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In a landmark ruling Tuesday, a federal appeals court in New York cleared the way for a bankruptcy deal for opioid manufacturer Purdue Pharma. The deal will shield members of the Sackler family, who own the company, from future lawsuits. The 2nd Circuit Court of Appeals spent more than a year reviewing the case after a lower court ruled it was improper for Purdue Pharma's bankruptcy deal to block future lawsuits against the Sackler family. (Mann, 5/30)

A federal appeals court on Tuesday potentially laid the groundwork for corporations to avoid legal exposure in future opioid lawsuits through a technicality in bankruptcy law. ... Tuesday's decision presses the boundaries of "what we understood commercial bankruptcy to be about" and could inspire more corporations with similar circumstances to limit liability through bankruptcy courts, said Deborah Hensler, a professor at Stanford Law School. This could include mass litigation over toxic chemical exposure or contaminated water, Hensler told Axios. (Moreno, 5/31)

The United States Treasury sanctioned more than a dozen people and businesses in China and Mexico Tuesday that allegedly helped provide machines used to make counterfeit prescription drugs in the latest efforts to confront trafficking of the deadly synthetic opioid fentanyl. Those targeted for sanctions were all involved in one or another with the sale of pill press machines, molds and other equipment drug cartels use to produce counterfeit pills. (5/30)

By a line of ragged RVs slung along 78th Street in South Los Angeles, a seven-member team passes out glass pipes used for smoking opioids, crack and methamphetamine. Part of the front line of Los Angeles County’s offensive against the deadly fentanyl epidemic, the group hands out other supplies: clean needles, sanitary wipes, fentanyl test strips and naloxone, medication that can reverse an overdose. (Holland, 5/30)

A string of fentanyl-related overdoses in recent weeks has drawn attention to the drug's growing presence in Portland. Why it matters: Illicitly manufactured fentanyl has fueled a significant increase in overdoses since 2019, according to Oregon Health Authority data. (Gebel, 5/30)

For years, Oregonians have reported some of the highest rates of substance use disorder in the nation on federal surveys. The opioid crisis is nearly three decades old and use of methamphetamine, long Oregon’s deadliest drug, has not abated. At the same time, the state consistently has among the lowest treatment availability in the country, according to surveys conducted by the U.S. Department of Health and Human Services. Fentanyl — a cheap, incredibly addictive synthetic opioid — has made all of those problems much worse. (Wilson, 5/30)

While Republicans say the expanded work requirements would help people get jobs, anti-hunger advocates argue that requirements should be eliminated altogether, citing research that indicates they don’t have a measurable effect on participants’ employment. “It’s not doing anything to help them, to help the economy. It’s just a punitive way to take food away from people,” said Ellen Vollinger, the SNAP director for the Food Research & Action Center, an anti-hunger group. (Chuck and McCorvey, 5/30)

Some older adults would be required to work to get food aid under the federal debt-limit deal set for congressional votes this week, while others would be newly exempt from having to find a job, in one of the more controversial provisions of the compromise agreement. The deal struck by President Biden and House GOP negotiators over the weekend would raise the age to 54, up from 49, for able-bodied, low-income adults without dependents who would be required to work at least 80 hours a month to receive food aid. (Peterson, 5/31)

Adoption of the rule allows the debt limit bill to advance to the floor for debate and a vote on Wednesday, just five days before the June 5 deadline. Treasury Secretary Janet Yellen has said the U.S. could default on its debts by that day if the borrowing limit is not raised. It also marks a procedural victory for congressional leaders, who are working to rally support for the legislation ahead of Wednesday’s vote. A number of conservatives and some liberal House lawmakers have announced plans to vote against the bill, upping pressure on leaders to corral enough votes for the legislation to cross the finish line on Wednesday. (Schnell, 5/30)

Kevin McCarthy and Joe Biden achieved what once looked improbable: A bipartisan deal to raise the debt ceiling. Now any one senator has the leverage to bring the country right to the brink of default. After the House’s planned Wednesday vote to raise the debt ceiling through 2024, the Senate will have only days before the June 5 deadline. And Senate leaders may have to do procedural acrobatics to clear the bill through their chamber in time to keep financial markets and everyday Americans comfortable. (Everett and Diaz, 5/30)

Nevada’s Joe Lombardo on Tuesday became one of the first Republican governors to enshrine protections for out-of-state abortion patients and in-state providers, adding the western swing state to the list of those passing new laws to solidify their status as safe havens for abortion patients. The legislation codifies an existing executive order from former Gov. Steve Sisolak last year — who lost reelection to Lombardo — that bars state agencies from assisting in out-of-state investigations that could lead to the prosecution of abortion patients who travel to Nevada. It also ensures medical boards and commissions that oversee medical licenses do not discipline or disqualify doctors who provide abortions. (Stern, 5/31)

Wisconsin Republicans released a package of legislation Tuesday that would tweak the state’s abortion ban by specifying medical procedures to save a mother’s life that don’t qualify as abortion. Democratic Gov. Tony Evers is almost certain to veto the measure should it pass the Republican-controlled Legislature. He has already promised to veto a different Republican-backed bill that would allow abortions in the case of rape or incest, saying he supports restoring abortion rights to what they were in Wisconsin before the U.S. Supreme Court overturned Roe v. Wade last year. (Richmond, 5/30)

As promised, the American Civil Liberties Union is suing to block the Nebraska Legislature’s most controversial measure combining an abortion ban with restrictions on gender-affirming care for minors, just days after it was signed into law. The lawsuit, filed in state court Tuesday by the ACLU on behalf of Planned Parenthood and one of its doctors who performs abortions in Nebraska, argues that the law violates a state constitutional requirement that legislative bills stick to a single subject. The lawsuit is also asking for an injunction to block enforcement of the trans health and abortion restrictions until the court case is decided. (Beck, 5/30)

The Tennessee woman would end up needing a lifesaving emergency hysterectomy, ending her opportunity to give birth to more children, after she says she was denied medically necessary abortion care at a hospital in her home state for life-threatening complications earlier in her pregnancy. (El-Bawab, 5/31)

Republican and Democratic members of Congress from Alabama submitted a draft House bill late last week that would block funding for the continued growth of U.S. Space Command's temporary headquarters in Colorado, according to documents reviewed by NBC News. Two congressional officials said the bill would prohibit SPACECOM from spending money on constructing, leasing or modernizing facilities until the secretary of the Air Force formally selects and publicly announces the final location, which the Trump administration said would be in Huntsville, Alabama. (Kube, 5/31)

Sen. Elizabeth Warren (D-Mass.) is launching a fresh round of questioning on states’ limits to abortion rights as a battle on medication abortion hangs in the balance at a federal court. (Owermohle, 5/30)

Threats and acts of violence against abortion providers increased dramatically in 2022, according to data collected each year by the National Abortion Federation, a professional association. States that continue to offer legal abortions, like Oregon and Washington, had the biggest increases in violence directed at providers and disruptions meant to stop abortions from happening, according to the federation. (Hughes, 5/30)

Asian Americans do not have adequate access to information about how to obtain an abortion, according to a new report. Cultural stigmas against conversations about sexual and reproductive health and a lack of in-language information on abortion has stifled knowledge of abortion care among Asian Americans, Pacific Islanders and Native Hawaiians, researchers found. (Yang, 5/31)

When Rose Al Abosy began weighing which obstetrics and gynecology residencies to apply to, she spoke to advisers, considered programs’ academics and evaluated how state laws would affect her ability to train in providing abortions. The Boston University Medical School graduate narrowed down the options to 80 programs in states that had not enacted restrictions on abortion care. (Raman, 5/31)

Food workers who showed up while sick or contagious were linked to about 40% of restaurant food poisoning outbreaks with a known cause between 2017 and 2019, federal health officials said Tuesday. Norovirus and salmonella, germs that can cause severe illness, were the most common cause of 800 outbreaks, which encompassed 875 restaurants and were reported by 25 state and local health departments. (Aleccia, 5/30)

Having a healthy sleep schedule before COVID-19 infection may help prevent long COVID, according to a study today in JAMA Network Open. The cohort study included 1,979 women who participated in the Nurses' Health Study II, completing surveys about sleep habits and COVID infections between April 2020 and November 2021. (Soucheray, 5/30)

Working the night shift or binge drinking may double the risk of COVID-19 infection, according to a study of nurses published this week in Alcohol: Clinical and Experimental Research. Poor sleep quality and binge drinking have been associated with COVID-19 infections, likely because both promote a pro-inflammatory state. (Soucheray, 5/30)

A Jackson County judge ruled the state’s former attorney general lacked the authority to order school districts to drop their mask mandates during the COVID-19 pandemic. The decision from Judge Marco Roldan on Friday found Eric Schmitt, now a U.S. senator, “exceeded his lawful authority” when he ordered dozens of school districts in December 2021 to rescind measures put in place to mitigate COVID transmission in schools. (Fortino, 5/31)

A family nurse practitioner in New York City, Jose M. Maria has come to expect overt racism from patients. “I’ve been called the N-word, I’ve been called, you name it,” he said. A triple minority in nursing — Black, Latino, and male — he often gets mistaken for a janitor. More subtle racist behavior has come from supervisors and fellow nurses in past jobs, too — uncomfortable looks in the break room, extra questioning from supervisors over narcotics errors he’s responsibly reported and been cleared for. “I’ve felt I’ve had a target on my back.” (McFarling, 5/31)

“Organizations have taken a really hard stance at how they’re going to improve margin, and they’ve gone through and looked at every opportunity,” said Rick Kes, healthcare partner at professional services firm RSM. “Now it’s like… we have to make these decisions, and there’s no other choice. I think everyone in the ecosystem understands that.” Here are four key takeaways from the latest round of earnings reports. (Hudson, 5/30)

"Our priority and commitment is to do everything within our power to help keep people covered for the coverage that they're eligible for," Center for Medicaid and Children's Health Insurance Program Services Director Dan Tsai said at a news conference Tuesday. "We are deeply concerned when we see large termination numbers—in particular with non-response—because our concern is that they're eligible kids and families, he said. (Turner, 5/30)

�Թϲ�����: How A Medical Recoding May Limit Cancer Patients’ Options For Breast Reconstruction 

The federal government is reconsidering a decision that breast cancer patients, plastic surgeons, and members of Congress have protested would limit women’s options for reconstructive surgery. On June 1, the Centers for Medicare & Medicaid Services plans to reexamine how doctors are paid for a type of breast reconstruction known as DIEP flap, in which skin, fat, and blood vessels are harvested from a woman’s abdomen to create a new breast. (Pradhan, 5/31)

The Oakland, California-based integrated health system will give a $5 million grant to Denver Health and another $5 million in matching funds if area organizations or other health systems financially support the safety-net hospital. Denver Health, which cares for about 30% of the city's population each year, including many indigent and uninsured residents at its 555-bed hospital and affiliated outpatient network, reported a $23.8 million operating loss in 2022 as its uncompensated care costs increased and its labor and supply costs swelled. (Kacik, 5/31)

Elizabeth Holmes, the disgraced entrepreneur who was convicted of defrauding investors at her failed blood testing start-up, Theranos, reported to a federal prison in Texas on Tuesday to begin her 11-year, three-month sentence. Ms. Holmes surrendered to F.P.C. Bryan, a minimum-security prison camp for women roughly 90 minutes from Houston. She pulled up in a Ford Expedition that appeared to be driven by her mother, Noel Holmes. Her father, Christian Holmes, appeared to be inside. (Griffith, 5/30)

The PBM, which is owned by UnitedHealth Group, will work with pharmacies in seven states to connect pregnant women and patients with diabetes with housing, transportation and food support, the company said Tuesday. OptumRx will rely on community pharmacists to connect members with Unite Us, a software company that will link members in Louisiana, Nebraska, New Jersey, New Mexico, New York, North Carolina and Texas with local resources beginning in June. Plans call for the program to expand nationally in the fall. (Tepper, 5/30)

Weight-loss surgeries among adolescents increased substantially in recent years, part of an overall rise in obesity treatments in the US. The number of adolescents ages 10 to 19 who underwent metabolic or bariatric surgery rose about 20% in 2021 from the year before, according to a research letter published Tuesday in the Journal of the American Medical Association, Pediatrics. Rates of these surgeries, which are uncommon, also rose among minors between 2019 and 2020, even as rates for adults dipped. (Peng and Court, 5/30)

A new study has found a rapid decline in global cognition, memory and executive function in those who suffer from a heart attack compared to those who do not. In a study published in the JAMA Neurology journal, researchers found that people who suffered from at least one or more incidents of myocardial infarction (MI), also known as a heart attack, had a "significantly faster" rate of decline in global cognition, memory and executive function over the years compared to those who did not. The research also found that having a heart attack was not associated with an immediate decrease in these functions after the event, but rather impacted long-term brain health. (Sforza, 5/30)

Cardiologists hope to use such tests, which cost about $150 and are not typically covered by health insurance, to identify people most likely to have heart attacks long before they have them. Some doctors envision testing children as part of routine pediatric care. (Kolata, 5/30)

If your diet is low in flavanols — antioxidant compounds found in foods such as green tea, apples, berries and cocoa — adding 500 milligrams a day to your diet may slow and possibly improve age-related mental decline, according to a new study. (LaMotte, 5/29)

Former first lady Rosalynn Carter has dementia, her family announced Tuesday. Carter, now 95, remains at home with former President Jimmy Carter, 98, who has been at home receiving hospice care since early this year. “She continues to live happily at home with her husband, enjoying spring in Plains and visits with loved ones,” the family said via The Carter Center, the global humanitarian organization the couple founded in 1982, less than two years after Jimmy Carter’s landslide defeat. (Barrow, 5/30)

Ralph Yarl — a Black teenager who was shot in the head and arm last month after mistakenly ringing the wrong doorbell — walked at a brain injury awareness event Monday in his first major public appearance since the shooting. The 17-year-old suffered a traumatic brain injury when he was shot while trying to pick up his younger brothers in April, the Kansas City Star reported. Yarl walked with family, friends and other brain injury survivors Monday at Going the Distance for Brain Injury, a yearly Memorial Day race at Loose Park in Kansas City, Missouri. (5/30)

�Թϲ�����: Mood-Altering Mushroom Sales Bloom Despite Safety Concerns 

When a hemp dispensary in this Florida city started to stock edibles with certain mushroom extracts last year, state regulators quickly ordered it to stop selling the items. The shop had been advertising fruit-flavored gummies and other products containing tiny doses of mood-altering chemicals from the mushroom Amanita muscaria. The red-capped, white-spotted fungus — rooted in popular culture through the Super Mario Nintendo game franchise, “The Smurfs,” and “Alice’s Adventures in Wonderland” — is legal for consumers to possess and eat in every state except Louisiana, according to a review of state laws. (Ogozalek, 5/31)

�Թϲ�����: Readers And Tweeters Weigh Marijuana’s Merits Against Those Of Alcohol Or Opioids

�Թϲ����� gives readers a chance to comment on a recent batch of stories. (5/31)

�Թϲ�����: Listen To The Latest ‘�Թϲ����� Minute’ 

This week’s �Թϲ����� Minute: Potent new forms of recreational cannabis are increasing the risk of dependency, and learn how Medicare fraud could prevent you from getting the medical supplies you need. (5/25)

In the midst of a surge in eating disorders across the country, Colorado’s acting governor signed bills Tuesday that will create a state program dedicated to addressing the mental illness, limit the use of body mass index in determining treatment and restrict the sale of diet pills to minors. Colorado and several other states tackling the issue are responding to the nearly 30 million Americans — roughly the population of Texas — who will struggle with an eating disorder, such as anorexia or bulimia, in their lifetime. More than 10,000 people will lose their life to the condition every year, according to data cited by the National Association of Anorexia Nervosa and Associated Disorders. (Bedayn, 5/30)

�Թϲ����� has learned that a coalition of doctors, hospitals, insurers, and community clinics want to lock in a tax on health insurance companies to draw in extra Medicaid funding. It also wants to make the tax permanent. (Hart and Young, 5/31)

The North Carolina legislature gave final approval Tuesday to a bill allowing the state’s leading health insurance provider to restructure despite criticisms from the state insurance commissioner that it would erode his regulatory authority and undermine his ability to protect consumers. The measure, which permits Blue Cross and Blue Shield of North Carolina and a dental insurance provider to transfer assets into a parent holding company, cleared the Senate 41-5 Tuesday after passing the House with similar bipartisan support earlier this year. (Schoenbaum, 5/30)

Healthcare workers, residents, and elected officials rallied Tuesday at UMass Memorial Health’s Leominster campus to protest the planned closure of its maternity ward, which they say will endanger the lives of mothers and infants across North Central Massachusetts. The crowd of more than 100 people, including several nurses and pediatricians, gathered on the hospital’s lawn to condemn the closure they say will place a greater burden on emergency services and leave an already vulnerable population without accessible maternal care. (Mohammed, 5/30)

The renovated Hampstead Hospital, now called East Acres at Hampstead and set up to provide psychiatric care for children, is expected to open to patients next week. The state purchased the hospital with federal aid. State health officials said the 12-bed facility is expected to welcome its first overnight patients Tuesday. It's meant to provide high-level mental heath care that young patients would otherwise need to travel out of state to receive. (Rogers, 5/26)

More than one in five U.S. adults missed a medical appointment last year because they didn't have a way to get to it, according to a report by the Urban Institute. It's a problem that disproportionately affects women and households of color. Transportation is a key social driver of health equity. (Hurt and Neese, 5/30)

A man in police custody died Thursday in Northern California after he broke a hospital’s window with a metal oxygen tank and fell off a ledge following an altercation with an officer and a nurse, authorities said. (5/28)

The body of a Missouri emergency room doctor who has been missing for more than a week has been found in northwest Arkansas, his brother told The Associated Press on Tuesday. ... Police said John Forsyth, 49, was reported missing when he failed to show up for work May 21 at Mercy Hospital in Cassville, a town of 3,100 residents deep in the Missouri Ozarks. (Bauman and Salter, 5/31)

Bills that would limit gender-affirming care, prevent trans youth from competing in sports and require schools to tell parents if a child wants to use other pronouns represent “an unprecedented attack” on trans rights in North Carolina, Ellie Harleen Isley told a crowd at a Trans Rights Rally in downtown Greensboro on Friday. (Fernandez, 5/31)

Three states want to stipulate how, and whether, autistic transgender youth and those with mental health conditions are able to access gender-affirming care — a new tactic aimed at the intersection of two marginalized groups. (Rummler and Luterman, 5/30)

It’s been a winding road full of potholes, but Lexicon Pharmaceuticals has finally reached its destination, gaining an FDA approval for Inpefa (sotagliflozin). (Dunleavy, 5/30)

Using AI, researchers identified a new antibiotic that can kill Acinetobacter baumannii, a type of bacteria that is responsible for many drug-resistant infections. (Massachusetts Institute of Technology, 5/25)

Electroconvulsive therapy (ECT) and subanesthetic intravenous ketamine are both currently used for treatment-resistant major depression, but the comparative effectiveness of the two treatments remains uncertain. (Anand, M.D., et al, 5/24)

New data published today in Clinical Infectious Diseases indicates that early implementation of shorter treatment regimens for drug-resistant tuberculosis (TB) in the United States was successful. The data come from a cohort of 70 US patients who were started on the 6-month, all-oral bedaquiline, pretomanid, and linezolid (BPaL) regimen for rifampin-resistant TB (RR-TB) in October 2019, shortly after the US Food and Drug Administration approved the regimen. (Dall, 5/30)

The US Food and Drug Administration (FDA) yesterday approved the combination antibiotic sulbactam-durlobactam for the treatment of patients with hospital-related bacterial pneumonia caused by a highly resistant superbug. The drug, marketed as Xacduro, combines a beta-lactam antibiotic (sulbactam) with a novel, broad-spectrum beta-lactamase inhibitor (durlobactam) and specifically targets susceptible strains of Acinetobacter baumannii-calcoaceticus complex. (Dall, 5/24)

The drug is a central α2-adrenergic receptor agonist that causes a rapid decrease in the release of norepinephrine and dopamine in the central nervous system, according to the FDA. (Rubin, MA, 5/24)

Fentanyl is a lab-made opioid developed to treat severe pain. Like other opioids, it’s extremely effective − and extremely addictive. As the opioid crisis raged through the mid-1990s, people addicted to prescription opioids turned to the street. (Tracy Vonder Brink, 5/30)

In this issue of the Journal, Loftus et al.1 report the results of three trials of upadacitinib (a small-molecule drug that inhibits the Janus kinase [JAK] 1 [JAK1] protein) for the treatment of moderate-to-severe Crohn’s disease, an inflammatory bowel disease (IBD). Two were trials of induction therapy, and one was a trial of maintenance therapy. (Maria T. Abreu, M.D., 5/25)

Imagine a future where far fewer women are diagnosed with breast cancer, and women with a family history of breast cancer don’t have to make the difficult, even devastating choice to get a preventive mastectomy. Instead, women would get a series of shots that teach their immune systems how to quash breast cancer before it becomes a problem. (Lisa Jarvis, 5/30)

“Hey, I’m sorry to bother you, but I could really use your advice on something.” As fellows in oncology training programs, we’re both accustomed to fielding texts, emails, and calls that start out like the above from family, friends, and acquaintances seeking guidance for themselves or their loved ones after a cancer diagnosis. (Samyukta Mullangi and Vinayak Venkataraman, 5/31)

I woke up crying in the gray light of early morning. For the first time in eight weeks, I found myself alone. My husband and our son were on a camping trip, one that I could no longer join them on because my body had turned on me. Work had kept me busy the previous evening, but now, it was just me and Potter, our aussiedoodle, in a quiet house. Me, the dog and the tumor. I’m not a crier. I’m an editor and a mom, constantly juggling stories and meetings and car lines. I’d only cried twice up to this point, both times out of shock and over quickly. (Ellen E. Clarke, 5/30)

More than three years after the World Health Organization characterized COVID-19 as a pandemic — and three weeks after WHO said that the virus is no longer a “public health emergency of international concern” — COVID landed at my door. (Renee Graham, 5/30)

A child has cancer. Should parents or the medical establishment decide the healing journey? Do parents have a right to seek alternative approaches, or are they beholden to the cancer industry and its protocols? Should the state have the right to remove a child from the home if parents decline a treatment they deem destructive? (Lisa Swanson, 5/30)

I was always a person who had to have everything together. Failure was not an option in my book. Neither was asking for help. Then I had a baby. I was – or I should have been – ecstatic to embark on this new journey. But why was it so difficult? It’s hard to understand how the body that just birthed an entire, beautiful human being can turn on you so effortlessly. (Jordyn Wilson, 5/31)

Connecticut can be a state of vast disparities despite our small size. This is particularly evident in the area of healthcare. We have some of the best medical training programs in the country, yet Connecticut ranks 47th in retaining the physicians we train in our state. We also have world-class health systems and virtual healthcare deserts in parts of our state with severely underserved areas and populations. (David J. Hass MD, 5/31)