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BACKGROUND: Grade 3 gastroenteropancreatic neuroendocrine neoplasms (G3 GEPNENs) are often aggressive, and the optimal treatment is unclear for this subgroup of neuroendocrine neoplasms (NENs). Temozolomide (TEM)-based regimens have been increasingly used to treat grade 1-2 NENs, but their efficacy in G3 NENs remains undetermined. We aimed to assess the clinical efficacy of TEM-containing regimens in advanced grade 3 GEPNENs. MATERIALS AND METHODS: A multicenter retrospective review (2008-2018) of patients with metastatic/unresectable G3 GEPNENs who received a TEM-containing regimen was undertaken within a North American partnership to pool data. The primary endpoint was time to treatment failure (TTF). Radiologic response was extracted from local reports. RESULTS: One hundred and thirty patients in six high-volume NEN centers were included (median age 55, 64% male, 18% functional, 67% pancreatic NEN). Forty-nine percent were well-differentiated, 35% poorly differentiated, and 15% unknown based on local pathology reports. The regimen used was capecitabine and temozolomide (CAPTEM) in 92% and TEM alone in 8%. Radiological response by local assessment was seen in 36% of patients. Median TTF was 3.6 months and median overall survival (OS) 19.2 months. Six percent of patients required discontinuation of therapy due to adverse events. TTF was longer in first-line treatment (7.8 months vs. 2.9 months; hazard ratio, 1.62; 95% confidence interval, 1.11-2.36; p = .015) and in patients with pancreatic NENs (panNENs) compared with gastrointestinal NENs (5.8 months vs 1.8 months; p = .04). The overall response rate was higher in the first-line setting (51% vs 29%; p = .02) and in panNEN (41% vs 23%; p = .04). CONCLUSION: This is the largest TEM treatment series in G3 NEN, involving collaboration of several major North American NEN centers as a partnership. Thirty-six percent of patients showed some degree of radiographic response, and tre

This study aimed to investigate whether gender differences existed in deal-hunting behavior during the hotel booking process. The research model was structured to understand the factors that influence consumers to search and book hotel deals. Results showed there were significant differences between females’ and males’ deal-searching behavior and purchase intentions. Male consumers were likely influenced by emotional gratification, such as feeling excited about finding a good deal online. Alternatively, female consumers were not influenced by affection but by their cognitive evaluation.

This study aims to identify the representativeness of hospitality and service industry firms on flash-sale sites such as Groupon and LivingSocial. Currently, academic findings related to the frequency of offerings from these firms are nonexistent. This research relied upon a content analysis rubric and daily measurement of offerings from randomly selected cities represented by Groupon and LivingSocial for a period of 6 weeks. The daily offerings for specific cities on the Groupon and LivingSocial sites were utilized as the primary data sources. Findings indicate firms in these industries, outside of restaurants, have shunned away from offering their services via flash-sale mediums.

Counselor education departments are often required to meet multiple accreditation standards that include assessment of individual student learning. Additionally, faculty in counselor education departments are responsible for acting as professional gatekeepers. The authors propose a model for assessment of individual student potential at the time of program admission. In addition, a comprehensive assessment process applied as students make the transition into clinical fieldwork is described.

The purpose of this research was; 1. to assess differences in level of depression between female children of alcoholics (COAs) and female children of non-alcoholics, 2. to assess potential differences in choice of coping strategies between COAs and children of non-alcoholics, and 3. to determine the extent to which the eight coping strategies under study were useful in predicting group (COA group or children of non-alcoholic group) placement. A sample of 103 (76 children of non-alcoholics and 27 COAs) traditional-aged undergraduate college students comprised the sample. An independent two-sample t-test revealed statistically significant differences in level of depression between the COAs and the children of non-alcoholics, with the children of alcoholics exhibiting a higher level of depression. However, the mean depression scores for both groups were within the no depression range.

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