SummaryBackgroundLocalised prostate cancer is commonly treated with external-beam radiotherapy. Moderate hypofractionation has been shown to be non-inferior to conventional fractionation. Ultra-hypofractionated stereotactic body radiotherapy would allow shorter treatment courses but could increase acute toxicity compared with conventionally fractionated or moderately hypofractionated radiotherapy. We report the acute toxicity findings from a randomised trial of standard-of-care conventionally fractionated or moderately hypofractionated radiotherapy versus five-fraction stereotactic body radiotherapy for low-risk to intermediate-risk localised prostate cancer.MethodsPACE is an international, phase 3, open-label, randomised, non-inferiority trial. In PACE-B, eligible men aged 18 years and older, with WHO performance status 0–2, low-risk or intermediate-risk prostate adenocarcinoma (Gleason 4 + 3 excluded), and scheduled to receive radiotherapy were recruited from 37 centres in three countries (UK, Ireland, and Canada). Participants were randomly allocated (1:1) by computerised central randomisation with permuted blocks (size four and six), stratified by centre and risk group, to conventionally fractionated or moderately hypofractionated radiotherapy (78 Gy in 39 fractions over 7·8 weeks or 62 Gy in 20 fractions over 4 weeks, respectively) or stereotactic body radiotherapy (36·25 Gy in five fractions over 1–2 weeks). Neither participants nor investigators were masked to allocation. Androgen deprivation was not permitted. The primary endpoint of PACE-B is freedom from biochemical or clinical failure. The coprimary outcomes for this acute toxicity substudy were worst grade 2 or more severe Radiation Therapy Oncology Group (RTOG) gastrointestinal or genitourinary toxic effects score up to 12 weeks after radiotherapy. Analysis was per protocol. This study is registered with ClinicalTrials.gov, NCT01584258. PACE-B recruitment is complete and follow-up is ongoing.FindingsBetween Aug 7, 2012, and Jan 4, 2018, we randomly assigned 874 men to conventionally fractionated or moderately hypofractionated radiotherapy (n=441) or stereotactic body radiotherapy (n=433). 432 (98%) of 441 patients allocated to conventionally fractionated or moderately hypofractionated radiotherapy and 415 (96%) of 433 patients allocated to stereotactic body radiotherapy received at least one fraction of allocated treatment. Worst acute RTOG gastrointestinal toxic effect proportions were as follows: grade 2 or more severe toxic events in 53 (12%) of 432 patients in the conventionally fractionated or moderately hypofractionated radiotherapy group versus 43 (10%) of 415 patients in the stereotactic body radiotherapy group (difference −1·9 percentage points, 95% CI −6·2 to 2·4; p=0·38). Worst acute RTOG genitourinary toxicity proportions were as follows: grade 2 or worse toxicity in 118 (27%) of 432 patients in the conventionally fractionated or moderately hypofractionated radiotherapy group versus 96 (23%) of 415 patients in the stereotactic body radioth...

Risk management is an important field of construction industry and has gained more importance internationally due to the latest researches carried out on a large scale. However, this relatively new field requires more attention to bring some benefit. Construction projects are facing a number of risks which have negative effects on project objects such as time, cost and quality. This study is based on findings of a questionnaire-based survey on risk management in construction projects in Pakistan, reporting the significance of different type of risk, ultimate responsibility for them and the effectiveness of some most common risk management techniques practiced in the industry. Two types of risk management techniques were considered: preventive techniques which can be used before the start of a project to manage risks that are anticipated during the project execution; and remedial techniques that are used during the execution phase once a risk has already occurred. The study revealed that financial issues for projects, accidents on site and defective design are the most significant risks affecting most of construction projects. As further reported, the contractor is responsible for management of most risks occurring at sites during the implementation phase, such as issues related to subcontractors, labour, machinery, availability of materials and quality, while the client is responsible for the risks such as financial issues, issues related to design documents, changes in codes and regulations, and scope of work. Further reported results of the analysis demonstrate that the production of proper schedule by getting updated data of the project and guidance from previous similar projects are the most effective preventive risk management techniques while close supervision and coordination within projects are the most effective remedial risk management techniques. It may be concluded that the most significant risks must be managed with greater effort to reduce/eliminate their effects on the project. As the study concludes, preparation of a proper schedule and good coordination during the implementation stage are very important as they may help project managers to focus on critical areas for better management of projects in Pakistan.

The study is based on validating and exploring the effects of a mega project plan (CPEC) on infrastructure development and Sustainable Project Management. The CPEC has great importance to infrastructure development and economy-boosting. The current study's primary aim is to deal with environmental protection, economic boost up, international relations influencing to the Project's success. The paper also addressed project management as a moderator between environmental protection, economic boost up, international relations, and the CPEC project's success. The primary data has been gathered by using questionnaires, and PLS-SEM has been employed for the analysis. The results revealed that environmental protection, economy boost up, and international relations have a positive association with the success of CPEC. The outcomes also exposed that project management moderating among the nexus of economy boosts up the international relations and success of CPEC. The present study results guided how Pakistan and China make the CPEC project stronger with the efficient implementation of practices required for protecting the environment, with the economic growth and boost up, and good strong relations with foreign countries. This study was an attempt to validate the different factors to check their association with each other in a new environment, resulting in a leading edge for the success of mega projects that influence project management.

The coronavirus disease (COVID-19) was first reported in China (Wuhan) at the end of 2019. It has rapidly spread over 216 countries, including the USA, UK, Europe, Russia, and many Asian countries. It has affected more than 4.5 million people, and around 0.3 million deaths have been reported globally. Many preventive measures have been adopted worldwide to mitigate its spread. The government of Pakistan has also taken many preventive measures to combat the COVID-19 outbreak, such as rapid response by governance, continuous monitoring of the pandemic spread in the affected areas, and integration of resources from multiple sectors, including health, education, defense, and media. According to global statistics, the number of COVID-19 cases in the country remained remarkably lower than the expected number for the first 169 days, as compared to other countries. A total of 286,674 confirmed cases, including 16,475 active, 6,139 deaths, and 264,060 (92%) recoveries were reported. The study finds that strict adherence to national policies, effective governance, and unity at the national level resulted in better outcomes. Hence, the preventive measures, rapid responses, and strategies adopted for combating the challenges could be adopted as a learning tool for other countries having similar work environments and financial constraints. This paper can help and guide governance/public actions in response to the possible rebound of coronavirus this fall/winter.

Relationship standards are the beliefs people hold about what a good relationship should be like, which vary substantially across Western and Chinese cultures. The current study extends the assessment of couple relationship standards to Pakistan, a large, developing Muslim majority country with a distinctive collectivistic, hierarchical, religious, and tight culture. We administered the Cross-Cultural Couple Relationships Standards Scale to 354 Pakistanis and compared their standards with those of 312 Westerners living in Australia and 286 Chinese living in Hong Kong, China. A confirmatory factor analysis revealed an acceptable fit of a model of two positively correlated latent factors, Couple Bond and Family Responsibility, in each sample. We added two standards hypothesized likely to be of importance to Pakistanis: Religion and Relationship Self-Regulation. Pakistanis endorsed all standards as important; they endorsed Couple Bond standards more than Westerners or Chinese, and Family Responsibility standards a lot more than Westerners or Chinese. Gender differences were of very small effect size.

Purpose Despite burgeoning interest in knowledge hiding (KH), there are still significant gaps in the understanding of the boundary conditions under which KH is more or less likely to occur. To address this research gap, the researchers examined abusive supervision as an interpersonal antecedent of KH. In addition, this paper aims to investigate the moderating roles of negative reciprocity beliefs (NRB) and moral disengagement (MD) in the relationship between abusive supervision and KH. Design/methodology/approach Two-wave data using a non-experimental face-to-face method was collected from 257 service employees in Pakistan, which supported the hypothesized model. Considering minimum sample size requirements (i.e. n = 208) in partial least squares structural equation modeling, the researchers analyzed a two-stage approach to test the measurement model and the structural model. Findings The study found that abusive supervision was positively related to evasive hiding and playing dumb but not associated with rationalized hiding. Further, the results confirm the moderating roles of NRB and MD. The positive relationships between abusive supervision and evasive hiding and playing dumb are intensified at high levels of NRB and MD. Originality/value Given the complicated nature of KH, this is one of the few efforts that outstretch the boundary conditions of KH.

PurposeWith a basis in the conservation of resource (COR) theory, this study examines the relationship between workplace ostracism and job performance while also investigating the mediating role of defensive silence and the moderating role of emotional intelligence.Design/methodology/approachThe study uses a multisource, three-wave data collection technique to gather data from employees and their peers working in Pakistan's service sector organizations. Data are analyzed using partial least squares structural equation modeling (PLS-SEM) (v 3.2.7) to assess the measurement model and the structural model.FindingsThe findings reveal that the perception of workplace ostracism provokes self-avoidance strategy, defensive silence, which attenuates job performance. However, defensive silence's mediating role is mitigated if employees can draw from their emotional intelligence ability, which induces a self-regulation mechanism that curbs workplace ostracism's negative consequences.Practical implicationsThe study demonstrates how employees in collectivist, high-power distance cultural settings may strategically choose silence by exercising emotional intelligence to enhance job performance.Originality/valueThis study is one of the few efforts that examined defensive silence in non-Western cultural settings. This is also the first study that examined emotional intelligence's role in the proposed moderated mediation framework.

PurposeResearch on adopting leadership style like ambidextrous leadership to enhance employees' innovative work behavior (IWB) is in an initial stage. Moreover, employees need a high knowledge sharing attitude to show more IWB. The purpose of this study is to empirically test the impact of ambidextrous leadership on IWB with the mediating role of knowledge sharing and the moderating role of innovativeness as a project requirement (IAPR).Design/methodology/approachThe simple random sampling technique was used to collect data from 542 employees of project-based construction companies operating in Pakistan. Smart partial least squares-structural equation modeling (Smart PLS SEM v.3.2.8) was used to test the hypotheses.FindingsThe result revealed that ambidextrous leadership has a significant and positive effect on knowledge sharing but negative effect on IWB at the workplace. Additionally, the mediating role of knowledge sharing has been tested and proved to be a potential mediator between ambidextrous leadership and IWB. Also, IAPR as moderator has a significant and positive effect on knowledge sharing and IWB.Practical implicationsThe managers need to develop an ambidexterity-oriented strategy and communicate this strategy across the members of the whole organization. These processes can be facilitated by ambidextrous leaders with complex behavioral repertoires and specific constellations and characteristics of top management teams.Originality/valueThe relationship between ambidextrous leadership and IWB is the new contribution through the mediating of knowledge sharing between AL and IWB also moderation role IWB between knowledge sharing and IWB.