EXPRESS: Onboarding Salespeople: Socialization Approaches

The effective training of salespeople is crucial to a firm’s success; there is arguably no more critical type of training than a salesperson’s onboarding. In this study, the authors leverage a natural field experiment in which a firm’s newly hired salespeople can undergo onboarding through either a decentralized program or a centralized program to examine the relative impact of each program. Drawing on organizational socialization theory, the authors consider whether an onboarding program that incorporates both individualized and institutionalized socialization tactics (the decentralized program) can develop salespeople into higher performers by encouraging them to take a more innovative and adaptive approach to different facets of the sales role. The findings reveal that salespeople who underwent the decentralized program achieved approximately 23.5% higher sales performance than those who underwent the centralized program. The performance benefits of the decentralized program were amplified for salespeople whose managers had a narrower span of control. In addition, these performance benefits were appreciable for those salespeople transitioning from another job but negligible for those transitioning from school. A scenario-based experiment enriches the field experiment’s findings by showing evidence of the theorized mechanism underlying the sales performance benefits observed: the fostering of an innovative role orientation.

Meta-Analysis of D-Dimer, hsCRP and Cytokines in COVID-19 Severe/Critical Patients in China

Objective: To analyze the relationship between D-dimer, inflammatory markers, cytokines and disease severity, and the possibility of early identification of COVID-19 critical type patients. Methods: PubMed, EMBASE and CNKI databases were searched by computer, and references of related reviews and systematic reviews were manually searched as supplements. The retrieval deadline is February 9, 2021. According to the inclusion and exclusion criteria, the literatures were screened and the quality was evaluated, and then the data were extracted for meta-analysis. The fixed/random effects model was used to calculate the weighted mean difference (WMD) and 95% CI to evaluate whether the levels of D-dimer, hsCRP, IL-6, IL-8, IL-10 and TNF-α in critical type patients were statistically different from those in severe type patients. If there were statistical differences, logistic regression analysis was used, and establish the receiver operating characteristic curve (ROC) and area under the curve (AUC) of each index for the diagnosis of critical type patients. The best diagnostic value of COVID-19 critical type patients was calculated by Youden index. Results: A total of 3519 literatures entered the screening process. According to the inclusion and exclusion criteria, 40 articles were finally included in this study, and all of them were high-quality studies after evaluation. The results of meta-analysis showed that the levels of D-dimer, hsCRP, IL-6, IL-8 and IL-10 in critical type group were significantly higher than those in severe type group (P<0.05). Based on ROC curve, the AUC of D-dimer was 0.785 (95% CI: 0.671-0.899), AUC of hsCRP was 0.884 (95% CI: 0.632-1.000), AUC of IL-6 was 0.819 (95% CI: 0.700-0.939), which had diagnostic significance for critical type patients (P<0.05). The optimal diagnostic threshold of D-dimer was ≥2.00 mg/L (sensitivity 89.3%, specificity 64.0%); the optimal diagnostic threshold of hsCRP was ≥64.22 mg/L (sensitivity 75.0%, specificity 100%); the optimal diagnostic threshold of IL-6 was ≥33.01 ng/L (sensitivity 68.0%, specificity 92.0%). Conclusion: The levels of D-dimer, hsCRP, IL-6, IL-8 and IL-10 in COVID-19 critical type patients were significantly higher than those in severe type patients. Our results might be helpful in identify and risk reduction of mortality in critical types patients infected with COVID-19. Disclosures No relevant conflicts of interest to declare.

Prognostic Role and Diagnostic Power of Seven Indicators in COVID-19 Patients

The prognostic role and diagnostic ability of coronavirus disease 2019 (COVID-19) disease indicators are not elucidated, thus, the current study aimed to investigate the prognostic role and diagnostic ability of several COVID-19 disease indicators including the levels of oxygen saturation, leukocytes, lymphocytes, albumin, C-reactive protein (CRP), interleukin-6 (IL-6), and D-dimer in patients with COVID-19. The levels of oxygen saturation, lymphocytes, and albumin were significantly higher in the common and severe clinical type patients compared with those in critical type patients. However, levels of leukocytes, CRP, IL-6, and D-dimer were significantly lower in the common and severe type patients compared with those in critical type patients (P < 0.001). Moreover, the current study demonstrated that the seven indicators have good diagnostic and prognostic powers in patients with COVID-19. Furthermore, a two-indicator (CRP and D-dimer) prognostic signature in training and testing datasets was constructed and validated to better understand the prognostic role of the indicators in COVID-19 patients. The patients were classified into high-risk and low-risk groups based on the median-risk scores. The findings of the Kaplan–Meier curve analysis indicated a significant divergence between the high-risk and low-risk groups. The findings of the receiver operating curve (ROC) analysis indicated the good performance of the signature in the prognosis prediction of COVID-19. In addition, a nomogram was constructed to assist clinicians in developing clinical decision-making for COVID-19 patients. In conclusion, the findings of the current study demonstrated that the seven indicators are potential diagnostic markers for COVID-19 and a two-indicator prognostic signature identification may improve clinical management for COVID-19 patients.

Vascular injury in macroscopically normal skin of patients with severe COVID-19 infection: clinical-pathologic correlations

Objectives: Taking into account that the documentation of the histopathological features in severe disease caused by SARS-CoV-2 has been scarce due to the avoidance of performing autopsies, the aim of the study was to detect the microscopic changes associated with severe COVID-19 infection in normal-appearing skin, without prominent dermatologic signs of a generalized microvascular thrombotic disorder, in accordance with the clinical evolution of disease. Methods: In this morphological and immunohistochemical study we included cutaneous biopsy samples from 12 symptomatic patients with severe and critical type SARS-CoV-2 infection (with the admission date between February and June 2020), treated in the Intensive Therapy Unit Care of Emergency County Hospital Targu-Mures, Romania. Results: The average age of our patients was 65.18 ± 14.21 years (range 41 to 83), and 66.67% of the patients were male. The histological and immunohistochemical assessment of cutaneous biopsies: in 4 cases the histological examination revealed small fibrin thrombi in deep-seated venules and small veins of subcuticular adipose tissue, and also 4 cutaneous biopsies showed occlusive vascular thrombosis in association with massive perivascular inflammatory infiltrate destroying and compromising the integrity of the vessel wall. The immunohistochemical examination of the composition of perivascular inflammatory infiltrate showed a predominance of CD3 positive lymphocytes, admixed with CD68 positive Mo/ MF, some of them activated with FXIII expression. In the perivascular infiltrate, the presence of granulocytes and B lymphocytes was not characteristic. Conclusion: According to our observations, in severe COVID-19, the cutaneous tissue is involved even in the absence of clinically obvious changes. Due to the relatively easy accessibility of skin samples, these could be applied to determine the severity of the patient’s clinical status, and to predict the necessity for anti-complement or anticoagulant treatments in the early stages of a severe SARS-CoV-2 infection.

The Expression of Serum Ferritin and Its Clinical Predictive Value in Patients With Hemorrhagic Fever With Renal Syndrome

As a natural focus disease characterized by systemic immunopathological injury, there is a considerable diversity and heterogeneity in clinical course and prognosis of the patients with hemorrhagic fever with renal syndrome (HFRS). Therefore, the importance of early prediction and prognostic evaluation of severe patients in reducing mortality is self-evident. In this study, we detected the expression of serum ferritin and investigated its role on disease severity assessment and prognosis prediction in HFRS patients. The levels of serum ferritin in acute phase were higher than that of healthy controls and in convalescent phase of the same type, and gradually increased with the aggravation of the disease, which showed highest expression in the critical-type patients. Serum ferritin demonstrated significant correlations with conventional laboratory parameters (WBC, PLT, AST, ALB, APTT, Fib) and the length of hospital stay. High levels of ferritin were significantly associated with the death of HFRS, with a hazard ratio of 4.12. Serum ferritin showed a comparable predictive efficacy for the prognosis (death) of HFRS with that of conventional laboratory parameters, which with the AUC of 0.860 (95%CI: 0.782 ~ 0.938, P < 0.001). These results indicated that the detection of serum ferritin might be beneficial to early prediction and prognosis evaluation in severe HFRS patients and which is worthy of clinical application.

Application of quantitative lung ultrasound instead of CT for monitoring COVID-19 pneumonia in pregnant women: a single-center retrospective study

Background Computed tomography (CT) is the preferred imaging technique for the evaluation of COVID-19 pneumonia. However, it is not suitable as a monitoring tool for pregnant women because of the risk of ionizing radiation damage to the fetus as well as the possible infection of others. In this study, we explored the value of bedside lung ultrasound (LUS) as an alternative to CT for the detection and monitoring of lung involvement in pregnant women with COVID-19. Methods Clinical and LUS data of 39 pregnant women with COVID-19 were retrospectively reviewed. All LUS and CT images were analyzed to summarize the findings and calculate LUS scores and CT scores for each patient. LUS findings were compared with CT, and correlation between LUS scores and CT scores was evaluated. Results Among the 39 pregnant women, there were 6 mild-type cases, 29 common-type cases, 4 severe-type cases, and no critical-type cases. The most common LUS findings of COVID-19 pneumonia in pregnant women were various grades of multiple B-lines (84.6%), thickened and irregular pleural lines (71.8%), pleural effusion (61.5%) and small multifocal consolidation limited to the subpleural space (35.9%). The mean LUS score at admission was 0 points in mild-type cases, 10.6 points in common-type cases and 15.3 points in severe-type cases (P < 0.01). The correlation between LUS scores and CT was 0.793. All patients were clinically cured and each underwent an average of three LUS follow-ups during hospitalization. The mean LUS score at discharge was 5.6 points lower than that at admission. The consistency of LUS and chest CT during follow-up was 0.652. Conclusions Quantitative LUS scoring can effectively instead of CT for detecting and monitoring of COVID-19 pneumonia in pregnant women and protect fetuses from the risk of ionizing radiation.

Atrial Arrhythmias in Patients with Severe COVID-19

The number of confirmed COVID-19 cases has increased drastically; however, information regarding the impact of this disease on the occurrence of arrhythmias is scarce. The aim of this study was to determine the impact of COVID-19 on arrhythmia occurrence. This prospective study included patients with COVID-19 treated at the Leishenshan Temporary Hospital of Wuhan City, China, from February 24 to April 5, 2020. Demographic, comorbidity, and arrhythmias data were collected from patients with COVID-19 (n = 84) and compared with control data from patients with bacterial pneumonia (n = 84) infection. Furthermore, comparisons were made between patients with severe and nonsevere COVID-19 and between older and younger patients. Compared with patients with bacterial pneumonia, those with COVID-19 had higher total, mean, and minimum heart rates (all P < 0.01 ). Patients with severe COVID-19 (severe and critical type diseases) developed more atrial arrhythmias compared with those with nonsevere symptoms. Plasma creatine kinase isoenzyme (CKMB) levels ( P = 0.01 ) were higher in the severe group than in the nonsevere group, and there were more deaths in the severe group than in the nonsevere group (6 (15%) vs. 3 (2.30%); P = 0.05 ). Premature atrial contractions (PAC) and nonsustained atrial tachycardia (NSAT) were significantly positively correlated with plasma CKMB levels but not with high-sensitive cardiac troponin I or myoglobin levels. Our data demonstrate that COVID-19 patients have higher total, mean, and minimum heart rates compared with those with bacterial pneumonia. Patients with severe or critical disease had more frequent atrial arrhythmias (including PAC and AF) and higher CKMB levels and mortality than those with nonsevere symptoms.

موقف الإمام الدارقطني حول التفرد غير المحتمل عن الإمام المكثر: دراسة تحليلية

The Taffarud or singurality in ḥadīth sciences is one of the important and most critical type. Therefore, scholars of the ḥadīth paid it much attention and wrote number of books on the account of “al-Afrād and al-Gharīb aḥādīth”. Many scholars like Īmām al-Daraquṭnī, Īmām al-Bazzār, al-Īmām al-Ṭabrānī and other critics composed books on this subject. The discussion about the narrator’s uniqueness and singularity compared to other narrators from his sheikh who has many students, includes in the issue of reasoning, that a transmitter narrates a ḥadīth from that sheikh which his peers do not know about it. If a transmitter who is unique in its narration and also contains the critics of the scholars is called “Taffarud” which comes with different conditions in terms of acceptance and rejection. In that case, it is not acceptable to consider those terms as a totality and whoever takes it as such will be mistaken, as these rules must be understood in the light of the scholar’s understandings and their intention of usage. Otherwise we will eventually deviate from their methodology. This research is divided into an introduction, two articles, and a conclusion. As for the introduction, author defined the “taffarud” literally and lexically. In the first section, author explained the opinions of critics regarding; not to accept the uniqueness of the narrators narrating from a lot others. In the second section, author conducted an applied study on the transmitters who are not likely to be accepted in their narrations from the one who narrates a lot. As well as, author mentioned the conclusion and stidy results.

Quarantine at home may not enough!-from the epidemiological data in Shaanxi Province of China

Objectives A pneumonia associated with 2019 novel coronavirus (2019-nCoV, subsequently named SARS-CoV2) emerged worldwide since December, 2019. We aimed to describe the epidemiological characteristics of 2019 coronavirus disease (COVID-19) in Shaanxi province of China. Results 1. Among the 245 patients, 132 (53.9%) were males and 113 (46.1%) were females. The average age was 46.15 ± 16.43 years, ranging from 3 to 89 years. 2. For the clinical type, 1.63% (4/245) patients were mild type, 84.90% (208/245) were moderate type, 7.76% (19/245) were severe type, 5.31% (13/245) were critical type and only 0.41% (1/245) was asymptomatic. 3. Of the 245 patients, 116 (47.35%) were input case, 114 (46.53%) were non-input case, and 15 (6.12%) were unknown exposure. 4. 48.57% (119/245) cases were family cluster, involving 42 families. The most common pattern of COVID-19 family cluster was between husband and wife or between parents and children.

Features of creatine-kinase in COVID-19 patients within various specific periods: A cohort study

ABSTRACTBackgroundCoronavirus disease 2019 (COVID-19) has been declared as a threat to the global. Due to the lack of efficient treatments, indicators were urgently needed during the evolvement of disease to analyze the illness and prognosis, and prevent the aggravation of COVID-19.MethodsPatients’ general information, clinical type, all CK values and outcome were collected. CK value of all cases during disease course started from different initial time were analyzed.ResultsAll cases underwent 504 tests of CK since symptom onset and the median value was 51.7 (35.0-91.5) U/L. The first median value on the day 8 from exposure onset was 78.1 (69.1-85.8) U/L then showed an upward trend from the day 8 to the day 12 (reaching a peak of 279.3 U/L), finally showed a fluctuation decline after the day 12. The CK median value in critical cases reached the peak (625.5 U/L) on the transforming date, and then decreased rapidly to the normal range. Before death, the CK median value in dead cases firstly increased until the day −14 with a peak as 470.0 U/L, then decreased with fluctuation until day −2, and finally increased again on the day 0.ConclusionsCK reached its peak on the day when it became critical type, dynamic detection of CK can guide clinical judgment of prognosis. The increase of CK is a high risk factor of death. Severe cell damage 2 weeks before death might determines the outcome of the disease even if CK drops to the normal range afterward.