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Background Colon Capsule Endoscopy (CCE) has proven efficacy in a variety of gastrointestinal diseases. Few studies have assessed patient-reported outcomes and preference between colonoscopy and CCE. Methods Patients from our centre who had both a CCE and colonoscopy within a 12-month period were identified. We performed over-the-phone interviews focused on satisfaction, comfort, and overall preference with a 10-point Likert scale. Electronic records were reviewed; reported Modified-Gloucester-Comfort-Scale (GCS) score, sedation, bowel preparation and endoscopist grade were documented. Data was compared between procedures. A Fishers exact test was used to compare proportions and a Student t-test was used to compare means, a p  < 0.05 was considered significant. Results In all, 40 patients were identified, 57.5% (23/40) were female and the mean age was 48 years (24–78). All patients were referred for investigation of lower gastrointestinal symptoms as part of an ongoing study [Endosc Int Open. 2021;09(06):E965–70]. There was a significance difference in mean comfort (9.2 vs 6.7, p  < 0.0001, 95% CI − 3.51 to − 1.44) but not satisfaction (8.3 vs 7.7, p  = 0.2, 95% CI − 1.48 to 0.33) between CCE and colonoscopy. Main cause of dissatisfaction with CCE was bowel preparation and for colonoscopy was discomfort. Age and gender were not found to be variables. The correlation between GCS and patient reported values was weak (R = − 0.28). Overall, 77.5% (31/40) of patients would prefer a CCE if they required further bowel investigation. Of these, 77.4% (24/31) preferred a CCE despite the potential need for follow-up colonoscopy. Conclusions CCE has a high satisfaction rating (8.3 vs 7.7) and has a higher patient reported comfort rating (9.2 vs 6.7) than colonoscopy. Studies have confirmed CCE and colonoscopy have equivalent diagnostic yields. The majority of patients in our cohort prefer CCE to colonoscopy. CCE should be considered as an alternative to colonoscopy in selected individuals.

Smoking cessation is the most effective intervention to reduce mortality in patients with established atherosclerotic cardiovascular disease (ASCVD), with ‘e-cigarettes’ becoming an increasingly used intervention to achieve smoking cessation. The current review aims to summarise the current evidence base for their efficacy and safety in the ASCVD cohort. A search of the PUBMED and MEDLINE databases using the terms ‘e-cigarette’, ‘cessation’, ‘safety’ and ‘efficacy’ since 2012 yielded 706 results. Both observational and experimental studies were included, while those with an unavailable full text, non-English or duplicates were excluded, yielding 78 relevant articles, with 13 subsequent additional articles included from a search of reference lists, for a total of 91 included papers. E-cigarette vapour contains many known pro-atherosclerotic substances and has been demonstrated to potentiate traditional atherosclerotic mechanisms. While e-cigarettes may be more effective in promoting smoking cessation in the general population over a medium term (>6 months), when compared with nicotine replacement therapy (NRT), few studies specifically examined those with ASCVD, despite the latter having a higher baseline quit rate (52% vs 2%). Most studies compare e-cigarettes with NRT alone and do not include pharmacotherapy, which may be more effective in the ASCVD cohort. The single randomised controlled trial addressing the research question favoured traditional methods. Those that successfully quit smoking using e-cigarettes are more likely to continue to use the intervention at 1 year (90% vs 9%). Conflicting advice exists regarding the utilisation of e-cigarettes for smoking cessation. E-cigarettes may be inferior to standard care for smoking cessation in those with ASCVD, and their use is likely to promote the key drivers of the atherosclerotic process already active in this cohort.

Background Obstructive sleep apnoea (OSA) is present in 40–80% of patients with cardiovascular morbidity and is associated with adverse effects on cardiovascular health. Continuous positive airway pressure (CPAP) maintains airway patency during sleep and is hypothesised to improve cardiac function. In the present study, we report on the impact of 12 weeks of CPAP and improvements in echocardiographic parameters of the right ventricle (RV). Methods Nineteen newly diagnosed patients with OSA and a respiratory disturbance index (RDI) greater than 10 were enrolled. Echocardiography was performed before treatment and with a follow-up assessment after 12 weeks of CPAP. Echocardiographic and Doppler measurements were made following the American Society for Echocardiography guidelines. The primary outcome was isovolumetric acceleration (IVA). Secondary outcomes include tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), RV % strain, TEI index and RV dimension (RVD1). Results There was significant improvement in isovolumetric acceleration of 0.5ms 2 ( P  = 0.0012 (95% CI -0.72, -0.20)) and significant improvement of 2.05 mm in TAPSE ( p  = 0.0379 (95% CI -3.98 - -0.13). There was no significant difference in FAC, RV % strain, TEI index or RVD1 with twelve weeks of CPAP therapy. Conclusion The present study highlights significant improvement in TAPSE and IVA with 12 weeks of CPAP treatment and no significant improvement in FAC, RVD1 and RV % strain. These data indicate favourable characteristics on both load dependent and load independent markers of RV function with CPAP.

High-throughput sequencing (HTS) of host plant small RNA (sRNA) is a popular approach for plant virus and viroid detection. The major bottlenecks for implementing this approach in routine virus screening of plants in quarantine include lack of computational resources and/or expertise in command-line environments and limited availability of curated plant virus and viroid databases. We developed: (1) virus and viroid report web-based bioinformatics workflows on Galaxy Australia called GA-VirReport and GA-VirReport-Stats for detecting viruses and viroids from host plant sRNA extracts and (2) a curated higher plant virus and viroid database (PVirDB). We implemented sRNA sequencing with unique dual indexing on a set of plants with known viruses. Sequencing data were analyzed using GA-VirReport and PVirDB to validate these resources. We detected all known viruses in this pilot study with no cross-sample contamination. We then conducted a large-scale diagnosis of 105 imported plants processed at the post-entry quarantine facility (PEQ), Australia. We detected various pathogens in 14 imported plants and discovered that de novo assembly using 21–22 nt sRNA fraction and the megablast algorithm yielded better sensitivity and specificity. This study reports the successful, large-scale implementation of HTS and a user-friendly bioinformatics workflow for virus and viroid screening of imported plants at the PEQ.

PurposeThis study aims to examine the potentially important effects of academic embeddedness on college of business student retention and performance as well as the mediating effects of self-efficacy on the academic embeddedness student outcomes relationships. Improvements in student retention and performance reduce costs for students and universities and lead to higher incomes for graduates.Design/methodology/approachData were gathered from students in an entry-level business course at a public university in a rural western state. Approximately 45% of the students were female, and the average age of participants was 20 years old. A survey was administered midsemester to gather data on academic embeddedness and self-efficacy. Retention was indicated by a student enrolling in a business course in a subsequent semester. Performance was measured using end-of-semester course grades. Logistic and linear regression as well as mediation analysis were used to test the hypotheses.FindingsAcademic embeddedness was found to positively predict both retention and performance, while self-efficacy was found to positively mediate the academic embeddedness retention relationship. The direct effect of embeddedness on performance was not found when controlling for self-efficacy.Practical implicationsStudent retention and performance are important to both students and academic administrators. The findings of this study suggest that retention and performance can both be improved by focusing on factors that more strongly embed students to their colleges.Originality/valueEmbeddedness has been found to have high predictive validity in the employment context. This is one of the first studies to consider the effects of embeddedness in the academic context.

Diversification is a common goal for many small firms, yet research examining whether small firm ownership structure influences their use of the tactic is limited. As such, this paper provides one of the first empirical investigations of the subject by examining whether the presence of a corporate parent positively influences the likelihood that small firms will utilize diversification. Results indicate that small firms with corporate parents are more likely to use both related and unrelated diversification than comparable firms that are independently owned. Such findings are noteworthy because diversification may be more beneficial for small, independently owned firms, yet small, subsidiary firms appear to be better able to utilize diversification. Implications of these findings are discussed.

BackgroundAcute haemorrhagic oedema of infancy (AHOI) or Finkelstein/Seidlmayer disease, is an uncommon leukocytoclastic small-vessel vasculitis typically occurring between the ages of 6 months and 2 years. Despite its alarming presentation, it is benign and often has a self-limiting course.Case reportA 4-year-old girl presented to the Emergency Department with a 2-day history of a diffuse spreading erythematous rash, joint pain and swelling. She was unwell for the previous 2 weeks with cough and upper respiratory tract symptoms, and was treated with a course of co-amoxiclav. Otherwise she had no relevant past medical history.There was a widespread, macular rash that spread to form large confluent areas over the face, buttocks, torso, posterior legs, and arms [PICTURED]. The lesions had an erythematous margin with a central area of clearing. Characteristically these lesions faded in places as bruises with blue discolouration, particularly in the popliteal fossa and at the ankle, concerning for vasculitis. There was pain and swelling of both ankle joints rendering her unable to mobilise. There was a history of Sjogren’s disease in the maternal grandmother.Investigations revealed an elevated white cell count of 20.5, predominantly neutrophilic, and a C-Reactive Protein of 51. Urinalysis and blood pressure were normal. Initial treatment with prednisolone and antihistamines in ED had minimal effect. Following medical and dermatology consultation, a diagnosis of Acute Haemorrhagic Oedema of Infancy was considered.She improved significantly over the next 48 hours without further intervention and was discharged home. There was complete resolution of her symptoms on follow up 2 days later.DiscussionAHOI is a rare, benign form of vasculitis. It typically follows a recent respiratory prodrome. There are overlapping features with Hennoch-Scönlein purpura (HSP) that have been described. Some have contemplated whether AHOI is merely a milder variant of HSP or a separate entity. Nevertheless, its dramatic presentation often results in consideration of more sinister ailments.Skin biopsy can confirm AHOI but if identified early, the diagnosis can be made on clinical findings alone. Conservative management is the most commonly followed approach. Renal involvement and gastrointestinal bleeding are uncommon complications. Prompt recognition of this condition can spare children from invasive investigations and unnecessary treatment, therefore heightened physician awareness of this phenomenon is paramount.

Recent research suggests that (1) business failure rates are lower than previously thought and (2) business owners exit businesses for myriad reasons besides performance. Despite these findings, relatively little is known about whether personal characteristics (i.e. expectations, competencies, education) of small firm owners influence their likelihood to persist with business ownership. Given this gap, the present study investigates the relationship between owner characteristics and persistence intentions. Framed by threshold theory, we theorize and test whether owner growth expectations, satisfaction, education, competencies, and financial investment influence their persistence intentions. Results indicate that owner future growth expectations for the business, their opportunity recognition abilities, and their satisfaction with the business significantly impact persistence intentions. Implications of study findings are discussed.

The goals of transurethral resection of bladder tumour (TURBT) for urothelial carcinoma are pathological staging and the removal of all visible tumour tissue. Typically, a deep and extensive resection beyond the basement membrane, including some muscularis propria, is performed. However, this also carries a risk of perforating the bladder wall, creating the ideal circumstances to facilitate peritoneal or abdominal metastases. Small, asymptomatic bladder perforations occur frequently and are associated with gender: female, decreasing body mass index, higher tumour stage, deeper infiltration and higher resection weight. Since many of these perforations are extraperitoneal, heal spontaneously and do not elicit any significant perioperative symptoms, they remain undiagnosed. Even in cases of intraperitoneal perforation, peritoneal tumour recurrence has been rarely reported. We report on the unusual case of a 61-year-old woman who underwent TURBT for non-muscle invasive urothelial carcinoma that was complicated by intraperitoneal bladder perforation requiring open repair.

The new millennium has seen the projected growth of older populations as a source of many problems, not the least of which is how to sustain this increasingly aging population. Some decades ago, early retirement from work posed few problems for governments, but most nations are now trying to ensure that workers remain in the workforce longer. In this context, the role played by older employees can be affected by at least two factors: their productivity (or perceived productivity) and their acceptance by younger workers and management. If the goal of maintaining employees into older age is to be achieved and sustained, opportunities must be provided, for example, for more flexible work arrangements and more possibilities to pursue bridge employment (work after formal retirement). The retirement experience varies, depending on people's circumstances. Some people, for example, have retirement forced upon them by illness or injury at work, by ill-health (such as chronic illnesses), or by downsizing and associated redundancies. This article focuses on the problems and opportunities associated with working to an older age or leaving the workforce early, particularly due to factors beyond one's control.