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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