Idiopathic benign retroperitoneal cyst: a case report

<p>Abstract</p> <p>Introduction</p> <p>Retroperitoneal cysts are uncommon, with an estimated incidence of 1/5750 to 1/250,000.</p> <p>Case presentation</p> <p>A male patient was admitted with an abdominal pain, jaundice and fever. Clinical examination and investigations confirmed an idiopathic benign retroperitoneal cyst. He underwent surgery and was discharged after making good recovery.</p> <p>Conclusion</p> <p>Retroperitoneal cysts are very rare, and most of the time they are discovered incidentally. Patients may be asymptomatic or present with abdominal pain, referred pain to the legs or weight loss. Imaging may help diagnose these lesions, but surgery is the keystone in confirming the diagnosis. This case is very rare and very educational as it highlights an unusual presentation of a benign retroperitoneal cyst. In our patient, the course of the disease was unique as the patient presented with jaundice.</p

The academic backbone: longitudinal continuities in educational achievement from secondary school and medical school to MRCP(UK) and the specialist register in UK medical students and doctors

Background: Selection of medical students in the UK is still largely based on prior academic achievement, although doubts have been expressed as to whether performance in earlier life is predictive of outcomes later in medical school or post-graduate education. This study analyses data from five longitudinal studies of UK medical students and doctors from the early 1970s until the early 2000s. Two of the studies used the AH5, a group test of general intelligence (that is, intellectual aptitude). Sex and ethnic differences were also analyzed in light of the changing demographics of medical students over the past decades. Methods: Data from five cohort studies were available: the Westminster Study (began clinical studies from 1975 to 1982), the 1980, 1985, and 1990 cohort studies (entered medical school in 1981, 1986, and 1991), and the University College London Medical School (UCLMS) Cohort Study (entered clinical studies in 2005 and 2006). Different studies had different outcome measures, but most had performance on basic medical sciences and clinical examinations at medical school, performance in Membership of the Royal Colleges of Physicians (MRCP(UK)) examinations, and being on the General Medical Council Specialist Register. Results: Correlation matrices and path analyses are presented. There were robust correlations across different years at medical school, and medical school performance also predicted MRCP(UK) performance and being on the GMC Specialist Register. A-levels correlated somewhat less with undergraduate and post-graduate performance, but there was restriction of range in entrants. General Certificate of Secondary Education (GCSE)/O-level results also predicted undergraduate and post-graduate outcomes, but less so than did A-level results, but there may be incremental validity for clinical and post-graduate performance. The AH5 had some significant correlations with outcome, but they were inconsistent. Sex and ethnicity also had predictive effects on measures of educational attainment, undergraduate, and post-graduate performance. Women performed better in assessments but were less likely to be on the Specialist Register. Non-white participants generally underperformed in undergraduate and post-graduate assessments, but were equally likely to be on the Specialist Register. There was a suggestion of smaller ethnicity effects in earlier studies. Conclusions: The existence of the Academic Backbone concept is strongly supported, with attainment at secondary school predicting performance in undergraduate and post-graduate medical assessments, and the effects spanning many years. The Academic Backbone is conceptualized in terms of the development of more sophisticated underlying structures of knowledge ('cognitive capital’ and 'medical capital’). The Academic Backbone provides strong support for using measures of educational attainment, particularly A-levels, in student selection

A physarum-inspired approach to supply chain network design

A supply chain is a system which moves products from a supplier to customers, which plays a very important role in all economic activities. This paper proposes a novel algorithm for a supply chain network design inspired by biological principles of nutrients’ distribution in protoplasmic networks of slime mould Physarum polycephalum. The algorithm handles supply networks where capacity investments and product flows are decision variables, and the networks are required to satisfy product demands. Two features of the slime mould are adopted in our algorithm. The first is the continuity of flux during the iterative process, which is used in real-time updating of the costs associated with the supply links. The second feature is adaptivity. The supply chain can converge to an equilibrium state when costs are changed. Numerical examples are provided to illustrate the practicality and flexibility of the proposed method algorithm

Understanding Project Champions’ Ability to Gain Intra-Organizational Commitment for Environmental Projects

A key enabler of environmental projects is the ability of the project champion to gain commitment to the project from other stakeholders in his or her organization. This paper develops a model of commitment-gaining success that is based on intra-organizational influence theory. The model also includes the project payback, customer pressure, government regulation, top management support and the project champion’s position in the organizational hierarchy. The model was tested using survey data from 241 environmental professionals describing their attempts to gain the buy-in of purchasing managers, operations managers, industrial engineers and others for environmental projects. The results (obtained from hierarchical regression analysis) show that intra-organizational commitment is positively associated with the project champion’s influence behavior—in particular, the champion’s use of three influence tactics (inspirational appeals, consultation and rational persuasion) and avoidance of a fourth tactic (ingratiation). Commitment is also positively associated with project payback and with top management support for the environment and negatively associated with environmental regulation. The paper contributes to the OM knowledge base of environmental project implementation by bringing new theory to bear on the topic, by focusing on individual-level, rather than organization-level, variables and by taking a confirmatory, large sample approach which complements extant exploratory research. In addition, the paper contributes to the OM field by evaluating various antecedents to cross-functional integration. The results also provide specific guidance to those who champion environmental projects within their companies

Doxycycline for Malaria Chemoprophylaxis and Treatment: Report from the CDC Expert Meeting on Malaria Chemoprophylaxis

Doxycycline, a synthetically derived tetracycline, is a partially efficacious causal prophylactic (liver stage of Plasmodium) drug and a slow acting blood schizontocidal agent highly effective for the prevention of malaria. When used in conjunction with a fast acting schizontocidal agent, it is also highly effective for malaria treatment. Doxycycline is especially useful as a prophylaxis in areas with chloroquine and multidrug-resistant Plasmodium falciparum malaria. Although not recommended for pregnant women and children < 8 years of age, severe adverse events are rarely reported for doxycycline. This report examines the evidence behind current recommendations for the use of doxycycline for malaria and summarizes the available literature on its safety and tolerability