No abstract

In his landmark critique of Victorian laissez-faire ideology and its consequences, The Great Transformation (1944), Karl Polanyi argued that "a belief in spontaneous progress must make us blind to the role of government in economic life" (1957: 37). This blindness could only be sustained, Polanyi reasoned, thanks to "the institutional separation of society into an economic and political sphere" (1957: 71). This notion of market and state as separate domains, operating according to different logics, is at the heart of the liberal vision of freedom. The question is whether it represents some underlying ontological reality, namely that market and state are independent of each other, or whether, as Polanyi claimed, it masks a political agenda, whereby the state imagines and constructs the free market it purports to be absent from. The critical distinction between liberalism and neoliberalism is that the latter abandons the vision of market and state as independent and ontologically distinct entities. In that respect, Polanyi's critique is one that is shared by neoliberal thinkers, only with very different ramifications. Where Polanyi argued that the myth of the self-regulating market was unsustainable and needed abandoning altogether, neoliberal thinkers have always argued for a more realistic, state-led market agenda, which is attuned to the dependence of economic liberalism on competition law, property rights, a culture of enterprise, a strong police force, strict monetary policies and so on. Neoliberals are anything but "blind to the role of government in economic life". In that respect, the starting point of neoliberal reason and reform is implicitly a political and sociological one (Gane, 2014), which recognizes that markets and individual economic liberty will not thrive of their own accord, but need actively instituting and defending. As Phillip Mirowski stresses, neoliberalism is a constructivist political project (Mirowski, 2009).

Background COVID-19 can present with cardiovascular complications. Case summary We present a case report of a 43-year-old previously fit patient who suffered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with thrombosis of the coronary arteries causing acute myocardial infarction. These were treated with coronary stenting during which the patient suffered cardiac arrest. He was supported with automated chest compressions followed by peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO). No immediate recovery of the myocardial function was observed and, after insufficient venting of the left ventricle was diagnosed, an Impella 5 pump was implanted. The cardiovascular function recovered sufficiently and ECMO was explanted and inotropic infusions discontinued. Due to SARS-CoV-2 pulmonary infection, hypoxia became resistant to conventional mechanical ventilation and the patient was nursed prone overnight. After initial recovery of respiratory function, the patient received a tracheostomy and was allowed to wake up. Following a short period of agitation his neurological function recovered completely. During the third week of recovery, progressive multisystem dysfunction, possibly related to COVID-19, developed into multiorgan failure, and the patient died. Discussion We believe that this is the first case report of coronary thrombosis related to COVID-19. Despite the negative outcome in this patient, we suggest that complex patients may in the future benefit from advanced cardiovascular support, and may even be nursed safely in the prone position with Impella devices.

The Financial Independence Retire Early (FIRE) community consists of individuals each personally dedicated to reducing consumption, so as to build up financial surpluses that are eventually adequate to live off. While it shares certain features in common with other 'financial independence' ideologies and self-help communities, one thing that distinguishes it is the emphasis on frugality. Freedom comes to consist not only in independence from the labour market, but also from materialism, consumerism, and consumer debt. At the same time, this freedom is predicated on passive investment in the stock market and reliance on financial techniques for representing the future. Using semistructured interviews with leading FIRE advocates and analysis of books and blog content, this paper assesses the ambivalent moral economy of FIRE, to understand how and why individuals seek this unusual relationship to capitalism, that pursues the status of rentier through the strategic rejection of materialism.

The use of transcatheter aortic valve implantation (TAVI) in the emergency setting has not been widely reported, and TAVI is generally contraindicated in the context of endocarditis. Here we describe a patient developing acute cardiogenic shock due to prosthetic aortic valve degeneration with free‐flow aortic regurgitation 8 months after receiving treatment for confirmed infective endocarditis. Due to his clinical status, he was deemed unfit for redo surgery, and he underwent salvage valve‐in‐valve (ViV)‐TAVI. The patient made an excellent recovery. Postprocedure he was treated with a 6‐week course of antibiotics, and at 18‐months follow‐up remains very well with no evidence of reinfection. This case may demonstrate that for selected patients with degenerative prosthetic aortic valve disease, despite a history of infective endocarditis, ViV‐TAVI may be considered an alternative to redo surgery in the emergency setting.