Purpose The purpose of this paper is to explain student loyalty beyond its customary relationship with student satisfaction by including two relational variables, trust and commitment, two cognitive traits (service familiarity and communication) and one affective trait (opportunism) as moderators of the impact of trust and commitment on loyalty. Design/methodology/approach Two relational constructs (trust and commitment) are employed to improve the loyalty model and key comparisons are performed to know if career, cohort and sourcing school generate differences in the explanation of student loyalty. Findings Results show that the explanation chain that starts with student satisfaction but continues with the development of student trust and the reaching of student commitment culminates with student loyalty. The moderators (student opportunism, service familiarity, communication, age and available income for education) significantly contribute to the explanatory power of the model. Career is a meaningful differentiator in reaching student loyalty as are student cohort and the type of high school from which the student came. Research limitations/implications This is one of first empirical studies on university student loyalty. Future research could test the same or new hypotheses using different samples and contexts. Practical implications University policies may benefit from the inclusion of norms regarding relational processes and outcomes such as the value of trust in the interactions and systematic recognition and awards assigned to student commitment achievements. Originality/value The explanation chain of customer loyalty was successfully applied to student loyalty, and strengthened with the addition of meaningful moderating variables.

A 54-year-old woman-with no past surgical history-presented to the emergency department with an 8-day history of abdominal pain in the left Xank and diarrhea. Initially, the patient underwent an abdominal ultrasound that showed a lower pole kidney mass. Computed tomography was performed and revealed a fragmented staghorn calculus complicated with a xanthogranulomatous pyelonephritis in the left kidney (Fig. 1). The cleavage plane between the left kidney and the colon was undistinguished and a nephrocolic Wstula (arrows) was diagnosed. To conWrm this Wnding a barium enema was carried out: demonstrating passage of intravenous contrast from the colon to the kidney. Finally, the patient was taken to the surgery room where nephrectomy and left hemicolectomy were carried out.Few nephrointestinal Wstulae have been described in the literature, and the cases of spontaneous appearance of this condition are even scarce [1]. The most common cause of spontaneous nephrocolic Wstulae involves staghorn calculi [2]. These calculi are formed of a rapidly growing stone and are mainly composed of struvite-carbonate-apatite matrix. These stones are likely to cause great morbidity and mortality if not treated. Treatment frequently includes: percutaneous nephrolithotomy, followed by extracorporeal shock wave lithotripsy and/or Xexible ureteroscopy, and laser [3]. Imaging procedures-abdominal X-rays and computed tomography-are the best diagnostic tools to be used in this condition.

This study investigates the impact of female sex hormones on women's consumption of fashion products. These hormones reach peak level when women are near ovulation, and this research examines how these hormones, when at peak level, influence women's attitudes and purchase intention towards sexy and revealing fashion products. The research is based on two theoretical frameworks: Ovulatory Shift Hypothesis (OSH) and Theory of Reasoned Action (TRA). Specifically, the OSH, based on the female ovulatory cycle, postulates that women change their sexual preferences for men with perceived good biological indicators of genetic fitness on the high-to-low fertility days of the cycle. Thus, these women may also exhibit increased mating interest and higher motivation to act in ways that would help secure a desirable partner. The theory of reasoned action sheds light on the indirect relationship between women's ovulatory period and their choice of apparel, with attitude as a mediator. A within-subject survey design was used to examine the proposed phenomenon. Vietnamese women were recruited for this specific study. In line with OSH, these study findings suggest that when near ovulation, women show more favorable attitudes and stronger purchase intention towards sexy and revealing fashion products. Further, as predicted by TRA, attitudes towards sexy and revealing fashion products mediate the relationship between ovulation and purchase intentions. The results of this study add to related streams of research which suggests that hormonal fluctuations influence consumers' attitudes and purchase intention. For managers, the results provide suggestions on how to target female consumers for sexy fashion products more effectively.