Background Inability to tolerate statins because of muscle symptoms contributes to uncontrolled cholesterol levels and insufficient cardiovascular risk reduction. Bempedoic acid, a prodrug that is activated by a hepatic enzyme not present in skeletal muscle, inhibits ATP ‐citrate lyase, an enzyme upstream of β‐hydroxy β‐methylglutaryl‐coenzyme A reductase in the cholesterol biosynthesis pathway. Methods and Results The phase 3, double‐blind, placebo‐controlled CLEAR (Cholesterol Lowering via Bempedoic acid, an ACL‐Inhibiting Regimen) Serenity study randomized 345 patients with hypercholesterolemia and a history of intolerance to at least 2 statins (1 at the lowest available dose) 2:1 to bempedoic acid 180 mg or placebo once daily for 24 weeks. The primary end point was mean percent change from baseline to week 12 in low‐density lipoprotein cholesterol. The mean age was 65.2 years, mean baseline low‐density lipoprotein cholesterol was 157.6 mg/dL, and 93% of patients reported a history of statin‐associated muscle symptoms. Bempedoic acid treatment significantly reduced low‐density lipoprotein cholesterol from baseline to week 12 (placebo‐corrected difference, −21.4% [95% CI, −25.1% to −17.7%]; P <0.001). Significant reductions with bempedoic acid versus placebo were also observed in non–high‐density lipoprotein cholesterol (−17.9%), total cholesterol (−14.8%), apolipoprotein B (−15.0%), and high‐sensitivity C‐reactive protein (−24.3%; P <0.001 for all comparisons). Bempedoic acid was safe and well tolerated. The most common muscle‐related adverse event, myalgia, occurred in 4.7% and 7.2% of patients who received bempedoic acid or placebo, respectively. Conclusions Bempedoic acid offers a safe and effective oral therapeutic option for lipid lowering in patients who cannot tolerate statins. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifier: NCT 02988115.

There is global concern regarding the increased prevalence of math anxiety among college students, which is credited for a decrease in analytical degree completion rates and lower self-confidence among students in their ability to complete analytical tasks in the real world. The present study identified that, as expected, displays of instructional immediacy related positively to student intrinsic motivation and negatively to student math anxiety in analytical reasoning courses. More importantly, the findings were consistent with a mediated model in which psychological response to immediacy mediated the relationships between instructional immediacy cues and the associated outputs. Implications for theory and instruction are discussed.

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Communication dynamics within the business world dictate that the formality of interaction between supervisor and subordinate is determined by the supervisor. The present study investigates the influence of negotiated formality and closeness via supervisor-subordinate solidarity on subordinates' burnout, motivation, and job satisfaction. An online questionnaire was administered to subjects across various occupations and organizations in the United States. The data are consistent with a mediated model in which job satisfaction mediates the relationships between solidarity-motivation and solidarity-burnout. These results are novel in that, first, job satisfaction is identified as an input of motivation and burnout rather than outputs of a shared induction, And, second, the results place renewed emphasis on the role of supervisor communication in the workplace as subordinates are unable to initiate solidarity.The present study seeks to investigate a unique form of rapport in the workplace via communication: interpersonal solidarity. Interpersonal solidarity is both the perceived synchronicity and closeness established through communication in a relationship

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Cognitive dysfunction syndrome (CDS) is a common condition in senior dogs, which may be analogous to dementia such as Alzheimer's disease (AD) in people. In humans, AD has been associated with many risk factors such as reduced cerebral glucose metabolism, docosahexaenoic acid (DHA) deficiency, chronic oxidative stress, and chronic inflammation. By targeting some of these risk factors, we have developed two nutritional solutions (medium chain triglyceride, MCT and Brain Protection Blend, BPB) to enhance cognitive function and slow aging-induced cognitive decline. These have been positively evaluated in colony housed senior dogs and cats. The objective of this clinical study was to evaluate the effects of diets with MCTs and the BPB on client-owned dogs with CDS. Participating veterinary clinics screened senior dogs for signs of CDS as determined by a Senior Canine Behavior Questionnaire and a Canine Medical Health Questionnaire. Eighty-seven dogs were randomly enrolled into one of three diet groups with 29 dogs per group: Control, 6.5% MCT oil + BPB (6.5% MCT diet), 9% MCT oil + BPB (9% MCT diet). Diets were fed for a period of 90 days, and each dog's CDS signs were re-evaluated at day 30 and day 90. All 6 categories of the CDS signs were significantly improved (p <0.05) in the dogs given the 6.5% MCT diet at the end of the 90-day study. Control only improved in 4 out 6 categories. The 9% MCT diet only improved in dogs that accepted the diet. The results from this dog study confirm the benefits of MCT and BPB in managing clinical signs of CDS in dogs. The results support our hypothesis that targeting known risk factors associated with brain aging and AD is able to improve symptoms of CDS in dogs. These data may facilitate the development of similar nutrient blends to manage MCI and AD.

The demand for writing skills is becoming increasingly prevalent within the U.S. job market. Yet, the biggest barrier to developing successful writing skills, writing apprehension, has received very little attention from scholars in the past 30 years. The present study sought to identify the influence of instructional communicative behaviors on business students’ writing apprehension. Specifically, the study tested a model in which instructors’ immediate behaviors and clarity indirectly influenced students’ writing apprehension through the mediation of perceived immediacy. The data were consistent with the hypothesized model.

Given the expanding globalized workforce, business educators continue to seek new ways to prepare students for intercultural encounters. Although immersion in other cultures is the optimal strategy, this method is not always feasible. As such, educators seek other mechanisms to simulate intercultural experiences. This study examines emotional intelligence as a predictor of intercultural communication apprehension among university students ( N = 425). Results indicate that three of the emotional intelligence subscales predict intercultural communication apprehension: emotionality, sociability, and self-control. These results support the premise that emotional intelligence manages and/or reduces intercultural communication apprehension and therefore should be integrated in business curriculum.