Open-Label Phase I Clinical Study to Assess the Safety and Efficacy of Cilostazol in Patients Undergoing Internal Carotid Artery Stent Placement

BACKGROUND: One-month dual antiplatelet treatment, with aspirin and clopidogrel, following internal carotid artery stent placement is the current standard of care to prevent in-stent thrombosis. Cilostazol, an antiplatelet drug, has been demonstrated to have a safety profile comparable to aspirin and clopidogrel. OBJECTIVE: To evaluate the safety and clinical efficacy of cilostazol and aspirin therapy following internal carotid artery stent placement up to 1 month postprocedure. METHODS: A phase I open-label, nonrandomized two-center prospective study was conducted. All subjects received aspirin (325 mg/day) and cilostazol (200 mg/day) 3 days before extracranial stent placement. Two antiplatelet agents were continued for 1 month postprocedure followed by aspirin daily monotherapy. The primary efficacy end point was the 30-day composite occurrence of death, cerebral infarction, transient ischemic attack, and in-stent thrombosis. The primary safety end point was bleeding. RESULTS: Twelve subjects (mean age ± SD, 66 ± 12 years; 9 males) were enrolled and underwent internal carotid artery angioplasty and stent placement. None of the subjects who successfully followed the study protocol experienced any complications at the 1- and 3-month follow-ups. One patient had a protocol deviation due to concurrent use of enoxaparin (1 mg/kg twice daily) in addition to aspirin and cilostazol, resulting in a fatal symptomatic intracerebral hemorrhage following successful stent placement on postprocedure day 1. One patient discontinued cilostazol after the first dose secondary to dizziness. CONCLUSION: The use of cilostazol and aspirin for internal carotid artery stent placement appears to be safe, but protocol compliance needs to be emphasize

Entrepreneurial intentions among University’s students in Malaysia

The issue of employability is rising year by year, and Malaysia is also taking it as a serious challenge. The Malaysian government has carried out various initiatives to address the issue of employability; conversely, one of them was successfully promoting the development of entrepreneurship by increasing entrepreneurial courses for instance. The intention was to increase the entrepreneurial intentions amongst university's students to create job opportunities for themselves which could lead to a boost for a developing nation's economy as well. However, the government's initiatives did not succeed as they were expected. The main reason for it ending as a flopped plan was due to failing to identify an individual's intentions. Therefore, the primary purpose of this research is to inspect the Malaysian universities student's intention of being an entrepreneur because, without intention, they might not even consider the option of initiating their own business. This research adapted and integrated the two most common models of examining the entrepreneurial intention, i.e, Theory of Planned Behaviour ('TPB') by Ajzen and Shapero and Sokol's model of an Entrepreneurial Event ('SEE'). This is a quantitative study and a total of 160 students from different Malaysian universities were surveyed using non-probability sampling techniques and by a well-established instrument with the standardized questionnaire, to examine hypothesized relationships. SPSS was used for analyzing the demographic profile and SMART-PLS was utilized for testing the developed hypotheses. The results show that attitude, subjective norms, and perceived behavioural control positively affect the perceived desirability as well as perceived feasibility. Moreover, perceived desirability and perceived feasibility are also positively associated with an entrepreneurial intention. Furthermore, perceived desirability is found as a mediator for the relationship among predictors of entrepreneurial intention but perceived feasibility fails to mediate the association of subjective norm and entrepreneurial intention. By understanding the background of university student's intentions towards entrepreneurship, the Malaysian government and organizations can better present themselves in formulating better initiatives to stimulate and encourage youth to have entrepreneurial intentions in order to initiate their own business. This study also offers some useful managerial implications using the advanced technique of IPM to enhance the H1 H2 H3 H6 H5 H4 H7 H8 performance of critical factors that contribute towards entrepreneurial intentions

Linear optical properties of organic microcavity polaritons with non-Markovian Quantum State Diffusion

Hybridisation of the cavity modes and the excitons to polariton states together with the coupling to the vibrational modes determine the linear optical properties of organic semiconductors in microcavities. In this article we compute the refractive index for such system using the Holstein-Tavis-Cummings model and determine then the linear optical properties using the transfer matrix method. We first extract the parameters for the exciton in our model from fitting to experimentally measured absorption of a 2,7-bis [9,9-di(4-methylphenyl)-fluoren-2-yl]-9,9-di(4-methylphenyl) fluorene (TDAF) molecular thin film. Then we compute the reflectivity of such a thin film in a metal clad microcavity system by including the dispersive microcavity mode to the model. We compute susceptibility of the model systems evolving just a single state vector by using the non-Markovian Quantum State Diffusion. The computed location and height of the lower and upper polaritons agree with the experiment within the estimated errorbars for small angles ($\leq 30^\circ$). For larger angles the location of the polariton resonances are within the estimated error.Comment: 10 pages, 4 figure

HRM practices for knowledge management and retail firms’ performances: a comparative study among Malay and Chinese firms

The current study examines the impact of human resource management (HRM) practices for knowledge management (KM) on perceived business performances among Malay and Chinese firms in Malaysia. Data were collected through a face-to-face survey with 200 owners of firms, comprising 100 Malay entrepreneurs and 100 Chinese entrepreneurs, operating in the retail sector of Klang Valley, Malaysia. Data were analysed using Partial Least Squares Structural Equation Modeling (PLS-SEM) and Multi-Group Analysis (MGA). The results of PLSSEM revealed that HRM practices for KM have a direct and positive impact on the perceived financial performance, perceived non-financial performance, and perceived business growth of Malay and Chinese firms. However, non-significant impact of HRM practices for KM on perceived performance relative to competitors was found among Chinese firms. Results of MGA revealed significant differences between Malay and Chinese firms in relation to the impact of HRM practices for KM on perceived financial performance and perceived performance relative to competitors

Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin

Objective: Deterioration in ventricular function is often observed in patients treated with anthracyclines for cancer. There is a paucity of evidence on interventions that might provide cardio-protection. We investigated whether prophylactic use of carvedilol can prevent doxorubicin-induced cardiotoxicity and whether any observed effect is dose related. Methods: A prospective, randomized, double-blind study in patients treated with doxorubicin, comparing placebo (n = 38) with different doses of carvedilol [6.25 mg/day (n = 41), 12.5 mg/day (n = 38) or 25 mg/day (n = 37)]. The primary endpoint was the measured change in left ventricular ejection fraction (LVEF) from baseline to 6 months. Results: LVEF decreased from 62 ± 5% at baseline to 58 ± 7% at 6-months (p = 0.002) in patients assigned to placebo but no statistically significant changes were observed in any of the 3 carvedilol groups. At 6 months, only one of 116 patients (1%) assigned to carvedilol had an LVEF < 50% compared to four of the 38 assigned to placebo (11%), (p = 0.013). No significant differences were noted between carvedilol and placebo in terms of the development of diastolic dysfunction, clinically overt heart failure or death. Conclusions: Carvedilol might prevent deterioration in LVEF in cancer patients treated with doxorubicin. This effect may not be dose related within the studied range

Identifying the origin of delayed electroluminescence in a polariton organic light-emitting diode

Modifying the energy landscape of existing molecular emitters is an attractive challenge with favourable outcomes in chemistry and organic optoelectronic research. It has recently been explored through strong light-matter coupling studies where the organic emitters were placed in an optical cavity. Nonetheless, a debate revolves around whether the observed change in the material properties represents novel coupled system dynamics or the unmasking of pre-existing material properties induced by light-matter interactions. Here, for the first time, we examined the effect of strong coupling in polariton organic light-emitting diodes via time-resolved electroluminescence studies. We accompanied our experimental analysis with theoretical fits using a model of coupled rate equations accounting for all major mechanisms that can result in delayed electroluminescence in organic emitters. We found that in our devices the delayed electroluminescence was dominated by emission from trapped charges and this mechanism remained unmodified in the presence of strong coupling.Comment: 11 pages + 8 supp pages, 4 figures + 8 supp figure

SARS-CoV-2-specific immunoglobulin Y antibodies are protective in infected mice

Safe, passive immunization methods are required against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its variants. Immunization of chickens with antigen is known to induce specific IgY antibodies concentrated in the egg yolk and has a good safety profile, high yield of IgY per egg, can be topically applied, not requiring parenteral delivery. Our data provide the first evidence of the prophylactic efficacy of Immunoglobulin Y antibodies against SARS-CoV-2 in mice. Lohmann hens were injected with recombinant SARS-CoV-2 RBD protein; IgY-Abs were extracted from the eggs and characterized using SDS-PAGE. Antiviral activity was evaluated using plaque reduction neutralization tests. In additional experiments, IgY-RBD efficacy was examined in mice sensitized to SARS-CoV-2 infection by transduction with Ad5-hACE2 (mild disease) or by using mouse-adapted virus (severe disease). In both cases, prophylactic intranasal administration of IgY-Abs reduced SARS-CoV-2 replication, and reduced morbidity, inflammatory cell infiltration, hemorrhage, and edema in the lungs and increased survival compared to control groups that received non-specific IgY-Abs. These results indicate that further evaluation of IgY-RBD antibodies in humans is warranted

Hyperhomocysteinemia and Low Folate and Vitamin B12 Are Associated with Vascular Dysfunction and Impaired Nitric Oxide Sensitivity in Morbidly Obese Patients.

There is a high prevalence of hyperhomocysteinemia that has been linked to high cardiovascular risk in obese individuals and could be attributed to poor nutritional status of folate and vitamin B12. We sought to examine the association between blood homocysteine (Hcy) folate, and vitamin B12 levels and vascular dysfunction in morbidly obese adults using novel ex vivo flow-induced dilation (FID) measurements of isolated adipose tissue arterioles. Brachial artery flow-mediated dilation (FMD) was also measured. Subcutaneous and visceral adipose tissue biopsies were obtained from morbidly obese individuals and non-obese controls. Resistance arterioles were isolated in which FID, acetylcholine-induced dilation (AChID), and nitric oxide (NO) production were measured in the absence or presence of the NO synthase inhibitor, L-NAME, Hcy, or the superoxide dismutase mimetic, TEMPOL. Our results demonstrated that plasma Hcy concentrations were significantly higher, while folate, vitamin B12, and NO were significantly lower in obese subjects compared to controls. Hcy concentrations correlated positively with BMI, fat %, and insulin levels but not with folate or vitamin B12. Brachial and arteriolar vasodilation were lower in obese subjects, positively correlated with folate and vitamin B12, and inversely correlated with Hcy. Arteriolar NO measurements and sensitivity to L-NAME were lower in obese subjects compared to controls. Finally, Hcy incubation reduced arteriolar FID and NO sensitivity, an effect that was abolished by TEMPOL. In conclusion, these data suggest that high concentrations of plasma Hcy and low concentrations of folate and vitamin B12 could be independent predictors of vascular dysfunction in morbidly obese individuals