By ALI SWENSON

NEW YORK (AP) — Dr. Casey Means, a wellness influencer, author and entrepreneur aligned with Health Secretary Robert F. Kennedy Jr. and his Make America Healthy Again movement, will appear before the Senate health committee on Wednesday as she seeks approval to be the nation’s surgeon general.

The Washington confirmation hearing was rescheduled from last October, when Means went into labor the day she was set to appear. It will give the 38-year-old nominee an opportunity to share her vision for ending chronic disease by addressing its root causes, including through dietary and lifestyle changes. It’s a message that dovetails with that of the nation’s health department, which has shifted its focus away from its controversial vaccine policy changes and toward healthy eating as the midterm elections approach.

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But Means also will likely face tough questions about her qualifications and potential conflicts. The Stanford-educated physician’s disillusionment with traditional medicine drove her to a career in which she has promoted a wide range of products, at times without disclosing how she could benefit financially.

As the nation’s doctor, the surgeon general is a leader for Americans and health officials on public health issues. If confirmed, Means would be empowered to issue advisories that warn of public health threats. She also would be tasked with promoting Kennedy’s sprawling MAHA agenda, which calls for removing thousands of additives from U.S. foods, rooting out conflicts of interest at federal agencies and promoting healthier foods in school lunches and other nutrition programs.

Surgeons general also have sometimes used the office to advocate on issues related to vaccination — though the office has no role in creating vaccine policy. Means has mostly steered clear of Kennedy’s debunked views on vaccines but has called for more investigations into their safety.

Means has no government experience, and her license to practice as a physician is not currently active. After graduating from medical school at Stanford University with a doctor of medicine degree, she dropped out of her surgical residency program at Oregon Health and Science University in 2018. She has cited her belief that the health care system was broken and exploitative as the reason for her withdrawal.

Means then turned to alternative approaches to address what she has described as widespread metabolic dysfunction driven largely by poor nutrition and an overabundance of ultraprocessed foods.

Because she had completed enough postgraduate training to obtain a medical license, she did so and started her own functional medicine practice in Oregon, which later closed. She co-founded Levels, a nutrition-, sleep- and exercise-tracking app that also can give users insights from blood tests and continuous glucose monitoring.

Financial disclosures show she made hundreds of thousands of dollars promoting health and wellness products, including specialty basil seed supplements, teas and elixirs, probiotic products and a prepared meal delivery service. An Associated Press investigation found that while recommending these products, she at times failed to disclose that she could profit or benefit from the sales.

In an ethics filing, Means said that if she is confirmed for the post by the full Senate, she will resign from her position with Levels and forfeit or divest stock options and stock in the company. She also pledged to stop working for Rupa, a specialty lab work company for which she developed an online course. While she may continue receiving royalty payments from her book “Good Energy,” she will not promote it, the filing said.

The filing also noted she will “not acquire any direct financial interest in entities listed on the Food and Drug Administration’s prohibited holdings list.”

At least two previous surgeons general have publicly suggested Means is not fit for the job.

In an op-ed in The Hill last May, former Bush administration surgeon general Dr. Rich Carmona wrote that Means’ professional qualifications “raise significant concerns.” Later that month, President Donald Trump’s first-term surgeon general, Dr. Jerome Adams, wrote on the social platform X that the surgeon general’s traditional leadership of the U.S. Public Health Service Commissioned Corps requires a medical license.

Means is seeking to join an administration for which her brother, Calley Means, already works. As a senior adviser to the U.S. Department of Health and Human Services, he has helped promote the Republican administration’s message about the dangers of ultraprocessed foods.

The nomination for Trump’s first pick for surgeon general, former Fox News Channel medical contributor Janette Nesheiwat, was withdrawn after she came under criticism from the president’s allies. Means was nominated to the role last May.

Ask not what you’re able to traverse, but what those least capable are

I am able bodied but have combat related PTSD and have a service animal.  I use ADA (Americans with Disabilities Act) seating a lot and as a result have become an amateur proponent for disability rights.

There is a multi-family property I walk by every day that does not maintain its sidewalks well. There are five other properties on the street and all those sidewalks are very well maintained. On the property in question, snow/ice built up on the northeast corner that would prevent anyone in a wheelchair or other mobility device from easily transitioning to/from the sidewalk and street. Another area has piled snow completely blocking the sidewalk. There is standing water or glare ice, depending on the weather, on another portion.

On Jan. 5 I notified the city of this via the online complaint system.  A few days later I got a response stating a letter would be sent to the property and subsequent fines would happen if not corrected. When no changes to the property occurred, I sent two more complaints to the city that went unanswered.

After almost a month from my initial complaint, I sent an email to Mayor Her’s office pointing out the failure in this city service. I got no response. I sent an email to my council member, who forwarded my email to the same office I filed my initial complaints to. Over five weeks after my initial complaint, the problem had not been resolved. I’m at a loss for understanding how a city that gets as much snowfall as it does does not have better ways to compel a property to maintain clear sidewalks.

If you are responsible for a property, I ask you to consider not what you are able to traverse, but what those least capable are able to. Contrary to the response, or lack thereof, of the city and some of its leaders, it’s the law.

Ryan Radunzel, St. Paul

The attitude of legacy media

As a longtime Pioneer Press subscriber, I look forward to the Sunday edition; the frequent inclusion of Soucheray columns; and, a couple of syndicated columns on subjects of national interest.

As to inclusion of The Los Angeles Times film critic Amy Nicholson’s column on the “Melania” film — I consider her column to be deservedly undistinguished. Although, she does well document the attitude and culture of America’s legacy media.

A few extracts from Nicholson’s column:

–A vapid, airless, mindless time-waster

— Trump getting to actually make public eye contact with his wife

— Baron’s goodbye, as he turns his back to lope down a hallway

— a black comedy, perhaps?

— a metaphor for Melania herself: a gown constructed with no visible seams

— the feel of a soothingly looped AI screen saver, a trance-inducing spell

— there is a truth in her SUV-to-tarmac-to-SUV-to-tarmac insularity.

God Bless America.

Gene Delaune, Arden Hills

Sainted

A big shout out and Thank You to Good Samaritan Elizabeth of Roseville for helping my auntie after she fell and did a slow slide down her front steps.

On Jan. 16 I took my 83-year-old aunt fabric shopping. We had a pleasant morning shopping, lunch, and I drove her home. When climbing the stairs, she missed the handrailing and fell backward, landing on the sidewalk.

Elizabeth was walking by with her dog and asked if we needed help, which we did. She was trained in safe, medical lifting and  instructed my aunt what to do. With Elizabeth ‘s calm coaching and direction, my aunt was able to get her knees and feet in place to be able to stand. We were very thankful for Elizabeth’s help. My aunt is fine and busy sewing baby blankets.

So thankful for the help,

Liz Biagi, North St. Paul

Sainted

To Regions Hospital Cancer Center, once again I feel compelled to express my most sincere and heartfelt thanks for the wonderful and professional treatment that I’ve received therein. We are indeed privileged to have such a wonderful medical facility in our midst.

The wonderful and professional doctors, nurses, medical technicians, and other support personnel are like a well-oiled machine; each knowing her/his responsibility and executing their training and skills perfectly! How thankful I am for their ability to enhance my quality of life dealing with multiple cancers. From day one of my diagnosis and treatments, without them and their compassion more than likely you would be reading my obituary.

To Dr. Kumar, my primary oncologist, my deepest gratitude for your exceptional care. Your expertise and, more importantly, your compassionate approach have made a profound impact on my palliative treatment journey. I truly believe that I am in the best hands possible.

To the oncology nurses/staff, especially Kathy, Kaitlin and Anne, and of course Rachel, the dedicated RNs in the infusion center,  words alone cannot express how thankful I am for your kindness during my treatments and beyond. You turn a very scary and difficult time into a more manageable experience with your warmth, patience and smiles.

As I reflect on my journey, I am filled with gratitude for the incredible care I receive from the Cancer Center and this team.Their dedication to not just treating the cancers, but caring for me as a person, has meant the world.

Mike Howard, St. Paul

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By YURI KAGEYAMA, AP Business Writer

Wall Street inched higher in early trading Wednesday as markets turned their attention away from President Donald Trump’s State of the Union speech and toward the latest earnings report from AI chipmaker Nvidia.

Futures for the S&P 500 and Dow Jones Industrial Average each rose 0.3% before the opening bell, while Nasdaq futures climbed 0.5%.

In his speech Tuesday night, Trump focused on jobs, manufacturing and an economy he says is stronger than many Americans believe. He didn’t dwell on efforts to lower the cost of living — despite polling showing that his handling of the economy and kitchen-table issues has increasingly become a liability.

Investors are closely watching for an earnings report due later in the day from chipmaking giant Nvidia. The quarterly report is likely to sway a jittery stock market as investors weigh whether the massive bets riding on technology’s latest craze will pay off.

As has been the case since Nvidia’s chipsets emerged as AI’s best building blocks, the expectations are sky-high for the results covering the company’s fiscal quarter, covering November through January.

In early equities trading Wednesday, First Solar shares slumped 16.5% after it fell short of fourth-quarter profit expectations and issued tepid sales guidance for 2026.

Cava jumped 11% in premarket trading after the fast-casual Mediterranean restaurant chain beat Wall Street’s sales and profit targets and gave a strong forecast for the current year. Higher prices and a surprising increase in same-store sales boosted the company’s latest results.

In Europe at midday, France’s CAC 40 and Germany’s DAX each added 0.4% while Britain’s FTSE 100 jumped 0.9%.

Japan’s benchmark briefly hit a record high as investors were cheered by an overnight Wall Street rally driven by optimism about the artificial-intelligence boom. Tokyo’s Nikkei 225 surged 2.2% to finish at 58,583.12.

Shares also rose in China. Hong Kong’s Hang Seng gained 0.7% to 26,765.72, while the Shanghai Composite added 0.7% to 4,147.23. South Korea’s Kospi surged 1.9% to 6,083.86, as the benchmark continued to benefit from the global demand for computer chips.

In Taiwan, the Taiex jumped 2.1% as shares in TSMC, the world’s largest contract manufacturer of computer chips, surged 2.5%. Australia’s S&P/ASX 200 jumped 1.2% to 9,128.30.

In energy trading early Wednesday, benchmark U.S. crude oil added 58 cents to $66.21 a barrel. Brent crude, the international standard, rose 71 cents to $71.29 a barrel.

The U.S. dollar recovered to 156.76 Japanese yen from 155.91 yen. The euro cost $1.1786, up from $1.1774.

Gold ticked up less than 1% while silver rose 3.1% to more than $90 per ounce.

Yuri Kageyama is on Threads: https://www.threads.com/@yurikageyama

By SEUNG MIN KIM

WASHINGTON (AP) — President Donald Trump has delivered the State of the Union. Now the challenge for him is to make that message stick.

His address on Tuesday was a declaration of pride in the achievements of his still-young second term, as he boasted of an economic renaissance at home while he’s imposed a new world order abroad. Trump is getting his first opportunity to test drive that midterm year message later this week, when he travels to Texas, where the Latino voters whose shift toward Trump in his successful 2024 reelection campaign highlighted how he had reshaped the Republican coalition.

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The White House is aiming to promote that message to a broader electorate that is largely disenchanted with Trump’s job performance, while a looming conflict in the Middle East threatens to shift focus away from his domestic priorities. Trump also has a proclivity to go off-script during political rallies, such as during a speech last week in Rome, Georgia, asserting that he’s “solved” affordability when high prices remain a chief concern for voters.

Still, the themes of economic prosperity and a more secure America that Trump emphasized in his 108-minute speech Tuesday night will underpin the broader narrative that he and his fellow Republicans will seek to sell to voters this November.

“This is going to be setting the tone for the following year,” Sen. Markwayne Mullin, R-Okla., who has close ties with Trump, told The Associated Press.

Trump is known for being a master of the ‘big moments’

Presidents often travel immediately after delivering the State of the Union to amplify their agenda. President Joe Biden, for instance, went to swing states such as Wisconsin and Pennsylvania the day after his speech in the last two years of his term.

Trump won’t leave the Washington area until later this week, when he heads to Texas, to talk about the economy and energy policies just days ahead of the state’s March 3 congressional primaries. Rather than hitting the road, the president will spend much of the day after his State of the Union participating in meetings at the White House, including policy sessions and a sit-down with Transportation Secretary Sean Duffy.

But Trump — who wove a series of made-for-social media surprises into his address — is known for being able to command attention in a fractured news environment, and he is likely to find other ways to break through aside from the usual post-State of the Union blitz.

“Donald Trump is a master at the big moments, so he obviously cares a lot about how the speech goes, but what he cares a lot about are the clips that get replayed over and over again from the State of the Union,” said Austin Cantrell, who served as an assistant White House press secretary in Trump’s first term.

Cantrell, who is now with the Chattanooga, Tennessee-based firm Bridge Public Affairs, said: “I don’t expect this to be some Aaron Sorkin-esque, perfectly choreographed post-State of the Union media fan-out.”

Six years ago, it was Trump’s move to award conservative radio host Rush Limbaugh with the Presidential Medal of Freedom, America’s highest civilian honor, that surprised the audience. Tuesday’s address — record-breaking in its length — included similar attention-grabbing moments. He said he would give the same honor to Connor Hellebuyck, goaltender for the U.S. men’s hockey team, fresh off winning a gold medal at the Winter Olympics in Milano-Cortina, Italy. Trump called Hellebuyck and his teammates into the House chamber, where they were greeted with roaring applause.

White House says Trump will get out on the trail for his party

Trump also used his speech to roll out some new proposals to address affordability concerns, while castigating Democrats for opposing policies that he said have led to a more prosperous, safer America. Virginia Gov. Abigail Spanberger, in Democrats’ response, argued that costs remain high for many Americans and that families are still struggling under Trump’s policies.

Trump called on both parties to “protect American citizens, not illegal aliens,” and pushed for measures to limit mail-in ballots and tighten voter identification rules, while warning about the dangers of unchecked, illegal migration.

“I do think a lot of the success outlined in the State of the Union will be a part of the Republican message in the fall,” Sen. Eric Schmitt, R-Mo., another close Trump ally, told the AP, pointing to the GOP’s achievements on tax policy and border security. “As far as the president is concerned, I think he’ll be anxious to get on the road and talk about the success.”

Senior White House officials have promised that Trump will travel the country regularly until the midterms. He so far has hit critical battleground states such as Michigan, Pennsylvania and North Carolina on his economy tour, but he also traveled to reliably conservative Iowa and the congressional district of former Georgia Rep. Marjorie Taylor Greene. He has boosted candidates — in Rocky Mount, North Carolina, he bantered with Republican Michael Whatley and promoted his Senate run — while sometimes veering far away from the economic points the trips are meant to emphasize.

Just the optics of leaving Washington can help telegraph to voters that a president cares about connecting with them. Edward Frantz, a historian at the University of Indianapolis, said Herbert Hoover — an engineer, self-made millionaire and technocrat — believed he could solve the nation’s ills by working with his team in isolation and rarely leaving Washington. That led to a perception among voters that Hoover simply didn’t care, because they didn’t see him connecting with Americans.

“If you think about a call and response … the call is the State of the Union, and if you really do care about being in touch with others, then what’s the response?” Frantz said. “The best way to be able to see that is by hitting the road.”

How Americans feel about Trump has remained relatively stable throughout his second term, making it unlikely that one speech will meaningfully shift the way he’s perceived. His approval rating has changed very little during his second term, Associated Press-NORC Center for Public Affairs Research polling has found, falling only slightly from 42% in March 2025 to 36% in early February.

Nevertheless, the annual address offers Trump the chance to reframe his message, just as it has for presidents who came before him.

Presidential historian Timothy Naftali pointed out that in 1996, Bill Clinton used his State of the Union to set the themes of his Democratic reelection campaign. After George W. Bush’s midterm drubbing in November 2006, the Republican struck a noticeably more conciliatory tone toward the new Democratic leadership that had just taken charge on Capitol Hill.

“The State of the Union, they’re less important than they once were because with a president like Trump, he’s always available,” said Naftali, a senior research scholar at the School of International and Public Affairs at Columbia University. “But the State of the Union is an opportunity to reset the president’s agenda or to reaffirm it, and resetting an agenda in the social media era is different from resetting it in previous times.”

Associated Press polling editor Amelia Thomson-DeVeaux contributed to this report.