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      Heart-Valve Patients Should Have Earlier Surgery, Study Suggests

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      The results of a new clinical trial have overturned the “wait and see” approach that cardiologists have long favored for symptom-free patients.For decades, people with failing heart valves who nevertheless felt all right would walk out of the cardiologist’s office with the same “wait and see” treatment plan: Come back in six or 12 months. No reason to go under the knife just yet.A new clinical trial has overturned that thinking, suggesting that those patients would be much better off having their valves replaced right away with a minimally invasive procedure.The trial, whose results were published this week in The New England Journal of Medicine, could change the way doctors treat severe aortic stenosis, a narrowing of the valve that controls blood flow from the heart. The disease, which has a prognosis worse than that of most cancers, afflicts more than 3 percent of people ages 65 and older. It is expected to become more common as people live longer.Replacing people’s heart valves, even if they were not yet experiencing any ill effects, appeared to roughly halve their risk of being unexpectedly hospitalized for heart problems over at least two years, the trial found.Patients who were put on the more conservative treatment plan overwhelmingly ended up needing surgery anyway: Roughly 70 percent of them developed symptoms and needed to have their valves replaced within two years, suggesting that the disease worsens more quickly than previously understood.“You may be able to at least prevent that progression and perhaps improve patient outcomes by treating earlier,” said Dr. Gregg Stone, a professor of medicine at the Icahn School of Medicine at Mount Sinai, describing the implications of the trial. The findings, he said, “will have a major effect on practice.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      In Election’s Final Days, Dark Money and ‘Gray Money’ Fund Hidden Agendas

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      Big-money operatives are taking advantage of lax rules at the end of the campaign to hide the true source of their money until after the election is called — or for forever.The campaign literature that landed in Republican mailboxes in North Carolina this week was jarring. On one side was a sonogram image of a human fetus, with this message: “Her heart is beating. We all know it. Only the courageous few will protect her.” On the other side was a call to action: “You have the courage and the conviction to vote for Randall Terry.”But the mailer did not come from supporters of Mr. Terry, a third-party presidential candidate and longtime leader in the anti-abortion movement.Rather, the fine print showed it was the work of a nascent super PAC with the anodyne name of Civic Truth Action that was funded by millions of dollars in difficult-to-trace money linked to Democrats trying to elect Vice President Kamala Harris as the next president.The final days of a high-stakes election are often a time of political mischief. The message pushed by Civic Truth Action — purportedly to help Mr. Terry but aimed at siphoning votes from former President Donald J. Trump — may be among the most cynical. But it is far from unique. Across the country, supporters of Ms. Harris and Mr. Trump are taking advantage of a patchwork of lax laws that allow partisans to funnel millions of dollars through daisy chains of opaque entities into hard-hitting campaign tactics, all to try to sway the tiny slice of swing-state voters who could make the difference.Campaign operatives and donors have long deployed creative accounting to mask the flow of money into politics. But in the decade and a half since the Supreme Court’s Citizens United decision paved the way for unlimited spending on political advertising, it has become particularly difficult to follow the big-money flow in the weeks before Election Day, despite the majority opinion’s assertions that “prompt disclosure” of political spending would enable voters “to make informed decisions.”“Now it’s sort of undeniable that the court was wrong with those predictions,” said Ian Vandewalker, a lawyer at the Brennan Center for Justice, a progressive nonprofit that works to reduce the influence of big money in politics. Mr. Vandewalker published an analysis this week of the increase in difficult-to-trace funding to super PACs. “The ability to hide funding for those types of things is attractive for people who want to engage in dirty tricks,” he said in an interview.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      UK Budget: Labour Party to Raise Capital Gains and Inheritance Taxes

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      Rachel Reeves, the new finance minister, announced substantial tax increases in her first budget as she sought to strengthen public finances and services.The new British government, led by the Labour Party, said it would substantially raise taxes and borrow more for investment as it sought to steer the country out of a long run of economic stagnation.Rachel Reeves, the chancellor of the Exchequer, delivered her first budget — and the first one ever by a woman — in Parliament on Wednesday. In a nearly 80-minute speech, Ms. Reeves announced about 40 billion pounds ($51.8 billion) in tax increases, more than half of which would come from higher taxes that employers pay on their workers’ salaries. She also increased capital gains and inheritance taxes.“The choices that I have made today are the right choices for our country,” Ms. Reeves said. “That doesn’t mean these choices are easy.”The budget was the first big opportunity for the Labour Party to set Britain’s economic agenda after it was swept into office with a large majority in July’s general election after 14 years out of power.But after a turbulent few months in office for the Labour Party, the budget has been seen as a reset moment for the party itself. Keir Starmer, the prime minister, said this week that the budget would “light the way” toward the government’s priorities of ensuring financial stability, improving public services and encouraging investment.For months, Ms. Reeves has warned that this budget would include “difficult” choices, signaling that Britons will have to swallow pain now for a bigger payoff later. These choices, government officials have said, will help the government achieve its goal of making Britain the fastest-growing economy in the Group of 7.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Looking for the Next Streaming Cult Classic? Try Arrow.

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      Horror is well-represented on this service, which makes it an ideal spooky season addition to your streaming menu.Over the past several months, we’ve examined and recommended several streaming services for the discriminating movie lover — sites and apps for those whose tastes run toward titles a bit more esoteric than the likes of Netflix and Amazon Prime Video. Our latest entry spotlights a terrific subscription streamer for genre film fans.The subscription streaming service Arrow has its roots in a boutique physical media distributor much beloved by cinephiles: Arrow Video, established in England in 2009 as an offshoot of the theatrical distributor Arrow Films. The company quickly established itself as a favorite among genre film fans, offering painstaking restorations of long-neglected horror and cult titles on discs packed with copious bonus features; they were one of the reasons so many American collectors invested in all-region disc players, before the company expanded to the U.S. market in 2015.Arrow was one of several companies to enter the subscription streaming space during Covid lockdown, with their platform launching in October 2020. Their initial offerings numbered around 400 titles; they’ve since doubled that number, bolstering their library with short films, documentaries and curated “Selects” collections from name-brand directors like Roger Avary, Eli Roth and Edgar Wright.Horror is unsurprisingly well-represented on Arrow, which makes it an ideal spooky season addition to your streaming menu; the scary movie offerings are so plentiful that one can even deep-dive into subgenres like slashers, giallo, J-horror, zombie movies and once-banned “video nasties.” But there’s more than mere horror in the catalog, which also features offbeat Westerns, science fiction, yakuza crime epics, martial arts movies galore and cult movies of all stripes and decades. Acclaimed directors such as George A. Romero, Dario Argento and Lucio Fulci get well-deserved spotlights, along with lesser-known (to the general public, at least) auteurs like William Grefé and Seijun Suzuki.Arrow’s interface is smooth and easy to use, and the pricing is agreeably reasonable: $6.99 per month or $69.99 for the year, with a current promotion (code: SHOCKTOBER24) cutting 50 percent of the price for the first month. Its offerings are certainly specialized; this is not a Netflix replacement. But viewers with a fondness for the esoteric (and we know you’re out there) will be hard-pressed to find more quality bang for their streaming buck.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Elon Musk’s SpaceX, Already a Leader in Satellites, Gets Into the Spy Game

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      The Pentagon needs what the company offers to compete with China even as it frets over its potential for dominance and the billionaire’s global interests.The breakthrough came last month, about 600 miles above Earth.For the first time, the Pentagon’s Space Development Agency used lasers transmitting data at light speed to communicate between military satellites on a secure network, making it easier to track enemy missiles and if necessary shoot them down.It was a milestone not only for the Pentagon. This was a defining moment for a certain up-and-coming military contractor that had built key parts of this new system: Elon Musk’s SpaceX.SpaceX over the last year started to move in a big way into the business of building military and spy satellites, an industry that has long been dominated by major contractors like Raytheon and Northrop Grumman as well as smaller players like York Space Systems.This shift comes as the Pentagon and U.S. spy agencies are preparing to spend billions of dollars to build a series of new constellations of low-earth-orbit satellites, much of it in response to recent moves by China to build its own space-based military systems.SpaceX is poised to capitalize on that, generating a new wave of questions inside the federal government about the company’s growing dominance as a military space contractor and Mr. Musk’s extensive business operations in China and his relations with foreign government leaders, possibly including President Vladimir V. Putin of Russia. Mr. Musk is also unpredictable in a sector in which security is often perceived to be synonymous with predictability. He chafes at many of the processes and rules of government, saying they hold back progress, and wants to make his own calls.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      A ‘Glorious’ Economy

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      Polling suggests that as we go into Election Day, the Republicans’ advantage on the economy is substantially smaller than it was a few months ago. But if you look at the numbers, what’s astonishing is that the advantage doesn’t go the other way.Wednesday’s data release on gross domestic product for the third quarter, the last one before the election, paints a portrait of remarkable economic success. One way to see how amazing that success has been — The Economist calls it “glorious” — is to compare where we are now with Congressional Budget Office projections released in January 2020, before Covid struck. There were widespread warnings that the pandemic would cause “scarring” — that is, do lasting damage; instead we have substantially outperformed those projections:Sources: CBO, Bureau of Economic AnalysisAt the same time, inflation looks beaten: The Federal Reserve’s preferred measure of underlying inflation is close to its 2 percent target. What looked like a bump in inflation early this year was probably just a statistical blip:Source: Bureau of Economic AnalysisToday’s political scene being what it is, Republicans will continue to denounce Biden-Harris economic policies as a failure. But if this is failure, what would success look like? Claims that we have a bad economy are about as credible as claims that armed migrants have taken over Times Square. More

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      Was This Scrap of Cloth Once a Tunic Worn by Alexander the Great?

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      A Greek researcher says a piece of purple-and-white fabric discovered decades ago in a tomb in northern Greece may have belonged to Alexander. Others disagree.Could it be a scrap of Alexander the Great’s clothing?A fragile piece of purple-and-white fabric, frayed over more than two millenniums, that was found in one of a series of tombs in northern Greece decades ago is at the center of a new claim ruffling feathers in the country’s archaeological community.The debate erupted this month after Antonis Bartsiokas, a paleoanthropologist at Democritus University of Thrace, published a paper arguing that one of the tombs, believed up to now to house the remains and treasures of Alexander’s father, actually held items belonging to Alexander the Great himself and his half brother. That included a purple chiton, or tunic.The claim challenges the work of one Greece’s most renowned archaeologists, Manolis Andronicos, who led the discovery of the tomb in 1977. Mr. Andronicos, who died in 1992, had asserted that the tomb and artifacts belonged to the father, Philip II of Macedon, whose military victories united ancient Greece and laid the foundation for his son’s conquests from Egypt to India.Mr. Bartsiokas, who specializes in the microanalysis of fossils, instead believes it was Alexander’s half brother, Arrhidaeus, or Philip III, who was buried in the tomb, along with some of Alexander’s possessions, including the chiton, a piece of purple cotton with a layer of white fabric in between.If the new claim were confirmed, it could upend long-held beliefs about one of the most important burial sites in Greece. Some Greek archaeologists say, however, that the claim is without substance.Mr. Bartsiokas said he used new technology and his interpretation of an ancient frieze found in the tomb to make his case.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Volkswagen Profit Shrinks as Unions Threaten Strike

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      Germany’s biggest automaker said its profit dropped 42 percent in the third quarter, as union leaders warned that workers were ready to walk out over a wage dispute.Volkswagen reported a 42 percent drop in quarterly profit on Wednesday, while emphasizing an “urgent need” to cut costs and gain efficiency in a challenging marketplace as it considers plant closures and layoffs in Germany.The automaker’s negotiator pointed to the company’s weak earnings ahead of his meeting with union leaders, who warned of imminent strikes if a solution to cut costs and restructure the brand was not found.The Volkswagen Group, which owns 10 brands, including Audi and Porsche, is Germany’s largest industrial employer, with 120,000 people working for its eponymous core brand. The country’s vision of itself as an economic powerhouse and automotive giant is also deeply intertwined with Volkswagen, and local economies across the country depend on the company and its well-paid workers.Representatives from the automaker and IG Metall, the union representing most of its workers, convened for a second round of wage negotiations on Wednesday in a conference room in the Volkswagen Arena, the stadium of the company’s professional soccer team, VfL Wolfsburg.Before the talks, Volkswagen reported that profit fell to 2.86 billion euros, or $3.1 billion, for the months of August to September, its lowest level in three years. The company is struggling against falling demand in China, the world’s largest car market, and high costs, especially in its homeland, Germany.“The situation is getting worse,” Arne Meiswinkel, the chief of personnel at Volkswagen, who is leading negotiations for the company, told reporters before the negotiations began.But union leaders insisted that a guarantee by the company that all 10 of its factories in Germany would remain open was a prerequisite for them to stay at the negotiating table. The union is prevented from staging any strikes until the end of November, but leaders said that they would begin preparing walkouts unless their demand was met.“We expect Volkswagen to declare its willingness to enter into negotiations with us on a viable future concept for all sites,” Thorsten Gröger, chief negotiator of IG Metall union, told reporters ahead of the talks.“Otherwise, I say quite clearly, we will have to plan the further escalation with our negotiating and bargaining committee,” he said.On Monday, the company’s top employee representative said that management had informed the works council that it was considering shutting down as many as three factories in Germany and laying off tens of thousands of workers. The closures would be the first in the 87-year history of the company and would be a further blow to Germany’s stagnant economy. More