•Total treatment duration increases the likelihood of treatment interruptions (TI)•High risk group patients with TI trended towards worse biochemical failure.•Within the high risk group of patients ...treated with ADT, TI were associated with a statistically significant increase in BF rate.
To date, no studies examining the effect of treatment interruptions (TI) with proton beam therapy (PBT) have been published. The goal of our study was to determine the predictors of TI amongst patients with prostate cancer (PCa) treated with PBT and to determine whether TI are associated with biochemical failure (BF). We hypothesized that any correlation between TI and biochemical control would be more pronounced in high risk groups.
Data for 4278 patients with PCa was obtained from the prospectively collected Proton Collaborative Group (PCG) data registry. Univariate and multivariate logistic regression analysis (MVA) was used to model possible predictors of BF. A subset analysis was performed for high risk patients treated with ADT and PBT. Finally, propensity score (PS) analysis was performed to account for any indication bias caused by lack of randomization.
Total treatment duration (OR, 1.05 1.04–1.06; p < 0.001) increased the likelihood of TI on MVA. TI did not have a statistically significant correlation with BF (OR, 1.44 0.86–2.39; p = 0.162) amongst PS matched patients. However, on subset analyses of high risk group patients with PS matching, there was a trend towards worse BF in patients with TI (OR 3.85; 95%CI (0.96–15.44); p = 0.057).
In the first analysis of its kind, the results suggest that TI in high risk PCa patients treated with PBT and ADT have worse BF rates. Interventions such as increased patient education, proper maintenance of proton facilities, and decreasing total treatment duration with alternative fractionation schedules may help avoid the unintended negative effects on tumor control due to TI. However, future analyses on a larger patient population is needed.
Improving upon previous studies on hotel performance evaluation in terms of efficiency, which usually treat different hotels as homogeneous in their product provision, this study examines the ...performance of 53 hotels in the Guangdong-Hong Kong-Macau Greater Bay Area (GBA) during 2015 to 2019, by employing data envelopment analysis with a non-homogeneous decision making units (DMUs) model. The results show that the hotels in GBA were inefficient, and those with high product diversification are generally closer to achieving optimal efficiency levels, particularly those providing rooms, food and beverage, meeting services, and spa services, while those providing only rooms had the worst performance. Among the GBA cities included in this study, the non-homogeneous efficiency scores of the hotels in Guangzhou outperformed those of hotels in the other cities, and the overall hotel efficiency score of the core cities was better than that of the key node cities.
Concurrent chemoradiation plays an integral role in the treatment of esophageal cancer. Proton beam radiation therapy has the potential to spare adjacent critical organs, improving toxicity profiles ...and potentially improving clinical outcomes.
We evaluated the REG001-09 registry for patients undergoing proton radiation therapy for esophageal cancer. Demographic, clinicopathologic, toxicity, and dosimetry information were compiled.
We identified 155 patients treated at 10 institutions between 2010 and 2019. One hundred twenty (77%) had adenocarcinoma and 34 (22%) had squamous cell carcinoma. One hundred thirty-seven (88%) received concurrent chemotherapy. The median delivered dose was 50.51 Gy-equivalent (GyE; range, 41.4-70.1). Grade ≥3 toxicities occurred in 22 (14%) of patients and were most commonly dysphagia (6%), esophagitis (4%), anorexia (4%), and nausea (2%). There were no episodes of grade ≥4 lymphopenia and no grade 5 toxicities. The average mean heart, lung, and liver doses and average maximum spinal cord dose were 10.0 GyE, 4.8 GyE, 3.8 GyE, and 34.2 GyE, respectively. For gastroesophageal junction tumors, 8% of patients developed acute grade ≥3 toxicity and the mean heart, liver, right kidney, and left kidney doses were 10.5 GyE, 3.9 GyE, 0.4 GyE, and 4.9 GyE, respectively. Gastroesophageal junction location was protective against development of grade ≥3 toxicity on univariate (P = .0009) and multivariate (P = .004) analysis.
Proton beam radiation therapy affords excellent dosimetric parameters and low toxicity in patients with esophageal cancer treated with curative intent. Prospective trials are underway investigating the comparative benefit of proton-based therapy.
This study assesses the relationship between casino-induced satisfaction of needs and casino customer loyalty, and explores the moderating role of gaming attitude, subjective norms, perceived ...behavioral control, perceived gaming value, and perceived personal luck in this relationship. With 425 valid responses collected from Macau casino goers, the results indicate that casinos can enhance customer loyalty by satisfying their customers' inner needs, including their self-actualization, esteem, belonging, safety and security, and physiological needs. In strengthening the relationship between casino-induced satisfaction of needs and customer loyalty, casinos should pay special attention to subjective norms and perceived gaming value.
This paper measures tourism carbon efficiency (TCE) in China by incorporating energy consumption and carbon dioxide (CO2) emissions into an efficiency assessment framework, and to further investigate ...the determinants of TCE by considering the spatial spillover effects. To do this, a bootstrap slacks-based measure (SBM) model was applied to assess the TCE in 30 provincial-level administrative regions of China from 2008 to 2019. Next, the Moran’s index and spatial Durbin model (SDM) were adopted to explore the spatial distribution and determinants of TCE. The results indicate that regional differences affect the level of China’s TCE, as do spatial spillover effects. In addition, technology innovation, urbanization rate, and government support positively affect TCE. In contrast, economic growth negatively affects TCE. Educational attainment, green infrastructure, and government support have a negative spatial spillover effect on TCE. Transportation infrastructure has a negative total effect on TCE.
This study examines the impact of internal and customer sexual harassment on job-related outcomes using a sample of 348 female frontline employees in the context of Macao casinos. The results showed ...that internal sexual harassment led to lower job satisfaction, as well as higher turnover intention through its impact on job satisfaction. Besides, internal sexual harassment had a significant negative impact on female frontline employees exceeding that accounted for by traditional job stressor. Surprisingly, sexual harassment committed by customers exhibited no significant impact on both female employees' job satisfaction and turnover intention. Implications are discussed.
To analyze the expression levels of Ki-67 and gelsolin in renal cell carcinoma (RCC) and determine their prognostic value in association with other clinicopathologic factors using tissue microarray ...technology. Histologic nuclear grade, performance status, and clinical stage are important prognostic factors in RCC. Because patients with tumors of similar grade, performance status, and stage may show a wide variation in biologic behavior and clinical outcome, additional biomarkers for RCC are needed to provide further prognostic information and possibly offer insight into the mechanisms of the disease.
Using a renal cancer tissue microarray, we correlated the expression of Ki-67, a marker of cell proliferation, and gelsolin, an actin-binding protein, with grade, stage, and survival in patients with clear cell RCC.
In Cox multivariate regression analysis, stage (pT) was the most significant predictor of cancer-specific survival (
P <0.0001), followed by Ki-67 (
P = 0.0216). In univariate analysis, increased Ki-67 expression predicted poor cancer-specific survival (
P = 0.0006) when a cutoff value for Ki-67 staining was applied. In patients with grade 2 tumors, increased Ki-67 expression and decreased gelsolin expression in the same tumor was suggestive of poor cancer-specific survival (
P = 0.0507).
Our findings support the utility of Ki-67 as a prognostic biomarker for RCC and suggest a role for gelsolin in renal carcinogenesis.
This study tests a long held anecdotal claim that a poker room draws people into the casino that might otherwise be absent. Using daily data from two major hotel casinos located on the Las Vegas ...Strip, this study examines the effect of poker on the business volumes of table and slot games. The time series regression analysis produce mixed findings that the significant effect of poker on gaming volumes only appears in a gaming-centric property but not in the other property offering diverse non-gaming attractions besides gaming. The findings of this study call for casino management's careful evaluation of poker's attractiveness as a draw. This study also provides guidelines for evaluating poker's contribution to the slot/table game department's operating profit.
Purpose
This study aims to empirically examine the relationship between industrial diversification and firm performance and the moderating effects exerted on that relationship by board size and ...family representation on the board.
Design/methodology/approach
Secondary financial data were collected for hotel firms listed on the Hong Kong Stock Exchange during the period 2005-2016. Subsequently, a bivariate correlation and a fixed-effects panel regression analysis were performed on the data.
Findings
The empirical results showed that diversification positively influenced firm performance until firms reached an optimal level of diversification (0.34); beyond that level, the effect was negative. In addition, firms with a larger board tended to show better performance when the level of diversification increased from medium to high, and firms with lower family representation on the board tended to exhibit better performance when the level of diversification increased from low to medium.
Practical implications
Theoretical and managerial implications are suggested in terms of balancing the size of a firm’s board and with regard to family representation on a board from the perspectives of resource dependence theory (RDT) and socioemotional wealth (SEW), the diversification of hotel firms and future research.
Originality/value
A limited number of studies have considered diversification as a corporate-level strategy in the hospitality field and in the unique context in which a service-oriented economy is dominant, such as in Hong Kong. The role of board composition on the diversification–performance relation has rarely been investigated theoretically and empirically. Apart from providing managerial implications for corporate governance, this study also offers theoretical generalizability, from the perspectives of RDT and SEW, to examine the moderating roles of board size and family representation on the diversification–firm performance relation.
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