Background and Objectives: Monosyllable words are the most common speech recognition stimuli since they test auditory perception and are used to assess speech recognition. However, there is a lack of resources available for the Urdu-speaking Pakistani population. This study aims to develop and psychometrically evaluate a digitally recorded Urdu monosyllabic word list for Word Recognition Score (WRS) testing. Subjects and Methods: A total of 135 monosyllabic words were selected from a previous study. These words were digitally recorded by a native female Urdu speaker in a studio. The recordings were psychometrically assessed by 30 native Urdu speakers with normal hearing. The 100 most familiar words were selected and organized into two lists, each further divided into four halves to ensure that the words were relatively homogeneous in terms of audibility. Results: The average psychometric slope between 20% and 80% for the full list was 4.78%/dB±0.22%/dB, while it was 4.81%/dB±0.35%/dB for the half list. No statistically significant difference in p-values was observed between the full and half lists. The mean psychometric slope for 50% intelligibility was 6.04%/dB for both the full list (SD=0.44) and the half lists (SD=0.40). Conclusions Digitally recorded Urdu monosyllabic word lists are valid for assessing speech recognition in native Urdu speakers with normal hearing.

Background and Objectives: Monosyllable words are the most common speech recognition stimuli since they test auditory perception and are used to assess speech recognition. However, there is a lack of resources available for the Urdu-speaking Pakistani population. This study aims to develop and psychometrically evaluate a digitally recorded Urdu monosyllabic word list for Word Recognition Score (WRS) testing. Subjects and Methods: A total of 135 monosyllabic words were selected from a previous study. These words were digitally recorded by a native female Urdu speaker in a studio. The recordings were psychometrically assessed by 30 native Urdu speakers with normal hearing. The 100 most familiar words were selected and organized into two lists, each further divided into four halves to ensure that the words were relatively homogeneous in terms of audibility. Results: The average psychometric slope between 20% and 80% for the full list was 4.78%/dB±0.22%/dB, while it was 4.81%/dB±0.35%/dB for the half list. No statistically significant difference in p-values was observed between the full and half lists. The mean psychometric slope for 50% intelligibility was 6.04%/dB for both the full list (SD=0.44) and the half lists (SD=0.40). Conclusions Digitally recorded Urdu monosyllabic word lists are valid for assessing speech recognition in native Urdu speakers with normal hearing.

Cranial prostheses are frequently required for patients with cranial defects secondary to trauma, decompressive craniectomy, or other pathologies. When the resected or craniotomized bone cannot be reused, cranioplasty with artificial materials offers both aesthetic and protective benefits. However, high-end custom-made options, like polyether ether ketone or titanium prostheses, are expensive and not widely available. Heat-cured polymethyl methacrylate (PMMA) prostheses are generally preferred over their cold-cured counterparts. In-house dental laboratories can provide a cost-effective and practical solution by employing a lost-wax technique akin to denture fabrication, utilizing a three-dimensional printed custom open mold. Fabricating large heatcured PMMA cranioplasts presents certain challenges, such as the need for large flasks and potential porosity. These can be overcome by using a large stainless steel container (a tiffin box) and M-Seal epoxy to ensure an airtight curing process. This method can be easily adopted by standard dental laboratories. At our center, four patients have successfully fitted with cranioplasty prostheses produced using this technique. Even though the patients are outside of the scope of this technical note all of them indicated high satisfaction, and no complications were reported. This straightforward approach demonstrates that in-house, heat-cured PMMA cranioplasts can represent a viable, cost-effective option for cranial reconstruction.

Cranial prostheses are frequently required for patients with cranial defects secondary to trauma, decompressive craniectomy, or other pathologies. When the resected or craniotomized bone cannot be reused, cranioplasty with artificial materials offers both aesthetic and protective benefits. However, high-end custom-made options, like polyether ether ketone or titanium prostheses, are expensive and not widely available. Heat-cured polymethyl methacrylate (PMMA) prostheses are generally preferred over their cold-cured counterparts. In-house dental laboratories can provide a cost-effective and practical solution by employing a lost-wax technique akin to denture fabrication, utilizing a three-dimensional printed custom open mold. Fabricating large heatcured PMMA cranioplasts presents certain challenges, such as the need for large flasks and potential porosity. These can be overcome by using a large stainless steel container (a tiffin box) and M-Seal epoxy to ensure an airtight curing process. This method can be easily adopted by standard dental laboratories. At our center, four patients have successfully fitted with cranioplasty prostheses produced using this technique. Even though the patients are outside of the scope of this technical note all of them indicated high satisfaction, and no complications were reported. This straightforward approach demonstrates that in-house, heat-cured PMMA cranioplasts can represent a viable, cost-effective option for cranial reconstruction.

Background/Aims: Self-expanding metallic stents (SEMS) are an alternative to emergency surgery (ES) for malignant colorectal obstruction. This study aimed to compare surgical outcomes between SEMS as a bridge to surgery (BTS) and ES in patients with malignant colorectal obstruction. Methods: A comprehensive database search was conducted until October 2023 to compare outcomes between SEMS as a BTS and ES. A subgroup analysis of results by malignancy site was performed. Results: We analyzed 57 studies, including 7,223 patients over a mean duration of 35.4 months. SEMS as a BTS showed clinical and technical success rates of 88.0% (95% confidence interval [CI], 86.1%–90.1%; I2=68%) and 91.6% (95% CI, 89.7%–93.7%; I2=66%), respectively. SEMS as a BTS revealed reduced postoperative adverse events (odds ratio [OR], 0.51; 95% CI, 0.41–0.63; I2=70%; p<0.001) and 30-day mortality (OR, 0.52; 95% CI, 0.37–0.72; I2=10%; p<0.001) compared to ES. Subgroup analysis showed postoperative mortality of 5% and 1.5% for left- and right-sided malignancies, respectively. Adverse events were 15% and 33% for the right and left colon, respectively. Conclusions SEMS as a BTS demonstrated a higher success rate, fewer postoperative adverse events, and a reduced 30-day mortality rate than ES, supporting its use as the preferred initial intervention for right- and left-sided obstructions and indicating broader clinical adoption.

Background/Aims: The irregular Z-line, defined as a segment of columnar mucosa less than 1 cm in the distal esophagus, is often biopsied despite guidelines advising against it due to a low risk of progression to esophageal adenocarcinoma (EAC). However, the clinical significance of an irregular Z-line remains unclear. This meta-analysis examines the prevalence of Barrett’s esophagus, dysplasia, and EAC in patients with an irregular Z-line. Methods: We searched Medline, Embase, and Scopus databases up to October 2023 for studies on the prevalence of Barrett’s esophagus, dysplasia, and EAC in these patients. A random-effects model was used for meta-analysis, and heterogeneity was assessed using I2 statistics. Results: Nine studies involving 17,637 patients were analyzed. Among those with an irregular Z-line, the prevalence of intestinal metaplasia was 29.4%. In patients with intestinal metaplasia, dysplasia was found in 6.2%, low-grade dysplasia in 5.9%, high-grade dysplasia in 1.6%, and EAC in 1.5%. These rates were higher compared to those without intestinal metaplasia. Conclusions Patients with an irregular Z-line and intestinal metaplasia may be at higher risk and could benefit from endoscopic surveillance. Further studies are needed to determine the necessity of biopsying irregular Z-lines.

Background/Aims: Self-expanding metallic stents (SEMS) are an alternative to emergency surgery (ES) for malignant colorectal obstruction. This study aimed to compare surgical outcomes between SEMS as a bridge to surgery (BTS) and ES in patients with malignant colorectal obstruction. Methods: A comprehensive database search was conducted until October 2023 to compare outcomes between SEMS as a BTS and ES. A subgroup analysis of results by malignancy site was performed. Results: We analyzed 57 studies, including 7,223 patients over a mean duration of 35.4 months. SEMS as a BTS showed clinical and technical success rates of 88.0% (95% confidence interval [CI], 86.1%–90.1%; I2=68%) and 91.6% (95% CI, 89.7%–93.7%; I2=66%), respectively. SEMS as a BTS revealed reduced postoperative adverse events (odds ratio [OR], 0.51; 95% CI, 0.41–0.63; I2=70%; p<0.001) and 30-day mortality (OR, 0.52; 95% CI, 0.37–0.72; I2=10%; p<0.001) compared to ES. Subgroup analysis showed postoperative mortality of 5% and 1.5% for left- and right-sided malignancies, respectively. Adverse events were 15% and 33% for the right and left colon, respectively. Conclusions SEMS as a BTS demonstrated a higher success rate, fewer postoperative adverse events, and a reduced 30-day mortality rate than ES, supporting its use as the preferred initial intervention for right- and left-sided obstructions and indicating broader clinical adoption.

Background/Aims: The irregular Z-line, defined as a segment of columnar mucosa less than 1 cm in the distal esophagus, is often biopsied despite guidelines advising against it due to a low risk of progression to esophageal adenocarcinoma (EAC). However, the clinical significance of an irregular Z-line remains unclear. This meta-analysis examines the prevalence of Barrett’s esophagus, dysplasia, and EAC in patients with an irregular Z-line. Methods: We searched Medline, Embase, and Scopus databases up to October 2023 for studies on the prevalence of Barrett’s esophagus, dysplasia, and EAC in these patients. A random-effects model was used for meta-analysis, and heterogeneity was assessed using I2 statistics. Results: Nine studies involving 17,637 patients were analyzed. Among those with an irregular Z-line, the prevalence of intestinal metaplasia was 29.4%. In patients with intestinal metaplasia, dysplasia was found in 6.2%, low-grade dysplasia in 5.9%, high-grade dysplasia in 1.6%, and EAC in 1.5%. These rates were higher compared to those without intestinal metaplasia. Conclusions Patients with an irregular Z-line and intestinal metaplasia may be at higher risk and could benefit from endoscopic surveillance. Further studies are needed to determine the necessity of biopsying irregular Z-lines.

Cranial prostheses are frequently required for patients with cranial defects secondary to trauma, decompressive craniectomy, or other pathologies. When the resected or craniotomized bone cannot be reused, cranioplasty with artificial materials offers both aesthetic and protective benefits. However, high-end custom-made options, like polyether ether ketone or titanium prostheses, are expensive and not widely available. Heat-cured polymethyl methacrylate (PMMA) prostheses are generally preferred over their cold-cured counterparts. In-house dental laboratories can provide a cost-effective and practical solution by employing a lost-wax technique akin to denture fabrication, utilizing a three-dimensional printed custom open mold. Fabricating large heatcured PMMA cranioplasts presents certain challenges, such as the need for large flasks and potential porosity. These can be overcome by using a large stainless steel container (a tiffin box) and M-Seal epoxy to ensure an airtight curing process. This method can be easily adopted by standard dental laboratories. At our center, four patients have successfully fitted with cranioplasty prostheses produced using this technique. Even though the patients are outside of the scope of this technical note all of them indicated high satisfaction, and no complications were reported. This straightforward approach demonstrates that in-house, heat-cured PMMA cranioplasts can represent a viable, cost-effective option for cranial reconstruction.

Chronic kidney disease (CKD) affects 8%-15% of the population globally and can cause renal failure, partly due to lack of effective treatments and drug targets. Three novel cembrane diterpenoids papyifurans A‒C (1-3), in particular of 1 with an unprecedented trioxatetracyclo[10.2.1.1^2,5.1^6,9]heptadecane polyether scaffold, derived from Boswellia papyrifera resin, were found to effectively protect against renal fibrosis in vitro and in vivo. Their structures were fully characterized using a combination of spectroscopic, computational, modified Mosher's, and X-ray crystallographic analysis. In particular, we performed chemical proteomic analyses and found that Elongation factor 2 (EEF2) is the key target of compound 1 for anti-renal fibrosis in vitro. Moreover, previous studies have linked EEF2 with lung fibrosis, while compound 1 was found to inhibit the hallmarks of organ fibrosis in vitro. Such effects were observed to decrease with the knock down of EEF2 in vitro, suggesting that EEF2 might be a universal drug target of organ fibrosis. Collectively, the present study demonstrated an example of identifying drug targets by using structurally novel natural products, which will be beneficial for developing therapeutic agents against organ fibrosis.