Community syndicalism for the United States: preliminary observations on law and globalization in democratic production

two structural labor crises for developed economies: 1) The channeling of substantial investment into non-productive, paper commodities, reducing growth of production for use and therefore reducing available aggregate job creation; and 2) The continued exportation of industrial jobs to other lower cost jurisdictions, and outsourcing, automation, just-in-time production, and speed-ups associated with global supply chains. As a result, local communities and regional populations have destabilized and even collapsed with attendant social problems. One possible response is Community Syndicalism – local community finance and operating credit for industrial production combined with democratic worker ownership and control of production. The result would increase investment directly for production, retain jobs in existing population centers, promote job skilling, and retain tax bases for local services and income supporting local businesses, at the same time increasing support for authentic political democracy by rendering the exploitive ideology of the Public/Private distinction superfluous. Slowing job exportation may reduce the global race to the bottom of labor standards and differential wage rates reducing the return to producers of value and increasing the skew of income distribution undermining social wages and welfare worldwide. Community Syndicalism can serve as moral goal in an alternative production model focusing incentives on long term stability of jobs and community economic base

Magnetotransport in the Normal State of La1.85Sr0.15Cu(1-y)Zn(y)O4 Films

We have studied the magnetotransport properties in the normal state for a series of La1.85Sr0.15Cu(1-y)Zn(y)O4 films with values of y, between 0 and 0.12. A variable degree of compressive or tensile strain results from the lattice mismatch between the substrate and the film, and affects the transport properties differently from the influence of the zinc impurities. In particular, the orbital magnetoresistance (OMR) varies with y but is strain-independent. The relations for the resistivity and the Hall angle and the proportionality between the OMR and tan^2 theta are followed about 70 K. We have been able to separate the strain and impurity effects by rewriting the above relations, where each term is strain-independent and depends on y only. We also find that changes in the lattice constants give rise to closely the same fractional changes in other terms of the equation.The OMR is more strongly supressed by the addition of impurities than tan^2 theta. We conclude that the relaxation ratethat governs Hall effect is not the same as for the magnetoresistance. We also suggest a correspondence between the transport properties and the opening of the pseudogap at a temperature which changes when the La-sr ratio changes, but does not change with the addition of the zinc impurities

Sleep-disordered breathing-do we have to change gears in heart failure?

The majority of patients with heart failure have sleep-disordered breathing (SDB)-with central (rather than obstructive) sleep apnoea becoming the predominant form in those with more severe disease. Cyclical apnoeas and hypopnoeas are associated with sleep disturbance, hypoxaemia, haemodynamic changes, and sympathetic activation. Such patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and partially normalise the sleep and respiratory physiology, but recent randomised trials of cardiovascular outcomes in central sleep apnoea have been neutral or suggested the possibility of harm, likely from increased sudden death. Further randomised outcome studies (with cardiovascular mortality and hospitalisation endpoints) are required to determine whether mask-based treatment for SDB is appropriate for patients with chronic systolic heart failure and obstructive sleep apnoea, for those with heart failure with preserved ejection fraction, and for those with decompensated heart failure. New therapies for sleep apnoea-such as implantable phrenic nerve stimulators-also require robust assessment. No longer can the surrogate endpoints of improvement in respiratory and sleep metrics be taken as adequate therapeutic outcome measures in patients with heart failure and sleep apnoea

Conduct of clinical trials in the era of COVID-19: JACC scientific expert panel

The coronavirus disease-2019 (COVID-19) pandemic has profoundly changed clinical care and research, including the conduct of clinical trials, and the clinical research ecosystem will need to adapt to this transformed environment. The Heart Failure Academic Research Consortium is a partnership between the Heart Failure Collaboratory and the Academic Research Consortium, composed of academic investigators from the United States and Europe, patients, the U.S. Food and Drug Administration, the National Institutes of Health, and industry members. A series of meetings were convened to address the challenges caused by the COVID-19 pandemic, review options for maintaining or altering best practices, and establish key recommendations for the conduct and analysis of clinical trials for cardiovascular disease and heart failure. This paper summarizes the discussions and expert consensus recommendations

Troponin Is Unrelated to Outcomes in Heart Failure Patients Discharged From the Emergency Department

Background: Prior data has demonstrated increased mortality in hospitalized patients with acute heart failure (AHF) and troponin elevation. No data has specifically examined the prognostic significance of troponin elevation in patients with AHF discharged after emergency department (ED) management. Objective: Evaluate the relationship between troponin elevation and outcomes in patients with AHF who are treated and released from the ED. Methods: This was a secondary analysis of the Get with the Guidelines to Reduce Disparities in AHF Patients Discharged from the ED (GUIDED-HF) trial, a randomized, controlled trial of ED patients with AHF who were discharged. Patients with elevated conventional troponin not due to acute coronary syndrome (ACS) were included. Our primary outcome was a composite endpoint: time to 30-day cardiovascular death and/or heart failure-related events. Results: Of the 491 subjects included in the GUIDED-HF trial, 418 had troponin measured during the ED evaluation and 66 (16%) had troponin values above the 99th percentile. Median age was 63 years (interquartile range, 54-70), 62% (n = 261) were male, 63% (n = 265) were Black, and 16% (n = 67) experienced our primary outcome. There were no differences in our primary outcome between those with and without troponin elevation (12/66, 18.1% vs 55/352, 15.6%; P = 0.60). This effect was maintained regardless of assignment to usual care or the intervention arm. In multivariable regression analysis, there was no association between our primary outcome and elevated troponin (hazard ratio, 1.00; 95% confidence interval, 0.49-2.01, P = 0.994). Conclusion: If confirmed in a larger cohort, these findings may facilitate safe ED discharge for a group of patients with AHF without ACS when an elevated troponin is the primary reason for admission