Amazon Stock Falls on Mixed Earnings Report and Weak Forecast. AWS Missed Too.

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Complications during pregnancy linked to a higher risk of heart disease, study finds


Five major pregnancy complications are strong lifelong risk factors for ischemic heart disease, a new study finds, with the greatest risk coming in the decade after delivery.

Ischemic heart disease refers to heart problems, including heart attack, caused by narrowed or dysfunctional blood vessels that reduce blood and oxygen flow to the heart.

Gestational diabetes and preeclampsia increased the risk of ischemic heart disease in the study by 54% and 30%, respectively, while other high blood pressure disorders during pregnancy doubled the risk. Delivering a baby early – before 37 weeks – or delivering a baby with a low birth weight were associated with a 72% and 10% increased risk, respectively.

The study, published in Wednesday in the BMJ, followed a cohort of more than 2 million women in Sweden with no history of heart disease who gave birth to single live infants between 1973 and 2015.

Roughly 30% of the women had at least one adverse pregnancy outcome. Those who had multiple adverse outcomes – whether in the same or different pregnancies – showed further increased risk of ischemic heart disease.

“These pregnancy outcomes are early signals for future risk of heart disease and can help identify high-risk women earlier and enable earlier interventions to improve their long-term outcomes and help prevent the development of heart disease in these women,” said Dr. Casey Crump, an author of the study and professor of family medicine at the Icahn School of Medicine at Mount Sinai.

Heart disease is the leading cause of death among women in the United States and accounts for 1 in 5 female deaths, according to the US Centers for Disease Control and Prevention. This research adds to mounting evidence that pregnancy provides important information about a woman’s cardiovascular health.

“What happens to a woman during pregnancy is almost like a stress test or a marker for her future cardiovascular risk after pregnancy. And unfortunately, a lot of women don’t get told this by anybody,” said CNN Medical Correspondent Dr. Tara Narula, an associate professor of cardiology and the associate director of the Women’s Heart Program at Lenox Hill Hospital. She was not involved in the new study.

Although it’s not completely clear why, experts say the normal changes that occur during pregnancy may unmask underlying health issues in some women with certain risk factors.

Experiencing an adverse pregnancy outcome – even temporarily – could result in changes to blood vessels and the heart that may persist or progress after delivery, increasing a woman’s risk for cardiovascular disease.

This heightened risk is a particular concern for women in the US, experts say, where the maternal mortality rate is several times higher than in other high-income countries.

“There’s been a change in the birthing population. US women are getting pregnant at a later age, and they have already increased maybe one or two cardiovascular risk factors. Perhaps there are other stressors in life – depression, stress, isolation, obesity – lots of different things that are impacting women in the US,” said Dr. Garima Sharma, associate professor of cardiology and director of the Cardio-Obstetrics Program at Johns Hopkins University School of Medicine, which also was not involved in the new study.

Pregnancy complications are carefully monitored during pregnancy, but there is little evaluation of and education about the effects on cardiovascular health after delivery for women, experts say.

“And so they have their delivery, they’ve had maybe preeclampsia or gestational diabetes, and nobody really follows up with them. They are not told that, in fact, they are at increased risk,” Narula said.

Gestational diabetes is a marker not only for increased risk of diabetes but also for general cardiovascular disease. Preeclampsia and eclampsia are markers for hypertension risk as well as general cardiovascular risks.

Narula, a cardiologist who specializes in caring for women, regularly considers adverse pregnancy outcomes when evaluating patients and emphasizes the continued need for this.

“The classic risk calculator that we use doesn’t have anything in there for pregnancy complications, but you know, it should for women, and hopefully someday, they will start to take that into account,” she said.

The American Heart Association recommends that all health care professionals take a detailed history of pregnancy complications when assessing a woman’s heart disease risk, but this is not consistently done in clinical practice, especially in primary care, where most women are seen, Crump says.

“Raising awareness of these findings among physicians as well as women hopefully will enable more of these women to be screened early and hopefully improve their long-term outcomes,” he said.

Roughly 1 in 3 women will have an adverse pregnancy outcome. Experts say that improving your health before getting pregnant can help avoid these issues.

“Reducing your risk should start preconception, and so getting your body and yourself into the healthiest state possible before you ever even get pregnant is really the first step,” Narula said.

This includes achieving and maintaining a healthy body weight with a good diet and regular exercise, controlling high blood pressure and diabetes, quitting smoking and managing stress.

Taking action after pregnancy is equally important, as research has estimated that only 30% to 80% of women have a postpartum checkup 6 to 8 weeks after delivery.

“Making sure that these women actually are appropriately followed after their delivery and that there is a warm handoff between [obstetrics] and [maternal-fetal medicine] to their primary care doctors or preventive cardiologists who can then talk about optimizing cardiovascular risks and reduction of these risk factors post-pregnancy in the postpartum time frame is crucial,” Sharma said.

Experts hope that increased patient and provider awareness of the connection between pregnancy and heart health will keep birth from being a cause of death.

“Cardiovascular disease is preventable. It’s a leading cause of maternal mortality, but it doesn’t have to be. If we do a better job at screening patients before they get pregnant, if we do a better job of treating them during pregnancy and postpartum, we can improve women’s outcomes,” Narula said. “It’s a tragedy to bring a new life into the world, and then the mother suffers some horrible complication and/or death that could have been prevented.”



About 1,000 US flights canceled as winter weather snarls travel

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More than 1,000 Monday flights have been canceled in the United States as winter weather moves through the middle of the country.

Most of the cancellations so far are affecting Dallas Love Field and Dallas-Fort Worth International airports in Texas.

As of about 5:30 pm ET, just over 1,000 flights within, into or out of the US had been canceled Monday, according to flight tracking site FlightAware, with more than 4,100 delays.

About half of those cancellations are Southwest Airlines flights. The Dallas-based airline, which had an operations meltdown over the holidays, had canceled about 12% of its Monday schedule – about 480 flights, according to FlightAware.

Southwest Airlines did not immediately respond to a request for comment. As recently as Monday morning, CEO Bob Jordan was outlining fixes to prevent a repeat of the airline’s Christmas travel meltdown.

By contrast, fellow Texas-based carrier American Airlines canceled 6% of its Monday schedule. American had canceled about 200 US flights by 5:30 pm ET Monday.

Regional carrier SkyWest had canceled more than 140 flights.

Cancellations were already piling up for Tuesday flights, with about 800 canceled system wide by early Monday evening. Southwest and American had already canceled 8% to 10% of their Tuesday schedules.

In addition to widespread cancellations in Dallas on Monday and Tuesday, about 200 Monday flights were also canceled in and out of Denver International Airport in Colorado. For Tuesday, more than 100 flights in and out of Austin, Texas, had already been canceled by Monday evening.

There’s a winter storm warning in effect for a large portion of Texas, including the Dallas-Fort Worth area, until 6 am Central Time on Wednesday.

Southwest Airlines issued a winter weather waiver on Sunday and had extended waivers by midday Monday to a dozen airports in Texas, Oklahoma, Tennessee, Arkansas and Kentucky. The latest waivers apply to travel from January 30 to February 1.

American Airlines issued a waiver on Sunday for Dallas-Fort Worth International Airport (DFW) that applies to travel from January 29 to February 2.

Delta and United have also issued weather waivers. Their Monday operations were not significantly impacted by cancellations.

Dallas Love Field tweeted on Monday that its team “stands ready to treat and clear surfaces to allow for safe operations.” DFW was also preparing for bad weather.

Both airports urged travelers to check with their airlines for flight status before going to the airport.

The weather will also make for treacherous road conditions. Up to a half an inch of ice or sleet is possible in parts of Texas, the National Weather Service warns. Ice accumulation is expected across at least 15 states, the National Weather Service’s Weather Prediction Center said.

“If you must travel, slow down and use extreme caution particularly when approaching bridges and overpasses,” the Texas warning says.

Motorists are advised to have a flashlight, food and water in their vehicles in case of an emergency. Here’s more on what to pack for winter driving.

Top image: Motorists in Dallas face wintry conditions. Credit: KTVT



Covid-19 is a leading cause of death for children in the US, despite relatively low mortality rate


Covid-19 has become the eighth most common cause of death among children in the United States, according to a study published Monday.

Children are significantly less likely to die from Covid-19 than any other age group – less than 1% of all deaths since the start of the pandemic have been among those younger than 18, according to federal data. Covid-19 has been the third leading cause of death in the broader population.

But it’s rare for children to die for any reason, the researchers wrote, so the burden of Covid-19 is best understood in the context of other pediatric deaths.

“Pediatric deaths are rare by any measure. It’s something that we don’t expect to happen and it’s a tragedy in a unique way. It’s a really profound event,” said Dr. Sean O’Leary, chair of the American Academy of Pediatrics’ Committee on Infectious Diseases.

“Everyone knows that Covid is the most severe in the elderly and immunocompromised and that it’s less severe in children, but that does not mean it’s a benign disease in children. Just because the numbers are so much lower in children doesn’t mean that they’re not impactful.”

In 2019, the last year before the pandemic, the leading causes of death among children and young adults ages 0 to 19 included perinatal conditions, unintentional injuries, congenital malformations or deformations, assault, suicide, malignant neoplasms, diseases of the heart and influenza and pneumonia.

The researchers’ analysis of data from the US Centers for Disease Control and Prevention found that there were 821 Covid-19 deaths in this age group during a 12-month period from August 2021 to July 2022. That death rate – about 1 for every 100,000 children ages 0 to 19 – ranks eighth compared with the 2019 data. It ranks fifth among teenagers ages 15 to 19.

Covid-19 deaths displace influenza and pneumonia, becoming the top cause of death caused by any infectious or respiratory disease. It caused “substantially” more deaths than any vaccine-preventable disease historically, the researchers wrote.

According to CDC data, children are less vaccinated against Covid-19 than any other age group in the US. Less than 10% of eligible children have gotten their updated booster shot, and more than 90% of children under 5 are completely unvaccinated.

“If we looked at all those other leading causes of death – whether you’re talking about motor vehicle accidents or childhood cancer – and we said, ‘Gosh, if we had some simple, safe thing we could do to get rid of one of those, wouldn’t we just jump at it?” And we have that with Covid with vaccines,” said O’Leary, who is also a professor of pediatric infectious disease at the University of Colorado School of Medicine and Children’s Hospital Colorado.

A CDC survey of blood samples suggests that more than 90% of children have already had Covid-19 at least once.

There is uncertainty about exactly how much risk the virus will continue to pose, O’Leary said, but the potential benefits of vaccination clearly outweigh any potential risks.

“Vaccination clearly is our best option right now,” and the benefits clearly outweigh the risks, he said. “Better safe than sorry.”

The findings of the new study, published in JAMA Network Open, may underestimate the mortality burden of Covid-19 because the analysis focuses on deaths where Covid-19 was an underlying cause of death but not those where it may have been a contributing factor, the researchers wrote. Also, other analyzes of excess deaths suggest that Covid-19 deaths have been underreported.

As Covid-19 continues to spread in the US, the researchers say that intervention methods such as vaccination and ventilation will “continue to play an important role in limiting transmission of the virus and mitigating severe disease.”



Adani Group slams Hindenburg ‘attack on India’ as stock rout hits $70 billion

New Delhi

The Adani Group has accused a US investment firm of launching “a calculated attack” on India by publishing a report alleging widespread fraud at the ports-to-power conglomerate.

Hindenburg Research released its report on billionaire Gautam Adani’s business last week, accusing the group of “brazen stock manipulation and accounting fraud scheme over the course of decades.” It said it had taken a short position in Adani Group companies, meaning it would benefit from a drop in their value.

Since the release of Hindenburg’s report, Adani’s business empire has lost more than $70 billion of its stock market value. The infrastructure tycoon’s net worth has also plummeted by some $30 billion, according to the Bloomberg Billionaires Index.

He is still Asia’s richest man with a personal fortune worth over $92 billion, which is $10 billion more than fellow Indian entrepreneur Mukesh Ambani.

The Adani Group had already denounced the Hindenburg report as “baseless” and “malicious” in its initial response a few hours after the report’s release, and said Thursday that it was considering legal action. It followed that on Sunday with a long and angry rebuttal running to more than 400 pages, in which it called Hindenburg’s allegations “baseless and discredited” and said the research firm had an “ulterior motive.”

“This is rife with conflict of interest and only intended to create a false market in securities to enable Hindenburg, an admitted short seller, to book massive financial gain through wrongful means at the cost of countless investors,” it said.

The 60-year-old tycoon founded the Adani Group over 30 years ago, and is seen as a close ally of India’s current prime minister, Narendra Modi.

Before the rout, which continued on the Mumbai stock exchange on Monday, markets had been cheering for the businessman and his breathless pace of expansion. Investors were betting on the self-made industrialist’s ability to grow his businesses in sectors that Modi had prioritized for development.

In its detailed response Sunday, the Adani Group portrayed the US short seller’s report as an “attack” on India, its economy and investors.

“This is not merely an unwarranted attack on any specific company but a calculated attack on India, the independence, integrity and quality of Indian institutions, and the growth story and ambition of India,” it said.

Hidenburg had concluded its report last week with 88 questions for the Adani Group. These ranged from asking for details on the group’s offshore entities, to why it has “such a convoluted, interlinked corporate structure.”

The Indian conglomerate called those questions “rhetorical innuendos coloring rumors as fact.” It then sought to answer them, and published some tables and charts to support its position.

The long rebuttal sought to reassure investors about the group’s debt, banking relationships and corporate governance practices. Shares in Adani Enterprises, the group’s flagship company, were up over 4% on Monday, but most Adani stocks extended last week’s losses.

The conglomerate’s chief financial officer Jugeshinder Singh compared the Indian market reaction to one of the most horrific events from the country’s colonial past under British rule.

“In Jallianwala Bagh, only one Englishman gave an order, and Indians fired on other Indians. So am I surprised by the behavior of some fellow Indians? No,” Singh told Mint business daily in an interview published Monday.

On April 13, 1919, British Brigadier General Reginald Dyer ordered his soldiers to fire without warning on a peaceful protest of thousands of unarmed people in Jallianwala Bagh, a public garden in the city of Amritsar. They stopped firing 10 minutes later when their ammunition ran out. The horrific event is now known as the Jallianwala Bagh or Amritsar Massacre.

Hindenburg’s claims come at a sensitive time for Adani. He is aiming to raise 200 billion rupees ($2.5 billion) by issuing new shares in Adani Enterprises this month. The offer will close on Tuesday.

Hindenburg responded to Adani’s rebuttal by saying “fraud cannot be obfuscated by nationalism.”

“Adani Group has attempted to conflate its meteoric rise and the wealth of its Chairman, Gautam Adani, with the success of India itself,” it said in a post on Twitter On Sunday.

Hindenburg went on to add that the group has ignored “every key allegation we raised.”

“In terms of substance, Adani’s 413 page response only included about 30 pages focused on issues related to our report,” it said.

“The remainder of the response consisted of 330 pages of court records, along with 53 pages of high-level financials, general information, and details on irrelevant corporate initiatives, such as how it encourages female entrepreneurship and the production of safe vegetables.”



Kansas City Chiefs to face Philadelphia Eagles in Super Bowl LVII


The Kansas City Chiefs are advancing to Super Bowl LVII following a 23-20 victory over the Cincinnati Bengals in the AFC Championship game on Sunday at Arrowhead Stadium in Kansas City, Missouri.

After suffering a high ankle sprain last week in the Chiefs’ Divisional Round win over the Jacksonville Jaguars, Patrick Mahomes led the team to a victory in a back-and-forth game.

Kansas City got out to a 6-0 lead after two field goals and before halftime, Mahomes found his favorite target – tight end Travis Kelce for a touchdown to take a 13-3 lead. Kelce was listed as questionable to play coming into the game due to a back injury.

Right before halftime, the Bengals drove down the field and kicked a field goal to cut the deficit to 13-6.

On the Bengals’ first offensive possession of the second half, quarterback Joe Burrow found wide receiver Tee Higgins for a 27-yard touchdown to tie up the game at 13. However, a clearly hobbled Mahomes and the Chiefs responded with a laser touchdown throw to Marquez Valdes-Scantling to take the lead right back.

The Chiefs defensive unit shut down the high-powered Bengals offense until the first play of the fourth quarter.

On fourth down, Burrow heaved the ball down the field and found Ja’Marr Chase for a 35-yard strike to move Cincinnati deep into Kansas City territory. Two plays later, the Bengals scored on a 2-yard touchdown run by running back Samaje Perine to tie the game yet again.

The Chiefs sacked Burrow on third down to give them the ball back with less than a minute left and the score tied at 20. Chiefs returner Skyy Moore returned the Bengals punt 29 yards to set the offense up with good field position. On third down, Mahomes scrambled and as he went out of bounds, Bengals defensive end Joseph Ossai pushed him and was called for a 15-yard unnecessary roughness penalty which put the Chiefs in field goal range.

Kansas City kicker Harrison Butker knocked down the 45-yard field goal to send the Chiefs back to the Super Bowl for the third time in four seasons.

The finale on February 12 will mark the first time in history that both teams contesting the Super Bowl will start Black quarterbacks.

Mahomes, who became the third Black quarterback to win the Super Bowl in 2020, is aiming to become the first Black quarterback in history to win multiple Super Bowls, while Eagles quarterback Jalen Hurts could become the fourth Black quarterback to win the Lombardi Trophy.

Earlier in the day, the Philadelphia Eagles defeated the San Francisco 49ers, 31-7, at Lincoln Financial Field in Philadelphia, to advance to championship game for the first time since the 2017-18 season.

The Eagles scored on their first possession and didn’t look back in the rout of the 49ers.

The 49ers were momentarily left without rookie starting quarterback Brock Purdy after he suffered a right elbow injury in the first quarter, on a hit by Eagles linebacker Haason Reddick that forced a fumble. Josh Johnson, who is the fourth string quarterback for San Francisco, filled in for Purdy until the third quarter before being ruled out of the game with a concussion.

Playing on the injured elbow, Purdy re-entered the game but the 49ers offense struggled to tally any points.

Meanwhile, Eagles quarterback Hurts and the Philadelphia run-game, ran all over the 49ers defense, notching 148 rushing yards and scoring all four touchdowns on the ground. With his rushing touchdown in the fourth quarter, Hurts (15) passed Cameron Newton (14) for most rushing touchdown’s in a single season by a QB in NFL history, including playoffs, according to NFL Research.



McDonald’s, In-N-Out, and Chipotle are spending millions to block raises for their workers

New York

California voters will decide next year on a referendum that could overturn a landmark new state law setting worker conditions and minimum wages up to $22 an hour for fast-food employees in the nation’s largest state.

Chipotle, Starbucks, Chick-fil-A, McDonald’s, In-N-Out Burger and KFC-owner Yum! Brands each donated $1 million to Save Local Restaurants, a coalition opposing the law. Other top fast-food companies, business groups, franchise owners, and many small restaurants also have criticized the legislation and spent millions of dollars opposing it.

The measure, known as the FAST Act, was signed last year by California Gov. Gavin Newsom and was set to go into effect on January 1. On Tuesday, California’s secretary of state announced that a petition to stop the law’s implementation had gathered enough signatures to quality for a vote on the state’s 2024 general election ballot.

The closely-watched initiative could transform the fast-food industry in California and serve as a bellwether for similar policies in other parts of the country, proponents and critics of the measure argued.

The law is the first of its kind in the United States, and authorized the formation of a 10-member Fast Food Council comprised of labor, employer and government representatives to oversee standards for workers in the state’s fast-food industry.

The council had the authority to set sector-wide minimum standards for wages, health and safety protections, time-off policies, and worker retaliation remedies at fast-food restaurants with more than 100 locations nationally.

The council could raise the fast-food industry minimum wage as high as $22 an hour, versus a $15.50 minimum for the rest of the state. From there, that minimum would rise annually based on inflation.

California’s fast-food industry has more than 550,000 workers. Nearly 80% are people of color and around 65% are women, according to the Service Employees International Union, which has backed the law and the Fight for $15 movement.

Advocates of the law, including unions and labor groups, see this as a breakthrough model to improve pay and conditions for fast-food workers and overcome obstacles unionizing workers in the industry. They argue that success in California may lead other labor-friendly cities and states to adopt similar councils regulating fast-food and other service industries. Less than 4% of restaurant workers nationwide are unionized.

Labor law in the United States is structured around unions that organize and bargain at an individual store or plant. This makes it nearly impossible to organize workers at fast-food and retail chains with thousands of stores.

California’s law would bring the state closer to sectoral bargaining, a form of collective bargaining where labor and employers negotiate wages and standards across an entire industry.

Opponents of the law say it’s a radical measure that would have damaging effects. They argue it unfairly targets the fast-food industry and will increase prices and force businesses to lay off workers, citing an analysis by economists at UC Riverside which found that if restaurant worker compensation increases by 20%, restaurant prices would increase by approximately 7% . If restaurant worker compensation increased by 60%, limited-service restaurant prices would jump by up to 22%, the study also found.

“This law creates a food tax on consumers, kills jobs, and pushes restaurants out of local communities,” said the Save Local Restaurants coalition.

On Wednesday, McDonald’s US President Joe Erlinger blasted the law as one driven by struggling unions that would lead to “an unelected council of political insiders, not local business owners and their teams,” making key business decisions.

Opponents have turned to a similar strategy used by Uber, Lyft and gig companies that sought to overturn a 2020 California law that would have required them to reclassify drivers as employees, and not “independent contractors,” which would provide them with benefits such as a minimum wage, overtime, and paid sick leave.

In 2020, Uber, Lyft, DoorDash, Instacart and others spent more than $200 million to successfully persuade California voters to pass Proposition 22, a ballot measure that exempted the companies from reclassifying their workers as employees.



Boeing Still Can’t Turn a Profit. The Stock Is Dropping.

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Oscar Nominations Are In. Netflix and Streaming Services Are Already Winners.

Avatar: The Way of Water

Courtesy of Disney

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DOJ sues Google over its dominance in online advertising market


The Justice Department and eight states sued Google on Tuesday, accusing the company of harming competition with its dominance in the online advertising market and calling for it to be broken up.

The move marks the Biden administration’s first blockbuster antitrust case against a Big Tech company. The eight states joining the suit include California, Colorado, Connecticut, New Jersey, New York, Rhode Island, Tennessee and Virginia.

The fresh complaint significantly escalates the risks to Google emanating from Washington, where lawmakers and regulators have frequently raised concerns about the tech giant’s power but have so far failed to pass new legislation or regulations that might rein in the company or its peers.

For years, Google’s critics have claimed that the company’s extensive role in the digital ecosystem that enables advertisers to place ads, and for publishers to offer up digital ad space, represents a conflict of interest that Google has exploited anticompetitively.

In Tuesday’s complaint, a copy of which was viewed by CNN, the Justice Department alleged that Google actively and illegally maintained that dominance by engaging in a campaign to thwart competition. Google gobbled up rivals through anticompetitive mergers, the US government said, and bullied publishers and advertisers into using the company’s proprietary ad technology products.

For 15 years, Google’s alleged anticompetitive behavior led to lower ad revenues for websites and publishers, as well as higher advertising costs for marketers, said Attorney General Merrick Garland during a press conference Tuesday. Even the US government was harmed, according to the complaint, which named the US Army as one of multiple government advertisers using Google’s tools. Since 2019, the US government has spent $100 million buying online ads, the complaint said.

As part of the lawsuit, the US government called for Google to be broken up and for the court to order the company to spin off at least its online advertising exchange and its ad server for publishers, if not more.

Google, the US government alleged, “has corrupted legitimate competition in the ad tech industry by engaging in a systematic campaign to sixteen control of the wide swath of high-tech tools used by publishers, advertisers, and brokers, to facilitate digital advertising. Having inserted itself into all aspects of the digital advertising marketplace, Google has used anticompetitive, exclusionary, and unlawful means to eliminate or severely diminish any threat to its dominance over digital advertising technologies.”

The suit was filed in the US District Court for the Eastern District of Virginia.

Tuesday’s suit marks the federal government’s second antitrust complaint against Google since 2020, when the Trump administration sued over Google’s alleged anticompetitive harms in search and search advertising. That case is still ongoing. Google has also been the target of antitrust litigation by state and private actors.

In a statement, Google said the DOJ follows “attempts to pick winners and losers in the highly competitive advertising technology sector.”

“DOJ is doubling down on a flawed argument that would slow innovation, raise advertising fees, and make it harder for thousands of small businesses and publishers to grow,” a Google spokesperson said, adding that a federal judge last year knocked down a claim that Google colluded with Facebook in a separate antitrust suit led by the state of Texas. That judge also ruled, however, that a number of monopolization claims in the Texas case could move forward.

Asked to respond to Google’s statement, Garland said Tuesday: “We don’t pick winners or losers. We pick those who violate the antitrust laws. Those are the people we sue.”

The lawsuit is a frontal assault against Google’s massive, primary business of advertising. Google generated $209 billion in advertising revenue in 2021, according to its annual report, a figure representing more than 80% of its total revenue. By comparison, the next largest giant in online advertising, Facebook-parent Meta, generated $115 billion in 2021. (Tuesday’s suit targets a subset of Google’s ad revenue represented by display advertising, a roughly $32 billion business for the company.)

Third-party estimates suggest that Google and Facebook accounted for the majority of US digital ad revenues, hitting a peak around 2017, with Google taking about a third of the market. Since then, however, others including Amazon have begun encroaching on that business.

The US complaint echoes concerns that have prompted similar antitrust investigations in the United Kingdom and in the European Union.

Google not only controls the platform publishers use to sell online ad inventory, the Justice Department alleged Tuesday, but also the advertising tools marketers use to claim that inventory and the exchange that facilitates those transactions.

“Google’s pervasive power over the entire ad tech industry has been questioned by its own digital advertising executives,” the complaint said, “at least one of whom aptly begged the question: ‘[I]s there a deeper issue with us owning the platform, the exchange, and a huge network? The analogy would be if Goldman or Citibank owned the NYSE.’”

Tuesday’s complaint marks an opening salvo against Big Tech by DOJ’s antitrust chief, Jonathan Kanter. Kanter has spent months laying the groundwork for a broader offensive against the tech industry’s most dominant companies, reflecting commitments by President Joe Biden and others in the US government to hold powerful firms accountable. Under Kanter, Justice Department antitrust officials have pushed to bring more cases to trial as well as to prosecute cases involving unconventional legal theories.

On Tuesday, Kanter told reporters that Google abused “longstanding monopolies in digital advertising technologies” to give itself an advantage.

“Google’s own documents estimate that it keeps at least 30 cents of each advertising dollar that flows through Google’s advertising tools,” Kanter said, adding that in some situations the figure may be far higher.

In 2020, House lawmakers released a 450-page report finding that Google, along with Amazon, Apple and Facebook, hold “monopoly power” in key business segments. The report was the result of a 16-month investigation in which congressional staff reviewed corporate documents and interviewed the tech industry’s many customers and rivals. It concluded, among other things, that Google was uniquely positioned to benefit from its powerful role in the online ad industry.

“With a sizable share in the ad exchange market and the ad intermediary market, and as a leading supplier of ad space, Google simultaneously acts on behalf of publishers and advertisers, while also trading for itself,” the report said.