gression of presbycusis.Smoking is considered as one of the major reasons behind genetic variations in cardiometabolic disorders. However, effect of nicotine via smoking on Pakistani population still needs to be elucidated. This study was aimed to investigate genetic variation among PPAR-γ, FTO, and ABCC8 genes in cardiometabolic patients along with their biochemical parameters. A total of 472 CVD patients were enrolled in this study and divided into three groups; n = 144 for PPAR-γ (C/G) variation and n = 164 in each group to investigate FTO (T/A) and ABCC8 (G/T) variation, respectively. Polymorphisms within groups were identified by using Tetra and/or Tri ARM-PCR. This study showed positive association among genetic polymorphisms in PPAR-γ, FTO, and ABCC8 groups with altered metabolic parameters in CVD patients. Findings showed that smoking is major contributory factor for genetic polymorphism that was strongly associated with elevated blood glucose and serum TGs accompanying PPAR-γ, FTO, and ABCC8 genetic polymorphism in 25%, 24%, and 20% in smokers and 11%, 10%, and 5% in non-smoker CVD patients, respectively. However, highest polymorphism occurred in PPAR-γ both in smokers and non-smoker CVD patients that show that smoking-mediated gene polymorphism might be a contributory factor in provoking CVD risk approximately twice in smokers as compared to that in non-smoker CVD patients.Constructed ditch wetland (CDW) is a combination of idle ditch and constructed wetland, which is typically used in rural areas to remove pollutants from domestic wastewater. However, its low total nitrogen (TN) removal remains a pressing issue. To enhance total nitrogen removal, an approach of supplying water at two locations in the CDW at different influent flow ratios, combined with artificial aeration, was proposed to adjust carbon and oxygen distribution in the system. The highest average TN removal was achieved at low influent concentration (CDW4; influent flow ratio 12). The removal of TN in winter and spring were 58.93 and 83.26%, respectively. The distribution of carbon sources in the back zone enhanced denitrification. Of the high influent concentration treatments, CDW2 (21) achieved 16.97% more TN removal on average compared with CDW1 (30), after extra artificial aeration was applied in the front zone. However, nitrification was a limiting step in the system, which became the primary problem preventing pollutant purification. Moreover, nitrifying bacteria abundance was negatively correlated to the influent flow ratio and autotrophic denitrifying bacterial abundance was positively correlated to the influent flow ratios. Graphical abstract. Functional impairments and socioeconomic constraints associated with stroke affect quality of life (QoL). With limited care and social support resources, there is a greater anticipated decline in QoL among stroke survivors in Africa. This study aims to examine post-stroke QoL, properties of outcome measures adopted and predictors of the QoL among African stroke survivors. African Journals Online, CINAHL, PsychINFO, PubMed and Web of Science databases were searched from inception to February 2020. Methodological quality was assessed using the Agency for Healthcare Research and Quality (ARHQ) methodology checklist for observational studies. Twenty-eight studies recruiting 2572 (76.4%) stroke survivors and 795 (23.6%) healthy volunteers were included. https://www.selleckchem.com/products/icrt14.html Studies were conducted in eight African countries between 2007 and 2019. Methodological quality of studies was good. Overall, stroke survivors reported a low QoL. Six studies comparing QoL between stroke survivors and healthy controls were pooled for meta-ana validated assessment tools and more robust post-stroke QoL evaluation across the African continent. To improve QoL of stroke survivors in Africa, early interventions should focus on reducing disability and depression associated with stroke. PROSPERO registration number CRD42019137653. The aim of the present study was to evaluate clinical efficacy and safety of superselective embolization of the superior rectal artery (SRA) for the treatment of internal hemorrhoidal bleeding. Patients with stage II and stage III internal hemorrhoids, treated by interventional embolization of the SRA in our department between January 2017 and June 2019 were retrospectively evaluated. All patients suffering from disabling chronic hematochezia and some with relative contraindications for operation (n = 17) orrejectionofconventional hemorrhoidectomy (n = 15). Superselective SRA branch embolization was performed using gelatin sponge particles (350-560μm) and metallic coils (2-3mm). This treatment process was planned by a multidisciplinary team consisting of proctologist,gastroenterologist and radiologist. The surgical efficacy, postoperative complications and follow-up outcomes were observed. There were 32 patients (18 males, mean age 52 ± 12years, range 22-78years), 12 (37%) with stage II hemorrhoids and perselective SRA embolization for grade II-III internal hemorrhoids is good, and this method is safe and feasible.Medical schools worldwide undertake widening access (WA) initiatives (e.g. pipeline, outreach and academic enrichment programmes) to support pupils from high schools which do not traditionally send high numbers of applicants to medicine. UK literature indicates that pupils in these schools feel that their teachers are ill-equipped, cautious or even discouraging towards their aspiration and/or application to medicine. This study aimed to explore teachers' perspectives and practices to include their voice in discussions and consider how medical schools might best engage with them to facilitate WA. Interviews were conducted with high school teachers in three UK regions, working in schools targeted by WA initiatives. Data were analysed thematically using template analysis, using a largely data-driven approach. Findings showed that although medicine was largely seen as a prestigious and worthwhile career, teachers held reservations about advocating this above other choices. Teachers saw it as their role to encourage pupils to educate themselves about medicine, but to ultimately allow pupils to make their own decisions.