Background The Ad26.COV2.S vaccine, which was approved as a single-shot immunization regimen, has been shown to be effective against severe coronavirus disease 2019. However, this vaccine induces lower severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein (S)–specific antibody levels than those induced by messenger RNA (mRNA)–based vaccines. The immunogenicity and reactogenicity of a homologous or heterologous booster in persons who have received an Ad26.COV2.S priming dose are unclear. Methods In this single-blind, multicenter, randomized, controlled trial involving health care workers who had received a priming dose of Ad26.COV2.S vaccine, we assessed immunogenicity and reactogenicity 28 days after a homologous or heterologous booster vaccination. The participants were assigned to receive no booster, an Ad26.COV2.S booster, an mRNA-1273 booster, or a BNT162b2 booster. The primary end point was the level of S-specific binding antibodies, and the secondary end points were the levels of neutralizing antibodies, S-specific T-cell responses, and reactogenicity. A post hoc analysis was performed to compare mRNA-1273 boosting with BNT162b2 boosting. Results Homologous or heterologous booster vaccination resulted in higher levels of S-specific binding antibodies, neutralizing antibodies, and T-cell responses than a single Ad26.COV2.S vaccination. The increase in binding antibodies was significantly larger with heterologous regimens that included mRNA-based vaccines than with the homologous booster. The mRNA-1273 booster was most immunogenic and was associated with higher reactogenicity than the BNT162b2 and Ad26.COV2.S boosters. Local and systemic reactions were generally mild to moderate in the first 2 days after booster administration. Conclusions The Ad26.COV2.S and mRNA boosters had an acceptable safety profile and were immunogenic in health care workers who had received a priming dose of Ad26.COV2.S vaccine. The strongest responses occurred after boosting with mRNA-based vaccines. Boosting with any available vaccine was better than not boosting. (Funded by the Netherlands Organization for Health Research and Development ZonMw; SWITCH ClinicalTrials.gov number, NCT04927936 .)

We study theory of mind (ToM)

Background During the COVID-19 pandemic, the scarcity of resources has necessitated triage of critical care for patients with the disease. In patients aged 65 years and older, triage decisions are regularly based on degree of frailty measured by the Clinical Frailty Scale (CFS). However, the CFS could also be useful in patients younger than 65 years. We aimed to examine the association between CFS score and hospital mortality and between CFS score and admission to intensive care in adult patients of all ages with COVID-19 across Europe. Methods This analysis was part of the COVID Medication (COMET) study, an international, multicentre, retrospective observational cohort study in 63 hospitals in 11 countries in Europe. Eligible patients were aged 18 years and older, had been admitted to hospital, and either tested positive by PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or were judged to have a high clinical likelihood of having SARS-CoV-2 infection by the local COVID-19 expert team. CFS was used to assess level of frailty: fit (CFS 1-3), mildly frail (CFS 4-5), or frail (CFS 6-9). The primary outcome was hospital mortality. The secondary outcome was admission to intensive care. Data were analysed using a multivariable binary logistic regression model adjusted for covariates (age, sex, number of drugs prescribed, and type of drug class as a proxy for comorbidities). Findings Between March 30 and July 15, 2020, 2434 patients (median age 68 years [IQR 55-77]; 1480 [61%] men, 954 [30%] women) had CFS scores available and were included in the analyses. In the total sample and in patients aged 65 years and older, frail patients and mildly frail patients had a significantly higher risk of hospital mortality than fit patients (total sample: CFS 6-9 vs CFS 1-3 odds ratio [OR] 2•71 [95% CI 2•04-3•60], p<0•0001 and CFS 4-5 vs CFS 1-3 OR 1•54 [1•16-2•06], p=0•0030; age ≥65 years: CFS 6-9 vs CFS 1-3 OR 2•90 [2•12-3•97], p<0•0001 and CFS 4-5 vs CFS 1-3 OR 1•64 [1•20-2•25], p=0•0020). In patients younger than 65 years, an increased hospital mortality risk was only observed in frail patients (CFS 6-9 vs CFS 1-3 OR 2•22 [1•08-4•57], p=0•030; CFS 4-5 vs CFS 1-3 OR 1•08 [0•48-2•39], p=0•86). Frail patients had a higher incidence of admission to intensive care than fit patients (CFS 6-9 vs CFS 1-3 OR 1•54 [1•21-1•97], p=0•0010), whereas mildly frail patients had a lower incidence than fit patients (CFS 4-5 vs CFS 1-3 OR 0•71 [0•55-0•92], p=0•0090). Among patients younger than 65 years, frail patients had an increased incidence of admission to intensive care (CFS 6-9 vs CFS 1-3 OR 2•96 [1•98-4•43], p<0•0001), whereas mildly frail patients had no significant difference in incidence compared with fit patients (CFS 4-5 vs CFS 1-3 OR 0•93 [0•63-1•38], p=0•72). Among patients aged 65 years and older, frail patients had no significant difference in the incidence of admission to intensive care compared with fit patients (CFS 6-9 vs CFS 1-3 OR 1•27 [0•92-1•75], p=0•14), whereas mildly frail patients had a lower incide...

Recent studies in psychophysiology show an increased attention for examining the reliability of Event-Related Potentials (ERPs), which are measures of cognitive control (e.g., Go/No-Go tasks). An important index of reliability is the internal consistency (e.g., Cronbach's alpha) of a measure. In this study, we examine the internal consistency of the N2 and P3 in a Go/No-Go task. Furthermore, we attempt to replicate the previously found internal consistency of the Error-Related Negativity (ERN) and Positive-Error (Pe) in an Eriksen Flanker task. Healthy participants performed a Go/No-Go task and an Eriksen Flanker task, whereby the amplitudes of the correct No-Go N2/P3, and error trials for ERN/Pe were the variables of interest. This study provides evidence that the N2 and P3 in a Go/No-Go task are internally consistent after 20 and 14 trials are included in the average, respectively. Moreover, the ERN and Pe become internally consistent after approximately 8 trials are included in the average. In addition guidelines and suggestions for future research are discussed.

We explore genetic and neurological bases for customer orientation (CO) and contrast them with sales orientation (SO). Study 1 is a field study that establishes that CO, but not SO, leads to greater opportunity recognition. Study 2 examines genetic bases for CO and finds that salespeople with CO are more likely to have the 7R variant of the DRD4 gene. This is consistent with basic research on dopamine receptor activity in the brain that underlies novelty seeking, the reward function, and risk taking. Study 3 examines the neural basis of CO and finds that salespeople with CO, but not SO, experience greater activation of their mirror neuron systems and neural processes associated with empathy. Managerial and research implications are discussed.Keywords Knowledge brokering . Opportunity recognition . Genetics . Customer orientation . Neuroscience . Biomarkers . Personal selling . Marketing concept "Everybody hates their phone," Jobs says, "and that is not a good thing. And there's an opportunity there." To Jobs' perfectionist eyes, phones are broken. Jobs likes things that are broken. It means he can make something that isn't and sell it to you at a premium price. In their visionary paper, Saxe and Weitz (1982) explore two contrasting orientations by which salespeople interact with customers: sales versus customer orientation. Under the former, salespeople are driven by such notions as, "I try to sell customers all I can convince them to buy, even if I think it is more than a wise customer should buy," where the motivation is to meet one's own short-term interests and goals and not necessarily the customer's. Under the latter, salespeople are guided primarily by such ideas as, "I try to align customers who have problems with products that will help them solve their problems," where the aim is to meet mutual needs and the hope is to build long-term relationships.Sales orientation (SO) involves persuasion and "selling to" customers, whereas customer orientation (CO) is more about "interacting with" and encouraging customers to talk about their problems so that the salesperson can figure out their needs (a process akin to co-creation of solutions) and bring them in touch with solutions to their problem. Seldom has a concept sparked so much interest, resonating with both researchers and practitioners (e.g., Franke and Park 2006;Homburg et al. 2009;Leigh et al. 2001 Mark. Sci. (2012) 40:639-658 DOI 10.1007 Academics and sales managers are very interested in successfully selecting and managing salespeople, but to understand the basis for salesperson motivation and implement successful policies in this regard, they need to know the why behind CO and SO. Here is where the situation is muddled, for many anecdotal and loosely conceived explanations lack coherence and managerial relevance. Saxe and Weitz (1982) proposed that researchers should explore the psychological mechanisms underlying CO, and indeed a plethora of selling and marketing research has attempted to do just this. For example, in their meta-study, F...