From Washington, DC,

• The Wall Street Journal reports,
  • “Senate Democrats took the threat of a government shutdown off the table, following a grueling intraparty fight in which lawmakers struggled with how best to resist President Trump’s fast-paced efforts to slim down federal agencies.
  • “Senate Minority Leader Chuck Schumer (D., N.Y.) said he would vote to advance a Republican measure, set for Friday morning, to fund the government through September. Earlier, in a closed-door lunch, he also said that enough Democrats would join him to help the Republicans clear the chamber’s critical 60-vote hurdle, people familiar with the matter said.
  • “I will vote to keep the government open and not shut it down,” Schumer said on the Senate floor, characterizing Democrats’ alternatives as a Hobson’s choice with no good option. He said that in a shutdown, Trump could decide “to cherry pick which parts of the government to reopen in a protracted shutdown.”

• The American Hospital Association News tells us,
  • “The White House March 13 withdrew the nomination of former Republican congressman Dave Weldon for director of the Centers for Disease Control and Prevention.
  • “Meanwhile, the Senate Committee on Health, Education, Labor and Pensions advanced the nominations of Jay Bhattacharya for director of the National Institutes of Health and Marty Makary for commissioner of the Food and Drug Administration. Both nominees will next be considered by a full Senate vote.”

• Federal News Network informs us,
  • “The Postal Service is letting a team from the Department of Government Efficiency take a closer look at its reform plans.
  • “Postmaster General Louis DeJoy, in a letter sent to congressional leaders Thursday, said he signed an agreement last night with DOGE representatives and the General Services Administration to “assist us in identifying and achieving further efficiencies.”
  • “DeJoy told lawmakers that USPS is heading in the right direction under his 10-year Deliverying for America reform plan and that DOGE’s work is “aligned with our efforts.”
  • “While we have accomplished a great deal, there is much more to be done. We are happy to have others to assist us in our worthwhile cause,” DeJoy wrote.”

From the judicial front,

• The Wall Street Journal relates,
  • “A federal judge has ordered six federal agencies to reinstate thousands of probationary employees who were fired last month, dealing a blow to the Trump administration’s efforts to rapidly scale back the size of the federal workforce.
  • “The Trump administration has encountered a number of legal challenges in its push to slash the government’s size and spending, including a lawsuit from a coalition of 20 states over plans to eliminate nearly half of the staff of the Education Department.
  • “The Education Department, with around 4,500 employees as of last year, is the smallest cabinet-level agency. Polls show most Americans oppose eliminating the department.”
• FEHBlog note — The Justice Department has noticed an appeal of the reinstatement order to the U.S. Court of Appeals for the Ninth Circuit.

• Bloomberg Law adds,
  • “A US judge in Maryland directed 18 agencies to temporarily rehire thousands of terminated employees, dealing another judicial defeat to Trump administration efforts to shrink the federal sector.
  • “The government gave no advance notice before firing newer workers, known as probationary employees, and conducted no individual assessments to justify their discharge based on performance, Judge James Bredar of the US District Court for the District of Maryland said Thursday in granting a temporary restraining order. 
  • “Bredar, an Obama appointee, found the terminations were unlawful workforce reductions that negatively impacted 19 states and the District of Columbia, which sued to challenge the firings.
  • “The ruling will apply for 14 days to workers at agencies including the Labor, Health and Human Services, Education, and Energy departments; the Environmental Protection Agency; the Consumer Financial Protection Bureau; and the US Agency for International Development. 
  • “It comes after a separate federal judge in California ordered six federal agencies to rehire probationary employees they fired since Feb. 13. Both decisions add to mounting setbacks for President Donald Trump and billionaire Elon Musk, who have attempted to cull the federal workforce in the name of efficiency.”

From the public health and medical research front,

• Cardiovascular Business points out,
  • “U.S. patients are significantly less likely to die from heart failure-related cardiac arrest now than they were 25 years ago, according to new data published in the American Journal of Cardiology. However, the authors noted, certain disparities still exist, suggesting cardiologists and other healthcare providers have much more work to do. 
  • “Heart failure currently affects over 64 million adults worldwide, with about 6 million impacted in the United States, a number expected to rise to 8 million by 2030, wrote corresponding author Sivaram Neppala, MD, an assistant professor with the cardiology division at The University of Texas Health Sciences Center, and colleagues. “Patients diagnosed with heart failure face a significantly higher risk of cardiac arrest, contributing to 30-50% of mortality cases within this population. Those with systolic dysfunction are six to nine times more likely to experience sudden cardiac death. Cardiac arrest and heart failure can lead to irregular heart rhythms and myocardial fibrosis, increasing the risk of ventricular arrhythmias and highlighting the need for urgent care.”
  • “Neppala et al. explored U.S. Centers for Disease Control and Prevention data from 1999 to 2023, tracking changes in the overall age-adjusted mortality rate (AAMR) for cardiac arrest in patients with heart failure. All patients included in their analysis were 25 years old or older.
  • “Overall, the researchers found that the AAMR for heart failure-related cardiac arrest dropped from 25.3 per 100,000 adults in 1999 to 20.6 in 2023. The reduction was the most pronounced from 1999 to 2011, with an annual percentage change of -2.95%, but then remained largely unchanged from 2011 to 2018. The overall AAMR then increased from 2018 to 2021—a time when the COVID-19 pandemic was at its most severe—before dropping yet again from 2021 to 2023. 
  • “The subsequent decline from 2021 to 2023 (APC: -4.05%) indicates recovery and improved access to healthcare, highlighting the pandemic’s effects on cardiovascular outcomes and the necessity for resilient healthcare systems,” the authors wrote.”

• STAT News discusses the importance of improving the availability of HIV self-testing.
  • “In May 2024, the Massachusetts Department of Public Health released a troubling report on a cluster of HIV infections, with more than 200 new cases since 2018 attributable to injection drug use in the Boston region. These findings have national implications: Similar HIV outbreaks have been described nationwide during the overdose crisis, including in West Virginia, Indiana, and Ohio. The increase in HIV cases amid the U.S. drug overdose crisis underscores the urgent need for a comprehensive response tailored to the unique challenges faced by people who use drugs. The importance of such efforts cannot be understated. In fact, in Massachusetts, 14% of new HIV diagnoses every year are attributed to injection drug use — nearly twice the national average.
  • “One potential solution is HIV self-testing, which would allow for rapid identification and treatment. Identifying HIV cases is the first step in addressing clusters, and quickly learning one’s status allows people to rapidly seek both treatment and prevention. Unlike traditional laboratory-based testing, which may take several days for results delivery, HIV self-testing relies on saliva and provides results in 20 minutes. The test is easily performed outside of a clinical setting by swabbing gums and collecting a sample of saliva. HIV self-testing has been available since 2012 and is recommended by the Centers for Disease Control and Prevention for accurate HIV diagnosis. It’s even part of the Department of Health and Human Services’ plan for Ending the HIV Epidemic (EHE) by 2030.
  • “But HIV self-testing remains underutilized among not only the general public, but especially people who use drugs. As the nation emerges from the Covid-19 pandemic, during which self-testing for infectious diseases became commonplace, increasing HIV self-testing among people who use drugs may limit the spread of a virus that, while manageable with medication, can lead to significant health risks if left untreated.”

• MedPage Today lets us know,
  • “Better midlife diet was tied to better brain connectivity and white matter integrity later in life.
  • “Lower waist-to-hip ratio was associated with better memory and executive function at 70.
  • “Diet improvements over time were linked with better white matter integrity in several brain regions.”

• The National Cancer Institute aggregated its latest research news while the National Institute of Diabetes and Digestive and Kidney Diseases reflects on its 75th anniversary.

• Per Beckers Hospital Review,
  • “A recently approved drug for acute ischemic stroke works as well as the treatment used in most U.S. hospitals and may offer advantages for some patients, according to a study led by a researcher from Dallas-based UT Southwestern Medical Center. 
  • “The study, published March 12 in JAMA Network Open, compared the newly approved tenecteplase in a single quick injection to alteplase, the stroke treatment that has been used for decades and requires an hourlong infusion. “

From the U.S. healthcare business front,

• Healthcare Dive reports,
  • “Cigna is revamping its C-suite and consolidating oversight of its two main businesses — insurance and health services operations — under one executive, the company announced Thursday.
  • “Brian Evanko, currently chief financial officer and the head of Cigna’s health insurance division Cigna Healthcare, will serve as Cigna’s chief operating officer, managing both Cigna Healthcare and health services division Evernorth. Ann Dennison, who was deputy CFO under Evanko, will step up as enterprise CFO. The changes are effective at the end of this month.
  • “Meanwhile, Eric Palmer, the current CEO of Evernorth, is departing the company at the end of April, an apparent victim of the restructuring. A spokesperson for Cigna did not respond to a request for comment on the reason behind Palmer’s departure.”

• Modern Healthcare notes,
  • “Highmark Health’s insurance business challenges weighed on the organization’s overall financial performance in 2024, the company reported Thursday.
  • “The nonprofit Blue Cross Blue Shield licensee saw its net income plummet 90.6% to $50 million while revenue rose nearly 9% to $29.4 billion. The company also reported operating losses of $209 million, compared with an operating gain of $338 million in 2023.
  • “Our entire industry faces strong financial headwinds. That underscores the need for a more economically sustainable approach that delivers better health experiences and outcomes,” Highmark Health President and CEO David Holmberg said on a telephone briefing announcing the financial results.”

• Per BioPharma Dive,
  • “Mallinckrodt and Endo Pharmaceuticals, which have struggled through bankruptcies related to opioid litigation, said Thursday that they will merge in a cash and stock transaction that will leave a combined company valued at $6.7 billion.
  • “Shareholders of Mallinckrodt will end up with 50.1% of the combined company and current Mallinckrodt CEO Siggi Olafsson will take the top job at the new entity as well. Per deal terms, Endo shareholders will receive Mallinckrodt stock and a share of $80 million in cash.
  • “After the merger, a business made up of Endo’s sterile injectables and both companies’ generic pharmaceuticals will be separated out. The companies haven’t yet decided what that separation will look like, Olafsson told analysts and investors on a conference call. The board will “make the best decision going forward” after the combination of the businesses, he said.”

• Per MedTech Dive,
  • “Vivani Medical said Wednesday it plans to spin off its neurostimulation business to form an independent, publicly traded company. 
  • “Formerly Second Sight Medical Products, the independent company will trade as Cortigent and advance brain implants to help people recover body functions such as vision and movement.
  • “Vivani, which is focused on GLP-1 implants, acquired the neurostimulation technology through a merger in 2022 and first filed paperwork to list Cortigent as an independent company in 2023.”