Kosin University

This study investigates the types of English sentences used in the essays of Albanian middle school students in Kosova learning English as a Foreign Language (EFL), with a particular focus on syntactic structures. The topic was chosen due to the crucial role sentence variety plays in developing students' writing proficiency and enhancing clarity, engagement, and coherence in written communication. The primary objectives of the study are to identify the types of sentence structures and functions used by EFL learners and to highlight the importance of syntactic variety in academic writing. The research is grounded in syntactic theory, emphasizing the role of sentence structure in language development and written expression. A qualitative study with quantitative elements was conducted, using content analysis of student essays alongside numerical analysis of sentence types based on structure and function. Sixteen Albanian middle school students participated in the study, each submitting one essay on a topic of their own choice. Analysis of 164 sentences revealed that the most frequently used sentence structure was the simple sentence (97 occurrences), while declarative sentences were the most commonly used sentence function (143 instances). These findings indicate a strong preference among students for simple and declarative forms, suggesting limited syntactic range. The study concludes that relying heavily on a single sentence type may hinder the effectiveness of student writing, making it monotonous and harder to follow. Therefore, the ability to use a variety of sentence structures is essential for effective written communication. Mastery of syntax and grammar is fundamental, and language educators must prioritize teaching sentence diversity and grammatical accuracy to support students' writing development.

This study aimed to identify differences in perceived task performance, task importance, and educational needs for novice-level tasks among neonatal intensive care unit (NICU) nurses with varying levels of clinical experience and to provide foundational data for developing systematic educational programs to strengthen the competencies of novice nurses. Participants were recruited from the NICUs of three hospitals-one university-affiliated hospital and two general hospitals located in B Metropolitan City, South Korea. Using convenience sampling, 116 staff nurses with at least 3 months of NICU experience were surveyed between March and November 2025. For comparative analysis, participants were divided into three career groups based on their NICU experience: <3 years, 3-9 years, and ≥9 years. Data were analyzed using descriptive statistics, analysis of variance, and the Scheffé test with IBM SPSS ver. 25.0, and importance-performance analysis (IPA) was conducted to prioritize educational needs. Across all career groups, the "direct nursing performance" domain showed the highest task performance. Novice nurses with <3 years of experience reported significantly higher performance in central line care and transfusion management than those with ≥9 years of experience. The IPA identified central line management, and transfusion management as priority areas for improvement, while vital sign monitoring, respiratory surveillance and discharge education for parents were common educational needs regardless of experience level. Educational programs for novice NICU nurses should focus on strengthening patient safety-related competencies and should be progressively structured with simulation and case-based learning to enhance clinical performance.

Secondary cytoreductive surgery is considered for selected patients with recurrent ovarian cancer. Although evidence supports its impact on progression-free survival, its effect on overall survival remains controversial. This study aims to identify patient sub-groups that benefit most from secondary cytoreductive surgery. A systematic review and trial-level meta-analysis of randomized controlled trials published through March 2025 was conducted. The primary end points were pooled hazard ratio (HR) for overall survival and progression-free survival comparing secondary cytoreductive surgery plus chemotherapy versus chemotherapy alone. Sub-group analyses were performed based on histology, platinum-free interval, number of recurrent lesions, individualized model or Arbeitsgemeinschaft Gynäkologische Onkologie score, and residual disease status. Three randomized controlled trials involving 1249 patients were included in this meta-analysis. Patients with favorable validated selection scores (positive Arbeitsgemeinschaft Gynäkologische Onkologie or individualized model ≤4.7) showed significantly improved overall survival (HR 0.79, 95% confidence interval [CI] 0.66 to 0.96). Complete resection was associated with significantly better overall survival (HR 0.53, 95% CI 0.43 to 0.64) and progression-free survival (HR 0.51, 95% CI 0.42 to 0.61) than patients who had residual disease. A progression-free survival benefit was also observed in the non-high-grade serous histology (HR 0.52, 95% CI 0.38 to 0.72). In patients with a platinum-free interval of 6 to 12 months (SOC-1, 6-16 months), there was a significant trend toward improved overall survival (HR 0.70, 95% CI 0.55 to 0.91). Secondary cytoreductive surgery significantly improves progression-free survival and provides an overall survival benefit in carefully selected patients, particularly, those with a high likelihood of complete resection, favorable surgical selection scores, and a shorter platinum-free interval (<16 months). These findings highlight the critical role of patient selection and surgical completeness in optimizing outcomes for recurrent ovarian cancer.

Janus kinase (JAK) inhibitors are an important treatment option for ulcerative colitis, providing rapid onset of action, oral administration, and efficacy even after biologic failure. The 3 approved agents—tofacitinib, filgotinib, and upadacitinib—differ in JAK isoform selectivity, leading to clinically meaningful differences in efficacy and safety. Evidence from network meta-analyses, clinical trials, and real-world studies consistently shows that upadacitinib provides the highest efficacy for induction and maintenance of remission, whereas filgotinib demonstrates the most favorable safety profile. The strong efficacy of upadacitinib and tofacitinib is particularly relevant in patients with severe disease, including acute severe ulcerative colitis, and upadacitinib maintains high efficacy regardless of prior advanced therapy exposure. JAK inhibitors also benefit extraintestinal manifestations. Although risks such as herpes zoster, serious infection, thromboembolism, and major cardiovascular events differ among agents, long-term data suggest generally acceptable safety when used appropriately. Intraclass JAK-to-JAK cycling is feasible, with about half of patients achieving steroid-free clinical remission in retrospective cohorts. Based on mechanistic, clinical, and real-world evidence, filgotinib may be a first-line option for patients with lower disease activity or when safety is a priority, whereas upadacitinib or tofacitinib may be preferred in higher disease activity. Strategically selecting agents may improve durability and outcomes.

Background: Accurate assessment of liver fibrosis is critical for the management of chronic liver disease. Noninvasive biomarkers are increasingly being investigated as alternatives to liver biopsy. Platelet count has emerged as a potential predictor of advanced fibrosis and may complement established indices such as the fibrosis-4 (FIB-4) score and the aspartate aminotransferase-to-platelet ratio index (APRI).Methods: This prospective analysis included 101 patients with histologically confirmed data obtained through liver biopsy or hepatic resection. Platelet count, APRI, FIB-4, Model for End-Stage Liver Disease score, Mac-2 binding protein glycosylation isomer (M2BPGi), and albumin-bilirubin score were measured and correlated with fibrosis stage using the METAVIR scoring system. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to assess the predictive performance of each marker.Results: Platelet count demonstrated an inverse correlation with fibrosis severity and was identified as the most reliable predictor of advanced fibrosis (METAVIR ≥3), with an area under the ROC curve of 0.822. Using a cutoff value of 184,000, platelet count yielded a sensitivity of 69.2% and a specificity of 87.8% for the detection of significant fibrosis.Conclusions: Platelet count is a simple, widely available, and robust predictor of liver fibrosis, outperforming APRI, FIB-4, and M2BPGi in multivariate analysis. Validation in larger, independent cohorts is warranted to confirm its clinical utility.

Purpose: We developed evidence-based recommendations for selecting and initiating the enteral nutrition (EN) delivery route in adult and pediatric patients to improve safety and standardize practice in Korea.Methods: Key questions covered feeding tube selection, methods to verify tube placement, confirmation in pediatric patients, and timing of EN following percutaneous endoscopic gastrostomy (PEG). Recommendations were drafted and refined through multidisciplinary expert consensus under the Korean Society for Parenteral and Enteral Nutrition (KSPEN).Results: Feeding tube selection should be based on gastrointestinal anatomy, function, and expected EN duration. Short-term feeding is recommended with nasogastric or orogastric tubes, whereas long-term feeding should use percutaneous or surgical routes such as PEG. Tube position must always be verified before use, preferably with radiography or pH testing; auscultation alone is unreliable and should not be used. In pediatric patients, radiographic confirmation remains the gold standard, although pH testing and insertion-length assessment may be considered when imaging is not feasible. After PEG, EN can be initiated safely within 4 hours in both adults and children without increasing complications if trained staff monitor for leakage or infection.Conclusion: This guideline offers a structured framework for safe and timely EN tailored to patient characteristics. Early verification and multidisciplinary collaboration help reduce complication, improving outcomes of EN therapy.

Background: Flavopiridol (Flavo), a synthetic flavonoid derived from Dysoxylum binectariferum, broadly inhibits cyclin-dependent kinases (CDKs) that regulate transcription in proliferative cells. In the peripheral nervous system, Schwann cells exhibit transcriptional changes during peripheral neurodegenerative processes (PNPs), involving c-Jun and Krox20 as key regulators. Additionally, hydrogen sulfide (H2S) promotes neuroprotection by activating the Wnt/β-catenin pathway, which induces cyclin D1 via β-catenin nuclear translocation. Methods: To assess the therapeutic potential of Flavo in the PNPs, we conducted experiments targeting Schwann cell responses both in vivo and ex vivo. Moreover, we examined changes in transcriptional regulation, focusing on c-Jun and Krox20, and analyzed the effect of Flavo on the H2S/β-catenin/CDK signaling pathway using Western blot and morphological evaluation of demyelination, axonal degeneration, and Schwann cell proliferation. Results: Flavo modulated Schwann cell transcription by shifting the c-Jun/Krox20 balance and significantly suppressed abnormal Schwann cell proliferation. The in vivo analysis revealed that Flavo dose-dependently reduced demyelination and axonal degeneration. Mechanistically, Flavo inhibited the H2S/β-catenin/CDK axis, reducing β-catenin nuclear translocation. Conclusion: Our findings suggest that Flavo provides multifaceted protection in peripheral nerves by correcting transcriptional dysregulation and attenuating key pathological features of Schwann cell dysfunction. Administering Flavo, in relation to the H2S/β-catenin/CDK pathway, may represent a promising therapeutic strategy for peripheral neurodegenerative diseases through multitarget transcriptional modulation.

Background/AimsDespite international guidelines recommending against the use of 5-aminosalicylic acid (5-ASA) for Crohn’s disease (CD), it remains widely prescribed. This study aimed to investigate current patterns of 5-ASA use and physicians’ perceptions of its efficacy among Korean specialists.MethodsA nationwide online survey was conducted in August 2025 targeting Korean gastroenterologists and colorectal surgeons managing inflammatory bowel disease. The questionnaire included 19 items addressing prescribing behaviors, perceived efficacy, and clinical decision-making regarding 5-ASA in CD.ResultsA total of 118 out of 124 physicians (95.2%) responded to the survey. The majority (67.8%) reported prescribing 5-ASA to more than half of their patients with CD. Standard to high doses (> 2 g/day) were commonly used (94.9%), and time-dependent formulations were preferred (92.4%). Although 55.1% used 5-ASA irrespective of disease location, it was frequently prescribed for colonic/ileocolonic disease (57.7%). Physicians primarily used 5-ASA in cases of non-active or mildly active CD. Notably, over 70% of respondents perceived 5-ASA to have a marginal yet beneficial effect on clinical remission, biomarker improvement, and mucosal healing. Approximately one-third of physicians reported continuing 5-ASA even after initiating biologics or small molecules.ConclusionsThis survey reveals a substantial gap between clinical guidelines and current practice in Korea regarding 5-ASA use for CD. Many physicians continue to view 5-ASA as a relevant option, particularly for patients with low inflammatory burden. These discrepancies likely reflect practical factors such as clinical experience and drug characteristics, which should be carefully considered before excluding 5-ASA from CD management.