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Abstract Background Merkel cell carcinoma is a rare skin cancer associated with poor survival. Based on a previous Phase II trial of adults with advanced Merkel cell carcinoma by Kim and colleagues (2022), there is now a strong rationale for combination therapy (i.e., nivolumab and ipilimumab) to become a treatment option for patients with advanced Merkel cell carcinoma. The goal of this paper was to report on the secondary outcome of quality of life (QOL) among patients on this trial. Methods Patients receiving combined nivolumab and ipilimumab, with or without stereotactic body radiation therapy (SBRT), completed the European Organisation for Research and Treatment of Cancer (EORTC) QLQ‐C30 prior to starting treatment and every 2 weeks thereafter. Changes in QOL during treatment and post‐treatment were evaluated using piecewise random‐effects mixed models. Exploratory analyses compared changes in QOL between study arms. The original trial was registered with ClinicalTrials.gov (NCT03071406). Results Study participants (n = 50) reported no changes in overall QOL (ps > 0.05), but emotional functioning improved during treatment (p = 0.01). Cognitive and social functioning worsened post‐treatment (ps

Abstract Background A phase 2 cemiplimab study (NCT03132636) demonstrated a 24.1% objective response rate in patients diagnosed with metastatic basal cell carcinoma (mBCC) who were not candidates for continued hedgehog inhibitor (HHI) therapy due to intolerance to previous HHI therapy, disease progression while receiving HHI therapy, or having not better than stable disease on HHI therapy after 9 months. Here, health‐related quality of life (QoL) for this patient population is reported. Methods Adult patients with mBCC were treated with intravenous cemiplimab at a dose of 350 mg every 3 weeks for 5 treatment cycles of 9 weeks/cycle then 4 treatment cycles of 12 weeks/cycle. Patients completed the European Organisation for Research and Treatment of Cancer Quality of Life‐Core 30 (QLQ‐C30) and Skindex‐16 questionnaires at baseline and Day 1 of each cycle. Across Cycles 2 to 9, the overall change from baseline was analyzed using a mixed model with repeated measures. Responder analyses determined clinically meaningful improvement or deterioration (changes ≥10 points) or maintenance across all scales. Results Patients reported low symptom burden and moderate‐to‐high functioning at baseline. Maintenance for QLQ‐C30 global health status (GHS)/QoL and across all functioning and symptom scales was indicated by overall mean changes from baseline. Clinically meaningful improvement or maintenance was reported at Cycle 2 for GHS/QoL (77%), functioning scales (77% to 86%), and symptom scales (70% to 93%), with similar proportions of improvement or maintenance at Cycles 6 and 9, excluding fatigue. On the Skindex‐16, clinically meaningful improvement or maintenance was reported across the emotional, symptom, and functional subscales, in 76%–88% of patients at Cycle 2, which were generally maintained at Cycles 6 and 9. Overall mean changes from baseline showed maintenance across these subscales. Conclusions The majority of patients treated with cemiplimab reported improvement or maintenance in GHS/QoL and functioning while maintaining a low symptom burden.

Polymers are the main building blocks of plastic, with the annual global production volume of fossil carbon-based polymers reaching over 457 million metric tons in 2019 and this figure is anticipated to triple by 2060. There is potential for environmental harm and adverse human health impacts associated with plastic, its constituent polymers and the chemicals therein, at all stages of the plastic life cycle, from extraction of raw materials, production and manufacturing, consumption, through to ultimate disposal and waste management. While there have been considerable research and policy efforts in identifying and mitigating the impacts associated with problematic plastic products such as single-use plastics and hazardous chemicals in plastics, with national and/or international regulations to phase out their use, plastic polymers are often overlooked. In this review, the polymer dimension of the current knowledge on environmental release, human exposure and health impacts of plastic is discussed across the plastic life cycle, including chemicals used in production and additives commonly used to achieve the properties needed for applications for which the polymers are generally used. This review focuses on polycarbonate, polystyrene, polyvinyl chloride, and polybutadiene, four common plastic polymers made from the hazardous monomers, bisphenol, styrene, vinyl chloride and 1,3-butadiene, respectively. Potential alternative polymers, chemicals, and products are considered. Our findings emphasise the need for a whole system approach to be undertaken for effective regulation of plastics whereby the impacts of plastics are assessed with respect to their constituent polymers, chemicals, and applications and across their entire life cycle.

Aim Conflicting results have been reported regarding the association between fluoroquinolones (FQs) and the risk of out-of-hospital cardiac arrest (OHCA). In particular, it has not become clear whether OHCA in FQ users is related to the inherent comorbidities or whether there is a direct pro-arrhythmic effect of FQs. Therefore, we studied the relation between FQs and OHCA in the general population.Methods Through Danish nationwide registries, we conducted a nested case–control study with OHCA cases of presumed cardiac causes and age/sex/OHCA date-matched non-OHCA controls from the general population. Conditional logistic regression models with adjustments for well-known risk factors of OHCA were employed to estimate the OR with 95% CI of OHCA comparing FQs with amoxicillin.Results The study population consisted of 46 578 OHCA cases (mean: 71 years (SD: 14.40), 68.8% men) and 232 890 matched controls. FQ was used by 276 cases and 328 controls and conferred no increase in the odds of OHCA compared with amoxicillin use after controlling for the relevant confounders (OR: 0.91 (95% CI: 0.71 to 1.16)). The OR of OHCA associated with FQ use did not vary significantly by age (OR≤65: 0.96 (95% CI: 0.53 to 1.74), OR>65: 0.88 (95% CI: 0.67 to 1.16), p value interaction=0.7818), sex (ORmen: 0.96 (95% CI: 0.70 to 1.31), ORwomen: 0.80 (95% CI: 0.53 to 1.20), p value interaction=0.9698) and pre-existing cardiovascular disease (ORabsent: 1.02 (95% CI: 0.57 to 1.82), ORpresent: 0.98 (95% CI: 0.75 to 1.28), p value interaction=0.3884), including heart failure (ORabsent: 0.93 (95% CI: 0.72 to 1.22), ORpresent: 1.11 (95% CI: 0.61 to 2.02), p value interaction=0.7083) and ischaemic heart disease (ORabsent: 0.85 (95% CI: 0.64 to 1.12), ORpresent: 1.38 (95% CI: 0.86 to 2.21), p value interaction=0.6230).Conclusion Our findings do not support an association between FQ exposure and OHCA in the general population. This lack of association was consistent in men and women, in all age categories, and in the presence or absence of cardiovascular disease.

The aim of this study is to examine the views of ninth grade students about 5E-based STEM learning strategies in the atomic and periodic system unit. The research was carried out with phenomenology which is one of the qualitative research designs. Purposive sampling was used and eight students participated in the study. The data was collected through a semi-structured interview at the end of the intervention and analyzed by content analysis. Based on findings, students emphasized that 5E-based STEM learning strategies promote their meaningful learning. Although the participants mentioned that 5E-based STEM learning strategies had advantages in terms of meaningful learning, they thought that this strategy could not be implemented efficiently due to the difficulties they experienced during the 5E-based STEM learning strategies as the incompatibility with the university entrance examination system. It was recommended that student-centered teaching methods should be utilized and students should be active in their learning process in order to overcome these difficulties.

The study aims to examine parents' opinions about Emergency Remote Education (ERE) during the pandemic and the feasibility of home-schooling in Turkey. The study uses a causal-comparative model. 654 parents took part in the study. ERE for Homeschooling Questionnaire developed by researchers is used to collect the data. Descriptive statistics, independent samples t-test, and ANOVA tests are used to analyse the data. The results of the study show that ERE during the pandemic is not effective enough. However, having someone at home to support the education of children can make ERE more effective. Parents have partial health anxiety about face-to-face education. Although parents have partially positive opinions about the feasibility of home-schooling, they also emphasize the need for support for home-schooling. As the parents' education level increases, both the challenges of home-schooling and the need for support for home-schooling decrease. Parents with low income have higher health anxiety than those with high income, and parents with low income need more support for home-schooling than those with high income. Parents who support their children's learning find ERE more effective and they find home-schooling more feasible. Parents who do not support their children's learning at home need more support for homeschooling. To practice home-schooling successfully, parents must have high level of education and must support their children's learning at home. Besides, institutions and organizations support parents for home-schooling.

The purpose of the study is to reveal the professional development barriers of teachers. The study was designed in the qualitative approach and as the research method, "phenomenology" was used. The maximum variation sampling method, which is one of the purposive sampling methods, was used in the selection of the study group. Since high school teachers face the phenomenon of professional development more often, the study was carried out with twelve branch teachers who work in high schools in Elazig city center in Turkey. Participants have the maximum variation in terms of participant profiles like gender, branch, seniority and educational level variables. The semi-structured interview was used as the data collection tool. Qualitative data was analyzed by using the descriptive analysis method. The results of the study indicated that teachers' professional development barriers were the inadequacy of in-service training, problems in school functioning, individual problems and other problems. Also, professional development barriers such as negative attitudes towards in-service training courses, inconvenient course time, the monotony of course content, inefficacy of course trainers, out of content knowledge, unsatisfactory performance evaluation, heavy workload, financial problems and, lack of professional development opportunities were emphasized more by the participants. The results of the study are consistent with the results of other studies in the literature on teachers' professional development. It was emphasized by the researchers that professional development programs should be developed according to the characteristics of effective professional development programs and, the professional development of teachers should be supported by stakeholders in order to overcome these obstacles.

The purpose of this study is to seek into middle school students' opinions on the use of digital storytelling in Turkish course. In this research, phenomenology, one of the qualitative research methods, was used. The study group was composed of 18 students in the 7th grade of a private middle school affiliated to the Central District of Kars. Semi-structured interview form and personal information form were used as data collection tools. The interview form contains 7 questions. Content analysis was employed for the analysis of the interviews. As a result of analysis it was concluded that students found this process entertaining and instructive students did not have any challenges at all; they enjoyed creating music and recording sounds. But they wanted more different types of music, and more variety in text fonts and visuals. In short, it can be said that the opinions of the 7th graders learning digital storytelling about the process are positive.

In the field of critical care medicine, substantial research efforts have focused on identifying high-risk patient groups. This research has led to the development of diverse diagnostic tools, ranging from basic biomarkers to complex indexes and predictive algorithms that integrate multiple methods. Given the ever-evolving landscape of medicine, driven by rapid advancements, changing treatment strategies, and emerging diseases, the development and validation of diagnostic tools remains an ongoing and dynamic process. Specific changes in complete blood count components, such as neutrophils, lymphocytes, monocytes, and platelets, are key immune system responses influenced by various factors and crucial in systemic inflammation, injury, and stress. It has been reported that indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and delta neutrophil index calculated using various ratios of these elements, are important predictors of various outcomes in conditions where the inflammatory process is at the forefront. In this narrative review, we concluded that NLR, PLR, SII, and SIRI show promise in predicting outcomes for different health conditions related to inflammation. While these tests are accessible, reliable, and cost-effective, their standalone predictive performance for a specific condition is limited.

Aim:Idiopathic peripheral facial paralysis [Bell’s palsy (BP)] is the most common cause of acute, one-sided facial paralysis, whose etiopathogenesis is currently unknown. However, inflammation is considered to play a role in etiopathogenesis. In this study, we examined the relationship between hematologic parameters and indices in children with BP.Methods:The study included 60 pediatric patients diagnosed with BP between December 2017 and May 2022 and 60 healthy controls of the same age and gender. The relationship between the patient and control cohorts and between the severity of the disease and inflammation markers was analyzed. Low-severe BP (House-Brackmann classification grade 2-3) and high-severe BP (House-Brackmann classification grade 4-5) were grouped. Complete blood count parameters and hematologic indices [neutrophil count/lymphocyte count (NLR), platelet count/lymphocyte count (PLR), monocyte count/lymphoid count (MLR), and platelet mass index] were recorded as inflammation markers.Results:55% of the patients had BP on the right side, 48.3% had grade 3, and 30.0% had grade 4 facial paralysis. Leukocyte, neutrophil, lymphocyte, monocyte, and platelet counts were significantly higher in the patient group than in the control group (p-values p

Objective: This study examined the relationship between sensory processing (SP) differences and behavioral problems in children with autism spectrum disorder (ASD). We also investigated whether audiological test results could objectively detect auditory processing differences. Method: Forty-six children with ASD, ages 3-9 years, were enrolled in the study. Problematic behaviors and sensory processing of children were assessed using scales. The otolaryngologist performed a detailed head and neck examination and a formal audiological examination was performed by an audiologist. Results: Stereotypy, hyperactivity, and irritability were related to sensation seeking. Stereotypy was also associated with visual processing. Touch processing differences was related to irritability and inappropriate speech. Lethargy was associated with auditory processing. There were no differences in SP and behavior problems in the children whose audiological profiles could be measured between those who passed or failed the test. Conclusion: There was an association between SP differences and behavioral problems in children with ASD, supporting previous studies. Audiological test results did not reveal the SP differences documented in the parent forms.

This study was conducted to examine the self-efficacy belief levels of preservice Turkish language education teachers on educational internet use in terms of various variables. The sample of the study was selected based on the non-random purposive sampling method and 197 preservice Turkish language education teachers who agreed to participate in and answer the questions in the scale generated the sample of the study. The study was conducted as a survey research and the data was collected via "Educational Internet Usage Self-Efficacy Beliefs Scale" which was developed by Akgün et al. (2017) and which consists of 26 items in 5-point-likert scale. The findings of the study present that the self-efficacy belief levels of preservice Turkish language education teachers on educational internet usage do not differ significantly according to the gender, class level and age variables. On the other hand, the self-efficacy belief levels of the preservice Turkish language education teachers on educational internet usage differ significantly according to computer using experience, weekly internet using time period, having an education on educational internet use and perceptions on the level of competence in using FATIH Project technologies within the education. It is highly recommended that similar studies with different and wider samples should be conducted in the future.

The aim of the study is to examine the effect of aerobic and aerobic-submaximal exercise on adolescents who are at risk of obesity. This research is an experimental study in the screening model. The sample group consists of volunteer 72 students but it continued with the 45 healthy volunteer students. The exercise groups were organized according to the same level age (12 years) by basing on resting pulse. The study was divided into three groups consisting 15 (8 girls, 7 boys), as control, aerobic exercise and aerobic-submaximal exercise. Data of the study were uploaded to the SPSS program and statistical procedures were measured by the Independed Sample T test, the Paired Sample T test and the Anova test. The level of significance was adopted as [alpha] = 0.05. In our study, there was no significant difference in height, body mass index (BMI), waist circumference, waist circumference, waist hip ratio, body fat percentage (BFP), body fat mass (BFM), body muscle mass (BMM) variance in control group (p < 0.05). While there was no significant difference in height variable in the group performing aerobic exercise, there was a significant difference in BMI, waist circumference, hip circumference, BFP, BFM, BMM variance (p < 0.05). While there was no significant difference in height variable in the group performing aerobic-submaximal running exercise, there was a similar difference in BMI, waist circumference, hip circumference, BFP, BFM, BMM (p < 0.05). In our study, between all girls and boys in all groups, men's waist circumference (p < 0.05), hip circumference (p < 0.10), BFP (p < 0.05) and BFM (p < 0.05) values were found more significant than women's. In this study, while there was no significant difference in height, weight, waist hip ratio in aerobic exercise and aerobic submaximal exercise method and significant difference (p < 0.05) was found in waist circumference, hip circumference, BMI, BFP, BFM, BMM. The hip circumference of the group applied the aerobic exercise method had a significant effect on the BFP variables compared to the aerobic-submaximal exercise group.

This study aims to investigate the relationship between general self-efficacy and scientific epistemological beliefs of the students in the school of physical education and sports. The study group consists of 400 students (174 female, 226 male) in total. Personal information form created by researchers and "Scientific Epistemological Beliefs Scale" transcribed to Turkish by Acat, Gülçin, and Karadag (2010) and "Self Efficacy Scale" transcribed to Turkish by Yesilay (1996) has been used as a data collector in the study. In the analysis of data, the T-test has been used in the comparison of quantitative continuous data between two independent groups and the One Way Anova test has been used in the comparison of quantitative continuous data between more than two independent groups. Scheffe test has been used as the completive post hoc analysis to determine the differences after the Anova test. Pearson correlation test has been implemented between the continuous variables of the study. As a result of the study, it has been seen that there is a significant difference on behalf of the ones who are 20 years old and over informing information as one of the scientific epistemological sub-dimensions on behalf of the students of Bingöl University (p<0.05). It has been also seen that there is a significant difference on behalf of Ankara University students and females in the gender variable in general self-efficacy points (p<0,05). It has not been seen that there is a significant difference in other variables (p>0.05).

The study aims to reveal Turkish Language teacher candidates' metaphorical perceptions of the concept of digital story. The study is phenomenological research, which is one of the qualitative research approaches. The study group consists of 68 Turkish Language teacher candidates studying at Firat University, Education Faculty, Department of Turkish Language Education in 2018-2019. The study uses a purposeful sampling method to determine the study group of the study. To determine the teacher candidates' metaphorical perceptions of the concept of the digital story, the study employs a metaphor questionnaire form developed by the researchers. The metaphors obtained are analyzed according to their reasons, and themes are created. As a result of the research, it is revealed that teacher candidates perceive digital stories as an instructional, mind-building, versatile, facilitating, entertaining, curious, relaxing, remarkable, and transparent tool. These results confirm that digital stories should be used in the training of Turkish Language teacher candidates, and other teacher candidates as well.