Prospective Taxpayers

The role of the community in development is characterized by a high awareness of paying taxes. People in the age range of compulsory education are potential taxpayers. The existence of badati culture, which is believed to have positive values for the people on the island of Ambon, is then designed in the form of a learning model. Through the implementation of the Badati Learning model, it is expected that it will have an impact on the level of tax awareness of 12th-grade high school students in Ambon City. The Badati model developed has a syntax: (1) formulation of activities, (2) formation of groups in representatives, (3) representatives disseminate to small groups, (4) small groups discuss, (5) the results of small group discussions are returned to the large group, (5) representatives disseminate classically by each representative in the gandong cloth. The research and development method, with the stages of preliminary studies on community leaders and youth leaders in Maluku, model trials. Limited test stages were conducted in two schools, broader test stages were conducted in three schools, and model validation was conducted in two schools. The results of the study illustrated that the Badati model is proven to have a good impact in increasing students' understanding of the importance of tax awareness for development with the average N-gain value at each stage of the trial, which is at a moderate level (limited trial N-gain value 0.6, broader trial, 0.7, and 0.7 validation test). Keywords: Badati learning model, tax awareness

Epigenetics in Heart Failure

Heart failure is a clinical syndrome with rising global incidence and poor prognosis despite improvements in medical therapy. There is increasing research interest in epigenetic therapies for heart failure. Pathological cardiac remodelling may be driven by stress-activated cardiac signalling cascades, and emerging research has shown the involvement of epigenetic signals that regulate transcriptional changes leading to heart failure. In this review, we appraise the current evidence for the role of epigenetic modifications in heart failure. These include DNA methylation and histone modifications by methylation, acetylation, phosphorylation, ubiquitination and sumoylation, which are critical processes that establish an epigenetic pattern and translate environmental stress into genetic expression, leading to cardiac remodeling. We summarize the potential epigenetic therapies currently in development, including the limited clinical trials of epigenetic therapies in heart failure. The dynamic changes in the epigenome in the disease process require further elucidation, and so does the impact of this process on the development of therapeutics. Understanding the role of epigenetics in heart failure may pave the way for the identification of novel biomarkers and molecular targets, and facilitate the development of personalized therapies for this important condition.

Augmented Reality-Based Learning Media in Computer Systems Subjects

This research aims to develop Augmented Reality (AR)-based learning media in the Computer Systems subject at SMK Negeri 2 Argamakmur, with the hope of increasing the effectiveness and involvement of students in the learning process. This study uses the Research method and Development (RD) with the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) development model. The subjects of the study consisted of 30 grade XI students at SMK Negeri 2 Argamakmur. Data collection instruments included questionnaires to measure student and teacher responses, and tests to assess the increase in conceptual understanding. The media feasibility test was carried out through validation by material experts and media experts, as well as limited trials. The results showed that AR-based learning media received a "very feasible" rating from material experts with a score of 88.5% and from media experts with a score of 91.2%. Testing the effectiveness of the media on student understanding showed an increase in learning outcomes with an average pre-test score of 65.3 increasing to 82.7 in the post-test, with a rise of 26.5%. Student responses to this learning media were also very positive, with a percentage of satisfaction reaching 89.4%. Based on these results, it can be concluded that the AR-based learning media developed effectively improves student understanding and can be used as a learning medium in the computer systems subjects.

3D Printed Orthodontic Aligners—A Scoping Review

This scoping review aims to provide a comprehensive summary of the current literature on 3D-printed orthodontic aligners. It was conducted following the Preferred Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. An electronic literature search was conducted across the PubMed, Embase, and Web of Science databases. After applying the inclusion criteria, a total of 46 eligible studies published until September 2024 were selected for qualitative synthesis. To date, scientific evidence is primarily available for Tera Harz TC (Graphy, Seoul, Republic of Korea), which is the only studied material approved for orthodontic tooth movements. Although additional materials were identified during the literature search, there is a lack of scientific studies regarding their characteristics and clinical use. This review highlights that while material properties and biocompatibility are of critical importance, the clinical efficacy and long-term safety of 3D-printed aligners require further investigation. Many studies exhibit significant variability in testing methodologies, making substantiated comparisons challenging. Moreover, the existing literature primarily comprises in vitro studies, with limited clinical trials assessing the effectiveness of 3D-printed aligners. Given the current gaps in knowledge and the evolving nature of this field, further well-designed controlled clinical studies are necessary to evaluate the clinical performance and safety of 3D-printed aligners. The findings underscore the need for standardized protocols and comprehensive reporting to enhance the reliability of future research in this area.

Empowering minds: An e-book blending contextual teaching learning with plant tissue exploration to boost argumentation and cognitive skills

This research was motivated by obstacles in implementing biology learning which resulted in the lack of training in argumentation skills and low cognitive learning outcomes. The current teaching materials does not yet support these skills optimally. The aim of this research is to develop an e-book blending contextual teaching learning that is feasible, practical and effective to boost high school student’s argumentation and cognitive skills. A research and development method was used using the ADDIE (Analyze, Design, Development, Implementation, Evaluation) development model. The subjects of this research were 34 high school students in Sleman, Yogyakarta in limited trials and 62 students in field trials. The type of research used in the field test was quasi-experimental with a pretest-post-test control group design. Class XI MIPA 1 was used as the control class and class XII MIPA 2 as the experimental class. Data collection instruments used included product assessment questionnaires by experts, biology teachers and students, argumentation skills and cognitive learning outcomes test instruments. Data analysis used the paired sample t-test, independent sample t-test and n-gain score test. The research results show that e-books is suitable for use in learning according to material experts and media experts, e-books is practical for use in learning according to teacher and student assessments, and e-books is effective for improving students' argumentation skills and learning outcomes. The conclusion in this research is that e-books blending contextual teaching and learning are feasible, practical and effective to use to boost students' argumentation and cognitive skills.

The Development of SETS-Based E-Modules for Industrial Chemistry According to IMO Model Course 7.04

The era of Industrial Revolution 4.0 encourages universities to utilize information technology. Learning industrial chemistry courses in maritime education is still conventional, with little time allocation. Apart from that, no digital-based learning resources comply with the IMO 7.04 standard. This research aims to develop a SETS (Science, Environment, Technology, and Society) based e-module Website for the Industrial Chemistry course according to IMO 7.04 standards, as well as analyze the feasibility of the product. This research method is R&D (Research & Development) using the ADDIE model but is limited to the development stage. Quantitative data is processed into interval data using a Likert scale. The research results show that the validation of material experts is 87.89% in the very valid category, and media experts are 91.67% in the very valid category. Limited trials on students showed a positive response 90.13% in the very good category. It is hoped that the development of this e-module can improve the quality of learning in maritime education.

Development of Socioscientific-Issue-Based Electronic Modules on Virus Material to Increase Interest and Argumentation Skills

This study aims to produce an electronic module based on socioscientific issues that is feasible to improve students' interest and argumentation skills. This research is development research with the ADDIE method (Analysis, Design, Development, Implementation, and Evaluation). The product to be developed is an electronic module based on Socioscientific Issues on virus material. Data collection techniques used are interviews, observations, learning interest questionnaires. The resulting product is then validated by material experts and media experts, and a limited trial is carried out. Based on the results of the development of an electronic module based on socioscientific issues, it is concluded that the electronic module is feasible to be used for biology learning in terms of the assessment of material experts with an average value of 3.11 (very feasible) and the assessment of media experts with an average value of 3.77 (very feasible). And it is effective for increasing students' interest in learning as seen from the n-gains value of 0.55 with a moderate category and to improve students' argumentation skills with an n-gains value of 0.4 with a moderate category.

DEVELOPMENT OF CONTEXTUAL-BASED MODULES ON LINES AND ANGLES FOR SEVENTH GRADE STUDENTS AT SMP NEGERI 1 ULUSUSUA

This research aims to develop a module focused on lines and angles to enhance students' contextual skills. The study employs a Research and Development (R&D) approach using the 4D model (define, design, development, disseminate), with data collected through validation, questionnaires, and tests, analyzed both qualitatively and quantitatively. Based on the findings, the lines and angles module is proven to be valid, practical, and effective. Subject matter experts rated it as valid (75%), media experts also rated it valid (74.07%), and language experts rated it as very valid (75%). In limited class trials, practicality was rated very high (average 4.57), and similarly high in field trials (average 4.43). Effectiveness in improving learning outcomes was moderately good in limited class trials (average 0.65) and field trials (average 0.68). The developed module is intended to support independent learning among students and assist teachers in effectively teaching mathematics.

Development of problem mind mapping-based learning model (PMM-BL) integration patterns to improve critical thinking skills in primary school students

PISA 2022 data shows that Indonesia's ranking has risen 5-6 positions compared to PISA 2018. However, even though there was an increase in ranking in PISA 2022, Indonesia recorded a decrease in scores in each ability assessment subject. Therefore, Indonesia actually still has the opportunity to develop a model (PMM-BL) integration patterns to improve critical thinking skills because it has the capacity and potential that have not yet been developed. The purpose of this research is to produce a PMM-BL model book product and its operational form to improve critical thinking skills and test differences in students' critical thinking skills before and after implementing the PMM-BL. The research subjects during the limited trial of the PMM-BL model were fifth-grade students at SDN Bandulan 2, Malang City, Indonesia. The research method used is research and development (R&D). The development procedure is guided by the stages of the systems approach model, namely Dick & Cary's learning system development design model. This study examined the development of the PMM-BL model and its operational form to improve critical thinking skills and examines differences in students' critical thinking abilities before and after implementing the PMM-BL model.

β-Amyloid impairs Proteasome structure and function. Proteasome activation mitigates amyloid induced toxicity and cognitive deficits.

Alzheimer's Disease (AD) is the leading cause of dementia globally, affecting around 50 million people and marked by cognitive decline and the accumulation of β-amyloid plaques and hyperphosphorylated tau. The limited treatment options and numerous failed clinical trials targeting β-amyloid (Aβ) highlight the need for novel approaches. Lowered proteasome activity is a consistent feature in AD, particularly in the hippocampus. Impaired proteasome function in AD is hypothesized to stem from direct inhibition by β-amyloid or hyperphosphorylated tau, disrupting critical neuronal processes such as memory formation and synaptic plasticity. This study tests the hypothesis that AD related deficits are driven in part by impaired proteasome function as a consequence of inhibition by Aβ. We evaluated how proteasome function is modulated by Aβ and the capacity of two proteasome-activating compounds, TAT1-8,9-TOD and TAT1-DEN to rescue Aβ-induced impairment in vitro, as well as survival deficits in cell culture and Aβ-induced cognitive deficits in Drosophila and mouse models. Our study demonstrates that oligomeric β-amyloid binds to the 20S proteasome and impairs its activity and conformational stability. The oligomers also destabilize the 26S proteasome to release the free 20S proteasome. Treatment with proteasome activators TAT1-8,9TOD and TAT1-DEN rescue the 20S proteasome function and reduces cell death caused by Aβ42 toxicity in SK-N-SH cells. In Drosophila models overexpressing Aβ42, oral administration of proteasome agonists delayed mortality and restored cognitive function. Chronic treatment with TAT1-DEN protected against deficits in working memory caused by Aβ42 in mice and in hAPP(J20) mice with established deficits, acute TAT1-DEN treatment significantly improved spatial learning, with treated mice performing comparably to controls. Aβ has dual impacts on 20S and 26S proteasome function and stability. Proteasome activation using TAT1-8,9TOD and TAT1-DEN shows promise in mitigating AD-like deficits by protecting against amyloid toxicity and enhancing proteasome function. These findings suggest that targeting proteasome activity could be a viable therapeutic approach for AD, warranting further investigation into the broader impacts of proteasome modulation on AD pathology.

Breaking barriers in Parkinson’s care: the multidisciplinary team approach

Parkinson’s disease is a complex neurodegenerative disorder presenting a range of motor and non-motor symptoms that greatly impact both patients and caregivers. The diverse needs arising from these symptoms make a multidisciplinary team (MDT) approach crucial for effective management. This article explores the role and benefits of MDTs in Parkinson’s care, highlighting how collaborative models improve clinical outcomes and quality of life. MDTs integrate neurologists, nurse specialists, therapists, and other professionals to deliver comprehensive, patient-centered care. The inclusion of patients and caregivers fosters shared decision-making, enhancing health outcomes. However, challenges like limited controlled trials, lack of comprehensive guidelines, and under-referral remain. Innovative models, such as telehealth and community-based care, offer promising solutions, especially in underserved regions. The article advocates for further research and standardized guidelines to optimize the MDT approach for Parkinson’s disease.

Softskill Base Arabic Language Teaching Model in Improving Talaqul Kalam for College Student in Universitas Sains Al-Quran Jawa Tengah Wonosobo

Arabic language learning has a major problem related to its renewal. Arabic language learning is always identical with grammatical (Qawa’id) aspects which seem to be rigid, complicated, and confusing. There are two major Arabic language learning orientations: as body of knowledge and mastery. The purpose of this research is to produce an Arabic language learning model based on soft skills to effectively improve the students’ Talaqah al kalaam at Universitas Sains Al-Qur’an (UNSIQ), Wonosobo, Central Java, Indonesia. This research was considered as a field study in the form of Research and Development (R&D) involving students from each faculty of Universitas Sains Al-Qur’an (UNSIQ), Wonosobo, Central Java, Indonesia. The research data were collected through observation, in-depth interview, questionnaire, test, and documentation. The collected data were then analyzed through several stages: (a) initial-product test analysis, (b) limited data trial result analysis, (c) extensive data trial result analysis, and (d) student learning response analysis. The research results showed that the Arabic language learning model based on soft skills had fulfilled the validity elements through Expert Judgment method and been considered very effective proven by the significant improvement in post-test results. This model was also proven practical proven by the test results showing that the supporting instruments, such as Course Learning Unit, Learning Module, Semester Learning Plan, Test Instrument, and Learning Implementation Sheet, were very good.

Robotic microinjection enables large-scale transgenic studies of Caenorhabditis elegans

The nematode Caenorhabditis elegans is widely employed as a model organism to study basic biological mechanisms. However, transgenic C. elegans are generated by manual injection, which remains low-throughput and labor-intensive, limiting the scope of approaches benefitting from large-scale transgenesis. Here, we report a robotic microinjection system, integrating a microfluidic device capable of reliable worm immobilization, transfer, and rotation, for high-speed injection of C. elegans. The robotic system provides an injection speed 2-3 times faster than that of experts with 7–22 years of experience while maintaining comparable injection quality and only limited trials needed by users to become proficient. We further employ our system in a large-scale reverse genetic screen using multiplexed alternative splicing reporters, and find that the TDP-1 RNA-binding protein regulates alternative splicing of zoo-1 mRNA, which encodes variants of the zonula occludens tight junction proteins. With its high speed, high accuracy, and high efficiency in worm injection, this robotic system shows great potential for high-throughput transgenic studies of C. elegans.

Early treatment for Clostridioides difficile infection: retrospective cohort study.

Clostridioides difficile (CDI) is a common cause of infectious diarrhea. The current recommendation is to initiate empirical antibiotic treatment for suspected CDI who have an anticipated delay of confirmatory results or fulminant colitis. This is based on limited clinical trials. The study aims to examine the impact of early treatment on mortality and clinical outcomes. This retrospective cohort study included adult patients with CDI. Early treatment was defined as the initiation of an anti-Clostridioides medication within the first 24h following stool sampling. Outcomes were 30 and 90day mortality, length of hospital stay (LOS), recurrence, and colectomy rate. To address potential bias, propensity score matching followed by logistic regression was performed, P value less than 5% was considered statistically significant. Study cohort consisted of 796 patients; clinical characteristics were balanced following matching. There was no difference, in favor of early treatment, between the groups regarding 30day mortality and 90day mortality with HR of 0.91 (95% CI 0.56-1.47) and 0.7 (95% CI 0.45-1.08), respectively. No statistically significant difference in recurrence rate, ICU admission or colectomy rate was observed. The LOS was shorter in the early-treatment group with 6days vs. 8days. Early treatment for CDI had shortened hospital stay. However, it did not affect clinical outcomes in adult patients.

Eccentric compression behavior of CFRP-confined reactive powder concrete-filled steel tube slender columns

Ultra high and large-span structural components are needed in urban modernization construction to meet the engineering requirements. Reactive powder concrete-filled steel tubes (RPCFSTs) provide a cost-effective and efficient solution for optimizing space utilization in super high-rise buildings and enhancing the crossing capacity of bridge, which accords with such development. However, these components have inherent drawbacks in terms of local buckling and corrosion resistance. The use of carbon fiber reinforced polymer (CFRP) confinement to suppress this innate deficiency has been proven to show great advantages in limited trial results. This article establishes a comprehensive test scheme to investigate the eccentric compression performance of CFRP-confined RPCFST columns. A total of 11 specimens were prepared and subjected to biased compression test by varying the component length (400, 800, 1200, and 1600 mm), number of CFRP layers (0–3), and load eccentricity (0, 10, 20, 30, and 40 mm). The results showed that the CFRP confinement could effectively enhance the bearing capacity and energy dissipation capability of RPCFST columns while delaying the local buckling of slender specimens with low slenderness ratios. The improvement of ultimate load due to CFRP confinement exceeded 42.5 %. However, in specimens with higher slenderness ratios and with increasing load eccentricity, the confinement effect of the steel tube on the core RPC tended to weaken. An N–M interaction model for slender CFRP-confined RPCFST columns was established, and this model was validated to be in good agreement with the experimental results. The conclusions drawn from this study might given a solid foundation for the future application of CFRP-confined RPCFST structures.

Therapeutic Potential of Fecal Microbiota Transplantation in Type 2 Diabetes Mellitus: A Systematic Review.

Diabetes mellitus is a chronic metabolic disease characterized by insulin resistance and hyperglycemia. It can cause various complications, which result in significant morbidity and mortality. There are multiple treatment options available to combat this disease; however, despite this, the incidence of type 2 diabetes mellitus is continuously increasing. Some promising results have shown that dysbiosis has a role in the pathogenesis of type 2 diabetes mellitus and fecal microbiota transplantation (FMT) in animals; however, the usage of FMT in humans needs further clarification and review. We explored PubMed, Popline, and Cochrane Library to identify relevant papers. Eight articles were then finalized after screening and applying eligibility criteria. These articles explored the role of the therapeutic efficacy of FMT in insulin resistance and hyperglycemia. The studies showed that the FMT had a positive impact on managing hyperglycemia and insulin resistance, which is evident in the decline of blood glucose and HBA1c levels and the rise of insulin and C-peptides. In addition, FMT also helped to control other risk factors such as hyperlipidemia and blood pressure; however, the impact on weight loss is not convincing. FMT also influenced the levels of some microbiota, which could be involved in controlling hyperglycemia and insulin resistance. Due to limited control trials and study periods and the small sample size of diabetic patients, more research is needed to explore the impact of FMT in controlling type 2 diabetes mellitus.

Medical Cannabis Dosing Trajectories of Patients: Evidence From Sales Data

Medical cannabis use is rising with limited high-quality clinical trial data to guide dosing. This study relies on real-world, longitudinal medical cannabis purchase data to provide information on Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) dosing trends for patients with qualifying medical conditions. A retrospective study of purchases by 16,727 patients obtaining medical cannabis from dispensaries located in New York between 2016 and 2019, recorded in point-of-sale data. Group-based trajectory modeling was used to identify clusters of patients following similar progressions in dosing of THC and CBD over time. χ2 tests were performed to identify which patient characteristics and qualifying medical conditions were associated with membership in each trajectory group. Six trajectory groups were identified that described different patterns in the THC and CBD doses that patients purchased over the whole time period. For THC, the majority of patients (62.6%) purchased a steady amount but at different levels: consistently low (4.1 mg) or moderate (7.4 mg). Three groups, representing 22.0% together, exhibited doses that either fluctuate or constantly increase over time (5-20 mg). A final group of patients (15.8%) exhibited constant decrease in dose from 11 to 5 mg. For CBD, the data show similar trajectories, but at the generally higher values (4-16 mg). Patients with chronic pain, neuropathy, and cancer were overrepresented in groups where higher doses of THC were purchased over time. Patients with epilepsy had a higher representation in groups with higher doses of CBD across time. Results suggest heterogeneous dosing patterns and trajectories in the use of medical cannabis by patients with different medical conditions.

Flipbook Platform E-Module Development: Geographic Information Systems Subject

This research aims to determine the feasibility and effectiveness of e-modules with the Flipbook platform in the Geographic Information Systems (GIS) Class XI Geospatial Engineering subject at SMK Negeri 1 Percut Sei Tuan. This research applies the Research and Development (R&D) method with the ADDIE model (Analysis, Design, Develop, Implement, and Evaluate). The research subjects were 30 students of Class XI Geospatial Engineering at SMK Negeri 1 Percut Sei Tuan. This research involved validation tests by material experts, media experts, and learning design experts, as well as trial stages, namely individual trials on 3 students, small group trials on 6 students, and limited field trials on 30 students. The research results show that the E-Module with the Flipbook platform is suitable for use based on media expert validation of 89.17% (very feasible), material expert validation of 92.13% (very feasible), and learning design expert validation of 88.71% (very feasible). In the individual trial, the score was 91.47% (very decent), the small group trial got a score of 92.33% (very decent), and the field trial got a score of 96.14% (very decent). The use of E-Modules with the Flipbook platform in GIS subjects is more effective than conventional whiteboard media, as can be seen from the results of tcount = 1.91 and tTable = 1.672, where 1.91 > 1.672 at the significance level α = 0.05. This shows that H0 is is rejected, and the alternative hypothesis (Ha) is accepted. This means that there is a noticeable difference in student learning results between the experimental and control classes with a significance level of 5%. The effectiveness value of the E-Module with the Flipbook platform is higher, namely 84.7%, compared to student learning outcomes using whiteboard media of 80.8%.