You are given a text that consists of multiple sentences. Your task is to perform abstractive summarization on this text. Use your understanding of the content to express the main ideas and crucial details in a shorter, coherent, and natural sounding text. 
Text: I'd also like to call your attention to supplemental slides related to our 2021 outlook posted on our website in the Investor Relations section.
The company has explained some of these risks and uncertainties in its SEC filings, including the Risk Factors section of its annual report on Form 10-K and quarterly report on Form 10-Q.
Today I'm joined by Ed Pesicka, our President and Chief Executive Officer; and Andy Long, our Executive Vice President and Chief Financial Officer.
I would like to start with a high-level recap of the strategic priorities that the Owens & Minor leadership team and I outlined during our Investor Day meeting in late May.
I spoke about our transformation based on our business blueprint that focused on; one, our culture, a culture that is based on hard work, stellar execution and an unrelenting focus on our customer, while being anchored by our mission and our ideal values.
Next our discipline, which is based upon the Owens & Minor business system that is laser focused on continuous improvement.
And third, our investments, our investments that are implemented in a disciplined manner enabling us to achieve our strategic priorities.
These three elements are ingrained in our corporate DNA, have set the foundation of our business blueprint, and have enabled us to ignite long-term profitable growth.
As committed during the Investor Day meeting, I will provide periodic updates.
Today let me start with an update on some of our investments, which we spent time at our Investor Day detailing.
These investments remain on track and are designed to provide attractive returns for our stakeholders.
Let me remind you of a few; one, we continue to expand our own manufacturing capability for nitrile gloves in our existing facility in Thailand.
This will put us in an advantaged position allowing us to have greater control and improved cost structure.
Our new capacity is expected to go live in early 2022.
Two, we remain focused on leveraging our manufacturing strength and brand value through the expansion of our product portfolio.
During the second quarter, we doubled our wound care product line and we remain on track to expand our incontinence care portfolio later this year.
Furthermore, we continue to identify additional product category opportunities to expand our proprietary product offering in the future.
Three, we are also diversifying into new verticals to sell specialty higher-margin products into new end markets.
For instance, we expanded into cleanroom glove market space under the HALYARD PUREZERO brand.
In addition, we recently launched our Safeskin consumer brand of gloves.
Next, we continue to invest in technology-based offerings that provide our customers with actionable data through our service solutions.
And finally, we are focused on the balance between technology and touch in our distribution centers, with continued investment in automation, AI and human capital, all of which expand our leading ability to be flexible and scalable to provide best service for our changing customer demands.
These initiatives are just a few examples of how we are investing to generate long-term profitable growth, while providing significant benefits for our customers.
In addition to having the Owens & Minor business blueprint in place and the investments that I just discussed, I'm equally proud of our focus on corporate social responsibility.
We are committed to delivering on both our financial and our corporate social responsibility obligations.
So far this year, we have launched the Owens & Minor Foundation, which is committed to improving our communities in which we operate and live.
Two, we released our first sustainability report, detailing the advancement that Owens & Minor has made in ESG.
And three, we undertook a first step in reducing our carbon footprint, with our electric fleet pilot initiative.
Our ESG efforts, just like our business blueprint, are part of who we are and that good corporate citizenship is fundamental to our mission and values.
Let me now shift gears to our second quarter performance.
I am extremely pleased to report another strong quarter that continues to build upon the solid performance from 2020.
A year ago, we were in uncharted waters due to the pandemic, but our ability to be flexible and adjust to meet the critical needs of our customers and the nation help to establish momentum that is carried into the second quarter.
Additionally, we continue to find ways to keep driving efficiency and be more productive, as markets begin to return to pre-pandemic form.
Now let me update you on the segments and I will start with our Global Solutions segment.
Within this segment, the medical distribution business performed well and posted much improved results.
We continue to bring in net positive wins, as a result of our market-leading service, combined with the trust we gained during the pandemic.
In addition, we saw volumes associated with elective procedures return to pre-pandemic levels during the second quarter.
Related to our patient direct business, we continue to grow through new patient capture in this rapidly growing patient direct markets.
And finally, our ongoing investments in our Global Solutions segment are expected to provide continued growth in an attractive long-term outlook.
Moving on to the Global Products segment.
This segment produced significant top line growth, as sales of our surgical infection and prevention products, including PPE, remained strong.
The strong sales are a result of our increased output of previously added capacity to fulfill continued high usage, share gains made during the pandemic, stockpile fulfillment and increased elective procedures.
In addition, we saw favorable timing for cost pass-through on gloves adding to the top line growth.
In addition to the solid performance in our two reporting segments, our balance sheet remains strong, with net leverage at 1.8 times and total net debt of less than $1 billion.
This gives us the latitude to continue to make well thought-out investments to improve our operations and drive growth.
Moving from the second quarter and looking to the rest of 2021 and beyond.
We are excited about the long-term future.
We expect the rest of the year to be driven by S&IP utilization, elective procedures, opportunity pipeline and continued strength of our patient direct business.
In addition to this, we will continue to have a tenacious focus on operational excellence and continuous improvements.
As we have said, we believe that the usage for S&IP products, including PPE, will be defined by the new normal; the new normal in the healthcare industry.
We continue to believe that usage for many PPE categories will settle somewhere below the peak of the COVID-19 outbreak, but in excess of the pre-pandemic levels as a result of established healthcare protocols, stockpile requirements and our share gains obtained during the pandemic.
In addition, we expect the expansion of our PPE into new markets like clean room and consumer to provide incremental opportunity.
However, as the year progresses, we expect moderation in both pricing and demand for PPE.
But let's not forget another factor to consider.
That is the elimination of PPE emergency use authorization which will create opportunity for our Americas-based, manufactured medical-grade PPE.
Let me give you a few examples.
First, most recently the FDA revoked emergency use authorization for non-NIOSH-approved disposable respirators, which will prohibit the use of these devices in the healthcare setting.
Second, the CDC has recommended that healthcare facilities return to conventional practices, and no longer use crisis capacity strategies like bringing in non-medical grade supplies.
And third, the EUA for Decontamination and Bioburden Reduction System has been revoked.
All of these actions by the federal agencies bring to light the significance of authorized medical-grade PPE in the healthcare setting.
Our unique value chain of vertically integrated Americas-based manufacturing footprint and supply chain will remain a distinct advantage for us, as we continue to work closely with the government and industry to help address the current and future needs for PPE requirements.
Next, on elective procedures, by the end of the second quarter we saw elective procedures return to pre-pandemic levels.
And we expect this to continue through the second half of the year.
This expectation is consistent with our customers' outlook and assumes COVID rates don't get markedly worse across the country.
Moving on to our pipeline, our medical distribution continues to provide best-in-class service and is backed by our complete suite of products and services.
These together provide one of the industry-leading offering to best serve our customers.
We will continue to advance with a large pipeline of opportunity, while capturing net new wins.
Again, our medical distribution continues to provide market-leading operational performance and stability, that supports our customers' need for continuity supply and supply chain resiliency.
And lastly, our patient direct business, our patient direct business enjoys a leading national presence as the partner of choice for referral sources.
We are uniquely positioned to meet the needs of our customers in this fast-growing home health space.
We expect this business to continue to grow across our major product categories with an annuity-like recurring revenue model.
I'd like to conclude by underscoring the success we've achieved during the quarter.
Our strong second quarter gives us the confidence to affirm the range of our 2021 guidance for adjusted earnings per share and of $3.75 to $4.25 and adjusted EBITDA of $450 million to $500 million as well as affirm our previously issued 2022 guidance.
We continue to be excited about, what's ahead.
We have one of the strongest value chains in the healthcare solutions market while having the ability to be flexible and scale, along with the financial flexibility to invest as appropriate.
And finally, we have our great teammates that exemplify our high deal values everyday and live our humble mission to empower our customers to advance healthcare, as we continue to deliver on our commitments to our stakeholders.
Today I'll review our financial results for the second quarter and the key drivers for our quarterly performance.
And then, I'll discuss our expectations and assumptions for the balance of the year.
I'd like to start by saying that, we're delighted to report a record second quarter with solid growth in revenue, EBITDA and earnings per share.
We're maintaining our expectations for adjusted earnings per share in 2021 to be in a range of $3.75 to $4.25 and adjusted EBITDA in the range of $450 million to $500 million.
Also we are affirming our previously announced guidance for 2022.
I'll provide additional color on this later in my remarks.
Let's begin with the results for the second quarter.
Starting with the top line, revenue for the second quarter was $2.5 billion, compared to $1.8 billion for the prior year.
This represents 38% growth with strong performance in both of our segments.
Top line growth in the quarter was driven by ongoing recovery of elective procedures glove cost pass-through and higher levels of PPE.
Gross margin in the second quarter was 16.1%, an improvement of 117 basis points over prior year due to revenue mix from higher margin sales in the Global Products segment and patient direct business, timing of the pass-through of glove costs and improved operating efficiency.
These were partially offset by higher commodity prices in Global Products and transportation costs across the business.
Also compared to Q1, gross margin was lower by nearly 300 basis points due to margin compression in gloves as anticipated and discussed last quarter.
We also began to see commodity and transportation inflationary pressures in the beginning of the quarter and expect this to continue through Q3.
Distribution, selling and administrative expense of $294 million in the current quarter was $52 million higher compared to the second quarter of 2020.
The increase represents higher variable cost to support top-line growth, funding of ongoing investments across all business lines and higher incentive compensation, driven by our financial performance.
This performance coupled with the efficiency gains from enterprisewide continuous improvement led to adjusted operating income for the quarter of $116 million, which was $77 million higher or three times the same period last year.
Adjusted EBITDA for the second quarter was $128 million, which increased by $76 million or over two times year-over-year.
Interest expense of $12 million in the second quarter was down 47% or $10 million compared to last year, driven by lower debt levels and effective interest rates.
On a GAAP basis, income from continuing operations for the quarter was $66 million or $0.87 a share.
Adjusted net income for the second quarter was $80 million, which yielded an adjusted earnings per share for the quarter of $1.06, which was over five times our performance from Q2 of last year.
The year-over-year foreign currency impact in the quarter was unfavorable by $0.02.
In the second quarter, the average diluted shares outstanding were 14.7 million higher year-over-year as a result of our equity offering in the fourth quarter of prior year and the impact of restricted shares for compensation.
Now I'll review results by segment for the second quarter.
Global Solutions revenue of $1.98 billion was higher by $429 million or 28% year-over-year.
The segment experienced continued growth, driven by ongoing recovery in volumes associated with elective procedures of approximately $300 million along with higher sales of PPE as well as continued strong growth in our patient direct business.
During the quarter, elective procedures continued to move toward pre-pandemic levels, while we recognize that a number of COVID hotspots remain throughout the country.
Global Solutions operating income was $18.5 million, which was $29 million higher than prior year as a result of higher volumes coupled with productivity and efficiency gains in our medical distribution business.
In our Global Products segment, net revenue in the second quarter was $689 million, compared to $370 million last year, an increase of 86%, which was led by higher S&IP sales particularly PPE volume as we benefited from our previous investments to expand capacity and the previously discussed impact of passing through higher acquisition costs of approximately $200 million.
Operating income for the Global Products segment was $95 million, an increase of 84% versus $52 million in the second quarter last year.
This was driven by higher PPE sales, favorable timing of cost pass-through on gloves, productivity initiatives and improved fixed cost leverage.
These were partially offset by higher commodity prices and elevated transportation costs.
Next, let's review cash flow, the balance sheet and capital structure.
In the second quarter, our cash flow was negatively impacted by our investment in working capital to support top line growth, inventory build to ensure supply given numerous supplier issues, global transportation delays and continued unfavorable payment terms with glove manufacturers.
We expect working capital to improve throughout the second half of the year as global supply chain issues subside and as payment terms to glove manufacturers return to historical levels.
As a result, we continue to expect 2021 cash flow to be back half loaded.
Total net debt at the end of the second quarter was $964 million and total net leverage was 1.8 times trailing 12-months adjusted EBITDA.
I'd like to highlight that despite our working capital consumption, we maintained our leverage profile below two times adjusted EBITDA.
Still the improvements we've made to enhance our capital structure provide us with the operational flexibility and put us in a strong financial position to implement our growth strategy.
Our achievement in this regard was recently rewarded with another credit upgrade from S&P last month.
Finally, turning to the outlook.
Earlier today, we affirmed our guidance for 2021 and 2022.
The confirmation of our guidance range for 2021 is a result of our strong Q2 performance and improved visibility into the second half of the year.
Let me provide some context on the assumptions for our outlook.
Our recently installed PPE-related capacity has been fully deployed and our previously announced glove manufacturing capacity expansion is on track to begin contributing to our financial results in early Q1 of next year.
We now expect the full year top line impact of glove cost pass-through to be in the range of $675 million to $725 million.
Any sudden unforeseen declines in the market price of gloves could result in downside to our revenue and adjusted earnings per share projection.
In addition, we believe our patient direct business will continue to perform above market and demonstrate attractive patient capture and retention rates.
As I mentioned earlier, elective procedure-related volumes are at or very close to pre-pandemic levels in much of the country, and we expect the trend to continue in the second half of the year.
As experienced in Q2, we are now including a headwind from elevated commodity pricing and transportation costs and expect this to continue through Q3.
Guidance for adjusted earnings per share is based on 75.5 million shares outstanding.
The increase in our dilutive share count is related to the treatment of certain performance share grants and incremental restricted stock grants driven by our strong financial results.
Even with the 6% increase in shares and new inflationary headwinds, we are confirming our outlook for 2021, 2022 and targets for 2026.
In terms of the calendarization of our guidance, starting with revenue, we expect Q3 revenue to decline slightly from Q2 as the pass-through of glove cost begins to ease.
The 2021 quarterly earnings pattern is contrary to our typical seasonality with most of the year's profitability weighted toward the first half of the year.
Specifically, we continue to expect Q3 earnings to be softer than Q2 due to the timing of glove cost pass-through.
However, we expect Q4 to improve due to the seasonal impact of healthcare utilization across our businesses.
Also, remember that cash flow is expected to improve in the back half of the year, as working capital headwind soften as previously discussed.
Please note that these key modeling assumptions for full year 2021 have been summarized on supplemental slides filed with the SEC on Form 8-K earlier today and have been posted to the Investor Relations section of our website.
In closing, I'm delighted with another strong quarter and proud of the efforts of our teammates around the world.
As we further embed our business blueprint into our day-to-day activities, we'll be well positioned to deliver on our long-term objectives.

user
sees fy adjusted earnings per share $3.75 to $4.25.
q2 gaap earnings per share $0.87.
qtrly adjusted earnings per share $1.06.
affirms previously announced 2021 and 2022 guidance.

assistant