• The Wall Street Journal reports
  • “Days after a hooded and masked man fatally shot a UnitedHealthcare executive in Manhattan, investigators have learned key details about the gunman’s stay in the city and how he planned his crime.
  • “Investigators are looking at the possibility that the shooter might be a disgruntled ex-employee of Brian Thompson’s insurance company or an angry client, according to NYPD Chief of Detectives Joseph Kenny. Investigators have been in touch with Thompson’s family, but there is no indication the shooting involved his private life, police said.
  • “New York Mayor Eric Adams told reporters Saturday that police have a name for the suspect but declined to disclose it pending the investigation. “The net is tightening,” the mayor said outside a Police Athletic League event in Harlem, according to footage from MSNBC. A New York police spokesman late Saturday said he couldn’t confirm that the department has the name of a suspect.
  • “The shooter might have used a large handgun, or possibly a veterinary gun, a firearm used to put down animals that doesn’t make a lot of noise, police said.
  • “The assailant likely left New York on a bus early Wednesday, not long after he fatally shot Thompson outside a hotel in Midtown Manhattan, investigators said. But he left behind a critical piece of evidence: the backpack he wore during the shooting and apparently abandoned in Central Park. Police found a bag there Friday afternoon.

From Washington, DC,

• The House of Representatives and the Senate will be engaged in Committee business and floor voting this week.

• OPM reminds us,
  • “OPM has extended Open Season for the Postal Service Health Benefits Program through Friday, December 13th at 11:59 pm EST. This extension is only for the PSHBP. This does not extend to FEHB or other benefits programs. The deadline for FEHB remains 11:59 pm, in the location of your electronic enrollment system, on Monday, December 9th.”

• Federal News Network tells us,
  • “Office of Personnel Management Acting Director Rob Shriver sees several areas of opportunity to build on the forward momentum to reform federal hiring and retention.
  • “During the Biden administration, the President’s Management Agenda focused one of its key priorities on strengthening and empowering the federal workforce. Though the efforts of the PMA are now coming to a close, administration officials pointed to promising signs of an improving federal hiring process.
  • “For example, the Biden administration has taken steps to keep the ball rolling on a push toward skills-based hiring. In April, the White House announced plans to transition the government’s primary job series for federal IT specialists away from college degree requirements over the next year.
  • “This really picked up on an initiative from the prior administration, and we’ve been grinding through the implementation of that,” Shriver said in an interview with Federal News Network at a Dec. 4 White House event. “But there are also a lot of challenges to implementing true skills-based hiring.”

From the public health and medical research front,

• Cardiovascular Business informs us,
  • “Heart surgeons with the WVU Heart and Vascular Institute have made a bit of history, performing the world’s first combined robotic aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) procedure—all through one small incision. Patients requiring these procedures typically undergo open-heart surgery. 
  • “The patient in question, 73-year-old Poppy McGee, presented with a history of stroke, brain surgery and ongoing weight loss. She was referred to Vinay Badhwar, MD, executive chair of the WVU Heart and Vascular Institute and chair of WVU’s department of cardiovascular and thoracic surgery, who initially recommended open-heart surgery. However, when McGee and her family heard that the odds of dying exceeded 10%, they inquired about less invasive treatment options. 
  • “Badhwar, a known pioneer of robotic aortic valve replacement (RAVR) and other robotic surgical techniques, said his team had developed a new technique for combining AVR and CABG—but it had not yet been tested on a patient. After a long discussion with McGee and her family about the risks, she agreed to the new-look surgical treatment.
  • “The combined surgery occurred on Oct. 31, 2024. Both the AVR and the CABG were performed using the same small incision on the far right of McGee’s chest. The surgery was a success, and a detailed account is expected to publish in The Annals of Thoracic Surgery.” ***
  • “Goya Raikar, MD, a member of Badhwar’s robotics team and an assistant professor a WVU, highlighted the progress this successful procedure represents for their work on advancing robotic surgical techniques.
  • “Until now, the main exclusion for us to perform a robotic approach has been the coexistence of valve and coronary artery disease,” he said. “Building on our experience with robotic aortic valve surgery, this new approach may help us extend robotic surgery options to many more patients.”  

• The Hill lets us know,
  • “A more potent form of fentanyl is contributing to the thousands of overdose deaths that happen every year, health officials warn.
  • “An extremely powerful derivative of fentanyl, called carfentanil, was detected in 513 overdose deaths between 2021 and early 2024, according to a report from the Centers for Disease Control and Prevention (CDC). 
  • “Carfentanil was designed to tranquilize large animals and is estimated to be 10,000 times stronger than morphine and 100 times stronger than fentanyl.  
  • “Just 2 milligrams is needed to tranquilize an elephant; that same amount is powerful enough to kill 50 people, according to a Department of Veteran Affairs report.
  • “Drug overdose deaths overall have been declining since 2023, according to the CDC. But they remain high in the United States, and the majority are connected to illegally manufactured fentanyls (IMFs).
  • “Carfentanil-related overdose deaths are becoming less rare, highlighting the “ever-changing illegal drug supply” that threatens the progress made in reducing overdose deaths, according to the report.” * * *
  • “Carfentanil-related deaths continued to rise this year, with a total of 238 people dying from the drug by June — a roughly 720 percent increase from the first half of 2023 to the first half of 2024.”

• Per Medscape,
  • “Vaccines for treating and preventing cancer have long been considered a holy grail in oncology.
  • “But aside from a few notable exceptions — including the human papillomavirus (HPV) vaccine, which has dramatically reduced the incidence of HPV-related cancers, and a Bacillus Calmette-Guerin vaccine, which helps prevent early-stage bladder cancer recurrence — most have failed to deliver.
  • “Following a string of disappointments over the past decade, recent advances in the immunotherapy space are bringing renewed hope for progress.
  • “In an American Association for Cancer Research (AACR) series earlier this year, Catherine J. Wu, MD, predicted big strides for cancer vaccines, especially for personalized vaccines that target patient-specific neoantigens — the proteins that form on cancer cells — as well as vaccines that can treat diverse tumor types.
  • “A focus on neoantigens that arise from driver mutations in different tumor types could allow us to make progress in creating off-the-shelf vaccines,” said Wu, the Lavine Family Chair of Preventative Cancer Therapies at Dana-Farber Cancer Institute and a professor of medicine at Harvard Medical School, both in Boston.”

• Fortune Well points out five symptoms that men over 40 should never ignore.
  • “Unexplained fatigue
  • “Chest discomfort
  • “Swelling in lower extremities
  • “Changes in exercise tolerance, and
  • “Loss of morning erections.”

• NPR Shots reminds us,
  • “[I]nstead of chilling out in front of the TV after you polish off a scrumptious dessert, consider venturing out for a walk. It’s one of the easiest things you can do to boost your health after a meal, and even a short stroll can yield big benefits.
  • “The concept of post-meal walks has been around for centuries, notes Loretta DiPietro, a professor of exercise and nutrition science at the George Washington University Milken Institute School of Public Health.”

From the U.S. healthcare business front,

• BioPharma Dive relates,
  • “BioAge Labs said it is terminating a mid-stage study of its obesity drug candidate azelaprag in combination with Eli Lilly’s tirzepatide due to safety concerns, causing its share price to slide by three-quarters in after-hours trading Friday.
  • “Eleven people who received azelaprag in STRIDES, BioAge’s Phase 2 study, showed elevated levels of liver enzymes that can warn of potential organ damage. As a result, the company is discontinuing dosing and halting further enrollment.
  • “The San Francisco Bay Area company raised $170 million in February and banked a $198 million initial public offering in September to fund its ambitious foray into metabolic drugs, not long after it pivoted from making treatments for age-related diseases.”

• MedTech Dive adds,
  • “Edwards Lifesciences predicted Wednesday that an expanded indication in transcatheter aortic valve replacement (TAVR) and rapid growth in its newer mitral and tricuspid heart valve technologies will accelerate total company sales in 2026 and beyond.
  • “Edwards anticipates mid-2025 approval for TAVR in people with asymptomatic severe aortic stenosis, the company said during an investor day event.
  • “The Sapien TAVR system is Edwards’ biggest product but has seen growth slow this year as hospital heart teams dealt with capacity constraints. Hospitals, however, are investing to increase capacity and avoid delays in patient treatment, which will support prioritization of aortic stenosis cases long term, Edwards said in its presentation.” 

• The Journal of Accountancy lets us know,
  • “A federal district court, finding that the Corporate Transparency Act (CTA) is likely unconstitutional, issued an order Tuesday prohibiting the enforcement of the CTA and the beneficial ownership information (BOI) reporting rule in the CTA’s accompanying regulations.
  • “The injunction, which according to the court should apply nationally, was issued in Texas Top Cop Shop, Inc. vs. Garland, No. 4:24-CV-478 (E.D. Texas 12/3/24).
  • “Under the injunction, the CTA and the BOI reporting rule cannot be enforced, and reporting companies need not comply with the CTA’s Jan. 1, 2025, BOI reporting deadline pending a further order of the court.
  • “The Financial Crimes Enforcement Network (FinCEN), which enforces the CTA, is reviewing the order, a spokesperson said Wednesday, pointing out that other courts have denied similar requests. The Justice Department (DOJ) filed a notice of appeal on Thursday night.
  • “An AICPA statement, released before the DOJ notice of appeal, acknowledged the potential effects of the injunction and urged CPAs assisting clients with BOI reporting to be prepared.
  • “Under the injunction, FinCEN is barred from enforcing BOI filing requirements while the case is pending,” the statement said. “Best practices dictate that at a minimum those assisting clients with BOI report filings gather the required information from the clients and are prepared to file the BOI report if the injunction is lifted. While it is unlikely that the injunction will be lifted prior to the final outcome of the proceedings, we advise being prepared in the event that there is a reversal.”